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Midterm postoperative follow-up after surgical correction of subaortic stenosis in infancy and childhood / Mohamed Mahmoud Ahmed Abdullah ; Supervised Mohamed Abdelraouf Khalil , Hesham Abdelfattah Shawky , Yasser Mohamed Menaissy

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Mohamed Mahmoud Ahmed Abdullah , 2016Description: 172 P. : charts , facsimiles ; 25cmOther title:
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Dissertation note: Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery Summary: Background: The term "subaortic stenosis" includes a variety of obstructions of the left ventricular outflow tract (LVOT), ranging from a short (discrete) subvalvular membrane to long, tunnel-like narrowing. Uncertainties remain regarding recurrence of subaortic obstruction and development of aortic insufficiency after repair. Surgical septal myectomy has been considered the gold-standard therapeutic option for symptomatic drug refractory patients with hypertrophic obstructive cardiomyopathy for over 50 years. However, it is being challenged by less- invasive interventional tools in the last 2 decades. The late effects of myocardial scar from alcohol septal ablation are unknown and, therefore, are not recommended in children and young adults. Objectives: To assess the immediate, short and mid-term outcome of surgical intervention for SAS in terms of safety, efficacy in eliminating symptoms and gradients and prevention of disease progression. Patients and methods: In this cohort study, a total of 50 patients underwent surgical interventions for SAS (41 patients underwent resection of subaortic membrane with added myotomy or myectomy in selected patients and 9 patients underwent septal myectomy for HOCM disease). All patients were below 12 years of age. The patients were operated upon by different surgical teams in Cairo University Hospitals, in the period between April 2014 and February 2016. Pre-operative and operative data were collected and analyzed statistically. Post-operative evaluation was documented at different periods and data collected and analyzed in comparison with pre-operative data as well as at these different follow up periods.Conclusion: Surgical procedures for SAS are generally safe and effective for improvement of symptoms, LVOT gradient, mitral and aortic valvular regurge. Early surgical intervention is advocated to prevent progression of valve disease
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Item type Current library Home library Call number Copy number Status Date due Barcode
Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.05.Ph.D.2016.Mo.M (Browse shelf(Opens below)) Not for loan 01010110070728000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.05.Ph.D.2016.Mo.M (Browse shelf(Opens below)) 70728.CD Not for loan 01020110070728000

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background: The term "subaortic stenosis" includes a variety of obstructions of the left ventricular outflow tract (LVOT), ranging from a short (discrete) subvalvular membrane to long, tunnel-like narrowing. Uncertainties remain regarding recurrence of subaortic obstruction and development of aortic insufficiency after repair. Surgical septal myectomy has been considered the gold-standard therapeutic option for symptomatic drug refractory patients with hypertrophic obstructive cardiomyopathy for over 50 years. However, it is being challenged by less- invasive interventional tools in the last 2 decades. The late effects of myocardial scar from alcohol septal ablation are unknown and, therefore, are not recommended in children and young adults. Objectives: To assess the immediate, short and mid-term outcome of surgical intervention for SAS in terms of safety, efficacy in eliminating symptoms and gradients and prevention of disease progression. Patients and methods: In this cohort study, a total of 50 patients underwent surgical interventions for SAS (41 patients underwent resection of subaortic membrane with added myotomy or myectomy in selected patients and 9 patients underwent septal myectomy for HOCM disease). All patients were below 12 years of age. The patients were operated upon by different surgical teams in Cairo University Hospitals, in the period between April 2014 and February 2016. Pre-operative and operative data were collected and analyzed statistically. Post-operative evaluation was documented at different periods and data collected and analyzed in comparison with pre-operative data as well as at these different follow up periods.Conclusion: Surgical procedures for SAS are generally safe and effective for improvement of symptoms, LVOT gradient, mitral and aortic valvular regurge. Early surgical intervention is advocated to prevent progression of valve disease

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