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

This is a study aims to evaluate angiography findings and hemodynamics of patients post glenn shunt at follow up. As well as to determine possible causes preclude fontan operation, hemodynamics suitable for fontan operation and clinical utility of routine cardiac catheterization before a fontan operation at Cairo university specialized children hospital from 2013 to 2015. During the duration of the study there were 75 cases diagnosed as different types of single ventricle after glenn palliation (cavopulmonary shunt) at follow up cardiac catheterization was done. The age of patients is from 3 to 14 years. Diagnostic cardiac catheterization was done in 57 cases (76%) while different interventions were done in 18 cases (24%). The different interventions were divided between embolization of venovenous collaterals, embolization of aortopulmonary collaterals and angioplasty of pulmonary artery branches. Catheterization allows different types of interventions to be performed which can improve postoperative outcomes and cardiac catheterization before fontan is a good method for selecting high risk patients and implementing measures to improve outcomes. We performed cardiac catheterization before fontan operation completion at older age in comparative with other studies. So as future strategies, it must be done at younger age of patients where possible and complete the Fontan operation at younger age, without CPB if possible, so as to reduce effusion time and length of hospital stay

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