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003 EG-GiCUC
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008 161024s2016 ua dh f m 000 0 eng d
040 _aEG-GiCUC
_beng
_cEG-GiCUC
041 0 _aeng
049 _aDeposite
097 _aM.Sc
099 _aCai01.11.05.M.Sc.2016.Ut.P
100 0 _aUthman Mohammed Uthman Toure
245 1 0 _aPerioperative evaluation of pulmonary hpertension in patients with mitral valve disease /
_cUthman Mohammed Uthman Toure ; Supervised Yasser Menaissy , Waleed Gamal Abosenna , Yasser Boraick
246 1 5 _aتقييم ارتفاع ضغط الشريان الرئوى فى مرضى الصمام الميترالى قبل و بعد الجراحة
260 _aCairo :
_bUthman Mohammed Uthman Toure ,
_c2016
300 _a93 P. :
_bcharts , facsimiles ;
_c25cm
502 _aThesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery
520 _aBackground: Left side heart disease (LHD) represents the most common causes of pulmonary hypertension (PH). Whether caused by systolic or diastolic dysfunction or valvular heart disease, the increase in left atrial pressure causes a passive increase in pulmonary pressure. In some patients, a superimposed active component caused by pulmonary arterial vasoconstriction and vascular remodeling lead to a further increase in pulmonary arterial pressure. When present, PHTN is associated with a worse prognosis in patients with LHD. In addition to local abnormalities in nitric oxide and endothelin production, gene modifiers such as serotonin polymorphisms may be associated with the pathogenesis of PHTN in LHD.. Recent studies suggest that sildenafil, a phosphodiesterase-5 inhibitor, is a promising in the treatment of PHTN in LHD. Objective: to assess the effect of the Sildenafil on the pulmonary hypertension in patient with mitral valve decease .Patients & Methods: This study was undertaken in the Department of Cardiothoracic Surgery of Kasr El Aini Faculty of Medicine, Cairo University after approval of the local ethical committee between 2015 and 2016. It enrolled 60 adult patients submitted to mitral valve surgery having mitral valve lesion and associated PHTN. Patients were allocated into either of 2 groups each having equal number (no=30) and properly-matched preoperative risk factors. Group A (no=30) with pulmonary artery pressure (50-80 mmHg) and group B (no=30) with pulmonary artery pressure above 80mmHg contained patients in whom Sildenafil Citrate was given . Hemodynamics (ABP, HR, CVP, PASP in mmHg) as well as mitral valve functions and LV performance (LVEF%) were assessed by clinical assessment and before surgery, during ICU and hospital stay, and 6 months post {u2013}operative Conclusion: Use of Sildenafil resulted in a significant reduction in pulmonary artery pressure Result: .In our study in group A the mean post six month pulmonary hypertension was 28.28+5.0mmHg while in group B was 46.40+ 4.8mmHg which showed an significant statistical difference as P value was 0.02.
530 _aIssued also as CD
653 4 _aMitral valve
653 4 _aPulmonary hypertension
653 4 _aTricuspid regurgitation
700 0 _aWaleed Gamal Abosenna ,
_eSupervisor
700 0 _aYasser Boraick ,
_eSupervisor
700 0 _aYasser Menaissy ,
_eSupervisor
856 _uhttp://172.23.153.220/th.pdf
905 _aNazla
_eRevisor
905 _aShaima
_eCataloger
942 _2ddc
_cTH
999 _c58275
_d58275