To study the relation between the systolic and diastolic right ventricular (RV) function in relation to the time of extubation after total repair of tetralogy of Fallot (TOF) in a pediatric population. Prospective, descriptive, non-randomized study. Pediatric cardiac surgery unit at Ain Shams University Hospitals, Cairo, Egypt. The study was conducted from January 2016 to February 2018. A total of 60 patients having elective primary total repairs of TOF made up the study sample. The patients were divided into two groups based on the time of extubation: Group I included patients who were extubated 6 hours or more after the procedure, while Group II included patients who were extubated within the first 6 hours. Total corrective surgery involving open-heart surgery with cardiopulmonary bypass. Measurements and Main Results: Early outcomes of mortality and morbidity were evaluated. RV systolic and diastolic functions were evaluated in the routine echocardiography performed on the first and fifth postoperative days. Additionally, patients’ inotropic drug requirements during their intensive care unit (ICU) stays were calculated to produce the inotropic index for evaluation of postoperative low cardiac output. Group I contained 32 patients, while Group II contained 28. The mean ages in Group I and II, respectively, were 1.2 ± 0.8 years and 1.5 ± 0.9 years (p = 0.180). The mean weight in Group I and II, respectively, was 10.5 ± 2.5 kg and 9.86 ± 3.2 kg (p = 0.396). There were 20 (62.5%) males in Group I and 18 (64.29%) males in Group II (p = 0.886). Mortality was 2 cases (6.3%) in Group I and 1 case (3.6%) in Group II, with no statistical difference. Postoperative echocardiographic examination revealed significantly better RV functional parameters in Group II than in Group I.
Unicuspid aortic valves are among the rarest congenital malformations. They are classified as either acommissural or unicommissural, with the unicommissural being presented in early adulthood. Unicuspid valves share many similarities with bicuspid valves, namely increased rates of valve degeneration and calcification, making them prone to secondary aortic stenosis, regurgitation, or both. Among other similarities are the increased risk of aortic root dilatation, dissection, and left ventricular dilatation. We report our case of a 23-year-old male with unicuspid unicommissural aortic valve with aortic root and left ventricular dilatation. He successfully underwent Wheat procedure.
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