English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

PRV/LV can be easily measured in the operating room by which we can assess the adequacy of relief of pulmonary stenosis. A number of studies carried out where PRV/LV ratio 0.7 was taken as cut off point however in this study post repair ratio 0.5 was taken as cut off value because a recent study has shown better outcome after total correction of tetralogy of Fallot when the post repair PRV/LV was below .05. When the ratio is above 0.5, some extra precaution may be needed in the post operative period to reduce the morbidity and mortality. Kev words: Tetralogy of Fallot, PRV/LV ratio, low output syndrome. University Heart Journal 2017; 13(2): 59-61 Received: 06 March, 2017 Accepted: 15 June, 2017 • Tetralogy of Fallot with other anomaly (Atrioventricular canal defect, Aortic stenosis, Mitral stenosis). • Patients with a prior systemic-pulmonary artery shunt. • Tetralogy of Fallot with coronary artery anomalies. Sample size calculation: Sample size for each group was 27 and Sample size of this study was 54. Grouping of the patients: Patients were divided into two groups according to the post-operative PRV/LV ratio .Group A (Post-operative PRV/LV ratio < 0. 5) and Group B (Post-operative PRV/ LV ratio > 0.5 ) Variables: A. Demographic variables: Age, Sex, body weigh B. Pre-operative investigative variables: Haematocrit, Percent saturation of oxygen (SpO2), Electrocardiogram, Z value for pulmonary valve annulus, RVOT-PA gradient. C. Per-operative variables: PRV/LV pressure ratio before and after repair, Trans-annular patch required/ not required, Cardiopulmonary bypass Time (minutes), Aortic cross-clamp time (minutes). D. Post-operative outcome variables: Ventilation time (hrs), Duration of inotrope support, ICU stay (hrs), Low output syndrome, Arrhythmia, Reintubation Renal dysfunction, Pleural effusion. Respiratory complication, Wound infection, Mortality E. Variables at discharge from hospital and follow up: RVOT-PA gradient, Pulmonary regurgitation and its severity, Right ventricular dysfunction and its severity, Mortality (within 30 days). Result: Age distribution of the patients between two groups were almost similar with mean ages of Group-A and Group-B being 9.95±4.51and 8.89±5.01years respectively (p=0.590). the sex distribution between two groups which was almost similar. The difference was not statistically significant between two groups. (p=0.273). Mean body weight of the group A and group B were 20.03 ± 7.89 and 19.40 ± 8.79 kg respectively The difference was not statistically significant between two groups (p=0.783). mean SpO2 were 85.00 ± 5.14 and 82.70 ± 5.48 in group A and group B respectively. The mean hematocrit (Hct) values were 48.46 ± 4.60 and 46.87± 4.15respectively. The difference was not statistically significant between two groups. Mean “Z” values for Pulmonary valve annulus(P-V) of group A and group B were -2.95 ± 0.81 and -3.22 ± 0.84 respectively (P=0.238). Mean RVOTPA pressure gradients of group A and group B were 75.33 ± 13.20 and 80.40 ± 13.81 respectively (P=0 .174). There is no difference in CPB, aortic cross clamp time, transannular patching (P=0.256, 0.84, 1.00). After repair both the groups exhibited reduction of PRV/LV pressure ratio, but the reduction was significantly higher in GroupA than Group-B (0.45±12vs. 0.32±17, p = <.001). The mean ventilation time of group A and group B were 11.30 ± 3.27 and 13.93 ± 5.93 hrs respectively. The difference was statistically significant between two groups (P=0.049). 51.85% patient of group B and 18.51% patient of group A required prolonged duration of inotropic support. The difference was statistically significant (p = 0.01). The patients of Group-B after operation stayed longer in the ICU than those of GroupA (83.55 ± 13.83vs. 78.85 ± 12.55) though it is statistically not significant (p=0.196). A significantly higher proportion of patients in Group-B exhibited low output syndrome (LOS) compared to those of Group-A (33.33% vs. 7.40%, p = 0.018). Arrhythmia, renal dysfunction, pleural effusion, wound infection, respiratory complication and reintubation, were all identically distributed in both groups (p > 0.05). One patient of group A and two patients of group B expired in post-operative period. RVOT-PA gradient, Incidence of pulmonary insufficiency, right ventricular dysfunction of the patients at discharge and 1 month after discharge was not statistically significant between groups. Discussion: The demographic variables were almost identically distributed between group A and group B. Preoperative investigative variable were identical between two groups. Peroperative variable like CPB, aortic cross clamp time, transannular patching were almost similar between two groups but After repair both the groups exhibited reduction of PRV/LV pressure ratio, but the reduction was significantly higher in Group-A than Group-B (0.45±12vs. 0.32±17, p = <001). The difference between mean ventilation time of group A and group B were not statistically significant. 11 patient of group B and 5 patient of group A required prolonged duration of inotropic support. The difference was statistically significant (p = 0.01). The patients of Group-B after operation stayed longer in the ICU than those of GroupA though it is statistically not significant (p=0.196). The incidence of low output syndrome was more in group B (P=0.018) this results reflect that PRV/LV ratio is associated with increased incidence of early adverse 60 Post Operative Systolic Pressure Ratio between Right and Left Ventricle Predicts A.T Shahrier Ahmed et al.

Post Operative Systolic Pressure Ratio between Right and Left Ventricle Predicts Early Outcome after Total Correction of Tetralogy of Fallot