005 in 3 months and stayed almost the same after 6 months 572 27 p 005 at 9

005 in 3 months and stayed almost the same after 6

This preview shows page 271 - 272 out of 294 pages.

0.005) in 3 months and stayed almost the same after 6 months 57,2 ± 2,7% ( p > 0.05); at 9 months it was 55.1 ± 1.8% ( p > 0.05), and at 12 months 58.4 ± 1.7% ( p > 0.05); however the basal part of the interventricular septum was hypokinetic. Conclusion: Post-rheumatic mitral valve regurgitation is the pathol- ogy most encountered. Post-surgical echocardiogram is characterised by motion abnormalities of the basal part of the interventricular septum. Because of financial limitations, poverty and illiteracy of parents, the post-surgical follow-up of patients is challenging. 1840: ANOMALOUS ORIGIN OF THE PULMONARY ARTERY FROM THE ASCENDING AORTA: TWO INSTITU- TIONAL REVIEWS OF CASES FROM 1991 TO 2012 G Dumani 1 , PA Adams 1 , B Fourie 1 , AM Cilliers 1 , A Nzimela 2 , E Hoosen 2 , D Reddy 2 , NJ Buckles 2 , J Ragadu 2 1 Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa 2 Inkosi Albert Luthuli Hospital, University of KwaZulu-Natal, Durban, South Africa Introduction: Anomalous origin of one pulmonary artery from the ascending aorta is a rare congenital anomaly associated with early onset of pulmonary hypertension and irreversible pulmonary vascu- lar disease. Methods: A retrospective clinical review ws done of 18 cases presenting to the Divisions of Paediatric Cardiology at the Chris Hani Baragwanath Academic Hospital and Inkosi Albert Luthuli Hospital, which are both tertiary care institutions in South Africa. Data collected included clinical features, diagnosis, operative procedures, pre-operative procedures and post-operative follow-up. Results: Sixteen infants, 1 child and 1 adult (11 males, 6 females) were diagnosed. The most common presenting features were respira- tory distress, a cardiac murmur, congestive cardiac failure and failure to thrive. Median age at presentation was 67 days. Diagnosis was made with echocardiography and confirmed with CT angiogram in 5 patients and angiography in 5 patients. There were 16 patients with anomalous origin of right pulmonary artery arising from the aorta (AORPA) and 2 cases of anomalous origin of left pulmonary artery (AOLPA). Patients were divided into three categories: isolated lesions (7); simple lesions with patent ductus arteriosus (8) and complex lesions (3). One patient with AOLPA had CATCH 22 and a second patient with AOLPA also had Mckusick-Kaufman syndrome. Five patients had successful direct re-implantation of the right pulmonary artery. One patient died the day after surgery following a pulmonary hypertensive crisis, one patient died 20 days after surgery from sepsis, and three patients remain well on follow-up. Three patients were deemed inoperable. The remaining 10 patients died before surgery could be undertaken. Conclusion: There is a high mortality associated with anomalous pulmonary artery arising from the aorta without surgery. A good outcome can be expected with early surgery before pulmonary vascular disease.
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  • pulmonary artery, CardioVascular Journal of Africa, cardiovascular journal

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