alexa Perioperative Course Of Pulmonary Hypertension In Infants With Congenital Diaphragmatic Hernia: Impact On Outcome Following Successful Repair | 7182
ISSN: 2161-0665

Pediatrics & Therapeutics
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Perioperative course of pulmonary hypertension in infants with congenital diaphragmatic hernia: Impact on outcome following successful repair

International Conference on Pediatrics & Gynecology

Al-Hathlol K, Elmahdy H, Nawaz S, Ali I, Al-Saif S, Tawakol H and Tawil K

Accepted Abstracts-2011: Pediatr Therapeut

DOI: 10.4172/2161-0665.S1.06

Mitral valve stenosis is a state of relatively of fi xed cardiac output.Normal mitral valve area is 4 to 5cmsq. Symptoms with exercise seen with valve area of less than 2.5cmsq.Symptoms at rest are expected at area of 1.5 or less.Severe stenosis is are a less than 1cmsq. Prepregnancy: Goal is to defi ne the severity of disease.2D echo and color doppler are method used .Allows noninvasive evaluation and decrease need for cardiac catheterization. Prenatal: Aim is to avoid cardiac decompsation.Symptoms of other fi ndings should be reported promptly.Avoid maternal tachycardia, restrict physical activity Medical management: B ?Blockers used empirically to prevent the tacycardia .AF can be managed with digoxin or cardioversion .Serial echoes are used to follow cardiac function objectively Surgical management: Surgical commissurotomy is the traditional modality. Percutaneous mitral valve commissurotomy is prefered alternative.Closed mitral valvotomy is another option BMV-Advantages: Safe,As eff ective as surgical approach,Less invasive,Less expansive,Prefered as fi rst line in prenatel period. Indications severe sysmptomatic mitral stenosis .Refractory pulmonary oedema despite medical management Factors to be evaluated Echocardiographicaly: Valvular rigidity, valvular calcifi cation, valvular thickening, amount of subvalvular disease, four factors are evaluated from 0 to 4 depending on severity. Contraindications Absolute: Evidence of left atrial thrombus,Severe dilation of arotic root,Th orolumber scolosis Rotational abnormalities of heart,Th ickning of atrial septum>4mm.Recent thromboembolic event,Left ventricular thrombus , Relative Severe mitral valve calcifi cation,Severe subvalvular fi brosis Best time to perform Before pregnency ,During 2 nd trimester,Aft er attaing the period of viability Complications Mitral regurgitation.Complications associated with trans septal puncture. Uncomplicated procedure.Yielding MVA of 1.5cmsq or more.Or 40% increase in MVA.Immediate post op MR grade less than 3+
I have done my MBBS,Post graduation in obstetrics and gynaecology from Maharishi Dayanand University and am presently workin g as a consultant in PGIMER,Chandigarh.Looking after cardio obstetric clinic is my area of interest. I have more than 30 publications in national and international journals,Life member of many societies.
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