Pediatric and Congenital Heart Surgery Unit

Accra, Ghana

Pediatric and Congenital Heart Surgery Unit

Accra, Ghana
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Fakhri D.,Pediatric and Congenital Heart Surgery Unit | Djauzi S.,University of Indonesia | Murni T.W.,Padjadjaran University | Rachmat J.,University of Indonesia | And 4 more authors.
Asian Cardiovascular and Thoracic Annals | Year: 2016

Background Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis. Methods A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score ≥6. Patients with an accompanying congenital anomaly, human immunodeficiency virus infection, or history of previous open heart surgery were excluded. The patients' nutritional status and genetic polymorphism were assessed prior to surgery. The results of genetic polymorphism were obtained through genotyping. Patients' ages on the day of surgery and cardiopulmonary bypass times were recorded. The diagnosis of sepsis was established according to Surviving Sepsis Campaign criteria. Results Postoperative sepsis was observed in 21% of patients. There were 92.6% patients with toll-like receptor 2 N199N polymorphism and 52.8% with toll-interacting protein rs5743867 polymorphism. Conclusions Toll-like receptor 2 N199N polymorphism tends to increase the risk of sepsis (odds ratio = 1.974; 95% confidence interval: 0.23-16.92; p = 0.504), while toll-interacting protein rs5743867 polymorphism tends to decrease the risk of sepsis (odds ratio = 0.496; 95% confidence interval: 0.19-1.27; p = 0.139) in infants <1-year old undergoing complex open heart surgery. © SAGE Publications.


PubMed | Padjadjaran University, National Cardiovascular Center Harapan Kita, Pediatric and Congenital Heart Surgery Unit and University of Indonesia
Type: Journal Article | Journal: Asian cardiovascular & thoracic annals | Year: 2016

Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis.A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score 6. Patients with an accompanying congenital anomaly, human immunodeficiency virus infection, or history of previous open heart surgery were excluded. The patients nutritional status and genetic polymorphism were assessed prior to surgery. The results of genetic polymorphism were obtained through genotyping. Patients ages on the day of surgery and cardiopulmonary bypass times were recorded. The diagnosis of sepsis was established according to Surviving Sepsis Campaign criteria.Postoperative sepsis was observed in 21% of patients. There were 92.6% patients with toll-like receptor 2 N199N polymorphism and 52.8% with toll-interacting protein rs5743867 polymorphism.Toll-like receptor 2 N199N polymorphism tends to increase the risk of sepsis (odds ratio=1.974; 95% confidence interval: 0.23-16.92; p=0.504), while toll-interacting protein rs5743867 polymorphism tends to decrease the risk of sepsis (odds ratio=0.496; 95% confidence interval: 0.19-1.27; p=0.139) in infants <1-year old undergoing complex open heart surgery.


Kinsley R.H.,Sunninghill Hospital | Edwin F.,Sunninghill Hospital | Edwin F.,Pediatric and Congenital Heart Surgery Unit
World Journal for Pediatric and Congenital Heart Surgery | Year: 2012

The 2011 symposium opened with a consideration of the challenges in the management of children undergoing the Fontan operation. Management options for patients with congenitally corrected transposition were then discussed, using several illustrative case examples and a review of the results from the Texas Children’s Hospital. There was a session dedicated to borderline hypoplastic left heart syndrome, concluding with a review of the results of the Single Ventricle Reconstruction (SVR) Trial in North America. Results of pediatric mechanical circulatory support were considered in the context of surgery for anomalous left coronary artery from the pulmonary artery after a more general overview of pediatric applications of extracorporeal membrane oxygenation and ventricular assist devices. Problems of monitoring in the intensive care unit, quality assurance, feeding algorithms for children, and morbidity associated with mechanical ventilation occupied most of the second day’s sessions. Results of the arterial switch operation for transposition, issues related to neonatal brain protection during open cardiac procedures, and, finally, training paradigms for congenital heart surgeons concluded the symposium’s talks. © 2012, World Society for Pediatric and Congential Heart Surgery. All rights reserved.

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