Mohsen Sedighi is a PhD candidate of Neuroscience at Iran University of Medical Sciences. He has been in collaboration with Chamran Heart Center since 2010 resulted in published several papers related to Congenital Heart Surgery in reputed journals and participated in several international cardiovascular congresses.
Arterial switch operation (ASO) has been a routine technique for simple TGA repair that restores the left ventricle (LV) function before involution. With regard to impact of surgical time on clinical outcome of TGA repair, 105 patients with simple TGA underwent ASO. The patients were divided into three groups. Group A (n=33) included infants who underwent intervention during the first week of life. Group B (n=35) and C (n=37) included the patients who underwent intervention during the second and third weeks of life, respectively. 82 patients received preoperative E1-prostaglandin and 14 patients underwent balloon atrial septostomy. The incidence of LV dysfunction (7 versus 0 and 3, P =0.02) and mortality rate (8 versus 1 and 3, P = 0.04) were significantly higher in patients of group C compare to A and B, respectively. There was a remarkable differences among the B and C groups compare to group A regarding duration of inotropic support (2.4±0.08 and 2.6±0.08 versus 1.8±0.1 days, P=0.001) and intensive care unit stay (8.4±0.57 and 9.7±.64 versus 6.6±0.21 days, P = 0.001). Arterial switch operation for \r\nPatients with simple TGA still can be tolerated beyond the first month of life. We recommend that simple TGA in neonates should be operated as soon as possible after birth. \r\n
Romamtiezer Sahat Basana Matondang is Faculty at Medicine University of Indonesia
A case of large liver focal nodular hyplerplasia in children: Imaging characterization\r\nRomamtiezer Sahat Basana Matondang\r\nDr. Cipto Mangunkusumo Hospital, Indonesia\r\n\r\nAbstract\r\n\r\nPrimary hepatic tumors in children represent a heterogeneous group of neoplasms of which malignant tumors are the most common, accounting for 60% of primary liver tumors. The benign hepatic lesions can be classified as cystic or solid lesions and the latter can be divided further according to their epithelial or mesenchymal origin. Vascular tumors (e.g., hemangioendothelioma) are the most common benign tumors followed by mesenchymal hamartoma and the rare hepatic adenoma (HA) and focal nodular hyperplasia (FNH), which are tumors of epithelial origin. The majority of FNH lesions are asymptomatic. Symptoms in children related to size of FNH include abdominal pain, abdominal mass, hepatomegaly and liver function test abnormalities. It is essential to differentiate FNH from liver adenoma because the latter has a different natural evolution; namely, an increased risk of hemorrhage and rupture and a well-documented malignant potential. The appearance of HA, however, can be highly variable and unfortunately, in many situations, HA and FNH have similar imaging appearances. Gadoxetic acid on delayed hepatobiliary phase appears to improve the specificity for characterization and differentiation of these two lesions. FNHs are usually iso- or hyperintense relative to the liver parenchyma but rarely hypointense like hepatic adenoma. This is presumably because of the presence of functioning hepatocytes and focal abnormal biliary excretion. Herein, we report the case of a 9-year-old child (female) with a huge FNH (9.8 cm in size).\r\n\r\nBiography\r\nRomamtiezer Sahat Basana Matondang is Faculty at Medicine University of Indonesia\r\n