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Systematic review and meta-analysis of outcomes of anatomic repair in congenitally corrected transposition of great arteries

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World Journal of Cardiology 2020年第8期12卷 427-436页

作者： Arka Chatterjee Neal J Miller Marc G Cribbs Amrita Mukherjee Mark A Law Division of Cardiovascular Diseases University of Alabama at BirminghamBirminghamAL 35294United States Department of Pediatric Cardiology University of Alabama at BirminghamBirminghamAL 35294United States Department of Epidemiology University of Alabama at Birmingham School of Public healthBirminghamAL 35233United States

BACKGROUND Treatment of congenitally corrected transposition of great arteries(cc-TGA)with anatomic repair strategy has been considered superior due to restoration of the morphologic left ventricle in the systemic ***,data on long term outcomes are limited to single center reports and include small sample *** To perform a systematic review and meta-analysis for observational studies reporting outcomes on anatomic repair for *** MEDLINE and Scopus databases were queried using predefined criteria for reports published till December 31,*** reporting anatomic repair of minimum 5 cc-TGA patients with at least a 2 year follow up were *** was performed using Comprehensive meta-analysis v3.0 *** Eight hundred and ninety-five patients underwent anatomic repair with a pooled follow-up of 5457.2 patient-years(PY).Pooled estimate for operative mortality was 8.3%[95%confidence interval(CI):6.0%-11.4%].0.2%(CI:0.1%-0.4%)patients required mechanical circulatory support postoperatively and 1.7%(CI:1.1%-2.4%)developed post-operative atrioventricular block requiring a *** surviving initial surgery had a transplant free survival of 92.5%(CI:89.5%-95.4%)per 100 PY and a low rate of need for pacemaker(0.3/100 PY;CI:0.1-0.4).84.7%patients(CI:79.6%-89.9%)were found to be in New York Heart Association(NYHA)functional class I or II after 100 PY follow *** re-intervention rate was 5.3 per 100 PY(CI:3.8-6.8).CONCLUSION Operative mortality with anatomic repair strategy for cc-TGA is *** that,transplant free survival after anatomic repair for cc-TGA patients is highly *** of patients maintain NYHA I/II functional ***,monitoring for burden of re-interventions specific for operation type is very essential.

关键词： Congenitally corrected transposition of great arteries anatomic repair Double switch operation Atrial switch Rastelli Hemi-Mustard Rastelli Atrio-ventricular block

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Syndesmotic Internal Brace^(TM) for anatomic distal tibiofibular ligament augmentation

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World Journal of Orthopedics 2017年第4期8卷 301-309页

作者： Markus Regauer Gordon Mackay Mirjam Lange Christian Kammerlander Wolfgang Bocker SportOrtho Rosenheim Praxis für Orthopadie und Unfallchirurgie Klinik für Allgemeine Unfall-und WiederherstellungschirurgieKlinikum der Ludwig-Maximilians-Universitat München Faculty of Health Sciences and Sport University of Stirling

Reconstruction of unstable syndesmotic injuries is not trivial, and there is no generally accepted treatment guidelines. Thus, there still remain considerable controversies regarding diagnosis, classification and treatment of syndesmotic injuries. Syndesmotic malreduction is the most common indication for early re-operation after ankle fracture surgery, and widening of the ankle mortise by only 1 mm decreases the contact area of the tibiotalar joint by 42%. Outcome of ankle fractures with syndesmosis injury is worse than without, even after surgical syndesmotic stabilization. This may be due to a high incidence of syndesmotic malreduction revealed by increasing postoperative computed tomography controls. Therefore, even open visualization of the syndesmosis during the reduction maneuver has been recommended. Thus, the most important clinical predictor of outcome is consistently reported as accuracy of anatomic reduction of the injured syndesmosis. In this context the Tight Rope~?system is reported to have advantages compared to classical syndesmotic screws. However, rotational instability of the distal fibula cannot be safely limited by use of 1 or even 2 Tight Ropes~?. Therefore, we developed a new syndesmotic Internal Brace^(TM) technique for improved anatomic distal tibiofibular ligament augmentation to protect healing of the injured native ligaments. The Internal Brace^(TM) technique was developed by Gordon Mackay from Scotland in 2012 using Swive Locks~? for knotless aperture fixation of a Fiber Tape~? at the anatomic footprints of the augmented ligaments, and augmentation of the anterior talofibular ligament, the deltoid ligament, the spring ligament and the medial collateral ligaments of the knee have been published so far. According to the individual injury pattern,patients can either be treated by the new syndesmotic Internal Brace^(TM) technique alone as a single anterior stabilization, or in combination with one posteriorly directed Tight Rope~? as a doub

关键词： Syndesmosis injury Rotational instability Stabilization anatomic repair Internal Brace^(TM) Surgical technique

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