RESUMEN
BACKGROUND: For years, septal myectomy has been considered the best available treatment for hypertrophic cardiomyopathy. In Bangladesh, however, this technique is only nascent. We present a case series of septal myectomy with outcomes after 1 to 6 years at the National Heart Foundation Hospital & Research Institute. METHODS: For this study, 21 patients who underwent septal myectomy from 2014 to 2019 were monitored retrospectively. Evidence was collected from the hospital database and followed up via telephone conversations using a structured questionnaire. Patients' preoperative, postoperative, and follow-up clinical data were collected and analyzed. RESULTS: The results reveal that after septal myectomy, there were significant improvements in terms of left ventricular outflow gradient (P ≤ .01), septal thickness (P ≤ .01), left ventricular ejection fraction (P = .001), pulmonary arterial systolic pressure (P ≤ .01), mitral regurgitation (P ≤ .01), systolic anterior motion (P ≤ .01), and New York Heart Association class (P ≤ .01). CONCLUSION: This study suggests that septal myectomy be offered to symptomatic hypertrophic obstructive cardiomyopathy patients, as its survival benefits and symptoms relief are excellent. This study suggests that septal myectomy that dynamic obstruction at the left ventricular outflow tract is the major hemodynamic problem. We hope that with appropriate measures, new myectomy programs in our country can provide extended longevity and restore the quality of life.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Cardiomiopatía Hipertrófica/cirugía , Tabiques Cardíacos/cirugía , Función Ventricular Izquierda/fisiología , Adulto , Cardiomiopatía Hipertrófica/diagnóstico , Cardiomiopatía Hipertrófica/fisiopatología , Femenino , Estudios de Seguimiento , Tabiques Cardíacos/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Volumen Sistólico/fisiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
West Nile Virus (WNV) is a vector-borne zoonotic disease maintained in a sylvatic cycle involving mosquito vectors and birds. To detect WNV and other flavivirus infections in wild resident and migratory birds, we tested 184 samples from 19 identified species within nine families collected during 2012-2016 from four districts in Bangladesh. We tested serum samples for the immunoglobulin G (IgG) antibody against WNV using competitive Enzyme-Linked Immunosorbent Assay (c-ELISA), whereas tracheal and cloacal swabs were subjected to consensus Polymerase Chain Reaction (c-PCR) for the detection of the flavivirus RNA. Overall, we detected 11.9% (n = 22; 95% CI: 0.07-0.16) samples were seropositive, including 15.9% in the migratory wild birds and 10.7% in the resident wild birds. The migratory wild Tufted duck showed 28.5% seropositivity, whereas the resident wild house crows showed 12.5% seropositivity. None of the swab samples was positive for flavivirus RNA infection (0%, n = 184; 95% CI: 0-0.019). These study findings recommend continued surveillance for early detection and to better understand the epidemiology of WNV and other flavivirus circulation in both birds and mosquitoes in Bangladesh.