ObjectiveTo determine the factors associated with mortality in a hospitalised cohort of infants in Asmara, Eritrea.DesignRetrospective cross-sectional review of all 2006 admissions to a specialised neonatal intensive care unit. Data on gestational age (prematurity), age at presentation, birth weight, gender, mode of delivery, Apgar score, maternal age, birth location, admission diagnosis, admission comorbidities, time of admission and outcome were collected.SettingOrotta Pediatric Hospital ‘Specialised Neonatal Intensive Care Unit’ (SNCU) in Orotta National Maternity Referral Hospital, the nation's only tertiary newborn centre.Primary and secondary outcome measuresFactors associated with mortality and length of stay via multivariate regression analysis and the combined association of both hypothermia and pneumonia. Other outcome measures were determination of the association of admission hypothermia, time of admission and pneumonia on mortality.ResultsA total of 1502 infants were admitted to the SNCU with an average preterm gestational age of 35.9 weeks. 87 died (mortality 8.2%). In bivariate analysis, the highest mortality rate (10.3%) was seen in patient's admitted <1 h after birth. Patients with hypothermia or pneumonia exhibited higher mortality rates (13.6% and 13.4%, respectively). In multivariate analysis, birth weight <2 kg (p<0.01), birth weight between 2.1 and 2.5 kg (p<0.01), Apgar score at 1 min (p<0.01), small for gestational age (p<0.01), hypothermia (p<0.04) and pneumonia (p<0.01) were associated with mortality.ConclusionHypothermia, pneumonia, younger gestational age, 1 min Apgar score and small size for gestational age are significantly associated with mortality and longer length of stay in the Eritrean SNCU.

BackgroundThis retrospectively study was conducted to assess the efficiency and safety of computed tomography (CT)‐guided hook wire localization of pulmonary ground‐glass nodules (GGNs) prior to video‐assisted thoracoscopic surgery (VATS).MethodsFrom 2015 to 2018, a total of 86 patients with 86 pulmonary GGNs underwent preoperative CT‐guided hook wire localization before VATS. The technical details and clinicopathological findings were analyzed.ResultsAll 86 pulmonary GGNs (25 pure GGNs and 61 part‐solid GGNs) were successfully located and resected. The mean diameter of the GGNs was 1.4 ± 0.4 cm (range 0.6–2.2) and the mean lesion distance to the pleural surface was 7.3 ± 4.3 mm (range 2–19). Complications of hook wire marking included asymptomatic minor pneumothorax in 21 patients (24%) and focal pulmonary hemorrhage in 18 (21%). The median hook wire localization time was 19.1 minutes (range 10–30) and the median VATS time was 49 minutes (range 28–89). Pathology revealed 72 precancerous lesions or primary lung adenocarcinomas, 5 metastatic tumors, and 9 benign lesions.ConclusionsPreoperative localization of small pulmonary GGNs using CT‐guided hook wire was efficient and safe prior to VATS resection.

Perventricular device closure of pmVSDs appears safe and effective with symmetric and asymmetric occluders. However, the lower residual shunt disappearance and higher branch block incidence rates for asymmetric occluders would favour more proactive conversion to surgical repair immediately when residual shunt is present intraoperatively.

Selecting an appropriate surgical approach for double-outlet right ventricle (DORV),D ouble-outlet right ventricle (DORV) is a complex congenital cardiac malformation, and until recently, it has been difficult to select an appropriate surgical approach for each variation. Regardless of the DORV classification system used, the choice of surgical approach depends on 3 factors: the relative positions of the great arteries, the relationship between the arteries and the ventricular septal defect (VSD), and the presence or absence of right ventricular outflow tract obstruction (RVOTO).The current DORV classification system is based on the international nomenclature databases adopted by the Society of Thoracic Surgeons and the European Association of Cardiothoracic Surgery.1 The system identifies 4 types of DORV, taking into account the types of VSD, tetralogy of Fallot (TOF), transposition of the great arteries (TGA), and remote type. The first 2 types of DORV-the VSD type and the TOF type-have clear surgical options. However, the choice of surgical treatment for DORV with TGA is more difficult because RVOTO may also be present; the current classification system does not adequately account for this possibility. This is especially problematic for patients with a noncommitted VSD and abnormal great arteries because they might need arterial switch operations or double-root translocations. 2To overcome these limitations, we developed an echocardiographic classification system based on the spatial relationships of the great arteries, the relationship of the VSD to the arteries, and the morphology of the RVOT. 3 We then compared our findings with those obtained through cardiac catheterization, computed tomographic (CT) angiography, and intraoperative inspection; monitored the surgical outcomes of patients in the different subgroups; and refined our surgical protocols. Our goal in this study was to evaluate our modified echocardiographic classification system,

Preoperative echocardiography provided crucial data to estimate the feasibility of intraventricular tunnel creation to either the aorta or the pulmonary artery and to guide the selection of either arterial switch or double-root translocation. Biventricular repair could be achieved with favorable outcomes in most patients with DORV.