The cosmetic appearance in the test group was excellent and the patients' wounds were scarcely apparent in the female patients. The study demonstrates the efficacy and safety of this older technique, with excellent cosmetic results and no additional cost or risk to the patients.

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Background: Provided the high incidence of Tetrology of Fallot, a compelling need for different surgical management techniques have been raised. Thus, a new era was developed in this field that gave favorable results, however a debate still exists on the optimal technique to relieve the Right Ventricular Outflow Tract Obstruction that could lead to less mortality and morbidity, hence it was necessary to analyze data that compare these different techniques. Moreover, there is a controversy between cardiac surgeons about the best technique to correct the RVOT in infants with Tetrology of fallot and so this study was done to compare between two frequent techniques according to their mortality and morbidity. Aim of the work: Assess the outcome after surgical repair of tetrology of fallot in pediatric patients comparing between transannular patch and valve sparing techniques. Methods: The present study was planned in accordance with current guidelines for performing comprehensive systemic reviews and meta-analysis including the PRISMA (Preferred Reporting Items For Systemic Review Meta-Analysis), MOOSE (Meta-analysis of Observational Studies in Epidemiology) and guidelines for randomized and nonrandomized studies. In this study a meta-analysis was done to compare between the two most common techniques (21-32) that are used to relieve the RVOT that are Transannular patch VS Valve Sparing Repair the variable chosen include: Mortality the Indexed Right Ventricular Volumes, QRS duration, incidence of pulmonary regurgitation, Right ventricular Ejection Fraction, Left Ventricular Ejection Fraction and incidence of Reoperation. The principal summary measures were difference in means with 95% confidence interval and p value (to be of significant if p < 0.005). The difference in means were combined across studies with MedCalc© version 15.8 (MedCalc© Software bvba, Ostend, Belgium. Results: A total of 72 citation were identified of which 20 studies were potentially relevant and retrieved in full text only 12 studies fulfilled the eligibility criteria There was 74% of patients had a TAP and 26% of patients had VSR. Mortality was 291 among patients with patch repair and 104 among valve sparing repair. Reoperation was detected in 7 patients with TAP VS 6 patients in VSR. Occurrence of PR was detected in 14 patients in TAP VS 12 patients in VSR. The study detected favorable measures in Indexed right ventricular volumes, RV ejection fraction and QRS duration in patients with VSR than those with TAP. This study detected that both group of patients had approximately equal results of LV ejection fraction. Conclusion: Our results reflected that Valve Sparing Repair for pediatric patients has better outcome in Mortality to relieve pulmonary stenosis, occurrence of pulmonary valve regurgitation as well as a less harmful effect on the right ventricular ejection fraction, better Indexed right ventricular volume and QRS duration than using transannular patching technique. Both transannular patching and valve sparing repair have approximately...

The mitral valve has been traditionally approached through a median sternotomy. However, mitral valve surgery could be performed using smaller incisions including the right minithoracotomy. This study was a case-control non randomized conducted on 60 patients. All patients had isolated mitral valve disease for mitral valve surgery, 30 of them were operated through right anterolateral minithoracotomy and the others through full median sternotomy to study the effects of minimally invasive mitral valve surgery through right anterolateral minithoracotomy on morbidity and mortality compared with conventional mitral surgery. Medico legal concent was taken from all the patients in this study. All the patients completed the study and there was no mortality among the patients. There was no statistically significant difference as regards the demograohic data, NYHA score and the preoperative echocardiographic findings. Regarding intraoperative comparison, there was statistically significant difference in the cross-clamp time, total bypass time & total operation time. This difference may be due to the new experiences in this MIMVS and the lack of instrumentation that narrow the field of MIMVS. The length of the incision was highly significantly lesser in the minimally invasive group than the full sternotomy group. There was significant difference in the intensive care parameters. The blood loss and the blood transfusion required were lesser in the minimally invasive group. But the ventilation hours and ICU stay was nearly the same in both groups. There was highly significantly less postoperative pain in the minimally invasive group than in the stenotomy group. Total hospital stay was nearly the same in both groups. Minimally invasive mitral valve surgery is a safe alternative to a conventional approach and is associated with less morbidity especially with expert surgeon in simple mitral valve surgery.

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