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Elnakib S, El Khoury G, Salameh P, Sacre H, Abirafeh L, Robinson WC, Metzler J. Investigating Incidence, Correlates, and Consequences of Child Marriage Among Syrian Refugees Residing in the South of Lebanon: A Cross-Sectional Study. J Adolesc Health 2022; 70:S64-S71. [PMID: 35184834 DOI: 10.1016/j.jadohealth.2021.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/01/2021] [Accepted: 08/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Research on child marriage has increased in volume but remains scarce in humanitarian settings. This study aimed to investigate rates, correlates, and consequences of child marriage among Syrian refugees in South Lebanon. METHODS A sample of 1,593 female adolescents and 893 adults was selected using a multistage stratified cluster survey design. We quantified the cumulative incidence of child marriage among age cohorts of female refugees and identified risk factors associated with child marriage using survival methods. We also presented sexual and reproductive health measures among child brides. RESULTS We found evidence that child marriage was widely practiced among adolescent girls, with Kaplan-Meier curves showing that 32.56% of girls aged 10-19 transitioned to marriage by age 17. Although high, this was lower than rates among women aged 25-29 (p < .005), indicating that child marriage was already widely practiced in prewar Syria. Our Cox models indicated that several factors, which mirror drivers of child marriage in stable settings, are associated with hazard of child marriage in this context. We additionally found important sexual and reproductive health gaps among child brides, such as low levels of knowledge of the dangers of early childbearing and closely spaced births as well as high rates of early and multiple births. CONCLUSIONS Child marriage is a pervasive practice among Syrian refugees residing in this setting. Our results suggest that a confluence of factors at different levels of the social ecology increase refugee girls' vulnerability to child marriage. They also demonstrate the pressing need for interventions that target refugee child brides.
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Affiliation(s)
- Shatha Elnakib
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maryland.
| | - Ghada El Khoury
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Pascale Salameh
- Department of Public Health, INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Department of Research, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- Department of Public Health, INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Lina Abirafeh
- Department of Research, The Arab Institute for Women, Lebanese American University, Beirut, Lebanon
| | - W Courtland Robinson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Maryland
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Lyles E, Arhem J, El Khoury G, Trujillo A, Spiegel P, Burton A, Doocy S. Multi-purpose cash transfers and health among vulnerable Syrian refugees in Lebanon: a prospective cohort study. BMC Public Health 2021; 21:1176. [PMID: 34147066 PMCID: PMC8214292 DOI: 10.1186/s12889-021-11196-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 06/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Multipurpose cash transfers (MPCs) are used on a widespread basis in the Syrian refugee response; however, there is little to no evidence as to how they affect health in humanitarian crises. Methods A prospective cohort study was conducted from May 2018 through July 2019 to evaluate the impact of MPCs on health care-seeking and expenditures for child, adult acute, and adult chronic illness by Syrian refugees in Lebanon. Households receiving MPCs from UNHCR were compared to control households not receiving UNHCR MPCs. Results Care-seeking for childhood illness was consistently high in both MPC and non-MPC households. An increased proportion of households did not receive all recommended care due to cost; this increase was 19.3% greater among MPC recipients than controls (P = 0.002). Increases in child hospitalizations were significantly smaller among MPC recipients than controls (DiD -6.1%; P = 0.037). For adult acute illnesses, care-seeking increased among MPC recipients but decreased in controls (adjusted DiD 11.3%; P = 0.057); differences in change for other utilization outcomes were not significant. The adjusted difference in change in the proportion of MPC households not receiving recommended chronic illness care due to cost compared to controls was − 28.2% (P = 0.073). Access to medication for adult chronic illness also marginally significantly improved for MPC households relative to controls. The proportion of MPC recipients reporting expenses for the most recent child and adult acute illness increased significantly, as did the [log] total visit cost. Both MPC and control households reported significant increases in borrowing to pay for health expenses over the year study period, but differences in change in borrowing or asset sales were not significant, indicating that MPC was not protective against for household financial risks associated with health. Conclusions While MPC may have shown some positive effects, findings were mixed and MPC appears insufficient on its own to address health utilization and expenditures. A broader strategy addressing Syrian refugee health in Lebanon is needed of which MPC should be incorporated, with additional support such as additional conditional cash transfers for health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11196-8.
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Affiliation(s)
- Emily Lyles
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8132, Baltimore, MD, 21205, USA
| | - Jakob Arhem
- United Nations High Commissioner for Refugees, Beirut, Lebanon
| | - Ghada El Khoury
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Antonio Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8132, Baltimore, MD, 21205, USA
| | - Paul Spiegel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8132, Baltimore, MD, 21205, USA
| | - Ann Burton
- United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Shannon Doocy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8132, Baltimore, MD, 21205, USA.
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Zeenny RM, Dimassi A, Sacre H, El Khoury G, Hajj A, Farah R, Hajj H, Lahoud N, Akel M, Hallit S, Salameh P. A cross-sectional survey on community pharmacists readiness to fight COVID-19 in a developing country: knowledge, attitude, and practice in Lebanon. J Pharm Policy Pract 2021; 14:51. [PMID: 34116719 PMCID: PMC8193173 DOI: 10.1186/s40545-021-00327-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/20/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Lebanon, a developing Middle Eastern country, was hit by the COVID-19 pandemic that occurred amid a severe national economic crisis. Community pharmacists are responsible for dispensing appropriate medications and products in addition to counseling, informing and educating the public, and promoting disease prevention and infection control. OBJECTIVE This study aimed to assess community pharmacists' knowledge, attitude, and practice towards the COVID-19 pandemic and evaluate behavior changes and safety measures. METHODS An anonymous and standardized online questionnaire in English was disseminated via social media platforms to Lebanese community pharmacists. The questionnaire consisted of 95 items designed as Likert-scales and multiple-choice questions divided into four different sections: socio-demographic characteristics, knowledge-based, attitude-based, and pharmacy practice questions. Descriptive statistical analysis was used to summarize the demographic characteristics, and indices were created for knowledge, attitude, and practice by computing the correct answers for each section. RESULTS A total of 310 questionnaires were completed. Around 61% have expressed their fear of getting infected with COVID-19 due to occupational exposure. The respondents were able to answer 80-90% of the knowledge-based questions of the survey. A more careful/anxious attitude, but not knowledge, was associated with overall better practice (p = 0.03). Also, respondents stated that they are dispensing protective equipment items such as masks (87%), gloves (60%), and sanitizers (77%) in small quantities due to limited availability. CONCLUSION Our findings revealed an adequate level of knowledge and good practice towards COVID-19 among Lebanese community pharmacists. Their fears of contracting the virus and compromising the safety of those around them are justified. However, their supply of protective equipment is limited.
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Affiliation(s)
- Rony M Zeenny
- Pharmacy Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad Dimassi
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon
| | - Ghada El Khoury
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Aline Hajj
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
- Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Pôle Technologie-Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
| | - Rita Farah
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Hind Hajj
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Nathalie Lahoud
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- CERIPH: Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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El Khoury G, Salameh P. Assessment of the awareness and usages of family planning methods in the Lebanese community. BMJ Sex Reprod Health 2019; 45:bmjsrh-2018-200067. [PMID: 31395753 DOI: 10.1136/bmjsrh-2018-200067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/22/2019] [Accepted: 07/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Worldwide, one in three women has unmet family planning (FP) needs because of difficulties in accessing or using contraceptives. In Lebanon, information from the scientific literature on the national prevalence of contraceptive use appears scarce. OBJECTIVE In view of this, we measured the current Lebanese national prevalence of FP methods' uptake among women and men of reproductive age, and we assessed barriers for potential unmet need. METHODS We conducted a cross-sectional survey on a nationally representative sample of 825 married women (aged 15-49 years) and men of reproductive age (aged 18+ years). We used the validated Demographic & Health Survey (DHS) data collection tool and analysed data with SPSS Version 22.0 with p values <0.05 considered statistically significant. RESULTS We found that the current prevalence of contraceptive use is 55.6%, the unmet need is 11.4%, the total demand for FP is 67% and the percentage of satisfied demand for FP is 83%. Despite favourable knowledge of and access to FP methods as well as positive attitudes towards FP; there is a clear stagnation in the rate of contraception use over the past four decades. The identified major factors hindering the use of FP methods in Lebanon appear to be religion, age and lower educational levels. CONCLUSION We suggest the implementation of effective interventions at the national level to promote and encourage the uptake of modern FP methods among couples. The latter will further promote maternal and child health, as well as empower women to fulfil their equal function in society.
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El Khoury G, Mansour H, Kabbara WK, Chamoun N, Atallah N, Salameh P. Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon. Curr Diabetes Rev 2019; 15:133-140. [PMID: 29357807 DOI: 10.2174/1573399814666180119142254] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/07/2018] [Accepted: 01/09/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. OBJECTIVE The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. METHODS The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. RESULTS A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). CONCLUSION Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.
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Affiliation(s)
- Ghada El Khoury
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O Box: 36-Byblos, Lebanon
| | - Hanine Mansour
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O Box: 36-Byblos, Lebanon
| | - Wissam K Kabbara
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O Box: 36-Byblos, Lebanon
| | - Nibal Chamoun
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O Box: 36-Byblos, Lebanon
| | - Nadim Atallah
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O Box: 36-Byblos, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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El Khoury G, Ramia E, Salameh P. Misconceptions and Malpractices Toward Antibiotic Use in Childhood Upper Respiratory Tract Infections Among a Cohort of Lebanese Parents. Eval Health Prof 2017; 41:493-511. [PMID: 28692318 DOI: 10.1177/0163278716686809] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Antimicrobial resistance is an emerging global health threat. Misuse and abuse of antibiotics are of particular concern in the pediatric population. Since management of childhood illnesses depends considerably on parents' perceptions, the objectives of this study were to report parents' perspectives and assess their practices toward antibiotics used for upper respiratory tract infections (URTIs) in children. Using a cross-sectional design, anonymous structured questionnaires were completed by 1,037 parents in public and private schools across Lebanon's largest governorate. Descriptive statistics were used to report participants' responses. A multivariate analysis was performed to identify factors affecting knowledge and malpractice related to antibiotic use. Significant misconceptions and malpractices were identified among parents. For instance, 33.9% of parents considered that antibiotics are helpful in treating common cold among children and 36.2% believed antibiotics expedite the recovery of their child with common cold infection. Moreover, there was a lack of knowledge concerning antibiotic coverage, since 37.9% of the respondents believed that antibiotics treat viral infections and 21.5% were neutral toward this question. Around 20% of the participants believed they can reduce the dose of antibiotics if the child gets better. Significant factors associated with poor knowledge and misuses were parents' lower educational and socioeconomic levels. Despite extensive evidence on the limited role of antibiotics in URTIs, parents in Lebanon continue to misuse them. More concerted efforts are needed to improve parents' knowledge and practices with regard to the rational use of antibiotics.
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Affiliation(s)
- Ghada El Khoury
- 1 School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Elsy Ramia
- 1 School of Pharmacy, Lebanese American University, Byblos, Lebanon
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El Khoury G, Ramadan W, Zeeni N. Herbal Products and Dietary Supplements: A Cross-Sectional Survey of Use, Attitudes, and Knowledge Among the Lebanese Population. J Community Health 2015; 41:566-73. [DOI: 10.1007/s10900-015-0131-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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El Khoury G, Salameh P. Influenza Vaccination: A Cross-Sectional Survey of Knowledge, Attitude and Practices among the Lebanese Adult Population. Int J Environ Res Public Health 2015; 12:15486-97. [PMID: 26690189 PMCID: PMC4690936 DOI: 10.3390/ijerph121215000] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 12/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Influenza is a common preventable infectious disease associated with high mortality and morbidity. Vaccination is the most cost-effective measure to prevent influenza, yet the vaccine uptake is known to be low. No previous studies have assessed the rate of seasonal influenza vaccination use among the Lebanese population, nor examined the knowledge and attitudes towards the influenza vaccine. METHODS A cross-sectional survey was performed in 30 pharmacies randomly selected across Lebanon. A 19-item questionnaire was used to record influenza vaccination status, knowledge and attitudes towards the influenza vaccine among the Lebanese general population. RESULTS The survey response rate was 93%. Among the 640 study participants, the overall 2014-2015 seasonal influenza vaccination rate was 27.6%. The majority of participants (72.4%) reported irregular uptake of the vaccine. Results of the multivariate analysis revealed that elderly people (OR = 2.25, CI = 1.08-4.71), with higher education (OR = 1.42, CI = 1.09-1.84), higher physical activity (OR significantly higher than 1 for all categories), and chronic respiratory disease (OR = 3.24, CI = 1.58-6.62) were more regularly vaccinated, while those who visit the doctor "only when needed" (OR = 0.55, CI = 0.34-0.88) and those who consume more than seven drinks/week (OR = 0.24, CI = 0.09-0.65) were less regularly vaccinated. When introducing knowledge and attitude variables to the model, "thinking that the vaccine was not needed" was the only correlate that demonstrated a significant inverse association with regular influenza vaccination (OR = 0.15; p = 0.017). CONCLUSIONS Suboptimal vaccination rates exist among the Lebanese ambulatory adult population. Clear misinformation on the importance of regular influenza immunization is also highlighted. This evidence underscores a compelling need to raise public awareness regarding the efficacy of the influenza vaccine.
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Affiliation(s)
- Ghada El Khoury
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box: 36-Byblos, Lebanon.
| | - Pascale Salameh
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box: 36-Byblos, Lebanon.
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Abstract
BACKGROUND One of today's most highly regarded procedures for treating inguinal hernia is the totally extraperitoneal approach (TEP), but it can on occasion lead to recurrence. This is commonly managed with an open repair, a transabdominal preperitoneal procedure (TAPP), or another TEP. We report here on our years of experience with the latter. METHODS The endeavor to a secondary TEP is much the same as to a primary one, but certain differences are encountered as the operation proceeds. For example, many anatomical landmarks found in a first TEP cannot be seen in a second. There can also be a diminished amount of working space, and this occasionally leads to an open conversion. RESULTS From September 1991 to September 2005, we repaired 1,526 hernias in 1,156 male patients, using the TEP in every case. Of these, 21 were TEPs after a previous TEP. In 3 cases, the space could not be opened, and they were converted to the open Lichtenstein. One patient had peritoneal tears that led to conversion and another had conversion because of excessive bleeding. There were no complications, no bladder or bowel injuries, no transfusions, no preperitoneal hematomas, and no fatalities. All patients were discharged the same day. CONCLUSIONS A secondary TEP, open repair, and TAPP are alternative solutions to the problem of recurrence after TEP. However, any TEP involves a very prolonged learning curve for general surgeons, since they must learn the anatomy as well as the procedure, both at the same time. This is doubly true for the TEP after a previous TEP.
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Affiliation(s)
- G S Ferzli
- Department of Surgery, Lutheran Medical Center, The State University of New York Health Science Center at Brooklyn, Brooklyn, NY, USA.
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Khoury GE, d'Udekem Y, Noirhomme P, Verhelst R, Rubay J, Dion R. Transfer of the posterior leaflet of the tricuspid valve to the mitral valve. J Heart Valve Dis 2000; 9:350-2. [PMID: 10888089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Coverage of large commissural defects may present a surgical challenge in mitral valve repair, for which the transfer of posterior tricuspid valve leaflet tissue is an attractive approach. METHODS Five patients aged between 35 and 55 years underwent this procedure. After wide excision of the diseased mitral commissures, the posterior leaflet of the tricuspid valve was carefully checked, removed with its subvalvular apparatus, and transferred to the commissural area of the mitral valve. The stress on the papillary muscle suture was relieved by reinforcement of the free edge of the transferred leaflet by natural or artificial chordae. The tricuspid valve was repaired using either a sliding plasty or an annuloplasty. RESULTS One patient who had no reinforcement of the subvalvular apparatus had a papillary muscle rupture and required mitral valve replacement during the early postoperative period. The four remaining patients remained asymptomatic and had no or trivial mitral regurgitation after a median of 13 months (range: 3-18 months), with excellent result at transesophageal echocardiography. CONCLUSION We conclude that transfer of the tricuspid valve leaflet allows coverage of large commissural defect, and deserves a place among the surgeon's arsenal of reconstructive techniques for mitral valve repair.
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Affiliation(s)
- G E Khoury
- Cliniques Universitaires St. Luc, Service de Chirurgie Cardiovasculaire et Thoracique, Brussels, Belgium
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