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Pan S, Bai J, Wang F, Yang S, Hu X, Peng W, Liang G. Successful one-stage surgical repair in a rare adult patient with berry syndrome. Perfusion 2024:2676591241251438. [PMID: 38703045 DOI: 10.1177/02676591241251438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND Berry syndrome is a rare congenital cardiac malformation, herein we report an adult male patient who was successfully repaired by one-stage surgery. CASE DESCRIPTION 18-year-old male patient presenting symptoms of chest tightness and shortness for over a year presented to outpatient clinic in our department to have corrective procedure heart. CTA revealed an Aortopulmonary Window (APW) type III, measuring 4.6 cm in maximum diameter. The right pulmonary artery originated from the ascending aorta, and the pulmonary trunk exhibited dilation with dimensions of 8.3 cm × 5.7 cm × 5.9 cm. Additional findings included Interrupted Aortic Arch (IAA) type A, intact ventricular septum, and Patent Ductus Arteriosus (PDA). Echocardiography showed bidirectional shunt at the level of APW in severe pulmonary hypertension. The right heart catheterization indicated a mean pulmonary artery pressure of 70mmHg and a pulmonary artery resistance of 5 Wood units. We evaluated after two weeks of treatment with epoprostenol at a rate of 20 ng/(kg. min) and found a significant improvement in pulmonary-artery pressure. Finally, we communicated with the patient's family and decided to proceed with the procedure. CONCLUSIONS For complex cardiovascular malformations, the ideal treatment strategy must be tailored to the characteristics of the patient to provide maximum efficacy and safety.
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Affiliation(s)
- Sisi Pan
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Jue Bai
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Feng Wang
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Siyuan Yang
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Xuanyi Hu
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Wanfu Peng
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Guiyou Liang
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
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Li W, Feng W, Chang C, Liu Y, Li X, Wang M, Gan L, Zhang J. Innovative cardiovascular casting technique features the complex malformation of berry syndrome. BMC Pregnancy Childbirth 2024; 24:194. [PMID: 38475705 DOI: 10.1186/s12884-024-06340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Prenatal diagnosis of Berry syndrome, a rare combination of cardiac anomalies including aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), interrupted aortic arch (IAA), hypoplastic aortic arch, or coarctation of the aorta (COA), poses a significant challenge. Due to the rarity of the disease, and the limited case reports available to features the complex malformation of Berry syndrome postpartum, this article introduces an innovative approach to visually showcase this unusual disease. The proposed method provides a comprehensive display of the structural deformities, offering valuable insights for clinical practitioners seeking to comprehend this condition. CASE PRESENTATION In this report, we present a case where fetal echocardiography aided in diagnosing Berry syndrome, which was later confirmed through postpartum cardiovascular casting. Our experience highlights the importance of using the three-vessel view to diagnose APW and aortic origin of the right pulmonary artery. Additionally, obtaining true cross-sectional and sagittal views by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch is necessary to image IAA or coarctation of the aortic arch. CONCLUSIONS Early and accurate prenatal diagnosis of Berry syndrome is feasible and our cardiovascular cast can perfectly display the microvascular morphology of the fetal heart, which may have great application prospects for postpartum diagnosis and teaching of complex cardiac abnormalities.
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Affiliation(s)
- Wei Li
- Hubei Provinical Clinical Research Center for Accurate Fetus Malformation Diagnosis, Department of gynaecology and obstetrics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, No 15, Jiefang Avenue, Xiangyang, 441000, China
| | - Wei Feng
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Caihong Chang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ya Liu
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Xue Li
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Mofeng Wang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Ling Gan
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China
| | - Jiaqi Zhang
- Depatment of Ultrasound, Hubei University of Medicine, Xiangyang No. 1 People's Hospital, Xiangyang, 441000, China.
- Department of Ultrasound, Hubei University of Medicine, Xiangyang No.1 People's Hospital, No 15, Jiefang Avenue, Xiangyang, 441000, Hubei, China.
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Tandayu KMHJ, Kurniawati Y, Atmosudigdo IS, Lilyasari O. Case Series of Berry syndrome: A rare constellation of fatal cardiac anomalies. Ann Pediatr Cardiol 2023; 16:374-377. [PMID: 38766446 PMCID: PMC11098299 DOI: 10.4103/apc.apc_109_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/17/2023] [Accepted: 01/16/2024] [Indexed: 05/22/2024] Open
Abstract
Berry syndrome is an extremely rare constellation of several congenital cardiac anomalies consisting of aortopulmonary window, aortic origin of the right pulmonary artery (AORPA), interrupted aortic arch or hypoplastic aortic arch or coarctation of the aorta, and an intact ventricular septum with high neonatal mortality rates. The disease is fatal with high mortality (90%) in the neonatal period with surviving patients mostly developing pulmonary hypertension. We describe the clinical presentation and diagnostic clues in two patients with Berry syndrome.
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Affiliation(s)
- Kevin Moses Hanky Jr Tandayu
- Department of Cardiology and Vascular Medicine, National Cardiovascular Centre Harapan Kita, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yovi Kurniawati
- Department of Cardiology and Vascular Medicine, Division of Pediatric Cardiology and Congenital Heart Disease, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
| | - Indriwanto Sakidjan Atmosudigdo
- Department of Cardiology and Vascular Medicine, Division of Pediatric Cardiology and Congenital Heart Disease, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
| | - Oktavia Lilyasari
- Department of Cardiology and Vascular Medicine, Division of Pediatric Cardiology and Congenital Heart Disease, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia
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Vollbrecht TM, Hart C, Luetkens JA. Fetal Cardiac MRI of Complex Interrupted Aortic Arch. Radiology 2023; 307:e223224. [PMID: 37219441 DOI: 10.1148/radiol.223224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Thomas M Vollbrecht
- From the Departments of Diagnostic and Interventional Radiology (T.M.V., C.H., J.A.L.) and Pediatric Cardiology (C.H.), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; and Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany (T.M.V., J.A.L.)
| | - Christopher Hart
- From the Departments of Diagnostic and Interventional Radiology (T.M.V., C.H., J.A.L.) and Pediatric Cardiology (C.H.), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; and Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany (T.M.V., J.A.L.)
| | - Julian A Luetkens
- From the Departments of Diagnostic and Interventional Radiology (T.M.V., C.H., J.A.L.) and Pediatric Cardiology (C.H.), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; and Quantitative Imaging Laboratory Bonn (QILaB), Bonn, Germany (T.M.V., J.A.L.)
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Verma M, Pandey NN, Ramakrishnan S, Jagia P. Evaluation of aortopulmonary window using virtual dissection of multidetector computed tomography angiography data sets. J Card Surg 2022; 37:4475-4484. [PMID: 36321703 DOI: 10.1111/jocs.17075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/14/2022] [Accepted: 09/10/2022] [Indexed: 11/06/2022]
Abstract
AIM The present study sought to evaluate the morphology and associated cardiovascular anomalies in patients with aortopulmonary window on virtual dissection of multidetector computed tomography (CT) angiography data sets. MATERIAL AND METHODS We conducted a retrospective search of our departmental database from January 2014 to September 2021 to identify patients with aortopulmonary window and relevant information was extracted from the electronic case records and from routine examination as well as virtual dissection of CT data sets. RESULTS An aortopulmonary window was observed in 26 patients (20 males; 6 females). Based on location of the defect, a distal aortopulmonary window was the most common subtype, seen in 13/26 (50%) patients followed by a proximal, complete and intermediate subtypes seen in 7/26 (27%), 5/26 (19%) and 1/26 (4%) patients respectively. Associated ventricular septal defect was observed in 9/26 (34.6%) patients while an interrupted aortic arch was present in 5/26 (19.2%) patients. Tetralogy of Fallot was seen in 5/26 (19.2%) patients. Anomalous origin of right pulmonary artery from ascending aorta and crossed pulmonary arteries were seen in 2/26 (7.6%) patients each. An isolated aortopulmonary window without any simple/complex congenital anomaly was seen in 10/26 (38.5%) patients. CONCLUSION Aortopulmonary window is associated with a wide gamut of cardiovascular lesions, with ventricular septal defect being the commonest associated anomaly followed by tetralogy of Fallot and interrupted aortic arch respectively. Virtual dissection of multidetector CT angiography allows detailed anatomical evaluation of aortopulmonary window, allowing a clear visualization of the defect and associated cardiovascular anomalies.
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Affiliation(s)
- Mansi Verma
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | | | - Priya Jagia
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
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Dias J, Marinho J, Rodrigues D, Pires A. Berry syndrome: a rare cause of cardiac failure in the early neonatal period. BMJ Case Rep 2022; 15:e252744. [PMID: 36428032 PMCID: PMC9703328 DOI: 10.1136/bcr-2022-252744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- João Dias
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Joana Marinho
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Dina Rodrigues
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - António Pires
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
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Kasielska-Trojan A, Święchowicz B, Antoszewski B. Coexistence of Thumb Aplasia and Cleft Lip and Alveolus with Aortopulmonary Window—A Tip for Prenatal Diagnostics for Rare Heart Anomalies. Diagnostics (Basel) 2022; 12:diagnostics12030569. [PMID: 35328123 PMCID: PMC8947534 DOI: 10.3390/diagnostics12030569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
Multiple congenital anomaly syndromes pose a challenge to neonatologists, as many anomalies may indicate cryptogenic malformations or disorders. Aortopulmonary window (APW) is a very rare congenital heart disease (CHD) and causes many difficulties in prenatal diagnostics. In this report, we describe a case of a female patient with multiple rare congenital malformations: aortopulmonary window, right thumb aplasia, facial nerve palsy and cleft lip and alveolus. None of the malformations were diagnosed prenatally. A long-term follow-up (40 years) is presented. The presence of certain defects (thumb aplasia) may indicate the need for a careful fetal examination extended by a fetal ECHO performed in a reference center of prenatal cardiology. The coexistence or syndromic character of the presented malformations should be verified in future if more such cases are described.
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Shi XC, Weng JB, Yu J, Ma XH, Pu YQ, Ying LY, Yu JG. Outcomes of One-Stage Surgical Repair for Berry Syndrome in Neonates. Front Cardiovasc Med 2022; 8:790303. [PMID: 35155602 PMCID: PMC8825814 DOI: 10.3389/fcvm.2021.790303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundBerry syndrome is a challenging disease for surgeons to make early diagnosis and successful surgical correction in the neonatal period. Here, we summarized the clinical features of three neonates with berry syndrome in our center to optimize the therapeutic effect in the future.MethodsFrom January 2014 to December 2019, three neonates with berry syndrome underwent one-stage surgical repair in our center. We mainly used two different surgical techniques to repair it, and collected clinical data retrospectively from hospitalization history, outpatient records, and telephone follow-up.ResultsThe age at operation was 28, 8, and 8 days and the body weight was 3.65, 3.86, and 3.0 kg, respectively. The morphology of the interrupted aortic arch (IAA) was type A in two patients and type B in one patient. The aortopulmonary window (APW) morphology was type IIa, III, and IIb, respectively. The phenotype of the IAA type B combined with APW type III in our second patient was reported for the first time so far. All patients survived and were followed up to date. The second patient using intra-aortic baffle experienced twice reoperation for right pulmonary artery (RPA) stenosis. All patients grew well so far.ConclusionOnce diagnosed in the neonatal period, berry syndrome can be safely corrected by one-stage surgical repair in experienced cardiac centers. Considering the variability of the location where the RPA arises from the posterior wall of the aorta, it is difficult to find the best surgical method for each patient.
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Affiliation(s)
- Xu-Cong Shi
- Department of Cardiac Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian-Bin Weng
- Department of Neurosurgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jin Yu
- Department of Ultrasound Diagnosis, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiao-Hui Ma
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yi-Qing Pu
- Department of Operation Room, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Li-Yang Ying
- Department of Cardiac Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian-Gen Yu
- Department of Cardiac Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- *Correspondence: Jian-Gen Yu
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Nandi D, Taxak A, Shaw M, Kumar S. Berry syndrome with bovine aortic arch. J Card Surg 2021; 36:4746-4748. [PMID: 34553423 DOI: 10.1111/jocs.15997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 11/28/2022]
Abstract
We present a case of berry syndrome and bovine aortic arch in a 2-month old child, detected on multidetector computed tomography.
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Affiliation(s)
- Debanjan Nandi
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Avichala Taxak
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Shaw
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjeev Kumar
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
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Habibie YA, Busro PW, Roebiono PS, Fakhri D. Berry syndrome; a successful one-stage repair in neonate periods, evaluation result after 9 years, a case report. Ann Med Surg (Lond) 2021; 64:102200. [PMID: 33732452 PMCID: PMC7941068 DOI: 10.1016/j.amsu.2021.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022] Open
Abstract
Backgroud IAA with an intact ventricular septum is distinctly unusual. Combination with an Aortopulmonary Window (APW), ascending aortic origin of the right pulmonary artery and PDA may be present which is called as Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. Case Report We report a 9 days-old male neonates weighing 3.85 kg was referred by local hospital to our center and was ventilated with history of respiratory distress and severe infection since he was born. Admitted to our PCICU, 2D echo showed an IAA type A associated with a huge APW type II and restrictif PDA. A PGE1 infusion was started, during the following days the baby experienced several epileptic episodes. After improvement of the clinical condition, surgery was performed on the 20th days of life on year 2011. A successful one-stage repair of such anomalies in which cutting of PDA that arised from PA trunk and distally becoming into descending aorta, extended end to end anastomosis to conduct the ascending aortic blood flow into the descending aorta and intra arterial baffle was used. A 4-0 Gore-Tex baffle was used both to close the APW and separated the RPA from aortic origin with a good result, as his recently grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. Conclusion Berry syndrome is a rare but well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. But well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Successful one-stage repair was done in a 20-days-old neonate using an alternative technique without circulatory arrest (performed on year 2011). Currently on year 2021, (after 9 years of evaluation) the patient has grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. During this patient last follow up on March 2019 at NCHHK Pediatric Cardiology clinic, echo result showed no residual AP Window, minimal pressure gradient of 18 mmHg across the aortic reconstruction with good LV function of 70%, good RV function, intact inter atrial & ventricular septum with TVG 20 mmHg. The latest echo follow up with the pediatric cardiologist showed good LV function with EF of 70%, no residual pumnonary hypertension was detected.
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Affiliation(s)
- Yopie Afriandi Habibie
- Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala, The Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
| | - Pribadi Wiranda Busro
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Poppy S Roebiono
- Division of Pediatric Cardiology, Dept. of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Dicky Fakhri
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
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