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@#Objective To study the diagnosis and treatment of aortopulmonary window (APW) associated with severe pulmonary hypertension. Methods The clinical data of 23 patients with APW undergoing surgical treatment in The First Affiliated Hospital of Air Force Medical University from 2010 to 2018 were retrospectively reviewed. There were 9 male and 14 female patients. The age was 3-132 (4.63±2.14) months. The weight was 3.3-35.0 (17.3±3.6) kg. Results Windows were situated in the proximal of semilunar valve (type Ⅰ) in 8 patients, and distal of the aorta (type Ⅱ) in 14 patients, from proximal to distal (type Ⅲ) in only 1 patient. Eleven patients were isolated APW, the others were combined with cardiac defects. The mean pulmonary artery pressure was 68.4±7.5 mm Hg. All patients underwent surgical correction under general anesthesia and hypothermia cardiopulmonary bypass. All patients were discharged uneventfully, with an average follow-up time of 4 years. The patients showed good outcomes and no residual shunt after surgery, and the pulmonary artery pressure decreased to normal. Conclusion APW is an uncommon congenital cardiac anomaly. The clinical presentation is an excessive left-to-right shunt, and most patients present early in life. Development of pulmonary hypertension and pulmonary vascular resistance is usually rapid. Operative treatment is indicated as soon as the diagnosis is established, regardless of the patient’s age, and most patients after surgery have a good long-term outcome.
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<p><b>OBJECTIVE</b>To review the experiences in surgical management and diagnosis for the children with multiple ventricular septal defects (VSDs).</p><p><b>METHODS</b>The clinical data of 21 children with multiple VSDs (8 males, 13 females) were analysed retrospectively. Multiple muscle defects in all patients were repaired by left ventricle incision and their near future clinical outcome was investigated.</p><p><b>RESULTS</b>The accuracy of diagnosis was 95.2% and the mortality was 9.5%. No residual shunts were found. Complete atrioventricular block was found early in 2 patients postoperation.</p><p><b>CONCLUSIONS</b>The operative outcome of children with multiple VSDs is satisfied. For these patients detailed preoperative color flow mapping and careful observation during operation are essential to increase the accuracy of diagnosis and prevention of residual shunts.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Cardiac Surgical Procedures , Heart Septal Defects, Ventricular , Diagnosis , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To study the changes of plasma ET-1,CGRP,TXA2 and their receptor expression in lung tissue of children with congenital heart disease-assicated pulmonary artery hypertension.Methods Plasma was collected from 60 children patients.ET-1,CGRP and TXB2 levels were measured by EIA,RIA and ELISA,respectively.Expression of their receptors in the lung tissue was detected by RT-PCR.Results The plasma ET-1 and TXB2 levels were significantly higher in CHD patients than in control children.The plasma CGRP level was significantly lower in CHD patients than in control children.Fourteen days after treatment with PGE1,the plasma ET-1 and TXB2 levels were significantly decreased with no significant changes in CGRP.The expression level of ET-1 and TXA2 receptor mRNA was significantly higher in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension.However,the expression of CGRP receptor mRNA was lower in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension.Conclusion Plasma ET-1,CGRP and TXA2 levels are closely related with congenital heart disease-associated pulmonary artery hypertension,and can be used as an index for its prognosis.
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In order to determine the relationship between pulmonary leukosequestration and oxygen free radical generation, We prospectively studied 20 patients undergoing cardiopulmonary bypass for open-heart procedure of congenital heart discases. Serum levels of SOD and MDA were measured at the begining and the end of extracorporeal circulation cell counts and differential counts were made from blood in the RV and LA after CPB. The results showed that CPB caused significant increase in WBC, Polymorphonuclear cells were the main species of leukocytes sequestered in the lungs. (Median cell difference 2.018?10~9/L, P