ABSTRACT
OBJECTIVES@#To evaluate the clinical effectiveness of integrated management during the perinatal period for fetuses diagnosed with total anomalous pulmonary venous connection (TAPVC) by prenatal echocardiography.@*METHODS@#Clinical data of 64 cases of TAPVC fetuses diagnosed by prenatal echocardiography and managed with integrated perinatal care in Qingdao Women and Children's Hospital from January 2017 to December 2021 were retrospectively analyzed. Integrated perinatal care included multidisciplinary collaboration among obstetrics, fetal medicine, ultrasound, pediatric cardiology, pediatric anesthesia, and neonatology.@*RESULTS@#Among the 64 TAPVC fetuses, there were 29 cases of supracardiac type, 27 cases of intracardiac type, 2 cases of infracardiac type, and 6 cases of mixed type. Chromosomal analysis was performed in 42 cases, and no obvious abnormalities were found. Among the 64 TAPVC fetuses, 37 were induced labor, and 27 were followed up until term birth. Among the 27 TAPVC cases, 2 cases accepted palliative care, 2 cases were referred to another hospital for treatment and lost to follow-up, while the remaining 23 cases underwent primary repair surgery. One case died within 6 months after the operation due to low cardiac output syndrome, while the other 22 cases were followed up for (2.1±0.3) years with good outcomes (2 cases underwent a second surgery within 1 year after the first operation due to anastomotic stenosis or pulmonary vein stenosis).@*CONCLUSIONS@#TAPVC fetuses can achieve good outcomes with integrated management during the perinatal period.
Subject(s)
Female , Humans , Pregnancy , Infant, Newborn , Echocardiography , Heart Defects, Congenital/surgery , Pulmonary Veins/surgery , Retrospective Studies , Scimitar Syndrome/surgeryABSTRACT
Objective To evaluate the value of transesophageal echocardiography (TEE) in transthoracic minimally invasive device closure of ventricular septal defect(VSD).Methods A total of 164 cases of VSD were recruited as candidates to receive transthoracic minimally invasive device closure between January 2007 and October 2010,including 138 perimembranous VSDs,3 muscular VSDs and 23 supracristal VSDs.Among these groups,85 male patients were included.Four-champer view,five-champer view,left ventricular long-axis view,short-axis view and right ventricular inflow view were detected to evaluate the availability of device closure.Results A total of 152 cases(92.7%)were successfully closed with a device.All the patients were followed up more than 3 months arranged with a standard protocol.No complete atrioventricular block (CAVB) or associated valvular complications were observed.Three of the five cases with traced residual shunt after device closure closed spontaneously.Conclusion TEE plays an important role in transthoracic minimally invasive device closure of ventricular septal defect,which has been proved by the good follow-up results without CAVB and associated valvular complications.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of Milkvetch Injection (MI) on cardiac function and hemodynamics in children with tetralogy of Fallot after radical operation.</p><p><b>METHODS</b>Thirty-two children with tetralogy of Fallot were divided into two groups, the 20 patients in the control group treated with conventional treatment and the 12 patients in the treated group treated with 15 ml of MI every 12 hrs for 7 days. The cardiac function and hemodynamic parameters were determined by echocardiography and thermodilution catheter inserted in pulmonary artery.</p><p><b>RESULTS</b>Patients' cardiac function and hemodynamic parameters were improved significantly 1 hr after administering 15 ml of MI Injection, but restored to the level before medication in 2-4 hrs. Administering MI injection for successive 7 days could gradually improve patients' cardiac function and hemodynamic parameters after operation, and the improvement became more evident with the prolonging time of medication. The intubation time, intensive care unit duration and the time of intravenously administration of inotropic drugs in the treated group were significantly shorter than those in the control group (P < 0.01).</p><p><b>CONCLUSION</b>MI could significantly improve the hemodynamics and cardiac function, and shorten the recovery time in children with tetralogy of Fallot after radical operation.</p>