ABSTRACT
OBJECTIVE@#To explore the predictive value of overall longitudinal strain for the development of cardiomyopathy without hypertrophic changes.@*METHODS@#Sixty five patients with suspected hypertrophic cardiomyopathy (HCM) but without hypertrophic changes were selected. Genetic variant, overall longitudinal strain, left ventricular ejection fraction, end diastolic volume, end systolic volume, interventricular septal thickness, left ventricular diameter and end diastolic diameter were detected. The risk factors of HCM were analyzed.@*RESULTS@#Forty four variants of 16 genes were identified, among which MYBPC3 13659G>A was the commonest (73.20%) and MYH7 13252C>T was the second (31.25%). MYBPC3 GG genotype, overall longitudinal strain and apical longitudinal strain were correlated with HCM (P<0.05).@*CONCLUSION@#The increase of longitudinal strain is of great value in predicting the occurrence of HCM.
ABSTRACT
Objective To summarize the clinical experiences of total cavopulmonary connection (TCPC), investigate the applications and short and mid term effects. Methods From 1999 to 2007,31 patients with complex congenital heart disease underwent TCPC. All patients were divided into child group(≤16 years old ,n =21 ) and a-dult group( n = 10 ), including 15 cases of functional univentricle, 8 cases of complete atrioventricular septal defect with double outlet of right ventricle, 3 cases of transposition with double outlet right ventricle, 3 cases of tricuspid atresia, 1 case of double outlet of right ventricle with hypoplastic left heart. 1 case of corrected transposition of the great arteries with TOF. Among them, 1 patient had cortriatriatum, 10 patients had left superior vena cave, moderate or severe mitral valve insufficiency occurred in 1, moderate atrioventricular valve insufficiency occurred in 3.28 pa-tients underwent TCPC with cardiopulmonary bypass ( CPB ) and 3 patients without CPB ;Of them, 21 patients were treated with extracardiac conduit and 10 cases with intratrial lateral tunnel. Results There was no early death,post-operative death or large quantities of pleural effusion in child group;but two deaths and three patients with large quantities of pleural effusion in adult group. One case caught up in inferior venous stasis and was cured. Follow- up was carded out from 6 months to 6 years. 26 patients were in NYHA class Ⅰ ,2 patients in NYHA class Ⅱ and only one patient in NYHA class Ⅲ. Conclusions TCPC is effectively used for complex congenital heart disease which can not be corrected in anatomy;serious postoperative complications often occur in adults. Atrioventricular valve in-sufficiency decisively affects the short and midterm effects, even the long-term effects.
ABSTRACT
Objective To study the brain protection of sequential double-sided antegrade cerebral perfusion to central nervous system in arotie arch surgery. Methods 24 patients received aortic arch replacement under deep hyperthermic circulatory arrest (DHCA) ,with fight-sided, and following double-sided, and left-sided,if necessary, antagrade cerebral perfnsion through right axillary arterial cannula or right femoral arterial eannula homeochronously. Post-operation recovery and the central nervous complications (CNC) were recorded and analyzed. Results 2 cases died, one of whom died of refractory low cardiac output syndrome and the other died of late massive gastrointestinal tract hemorrhage. No patient suffered severe CNC. Conclusion Sequential double-sided antegrade cerebral perfusion combined with DHCA can provide good brain protection in arotic arch replacement.