ABSTRACT
Objective To observe the changes of plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac performance in children with ventricular septal defect (VSD) before and after interventional therapy,and analyze the relationship between the cardiac performance and NT-proBNP level.Methods A total of 100 children[43 male,57 female,5-8(6.3 ±-2.1) years old] with VSD for cardiac catheter occlusion in the First Hospital of Hebei Medical University were enrolled in this study as the VSD group.The control group included 50 healthy children.Concentrations of plasma NT-proBNP were measured before operation and the 3rd day and the 6th month after cardiac catheterization,respectively.Before operation and the 7th day and the 6th month after cardiac catheterization,the parameters of left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume (LVESV),left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were measured by echocardiography.The relationships between plasma NT-proBNP levels and echocardiographic cardiac functional indexes were analyzed.Results There was a significant difference in plasma NT-proBNP levels measured between the 2 groups before catheterization(P ＜ 0.01) ;In the 3rd day and the 6th month after cardiac catheterization,the plasma NT-proBNP level decreased significantly as compared to that in the before operation and the 3rd day respectively (P ＜ 0.01),while it was similar to the control group (P ＞ 0.05).The para-meters of LVEDD,LVESD,LVESV and LVEDV in the 6th month and the 7th day after catheterization were decreased significantly as compared to those before catheterization in VSD group(all P ＜ 0.05),and those in the 6th month were more decreased as compared to those in the 7th day(all P ＜ 0.05).The plasma NT-proBNP level was significantly correlated with LVEDD,LVESD,LVESV,LVEDV in VSD group(r =0.82,0.56,0.62,0.77,all P ＜ 0.01).Conclusions The value of plasma NT-proBNP in the children with VSD was decreased after catheterization was correlated with the recover of the heart function.It is indicated that the test of plasma NT-proBNP will be of important significance in asses-sing the heart function change of the children with VSD after catheterization.
ABSTRACT
Objective To discuss the methods of selecting different shapes occluder and to evaluate the feasibility,safety and efficacy of them in transcatheter closures of congenital ventricular septal defect (VSD) in children.Methods Transcatheter closures were performed in 226 children with congenital VSD,age ranging from 2 to 14 years(mean 5.62 years) under the guidance of transthoracic echocardiography(TTE) and fluoroscopy.There were 14 patients with intracristal VSD,209 patients with perimembranous VSD and 3 patients with muscular VSD.Left ventriculography and transthoracic echocardiography were performed repeatedly after the procedure to assess the effect of occlusion.The echocardiography and electrocardiography were scheduled before discharge,1,6 and 12 months for the follow-up.Results The occluders were deployed successfully in 211 patients.The successful rate was 93.4%.Thin waist shape occluders,were deployed in 7 patients;equal side shape occluders,were deployed in 191 patients;eccentric shape occluders were deployed in 12 patients,and muscular defect occluders were deployed in 1 patient.There were no complications encountered during or after closure.Conclusions It is very important in transcatheter closure of congenital in children to select different shape occluder according to pathologic characteristics.In general,equal side shape occluder is suita-ble for a large number of defect and it is easy for deployment.In some conditions,the other shape occluder may be necessary.