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Objectives: The present first-in-human study aimed to assess the feasibility of percutaneous balloon mitral valvuloplasty (PBMV) for the treatment of isolated mitral stenosis (MS) under echocardiography guidance only. Methods: Data were obtained from 24 consecutive patients with severe MS, who underwent PBMV from October 2016 to October 2017 under the guidance of echocardiography only. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography was conducted at 1, 3, 6 and 12 months post procedure. Results: PBMV was successful in all 24 patients under echocardiography guidance without radiation and contrast agent. Mitral transvalvular pressure gradient derived invasive catheterization measurement dropped from(15.0±5.1) mmHg to (6.7±2.9) mmHg (P<0.01). Mitral valve area increased from (0.8±0.1) cm2at pre-PBMV to (1.7±0.1) cm2post-PBMV (P<0.01). Mean balloon diameter was (26.7±1.2) mm. Mild mitral regurgitation developed in 8 patients. Mean follow-up duration was (7.4±3.1) months. At the last follow-up, mitral valve area remained high (1.6±0.1) cm2and mean transmitral pressure gradient remained low (9.0±4.3) mmHg. No pericardial effusion or peripheral vascular complications occurred. Conclusions: In this patient cohort, PBMV could be successfully performed with echocardiography as the single imaging guidance modality, this procedure is safe and effective and avoids the radiation exposure and contrast agent use.
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Objective: To investigate the safety and efficacy of pulmonary vein deployment technique for percutaneous closure of atrial septal defects (ASD) solely under echocardiography guidance. Methods: A total of 38 ASD patients received pulmonary vein deployment in our hospital from 2012-10 to 2016-09 since the conventional method could not deliver the occluder to correct place. The patients were with the mean age at (16.0±15.6) years, body weight at (37.2±22.9) kg and ASD diameter at (17.1±4.2) mm. Operative effect was assessed by echocardiography. Follow-up study was conducted at 1, 3, 6, 12 months post-operation and at each year thereafter. Results: 37 patients were successfully finished pulmonary vein deployment for percutaneous closure of ASD solely under echocardiography guidance. One patient was successfully treated by a controlled steerable sheath. The mean operative time was (25.2±5.1) min and mean diameter of ASD occluder was (22.9±5.6) mm. 2 patients had trivial residual shunt at the early post-operative stage. No peripheral vascular injury, pulmonary vein and cardiac perforation occurred. All 38 patients were recovered and discharged. The average in-hospital time was (2.9±0.7) days. The patients were followed-up for (23.9±15.4) months, without complications of residual shunt, pericardial effusion, aortic regurgitation and pulmonary vein stenosis. Conclusion: Pulmonary vein deployment technique for percutaneous closure of ASD solely under echocardiography guidance was safe and effective; it can avoid radiation damage and provided a simple and practical method for ASD patients who failed to conventional method under echocardiography guidance.
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Objective To explore the expressions of the HA117,mdr1,mrp1,lrp and bcrp genes in bone marrow mononuclear cells(BMMNC) with acute leukemia (AL) and the clinical significance in AL.Methods Expressions of HA117,mdr1,mrp1,lrp and bcrp genes in 81 children with AL and 14 children with idiopathic thrombocytopenic purpura (ITP) were tested using semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) technique.Results 1.The expressions of HA117,mdr1,mrp1,lrp and bcrp genes in AL patients were higher than that in ITP children.And the expressions of these genes in refractory-relapsed patients also higher than that in the initially diagnosed patients or remission patients.2.The first complete remission (CR1) rate in HA117 and lrp positive cases was lower than that in negative cases(all P ＜ 0.05),but the CR1 rates in mdr1,mrp1 and bcrp positive cases had no significant difference from it in negative cases(all P ＞ 0.05).3.Correlation analysis showed:there was no correlation between the expression of HA117 and mdr1 or HA117 and rnrp1 or HA117 and 1rp or HA117 and bcrp in childhood AL(r =0.031,0.319,0.203,0.176,11.178,all P ＞ 0.05).mdr1 and mrp1 or mdr1 and bcrp or lrp and bcrp had obviously positive correlation (r =0.260,0.308,0.317,all P ＜ 0.05).In refractory-relapsed group,HA117 and rndr1 or rnrp1 or lrp or bcrp had obviously perfect positive correlation.Conclusions The gene HA117 and mdr1,mrp1,lrp,bcrp may be associated with muhidrug resistance of AL in children,therefore the detection of HA117 expression is helpful in management of AL patients.Comparing to the mdr1 or mrp1 or bcrp genes,the genes of HA117 and lrp can better predict the multidrug resistance in childhood AL.
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<p><b>OBJECTIVE</b>To assess the safety and effectiveness of percutaneous transcatheter closure of atrial septal defect (ASD) under transesophageal echocardiography (TEE) guidance in children.</p><p><b>METHODS</b>The study included 20 cases of patients with ASD. The patients were (4.2 ± 1.2) years old and the mean body weights were (18.2 ± 4.2) kg. The diameter of ASD before closure was (13.4 ± 3.3) mm . All procedures were guided under TEE. Procedure success was evaluated by TEE immediately after procedure.</p><p><b>RESULTS</b>Closure devices were successfully implanted in all 20 patients under TEE guidance. The diameter of closure devices was 14-26 mm. There were no procedure related complications. The ventilation time was (2.9 ± 0.8)h and the hospitalization time was (3.2 ± 0.7) days.</p><p><b>CONCLUSION</b>TEE guided percutaneous transcatheter closure is safe and effective for patients with ASD and avoids the radiation damages.</p>