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Objective To summarize the experience in surgical treatment of primary cardiac tumors in children .Meth-ods Retrospective analysis of 13 children with primary cardiac tumors which were surgically treated in our department from June 1994 to March 2016.Among the 13 patients, 8 were boys and 5 were girls.The mean and standard deviation(range) of age was(4.85 ±4.61) years(5 days -13 years).The diagnosis was identified by echocardiography and computed tomography before operation and by pathological diagnosis after operation .All patients were followed up after discharge .Results A num-ber of 13 patients underwent surgical treatment.One patient died from cardiac failure after surgery.Histologic examination re-vealed rhabdomyoma in 8 patients, myxoma in 2 patients, fibroma in 2 patients, and rhabdomyosarcoma in 1 patient.All the remaining 12 patients followed up for(85.71 ±17.04) months(3-247 months), one patient with benign tumor was relapsed without tumor-related symptoms, the other patient with malignant tumor was relapsed and died from abandoning treatment .Oth-ers had good cardiac function and symptom improvement .Conclusion Primary cardiac tumors in children are mostly primarily benign.Tumors with different characteristics get different clinical symptoms and prognosis .Personalized therapy strategies need to be performed to achieve better outcomes .
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the effectiveness of individualized strategy of surgical management on the great arteries (TGA).</p><p><b>METHODS</b>From March 1998 to October 2009, 127 cases (97 males and 30 females) with TGA were treated. There were 97 male and 30 female, aged from 4 hours old to 17 years old with a mean of (25 ± 37) months, weighted from 2.7 to 47.5 kg with a mean of (8 ± 8) kg. The palliative operations included Glenn operation in 14 cases (3 cases double Glenn procedure), Balalock-Taussing shunt in 14 cases, Banding operation in 8 cases, and atrial septal defect enlarge/Banding/Balalock-Taussing shunt in 15 cases. The end-stage operation included Senning procedure in 5 cases, Switch procedure in 32 cases, 2(nd)-stage Switch procedure in 11 cases, Switch procedure with VSD repairing in 20 cases, Switch procedure with Hybrid in 1 case, Nikaidoh procedure in 3 cases, Rastelli procedure in 13 cases, Fonton procedure in 18 cases, other procedure in 4 cases. Twenty-one cases underwent 2 operations, and 5 cases underwent 3 or more operations. Sixty-six cases underwent delayed sternal closure.</p><p><b>RESULTS</b>There were 12 cases of death operatively in 127 cases. The total operative mortality was 9.4%. There were 5 cases dying of low cardiac output during the operation, 2 of pulmonary hypertension crisis, 2 of hemorrhage, 1 of grafting problem of coronary artery deformation, 1 of renal failure after Fonton procedure and 1 case of newborn dying of spontaneous rupture of liver post-operatively. The patients were followed up for 1 month to 12 years. There were 10 patients with vary degrees complications such as pulmonary stenosis, residual shunt and narrow channel. Three cases underwent reoperation. The rest of survived cases had normal heart function, good growth and development state.</p><p><b>CONCLUSIONS</b>Individualized strategy of surgical management based on anatomical conditions of TGA can significantly improve the success rate of surgery and long-term survival.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Follow-Up Studies , Transposition of Great Vessels , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To determine the effects of diazoxide on oxygen free radicals and cell apoptosis in brain tissue after deep hypothermia cerebral ischemia reperfusion injury in young rats.</p><p><b>METHODS</b>Fifty-four 3-week-old Sprague-Dawley rats were randomly and equitably divided into sham-operated group, model group and diazoxide group respectively (n = 18). The model of hypothermia cerebral ischemia reperfusion injury was made. After 24 hours of operation, the brains of rats were removed and preserved. The content of superoxide dismutase (SOD) and malonaldehyde (MDA) in brain tissue were detected. Cytosolic C release of cytochrome was confirmed by Western Blot. The protein expression of Caspase-3 was determined by immunohistochemistry.</p><p><b>RESULTS</b>In the model group, the content of SOD was (198 +/- 41) U/mg, lower than the sham-operated group's (321 +/- 36) U/mg (P < 0.01). The content of MDA was (212 +/- 21) nmol/mg, was higher than the sham-operated group's (100 +/- 23) nmol/mg (P < 0.01), and the expressions of cytochrome C (0.72 +/- 0.09) and Caspase-3 (83 +/- 10) were all significantly higher than those in the sham-operated group (0.17 +/- 0.02 and 115 +/- 9) (P < 0.01). Compared with the model group, the content of SOD in the diazoxide group [(264 +/- 34) U/mg] was markedly increased (P < 0.05). In addition, diazoxide provided significant reductions in the content of MDA [(174 +/- 19) nmol/mg] and the expressions of cytochrome C (0.41 +/- 0.05) and Caspase-3 (99 +/- 11) (P < 0.05).</p><p><b>CONCLUSIONS</b>The neuroprotective effects of diazoxide against brain injury induced by deep hypothermia cerebral ischemia reperfusion through inhibiting oxygen free radicals and cell apoptosis. Diazoxide may become a new neuroprotective drug after infant complicated congenital cardiac operation.</p>