Safety of surgical therapy for neonate aortic coarctation combined with ventricular septal defect / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the safety of surgical repair for neonatal aortic coarctation combined with ventricular septal defect.
@*METHODS@#Twenty-three aortic coarctation neonates received surgical treatment and their clinical data between April, 2013 and May, 2015 were analyzed retrospectively. All patients underwent coarctation repair + ventricular septal defect repair and mild hyperthermia cardiopulmonary bypass under the condition of general anesthesia. All patients were subjected to delayed sternal closure.
@*RESULTS@#One patient died at early post-operation, and no one died during 2-27 months' follow-up. Operation time, cardiopulmonary bypass time, aortic cross-clamp time, ICU stay time, mechanical ventilation time, delayed sternal closure time, and post-operative hospital stay time were (192.7±43.4) min, (132.4±26.4) min, (65.3±18.4) min, (185.3±56.4) h, (42.4±24.5) h, (36.3±18.6) h, and (15.3±4.6) d, respectively. Post-operative complications presented in 12 patients, including post-operative hemorrhage in 6 patients, acute renal insufficiency in 4 patients, wound infection in 1 patient, and post-operative coarctation of the aorta in 1 patient. 
@*CONCLUSION@#One-stage complete repair for severe aortic coarctation combined with ventricular septal defect in neonates is safe, and the outcomes are satisfied. Fully free of the aortic arch and individual aorta reconstruction are the keies to successful operation.

Transesophageal Echocardiography in Monitoring Eccentric Occluders Transthoracic Mini-invasive Occlusion of Ventricular Septal Defect / 中国医学影像学杂志

PurposeTo explore the value of transesophageal echocardiography (TEE) monitoring mini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude in preoperative selection of patients, intraoperative guidance monitoring and postoperative evaluation.Materials and MethodsForty-five cases of VSD undertook mini-incision transthoracic occlusion with asymmetric ventricular defects occlude were enrolled, their clinical data was analyzed retrospectively, preoperative transthoracic echocardiography (TTE) was applied for choosing appropriate cases. During surgery, TEE was employed for evaluating the VSD and in which perimembranous VSD was found in 21 cases, intracristal VSD in 15 cases and subpulmonic VSD in 9 cases, suitable eccentric type occluders were chosen, guide occluder was placed, and the occlusion effect was evaluated right after operation.ResultsThe procedures were completed successfully in 42 cases, with a successful rate of 93.3%, of which 21 cases had perimembranous VSD, 15 cases had intracristal VSD, and 6 cases had subpulmonic VSD. The diameter of the VSD ranged from 3 to 7 mm, averaging (4.5±0.7) mm, the diameter of occluders ranged from 4 to 8 mm, averaging (5.7±1.2) mm, there was a good positive correlation between size of VSD and occlude (r=0.87,P<0.05). All patients received follow-ups from 3 months to 24 months after operation, all the occluders located normally, with no more than mildly residual shunt, valve regurgitation or severe arrhythmia discovered.ConclusionMini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude has high success rates, minimal injury, and lower complication rate. TEE can play a vital role by improving the success rate and safety of surgery.

Effect of panax notoginseng saponins on pulmonary artery pathology of pulmonary hypertension rats / 中国医师杂志

Objective To observe the effect of panax notoginseng saponins on pulmonary artery pathology in chronic hypoxic pulmonary hypertensionp (HPH) rats models, discuss the role and possible mechanisms of panax notoginseng saponins in prevention of chronic hypoxic pulmonary hypertension.Methods Forty male Sprague-Dawley (SD) rats were randomly divided into four groups (n =10).Group C: control group;Group H: rats were treated with hypoxia only;Group HC: rats were treated with hypoxia and captopril;and Group HP: rats were treated with hypoxia and panax notoginseng saponins.To observe the effect of panax notoginseng saponins prophylactic treatment in chronic hypoxic pulmonary hypertension rats,after the establishment of the model of hypoxic rat animal pulmonary hypertension models, transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure, at the end of separation and cut for pulmonary artery to observe the pathological changes of pulmonary artery, results were recorded and statistically analyzed.Results (1)Transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure: pulmonary artery systolic pressure (PASP) and mean pulmonary arterial pressure (MPAP) were significantly higher in Group H than in Group C (P ＜ 0.05), Group HP was no significant difference relative to Group C.(2)Pathological section shew that the primary pathological change of group H is vascular intimal hyperplasia and the proliferation of smooth muscle cells, medial hypertrophy, extracellular matrix increased, thickening of the vessel wall and the vascular stenos.Conclusions Panax notoginseng saponins inhibit the formation of chronic hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats,and have the effect of prevention and treatment of pulmonary hypertension.