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<p><b>OBJECTIVE</b>To compare the features of patients with pulmonary hypertension due to left heart disease classified according to transpulmonary gradient (TGP) or diastolic pressure difference (DPD).</p><p><b>METHODS</b>Thirty-three patients with pulmonary hypertension due to left heart disease diagnosed by right heart catheterization were enrolled. Patients were divided into two groups according to TPG: 17 patients with TPG ≤ 12 mmHg (1 mmHg = 0.133 kPa) and 16 patients with TPG > 12 mmHg; or divided into two groups according to DPD: 23 patients with DPD < 7 mmHg and 10 patients with DPD ≥ 7 mmHg. McNemar's method was used to test the agreement of the two classification methods.</p><p><b>RESULTS</b>Below are the patients features according to the classification by TPG: central venous pressure ((9.0 ± 2.5) vs. (12.7 ± 5.4) mmHg), mean right atria pressure ((9.1 ± 2.4) vs. (12.8 ± 5.2) mmHg), right heart systolic pressure ((45.5 ± 9.8) vs. (66.8 ± 15.4) mmHg), right heart mean pressure ((22.6 ± 5.2) vs. (33.1 ± 7.5) mmHg), pulmonary systolic pressure ((44.2 ± 10.3) vs. (64.8 ± 14.2) mmHg), pulmonary diastolic pressure ((24.2 ± 4.5) vs. (33.1 ± 8.3) mmHg), pulmonary mean pressure ((32.3 ± 5.7) vs. (45.8 ± 8.6) mmHg), cardiac index ((2.6 ± 1.0) vs. (1.9 ± 0.9) L · min(-1) · m(-2)), right heart EF ((31.2 ± 12.6)% vs. (22.6 ± 7.1) %) and pulmonary vascular resistance ((2.3 ± 0.8) vs. (6.3 ± 2.6) Wood) were significantly different between the two groups (all P < 0.05). According to the classification of DPD, only right heart diastolic pressure ((7.4 ± 3.7) vs. (11.5 ± 5.7) mmHg), pulmonary diastolic pressure ((25.9 ± 6.4) vs. (34.7 ± 8.0) mmHg) and pulmonary vascular resistance ((3.3 ± 2.0) vs. (6.2 ± 3.4) Wood) were significantly different between the two groups (all P < 0.05). These was a weak agreement (κ = 0.386 6, 95% CI: 0.092 2-0.681 0) between the two classification methods.</p><p><b>CONCLUSION</b>TPG classification is superior to DPD classification for pulmonary hypertension patients due to left heart disease on identifying the hemodynamic differences.</p>
Subject(s)
Humans , Blood Pressure , Cardiac Catheterization , Diastole , Heart , Heart Failure , Hemodynamics , Hypertension, Pulmonary , Vascular ResistanceABSTRACT
Objective To evaluate the effect of transcatheter closure of perimembranous ventricular septal defect (PMVSD) with symmetric ventricular septal occluder (SVSO). Methods Sixty-three patients with UCG confirmed PMVSD underwent transcatheter closure with SVSO. Results The implantation was successful in 58 patients (93.0%). The mean PMVSD diameter was 5.1?1.9 mm by angiography. The distance from the aortic valve to the rim of PMVSD was 2.7?1.0 mm and the mean size of SVSO was 7.2?2.1 mm. There was no residual shunt in 55 patients (94.8%) right after the deployment of SVSO. Arrhythmia was recorded in 15 patients (23.8%) during or after the procedure. New aortic regurgitation was observed in one patient after the implantation SVSO. Two patients developed myocardium injury and one patient developed obstruction of right ventricular outflow tract. Dislocation of the device was found in one patient. During the follow-up of 3 to 12 (means 7.4?2.7) months, no residual shunt, displacement or rupture of divices and endocarditis happened. Conclusion Transcatheter closure of PMVSD using SVSO is safe and effective, meanwhite attention should be paid to the complications such as arrhythmias.
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<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of the Amplatzer septal occluder for transcatheter closure in patients with secundum atrial septal defect (ASD II).</p><p><b>METHODS</b>Patients with clinically confirmed ASD II were recommended for transcatheter closure of ASD II.</p><p><b>RESULTS</b>30 ASD II patients (20 females) underwent transcatheter closure at a median age of 18.4 years (5-55 years). Both the stretched diameters of ASDs and the sizes of the devices were from 18 to 34 mm (25 +/- 7 mm). The successful placement rate was 100%. The rest shunt documented by color Doppler, was immediately after implantation in 40% of patients, in 9.9% after 24 hours, and in 3.3% trace at 3 months. No serious complications were observed. There was improvement in symptoms and in cardiac size. Septal motion abnormalities normalized in all patients after 3 months follow-up.</p><p><b>CONCLUSION</b>The Amplatzer septal occluder is a safe and effective device for transcatheter closure of ASD II. Long-term follow-up is still required before widespread clinical use can be recommended.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Follow-Up Studies , Heart Septal Defects, Atrial , General Surgery , Surgical InstrumentsABSTRACT
AIM To investigate the effect of frozen recombinant staphylokinase on the hemostatic and fibrinolytic systems in healthy volunteers, in order to obtain reliable evidence for the possibility of further clinical application. METHOD r-Sak had been taken intravenously by 20 cases of healthy volunteers in different dosages (1 mg, 2.5 mg, 5 mg, 10 mg, 15 mg). The clinical hemorrhagic manifestations were observed and a set of hemostatic tests(BT, BPC, ATPP, PT, TT, Fg) and fibrinolytic tests (PL∶A,α2-PI∶A, FDP, D-D) monitored before and after injection. RESULT Four of 20 volunteers showed slight hemorrhagic tendency on mucocutaneous area (3/4 from gingivea and 2/4 at the sites of injection). It stopped spontaneously. None of them showed visceral bleeding. There were no significant changes in hemorrhagic and coagulative phases. Only 4 of them showed slight abnormal changes in D-D. It was supported that r-Sak was a highly selective fibrirolytic agent without significant influence in human hemostatic and coagulatic system. CONCLUSION The specific ranges of doseges, r-Sak is a relatively safe and well tolerated agent for healthy people. Further clinical study is still needed for the suitable dosage for clinical application.
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heparin coating.Conclusion Anti-thrombogenicity in vitro of biomaterials designed for the closure of congenital heart defects can be improved by immobilizing Chi/Hep conjugating onto the surface,but proliferation of HUVEC could be inhibited by Chi/Hep coating.