Preliminary clinical application of transcatheter closure of ventricular septal defect via radial approach / 介入放射学杂志

Objective To explore the feasibility and efficacy of transcatheter closure of ventricular septal defect (VSD) through radial artery combined femoral vein approach. Methods A total of 11 patients with congenital VSD, who were admitted to authors' hospital during the period from June 2017 to November2017, were enrolled in this study. The patterns of lesion included intracristal type (n=3) and perimembranous type (n=8), and in 3 patients the VSD was associated with concant ventricular septal aneurysm. Transcatheter closure of VSD via radial approach was carried out in all patients. The mean age of the patients was (37.82±12.44) years old, and the average body weight was (62.79±14.95) kg. The transthoracic echocardiography (TTE) showed that the mean diameter of VSD was (5.87±1.91)mm. The effect of transcatheter closure therapy was assessed by intraoperative TTE and left ventriculography. All patients were followed up with electrocardiogram and TTE at 24 hours and one, 3, 6 months after transcatheter closure therapy. Results Successful closure was achieved in 10 patients, and one patient had to be transferred to surgery because the catheter could not pass through the defect. The mean diameter of the implanted occluders was (7.50±3.60)mm, the average procedural time and fluoroscopy time were (47.20±5.45) min and (13.00±3.65) min respectively. The postoperative average in-bed time was (99.00±11.97) min. Two patients developed radial artery spasm during the operation. During the follow-up period lasting for a mean of (3.50±1.90) months, no serious complications, such as dropping of occluder, residual shunt, atrioventricular block, aortic regurgitation, radial artery occlusion, etc. occurred in the 10 patients. Conclusion For the treatment of VSD, transcatheter closure through radial artery combined with femoral vein approach is safe and effective. Therefore, this technique is worthy of clinical application.

A novel double-ring aortic valve stent: its development and experimental study / 介入放射学杂志

Objective To discuss the feasibility and effectiveness of transcatheter implantation of double-ring aortic valve stent through puncturing the tip of the heart under thoracotomy.Methods A novel double-ring aortic valve stent was independently designed by the authors.Three healthy goats were selected for this study.A small incision on the left anterolateral thoracic wall was made to expose the cardiac apex,than the puncturing of the left ventricular apex was performed to establish the working pathway.Guided by fluoroscopy,along a hard guide wire a double-ring aortic valve stent was inserted through a 22-French sheath to the site above the aortic valve.By utilizing the opened outer ring of the stent,the double-ring aortic valve stent was accurately placed at the bottom of the aortic valve sinus.Then,the balloon was inflated and the stent was released to substitute the original aortic valve of the experimental goat.The experiment results were evaluated immediately after the procedure.Results Transcatheter aortic valve implantation (TAVI) was successfully accomplished in all the three experimental goats.DSA was performed immediately after the procedure and anatomy evaluation indicated that the position of the implanted artificial aortic valve was satisfactory,which could replace the work of original valve.Conclusion It is technically feasible and clinically effective to use this novel double-ring aortic valve stent to perform TAVI through transapical route by puncturing the left ventricular apex.

Radiofrequency ablation of ventricular outflow tract septum: a preliminary study in experimental canine / 介入放射学杂志

Objective To investigate the effect of radiofrequency ablation (RFA) of ventricular outflow tract septum on the left ventricular structure and function in experimental canine.Methods Healthy experimental dogs were used for this study.RFA of the myocardium at ventricular outflow tract septum was performed.Before RFA,thoracic ultrasound examination was used to determine the width of left ventricular outflow tract,the systolic interventricular septum thickness,left ventricular ejection fraction,etc.The ultrasound examination was performed immediately after RFA to check the above indexes.Ultrasound examination was employed one and 3 months after RFA to record the above indexes of the survived dogs,and pathological examination was made.Results Among the 10 experimental dogs,successful RFA was achieved in 9,and one dog died of ventricular fibrillation.In one dog RFA was successfully accomplished,but it died of respiratory inhibition due to over-deep anesthesia.Immediate success rate of surgery was 80％,eight dogs survived to the scheduled follow-up time point.The width of left ventricular outflow tract and the systolic interventricular septum thickness determined immediately after RFA as well as one and three months after RFA in the survived dogs were significantly different from the preoperative data (P＜0.05).Histopathologically,striking microscopic changes could be observed.No obvious changes in ECG and blood pressure were seen.Conclusion The results of this study indicate that RFA of ventricular outflow tract septum in experimental dogs is safe and effective,which provides useful parameters and experimental basis for further animal experiments and clinical trials.

Progress in clinical research of left atrial appendage occluder / 介入放射学杂志

Atrial fibrillation (AF) is a common kind of arrhythmia,it is one of the main reasons causing ischemic stroke in aged patients.Left atrial appendage is the primary site where the thrombus is formed in non-valvular atrial fibrillation (NVAF) patients.Recent researches have indicated that occlusion of left atrial appendage can effectively reduce the occurrence of ischemic stroke in NVAF patients,its curative effect is no less than the preventive treatment effect of warfarin.The use of an ideal left atrial appendage occluder is the key to ensure a successful occlusion of the left atrial appendage.After decades of research,several left atrial appendage occluders have been developed,among them Watchman occluder and Amplatzer cardiac plug (ACP) are commonly used nowadays in clinical practice,and some kinds of occluder are still at their experimental research stage.This article aims to make a brief introduction about the current status of the study and the clinical application of left atrial appendage occluder.(J Intervent Radiol,2017,26:281-284)

Devices used for percutaneous occlusion of left atrial appendage：recent progress in research / 介入放射学杂志

Clinically, atrial fibrillation (AF) is one of the most common cardiac arrhythmia, and patients with arterial fibrillation carry high risk of stroke. Oral administration of anticoagulation such as warfarin for the prevention of stroke has some risks to induce bleeding; moreover, some patients are not able to tolerate the medication. Percutaneous occlusion of the left atrial appendage is safe and effective for the prevention of stroke in patients with atrial fibrillation, although at present it is only used for the patients who have contraindications to anticoagulation medication. This paper aims to review a variety of left atrial appendage occlusion devices and to analyze the relationship between the different shape design of occluder and the left atrial appendage morphology.

Experimental study of transcatheter aortic valve implantation assisted with snare to fix the delivery system / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and effectiveness of transcatheter aortic valve implantation assisted with snare to fix the delivery system.</p><p><b>METHODS</b>This study was made in 5 healthy goats. After the abdomen was opened and the abdominal aorta was exposed, a stiff guide wire was advanced into the apex of the left ventricle through abdominal arterial puncture points. The delivery catheter equipped with valved stent was inserted into the descending aorta under fluoroscopy along the stiff guide wire. A minimal thoracic surgery approach was used to access the apex of the heart. A J-type guidewire and 5 F multifunction catheter were placed transapically and across the aortic valve down to the descending aorta. The snare was introduced through the 5 F catheter into the ascending aorta and was controlled to seize the head of stent delivery catheter. Then the delivery catheter was advanced into the left ventricle. The valved stent was positioned in the desired position under aortography and then the balloon was dilated and the valved stent was deployed into the aortic annulus assisted with snare to fix the catheter to prevent stent dispositions. Aortic angiography and echocardiography were performed to evaluate of valve performance post procedure.</p><p><b>RESULTS</b>The interventional procedure was completed successfully in all 5 goats. The mean aortic annulus diameter was (23.8 ± 2.6) mm, two valved stent of 23 mm diameter and three valved stent of 26 mm in diameter were implanted. The operation duration and X-ray exposure time were (112.3 ± 19.5) min and (16.8 ± 5.2) min, respectively. Immediate observation after procedure showed that the valved stents were in the desired position after implantation by angiography and echocardiography. No moderate to severe aortic regurgitation was observed. All goats were alive at 1 month post procedure.</p><p><b>CONCLUSIONS</b>The procedure of transcatheter implantation of a balloon-expandable valved stent into the aortic valve position of goats assisted with snare to fix the delivery catheter is feasible and effective. This procedure might be suitable also for patients with noncalcified aortic stenosis.</p>

An experiment study of transcatheter transapical aortic valve implantation with a new domestic balloon-expandable bioprosthetic aortic valve in goats / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and effectiveness of transcatheter transapical implantation of a new domestic balloon-expandable bioprosthetic aortic valve in goats.</p><p><b>METHODS</b>We developed a new tube-like balloon-expandable bioprosthetic aortic valve which was made from cobalt-chromium alloy and bovine pericardium. Briefly, fresh bovine pericardium was trimmed into artificial leaflets and sutured into the cobalt-chromium alloy stent by hand post cell extracting and anti-calcification treatments. A left anterolateral mini-thoracotomy was performed in the 5(th) intercostal space of 5 goats. After opening the pericardium, the apex of the left ventricle was punctured, a stiff guidewire was positioned across the aortic arch and anchored in the descending aorta. The delivery catheter (22 F) was then introduced through the stiff guidewire into the aorta arch under fluoroscopic guidance. After correct valve position was confirmed by digital subtraction angiography, the valved stent was implanted after rapid inflation of the balloon. The immediate results of implanted valved stents were evaluated with angiography and echocardiography.</p><p><b>RESULTS</b>Four devices were successfully implanted into aortic valve position of goats and one goat died of severe aortic valve regurgitation because the valved stent was implanted below the normal position.Immediate observation after procedure in 4 goats by angiography and echocardiography showed that the valved stents were in the desired position after implantation. Mild paravalvular leakage were found in 3 out of the 4 survived goats and there were no moderate to severe aortic regurgitation in survived goats.</p><p><b>CONCLUSION</b>The procedure of transcatheter transapic aortic valve implantation with our new-type domestic balloon-expandable valved stent and delivery system is feasible and effective.</p>

Transcatheter establishment of an animal model with acute aortic valve regurgitation：an experimental study / 介入放射学杂志

Objective To explore the feasibility and effectiveness of interventional transcatheter destruction of the aortic valve to establish an animal model with acute aortic valve regurgitation. Methods Eight healthy goats were used for this study. A limited sternotomy approach was used to access the apex of the heart. Puncturing of the apex of the heart was performed to establish a wire track, then, under fluoroscopic guidance a 10 F sheath was inserted along this track of hard wire until to the ascending aorta above the aortic valve. The internal sheath was removed. Via the 10 F sheath a 10 mm occluder of ventricular septal defect (VSD) was introduced into the ascending aorta above the aortic valve. The sheath was pulled back to the left ventricle, while the occluder remained in the ascending aorta above the aortic valve. Then the occluder was quickly pulled back into the left ventricle in order to make some certain damage to the aortic valve. And an acute aortic valve regurgitation model was thus established. Angiography of ascending aorta above the aortic Among the 8 animals, two died of acute left ventricular failure on the spot due to excessive regurgitation blood flow after the operation. Macroscopically, damage of the aortic valve was seen. In the six survivors, angiography of ascending aorta above the aortic valve and Doppler echocardiography showed that moderate degree of regurgitation was detected in 5 and small amount of regurgitation in one. Two experimental goats with moderate degree of regurgitation died of heart failure separately at seven days and fifteen days after the operation. The remaining four experimental goats survived for more than three months. Follow- up checkups with echocardiography suggested the presence of mild- moderate degree of regurgitation. Conclusion Acute aortic valve regurgitation model in experimental goats can be established through transapical transcatheter damage of aortic valve by quickly pulling back a VSD occluder which has been placed in the ascending aorta above the aortic valve. This method is clinically feasible, technically simple and repeatable, the result is reliable, and the degree of regurgitation is controllable.

Application of improved wire - maintaining technique in performing transcatheter closure of ventricular septal defects：a clinical study / 介入放射学杂志

Objective To discuss the clinical efficacy and safety of improved wire- maintaining technique in performing transcatheter closure of ventricular septal defects. Methods During the period from June 2011 to June 2013 at Changhai Hospital, percutaneous transcatheter closure of ventricular septal defect with improved wire-maintaining technique was carried out in 62 patients. According to the manipulation used , the patients were divided into traditional wire-maintaining technique group (group A, n = 30) and improved wire- maintaining technique group (group B, n = 32). The use of occluder during the procedure, the fluoroscopy time, the operation time and the complications were recorded. Follow-up examinations with ECG, echocardiogram and chest radiograph were performed at 24 hours and at 1 , 3 and 6 months after the procedure. The results were analyzed. Results No statistically significant differences in the use of occluder and in the incidence of complications existed between the two groups (P > 0.05). No severe complications occurred in both groups. The fluoroscopy time and the operation time in group A were (11.96 ± 3.63) min and (53.43 ± 14.48) min respectively, while the fluoroscopy time and the operation time in group B were (9.37 ± 2.77) min and (45.34 ± 10.38) min respectively, and the differences between the two groups were statistically significant (P < 0.05). Conclusion In performing transcatheter closure of ventricular septal defects, the practice.

Percutaneous occlusion of left atrial appendage in experimental canine models：the establishment of the delivery pathway / 介入放射学杂志

Objective To evaluate the feasibility and safety of a delivery pathway for the performance of percutaneous left atrial appendage (LAA) occlusion in experimental canine models. Methods Transseptal puncture was performed via femoral vein approach under fluoroscopic and angiographic guidance in 12 experimental dogs. A pigtail catheter was advanced into the left atrium (LA), which was followed by LA angiography. The diameters of the neck of LAA were measured on LAA angiogram obtained in appropriate projection. After the delivery sheath was advanced along the wire into LA, a pigtail catheter was inserted into the ostium of the LAA and the sheath was then advanced over the pigtail into the LAA. LAA angiography was then performed through the delivery sheath to confirm the position of the delivery sheath. One hour after the procedure both electrocardiography (ECG) and transthoracic echocardiography (TTE) were carried out in five dogs to check the results, immediately after which the five dogs were sacrificed to macroscopically observe the damages of the puncture site of inter-atrial septum as well as inside the LA and LAA. One hour and 2 weeks after the procedure TTE was conducted in the remaining 7 dogs and these dogs were followed up for one month. Results One dog died of pericardial tamponade during the operation. In 8 dogs the LAA was clearly displayed in the projection position of right anterior oblique (RAO) 30°/cranial (CRA) 20°,while in 3 dogs the LAA was well visualized in the projection position of RAO 30° , and in one dog in the projection position of RAO 30°/caudal (CAU) 20°. The diameter of LAA neck was (13.6 ± 5.2) mm. The delivery sheath was safely advanced into the LAA along the pigtail catheter in all dogs, and no air embolism, thrombus or pericardial tamponade occurred. Hematoma at puncture point of groin occurred in 2 dogs, which was absorbed through pressure dressing. Macroscopic examination of the heart performed immediately after the operation showed that no bloody pericardial effusion was found, and mild hematoma at posterior wall of LA was seen in one dog and mild damage of the upper-margin intima of LAA was noted in 2 dogs. The mean fluoroscopy time was (10.1 ± 2.5) minutes and the mean operation time was (58 ± 12) minutes. TEE showed no pericardial effusion 2 weeks after the procedure. During the follow-up period of one month no sudden death, stroke or infection occurred. Conclusion This method of placing the delivery sheath into the LAA is clinically safe and effective, and it can reliably establish a pathway to advance the LAA occluder into LAA.

Evaluation of the grading and disorder assessment of congenital heart disease with pulmonary arterial hypertension / 介入放射学杂志

Pulmonary arterial hypertension is one of the most common and serious complications in congenital heart disease.Identification of whether the pulmonary arterial hypertension is dynamic or resistance remains as the great importance for deciding to transfer for surgery,intervention or conservative therapy and directly concerning with the prognosis and choice of treatment.This review mainly deals with the problems such as grading,staging,pathophysiology and the correlative mechanism with clinical assessment of pulmonary arterial hypertension in congenital heart disease and furthermore providing comprehensive informations for clinical diagnosis and treatment.

Progress in the study of drug-eluting intra-stent thrombosis / 介入放射学杂志

Durg-eluting stent has been regarded as the milestone in the history of PCI for their efficiency in the prevention of coronary arterial restenosis after percutaneous coronary intervention. But unfortunately intra-stent thrombosis continues to be a serious complication of contemporary DES use. The incidence of drug-eluting stents thrombosis is at least not lower than that of bare metal stents at present. The clinical consequences of stent thrombosis are frequently catastrophic, including death in 40% to 50% of the cases or major myocardial infarction in 60% to 70%. Premature discontinuation of standard antiplatelet therapy is by far the most important predictor of stent thrombosis with DES and other predictors included renal failure, diabetes, bifurcation lesions, multiple lesions or multivessel disease, long stents, female, advanced age, stent underexpansion and residual stenosis etc. The delayed endothelialization may be the underling mechanism of DES thrombosis.

Evaluation of the clinical application and curative effect of femoral arterial closure devices / 介入放射学杂志

Along with the advances in interventional therapy, compression methods for arterial closure require prolonged compression or long arterial sheath dwelling period, which in turn would increase the procedural time, complication rates, and patients' discomfort. Under this circumstance, a variety of percutaneous arterial closure devices was invented offering rapid and reliable hemostasis but there are still some controversies concerning, whether it can reduce the incidence of postoperative complications or not. This paper reviewed and comprehended many researches and literatures to assess the efficacy and complication rates of device-mediated closure versus the gold standard of manual compression. (J Intervent Radiol, 2006, 15: 564-567)

Radiofrequency catheter ablation of atrial tachycardias related to myocardial scar or incision / 老年心脏病学杂志（英文版）

Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was ＜30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences ＜30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

Protective effects of trimetazidine on mitochondral in myocardial ischemia reperfusion rats / 医学研究生学报

Objective:To study the protective effects of trimetazidine (TMZ) on mitochondrial in myocardial ischemia reperfusion rats and its mechanism. Methods: Fifty SD rats were randomly divided into four groups; the pseudooperation group, the saline group and two TMZ treated groups(5 mg/kg and 10 mg/kg). In the pseudooperation group, the coronary artery was not ligated, but the chest was opened. Other groups were subjected to myocardial ischemia reperfusion injury. The serum level of mal onaldehyole ( MDA ) , superoxide dismutase ( SOD ) , glutathione ( GSH ) , glutathione peroxidase (GSH-PX) and the accumulation of Ca2+ in myocardial mitochondrial were detected at the time of 30 min ischemia and 40 min reperfusion. The myocyte ultrastnicture was also observed by electron microscope in the four groups. Results: Compared with the pseudooperation group, the MDA and total Ca2+ were significantly higher and the SOD, GSH, and GSH-PX were significantly lower in saline group and treatment groups. Compared with the saline group, the MDA and total Ca2+ was significantly lower and the SOD, GSH, and GSH-PX were significantly higher in the treatment groups. Conclusion: TMZ could significantly reduce lipid peroxidation in myocardial mitochondrial induced by ischemia and ische-mia-reperfusion. The mechanism may be that TMZ could increase the content of GSH and the acvitity of SOD and GSH-PX, and enhance its antioxidant production. TMZ could protect the cardiac cells by reducing calcium overload in myocardial mitochondrial.

The transcatheter closure of intracristal and subpulmonary ventricular septal defect / 介入放射学杂志

Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect(SVSD)with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD(n=22)and SVSD(n=6) at a age of 12.44?5.86 years (ranged from 3 to 34 years of age) The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the waist. The devices were deployed via the femoral vein using 7-10 Fr sheaths with the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD diameter was 4.54 ?1.93 mm (ranged 2 to 12 mm). the distance of VSD to aortic valve was 0.35?045 mm (range 0 to 1 mm )。The connecting waist diameter of device was 7.65?3.11 mm(ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. There was a trivial aortic regurgtation in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD, with having large defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07?5.19 min (range 9 to 40 min). The procedure time was 59.81?17.76 min (range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe.Longer follow-up is required to assess long-term efficacy.

Role of echocardiography in case selection in transcatheter closure of perimembranous ventricular septal defect using occluder / 中华超声影像学杂志

Objective To study the role of echocardiography in case selection in transcatheter closure of perimembranous ventricular septal defect (VSD) with occluder.Methods Transcatheter closure was conducted on 26 patients with perimembranous VSD. Occluders were made of China. The images were acquired with transthoracic echocardiography. Results Twenty four patients were implanted with occluders successfully. The VSD diameter by echocardiography was 4-10 mm, average was 6.4 mm.The implanted occluder device was 2 mm larger than VSD,the maximal one was 12 mm. Perimembranous VSDs were classified by subinfracristal ( 5 cases ),membranous(6 cases), submembranous (13 cases),and the minimum distance between VSD and aortic valve annulus was 2 mm,between VSD and tricuspid valve was 3 mm. Membranous VSD was easy to be occluded. Echocardiography immediately after placement showed no residual shunt in 21 patients. The one week follow up examination showed complete closures in 21 patients. Echocardiography immediately after placement showed mild residual shunts in 3 VSD, the residual shunt disappeared after one month in one patient, two patients had mild shunt. Two VSD abandoned the occlusion because of aortic valve regurgitation increasing. Conclusions Echocardiography plays an important role in case selection.

Transcatheter closure of ventricular septal defects / 医学研究生学报

Objective: To evaluate the feasibility and effect of transcatheter closure of ventricular septal defects(VSD) using the VSD occluder.Methods: From December 2003 to March 2005,13 VSD patients,8 males and 5 females,ranging in age from 4 to 35(15.2?10.7)years,underwent catheter closure using the VSD occluder.Tthe mean diameter of the VSD obtained by transthoracic echocardiography was 4-12(5.4?1.2) mm.Transcatheter closure was performed under transthoracic echocardiographic guidance after left ventriculography.All patients were followed up 1,3 and 6 months after the procedures. Results: The devices were successfully placed in 12 of the patients and complete closure achieved in 11.Trace residual shunt was observed in 1 patient but disappeared within 10 minutes.No severe complications were noted except 1 case of complete right bundle branch block revealed by electrocardiography. Conclusion: Transcatheter closure of VSD by the VSD occluder is a safe and effective procedure,with good immediate results.Further clinical trials are under way to assess its long-term effect.

Protective effect of trimetazidine on rat with experimental myocardial ischemia / 第二军医大学学报

Objective: To investigate the protective effect of trimetazidine on experimental myocardial ischemia and its mechanism. Methods: Fifty mice received isoproterenol (20 mg?kg -1 ?2 d,ip) were divided into control and treatment groups. The myocyte ultrastructure,serum creatine phosphokinase (CK) activities and lactate dehydrogenase (LDH), myocardial malondialdehyde (MDA) and superoxide dismutase (SOD) were observed in 3 groups. Results: Compared with the controls,in 2 groups pretreated with trimetazidine (5 mg?kg -1 ?d -1 and 10 mg?kg -1 ?d -1 ? 7 d, ip), the degree of myocardial damage were significantly reduced;the serum CK and LDH were lower;the myocardial MDA was lower;the myocardial SOD was higher. Conclusion: Trimetazidine can significantly reduce the degree of myocardial damage produced by isoproterenol;and it may play an important role in protecting ischemic myocardium, the mechanism may be associated with reduced oxygen free radical production.

The study of morphologic characteristics of the pulmonary vein and left atrium with 64 multislice computed tomography / 介入放射学杂志

Objective To evaluate the feasibility of the demonstration for morphologic characteristics of pulmonary vein(PV)and left atrium(LA)with 64-multislice computed tomography(MSCT).Methods Between February 2006 and February 2007,we studied morphologic characteristics of the pulmonary vein and left atrium in 88 patients undergone 3D imaging and virtual endoscopy with 64-slice MSCT scanner.46 patients in atrial frillation(AF)group and 42 subjects without history of AF in control group.Results 1.64-slice MSCT can reconstruct properly the morphology,number,size of orifice and flow route of pulmonary veins;among them,the sizes of orifice of pulmonary veins in AF group and control group showed no significant difference.2.The reconstruction images of left atrial appendages(LAA)showed that there were two kinds of morphologic variation existing at the crista between left auricle and left superior pulmonary vein with the continuatum of the left superior and inferior pulmonary veins.3.The reconstruction images,also revealed 3 types of left atrial top;including convex type(9%),concave type(32.9)and plateau type(58.1%);with approximately 12.5% of local convexity.Conclusion Clear demonstration of pulmonary vein and left atrium through 3D reconstruction of MSCT provides higher successful rate of RFCA for AF with simultaneous decrease of complications