ABSTRACT
@#Objective To evaluate the long-term clinical effect and risk factors of tricuspid valve replacement (TVR) as a relief treatment for adult patients with congenitally corrected transposition of the great artery (CCTGA). Method We retrospectively analyzed the clinical data of 47 adult patients with CCTGA who underwent tricuspid valve replacement in Fuwai Hospital between 2000 and 2017 year. There were 27 males and 20 females with operation age of 14–62 (38.8±13.5) years. Preoperative echocardiography showed moderate or more tricuspid regurgitation in all patients. The basic data of patients before and during operation were recorded. Survival was followed up by telephone and ultrasound report. Results The average follow-up time was 6.5±3.7 years. The 1-year, 5-year and 10-year survival rate or the incidence of heart transplant-free was 94.6%, 90.5% and 61.7%, respectively. During the follow-up period, the long-term right ventricular ejection fraction of most patients (>90%) was still greater than or equal to 40%. Increased preoperative right ventricular end diastolic diameter (RVEDD) was a risk factor for death or heart transplantation (risk ratio 1∶11, P=0.04). The survival rate of patients with RVEDD (>60 mm) before operation was significantly reduced (P=0.032). Conclusion TVP is a feasible treatment for adult patients with CCTGA. The increase of preoperative RVEDD is a risk factor for long-term mortality.
ABSTRACT
Objective To explore the effect of blood oxygen saturation on the hemodynamics in fetuses with complete transposition of the great artery ( CTGA ) without outflow tract obstruction in the second trimester of pregnancy . Methods The brain biometry and hemodynamics parameters were retrospectively analyzed in 38 fetuses with CTGA from multiple medical centers .All the fetuses with CTGA were divided into two groups ,ventricular septal defect ( VSD) group( 14 cases) and no VSD group( 24 cases) according to the VSD . Twenty-four gestational age (GA)-matched fetuses were chosed as control group . The biparietal diameter (BPD) and head circumference ( HC) ,pulsatility indexes ( PI) in the middle cerebral artery (MCA) and the umbilical artery ,the cerebroplacental ratio (CPR) were compared among different groups . Results There were no significant differences in GA ,BPD ,HC ,MCA-PI ,UA-PI and CPR among control group ,CTGA with VSD group and CTGA without VSD group in the second trimester of pregnancy ( P ＞0 .05) . Conclusions The altered oxygen saturation of the cerebral circulation in CTGA does not affect the brain biometry and hemodynamics in fetuses in the mid-gestational age .
ABSTRACT
Objective To summarize the nursing experience for three cases of above 1-month-oldinfants with total transposition of the great artery after Switch operation.Methods The vital signs of the infants were monitored,including the respiratory system,circulation system,temperature,urine quantity,feeding and delayed sternal closure.Appropriate measures were adopted to cope with changes in the above mentioned aspects.Results All the 3 infants were cured with good nursing effect.Conclusion Switch operation was a complicated operation.The 3 infants missed the-optimum operation time and left great difficulty for nursing.Close monitoring and delicate nursing proved to be the pivotal process to ensure the successful curement.