Nuevas técnicas de imagen en diagnóstico y planeación quirúrgica: reporte de caso de anillo vascular / New imaging techniques in diagnosis and surgical planning: case report of vascular ring

Resumen El crecimiento del campo de las imágenes cardiacas ha permitido realizar diagnósticos más precisos de enfermedades cardiacas complejas, con mejores planeaciones quirúrgicas; por esta razón, las imágenes multimodales cada vez son más útiles en el ámbito clínico y quirúrgico, ya que ofrecen información mejorada sobre la anatomía intracardiaca y extracardiaca. Se presenta el caso de un paciente masculino de once meses de edad, con sintomatología respiratoria y gastrointestinal, en quien se documentó doble arco aórtico gracias a la evaluación imagenológica multimodal, que permitió comprender, con mayor detalle morfológico, la anatomía cardiovascular y, a su vez, evaluar las diferentes proyecciones con las que los cardiólogos y los cirujanos cardiacos están familiarizados. Se contó con la posibilidad de realizar la impresión de corazones tridimensionales, lo cual facilita la comprensión de las relaciones anatómicas, y conduce a mejoría en la toma de decisiones clínicas individualizadas.

Abstract The growth in the field of cardiac imaging has made it possible to make more accurate diagnoses of complex cardiac pathologies, with better surgical planning. This is the because the multimodal images are increasingly useful in the clinical and surgical setting, since they allow improved information on intracardiac and extracardiac anatomy. We present the case of an eleven-month-old male patient with respiratory and gastrointestinal symptoms, in whom A double aortic arch was documented and, thanks to the multimodal imaging evaluation, it made it possible to understand cardiovascular anatomy in greater morphological detail, in turn evaluating the different projections with which cardiologists and cardiac surgeons are familiar, with the possibility of performing the impression. of three-dimensional hearts that can facilitate compression of the intracardiac anatomy, leading to improvement in individualized clinical decision making.

Asociación del complejo ring-sling con pig bronchus: a propósito de un caso pediátrico / Ring-sling complex association with pig bronchus: a pediatric case report

El complejo ring-sling es una asociación entre el sling de la arteria pulmonar y la estenosis traqueal congénita por anillos traqueales completos. El sling de la arteria pulmonar es una forma rara de anillo vascular dentro de las cardiopatías congénitas. Se presenta el caso clínico de un niño con estridor laríngeo asociado a dificultad respiratoria evaluado en otro centro, donde se realizó endoscopia respiratoria y se observó compresión traqueal extrínseca. Ante la sospecha clínica de anillo vascular, se solicitó angiotomografía computada (angioTC) y se confirmó diagnóstico de sling de arteria pulmonar. Fue derivado a nuestro hospital y durante la intervención quirúrgica se realizó nueva endoscopia respiratoria y traqueobroncografía. Se llegó al diagnóstico de estenosis traqueal congénita con bronquio derecho accesorio (pig bronchus) y anillos vasculares completos, ambos reparados en el mismo acto quirúrgico.

The ring-sling complex is an association between pulmonary artery sling and congenital tracheal stenosis. Pulmonary artery sling is a rare form of vascular ring in congenital heart disease. The clinical case of a child with inspiratory laryngeal stridor associated with respiratory distress is presented, evaluated in another center where respiratory endoscopy was performed, observing extrinsic tracheal compression. Given the clinical suspicion of a vascular ring, CT angiography was requested, confirming the diagnosis of pulmonary artery sling. He was referred to our hospital and during the surgical intervention a new respiratory endoscopy and tracheobronchography were performed, reaching the diagnosis of congenital tracheal stenosis, right accessory bronchus (pig bronchus) and complete vascular rings, both repaired in the same surgical act.

Serie de casos de arco aórtico derecho: aproximación diagnóstica prenatal / Case series of right aortic arch: prenatal diagnostic approach

RESUMEN El arco aórtico derecho es producto de la involución anormal de los arcos vasculares embrionarios. En los últimos años, el diagnóstico fetal se ha hecho más frecuente con la utilización de la ultrasonografía rutinaria del corazón y los grandes vasos. El hallazgo de un arco aórtico derecho involucra muchos aspectos que pueden afectar el pronóstico del feto; por ello, el estudio exhaustivo debe ser sistematizado. A continuación, presentamos una serie de seis casos de diagnóstico prenatal y sugerimos un algoritmo de evaluación.

ABSTRACT The right aortic arch is a product of abnormal involution of the embryonic vascular arches. In recent years, fetal diagnosis has become more frequent with the use of routine ultrasonography of the heart and great vessels. The finding of a right aortic arch involves many aspects that may affect the prognosis of the fetus; therefore, the exhaustive study must be systematized. Below, we present a series of six cases of prenatal diagnosis and suggest an evaluation algorithm.

Advances in clinical diagnosis and treatment of double aortic arch / 国际儿科学杂志

Double aortic arch is a congenital aortic arch malformation, which is caused by abnormal development of the fourth aortic arches during embryonic development.The patient with double aortic arch has no specific symptoms.It often encircles the trachea and esophagus.In severe cases, it causes dyspnea and dysphagia, and even endangers life.Currently, double aortic arch is diagnosed mainly by imaging techniques, such as echocardiography, computed tomography angiography, magnetic resonance angiography, cardiac catheterization.The main treatment is surgery.Therefore early diagnosis and treatment are very important to avoid tracheomalacia and improve the prognosis.This article will briefly review the research progress of embryonic development mechanism, classification, clinical diagnosis, treatment and prognosis of double aortic arch, aiming to improve the physician′s skills of diagnosis and treatment.

Hemorrhagic shock caused by double aortic arch and aortoesophageal fistula in a newborn: a case report and literature review / 中国新生儿科杂志

Objective:To study the clinical characteristics of double aortic arch (DAA) combined with aortoesophageal fistula (AEF), and summarize the diagnosis and treatment experience.Methods:Retrospective analysis was performed on the diagnosis and treatment of a newborn with hemorrhagic shock caused by DAA combined with AEF in the Guangzhou Women and Children's Medical Center. The key searching words included "double aortic arch", "aortoesophageal fistula", "vascular ring", "newborn or neonate", and "infant, newborn". The relevant reports were retrieved from databases of CNKI, Wanfang, VIP, PubMed, Springer Link, Google Scholar, Web of Science, Embase, Cochrane Library and OVID, to summarize the clinical features, diagnosis and treatment experience of neonates with DAA and AEF. The retrieval deadline was December 31, 2020.Results:A full-term female newborn was hospitalized for dyspnea immediately after birth, and failed to evacuate from the ventilator for several times. The patient was fed with nasogastric tube and transferred to our hospital because of hemorrhagic shock occurring in 32 days after birth, and gastrointestinal bleeding occurred repeatedly with the maximum bleeding volume reaching 200 ml/time. DAA was diagnosed by cardiac ultrasound and CT, AEF hemorrhage was finally confirmed by gastroscopy, aortography and operation. DAA correction and esophagus repair were successfully performed, and the infant recovered well after the operation. At 9-month old, the infant grew and developed well. At present, no reports of DAA combined with AEF neonates have yet to be published in medical literatures in China. Seven English language literatures included 7 cases of AEF complicated with DAA in neonatal period, 5 cases survived and 2 cases died have so far been reported. All patients have a long history of gastric tube indwelling.Conclusions:The incidence of DAA combined with AEF is rare in the newborn with respiratory and swallowing difficulties as the first manifestation. The disease symptoms progressed rapidly, and life-threatening digestive tract hemorrhage may occur, which often requires surgical treatment. Prolonged gastric tube retention should be avoided in DAA children to prevent the occurrence of AEF.

Diagnóstico prenatal de arco aórtico derecho fetal con anillo vascular / Prenatal diagnosis of fetal right aortic arch with a vascular ring

Resumen Las anomalías del arco aórtico se refieren a malformaciones congénitas de la posición o patrón de ramificación. Se pueden detectar mediante la visualización dirigida del corte de los tres vasos o de tres vasos y tráquea, con o sin Doppler de color. El diagnóstico prenatal debe conllevar un examen detallado de ultrasonido cardiaco y extra-cardiaco. La identificación de un arco aórtico derecho aislado es crucial para distinguir esta afección del arco aórtico doble. Se describe un caso de diagnóstico prenatal de arco aórtico derecho fetal con anillo vascular a las 29 semanas de gestación, quien fue referido por posible anomalía cardíaca en la ecografía de rutina. El ultrasonido demostró posición anormal de la aorta descendente, situada en el lado derecho de la columna vertebral en el plano tetracameral. La aorta se conectaba con la arteria pulmonar izquierda a través del ductus arterioso, configurando un anillo vascular. La detección prenatal de esta anomalía congénita vascular, ya sea de forma aislada o en asociación con otras malformaciones cardiacas o no cardiacas, podría conducir a un asesoramiento más adecuado.

Abstract Aortic arch anomalies refers to congenital malformations of the position or branching pattern. They can be detected by targeted visualization of the three-vessel slice or three-vessel and trachea, with or without color Doppler. Prenatal diagnosis should involve a detailed cardiac and extra-cardiac ultrasound examination. The identification of an isolated right aortic arch is crucial to distinguish this condition from a double aortic arch. We describe a case of prenatal diagnosis of fetal right aortic arch with vascular ring at 29 weeks gestation who was referred for possible cardiac anomaly on routine ultrasound. Sonography demonstrated abnormal position of the descending aorta, located on the right side of the spine in the tetra chamber plane. The aorta was connected to the left pulmonary artery through the ductus arteriosus, configuring a vascular ring. Prenatal detection of this congenital vascular anomaly, either in isolation or in association with other cardiac or noncardiac malformations, could lead to more appropriate counseling.

Double-lumen Aortic Arch: Persistence of the Fifth Aortic Arch?

Abstract Double-lumen aortic arch is a rare congenital anomaly related to persistence of the fifth aortic arch. It may be found alone or in association with other anatomical changes of the heart. We report a case of double-lumen aortic arch associated with coarctation of the aorta and patent ductus arteriosus in a child with a congenital malformation known as the VACTERL association (vertebral defects, imperforate anus, cardiopathy, tracheoesophageal fistula, renal abnormalities and limb anomalies).

Clinical analysis of surgical correction for congenital vascular ring in children in a single center / 中国胸心血管外科临床杂志

@#Objective    To investigate the best anatomical classification, surgical timing, procedure and clinical outcomes of congenital vascular ring. Methods    The clinical data of 58 patients who underwent congenital vascular ring surgery in Pediatric Surgery Center, Fuwai Hospital between 2014 and 2019 were retrospectively analyzed. There were 32 (55.2%) males and 26 (44.8%) females with a median age of 16.5 (2-73) months. Preoperative symptoms, imaging examinations, anatomical classifications, surgical procedures and postoperative recovery were assessed. Results    There were 20 (34.5%) patients of double aortic arch, 22 (37.9%) patients of right aortic arch with left arterial duct or ligament, 15 (25.9%) patients of left aortic arch with aberrant right subclavian artery, and 1 (1.7%) patient of circumflex aorta with cervical aorta arch. The median ventilator supporting time was 6.0 (0-648) h, and the median hospital stay time was 14.5 (7-104) d. One patient with coarctation of aorta died of severe pulmonary infection during perioperative period, and the others survived without symptoms and reoperation after discharge. The median follow-up time was 7.0 (1-62) months. Conclusion    For children with unexplained dyspnea and dysphagia, or with right aortic arch, preoperative imaging examinations such as computed tomography or magnetic resonance imaging are required to confirm the diagnosis of vascular ring. Surgical correction of congenital vascular ring is safe and reliable, and can effectively relieve symptoms. The mortality rate and reoperation rate are low, and the follow-up results are satisfactory.

Sling de la arteria pulmonar en paciente preescolar con compromiso de la vía aérea / Pulmonary artery sling in preschool patient with airway compromise

Resumen Introducción: El sling de la arteria pulmonar izquierda es una rara malformación congénita del arco aórtico en la que la rama pulmonar izquierda se origina a partir de la arteria pulmonar derecha. Generalmente se sitúa entre la tráquea y el esófago, que frecuentemente la comprimen. Dependiendo del grado de compromiso de la vía aérea, el esófago y las anomalías cardíacas asociadas, las manifestaciones clínicas varían. El tratamiento de esta malformación es quirúrgico; con el paso de los años, este abordaje ha mejorado, y se ha logrado una disminución de la morbilidad y mortalidad en esta condición. Caso clínico: Se presenta el caso de una paciente preescolar con hallazgo de sling de la arteria pulmonar izquierda con compromiso de la vía aérea. Conclusiones: Después de la corrección quirúrgica, se logró una respuesta clínica favorable y una mejoría significativa en la vía aérea, evidenciada en los hallazgos en la fibrobroncoscopia, sin necesidad de intervenciones adicionales.

Abstract Background: Left pulmonary artery sling is a rare congenital malformation of the aortic arch in which this artery originates from the right pulmonary artery and courses over the trachea and the esophagus. Clinical manifestations vary depending on the degree of airway compromise, the esophagus and associated cardiac anomalies. The treatment for this malformation is surgical; over the years, this approach has improved, achieving a decrease in morbidity and mortality in this condition. Case report: A preschool patient with incidental finding of sling of the left pulmonary artery with compromise of the airway is presented. Conclusions: After the surgical procedure, a favorable clinical outcome was observed and a significant improvement in the airway was shown by a fibrobronchoscopy, without any additional intervention.

Unrecognized double aortic arch in a preterm infant: Diagnostic challenges and perioperative management

Vascular rings are relatively rare, and are frequently overlooked as a potential cause of neonatal respiratory distress in non specialized centres. This might lead to delay in diagnosis during which the child is subjected to repeated respiratory insults. Procrastination in prompt diagnosis and management can lead to significant comorbidities or even death. We highlight the case report of a preterm infant with an unrecognized double aortic arch who presented with severe respiratory morbidity and the subsequent management.

Surgical treatment of aberrant left subclavical artery associated with Kommerell diverticulum in children / 中华胸心血管外科杂志

Objective To investigate the diagnosis, surgical treatment and surgical results of infantile left subclavian ar-tery combined with Kommerell diverticulum.Methods In our hospital from 2014 to 2017, there were 15 cases of left subclavi-an artery combined with Kommerell diverticulum, 10 males and 5 females, average age 11.8 months(2 to 48 months), average weight of 9.2kg(4 -24 kg), including 3 cases with ventricular septal defect ( VSD), and 1 cases of coarctation of aorta (COA).Children with postoperative respiratory difficulty, recurrent respiratory infection, chronic cough and other respiratory symptoms, preoperative detection of airway and or esophagus compression performance after cardiac computed tomography ex-amination confirmed, general anesthesia, thoracotomy or left chest lateral thoracotomy, cut off arterial ligaments and Kommerell diverticulum Resection and vagal left subclavian artery transplantation were performed in the left common carotid artery com-bined with cardiac malformation.Results All the children were cured and discharged from hospital.The follow-up and mid-term recovery were good.Conclusion Infants with airway and esophageal compression may have aberrant left subclavian artery combined with Kommerell diverticulum , cardiac CT is an effective means to diagnose this disease .Removal of the associated Kommerell diverticulum and transferring the left subclavian artery to the left common carotid artery , as the main operative meth-od has good early prognosis,and may eliminate residual symptoms and late complications .

A Rare Case of Tetralogy of Fallot Associated with Pulmonary Artery Sling

Pulmonary artery sling is a rare congenital cardiac anomaly, in which the left pulmonary artery originates from the right pulmonary artery and courses leftward between the trachea and the esophagus. Tetralogy of Fallot associated with pulmonary artery sling is even rarer, and only a few cases have been reported in the literature. We present a case of tetralogy of Fallot associated with pulmonary artery sling that was repaired successfully.

Anillos vasculares, hallazgos por Resonancia Magnética / Vascular rings, Magnetic Resonance findings

Los anillos vasculares son un espectro de patologías en las que el arco aórtico, la arteria pulmonar o la ramificación de los vasos supraaórticos tienen un origen o trayecto anormal y pueden comprimir la tráquea o el esófago, lo cual genera diferentes síntomas, como los respiratorios, que son lo más comunes. Estas patologías pueden estar asociadas a malformaciones cardiacas, del tracto gastrointestinal y en otros sistemas. Se realiza una revisión de la literatura sobre la embriología, epidemiología, clínica y hallazgos imagenológicos en resonancia magnética de los principales anillos vasculares.

Vascular rings are a spectrum of pathologies where the aortic arch, pulmonary artery and/or the supra-aortic vessels have a different origin or an abnormal course; this may or may not produce tracheal and/or esophageal compression. These entities have a variable clinical presentation, with respiratory symptoms being the most common. They are associated with cardiac, gastrointestinal and other system malformations. We reviewed the available literature about the embryology, epidemiology, clinical and Magnetic resonance imaging findings of the most common vascular rings.

Prenatal echocardiographic diagnosis of right aortic arch and its branch type / 中华超声影像学杂志

Objective To investigate the value of prenatal echocardiographic diagnosis of anomalies of the right aortic arch ( RAA ) and its branch type ,and provide rapid diagnostic methods . Methods A retrospective analysis of 55 cases of RAA of prenatal ultrasound diagnosis results ,and their imaging characteristics were summarized . Results There were 55 cases of anomalies of the RAA ,included 42 cases of RAA with aberrant left subclavian artery ( RAA-ALSA ) and 13 cases of RAA with mirror image branching pattern( RAA-MB) ,1 case of double aortic arch(DAA) was misdiagnosed as RAA . The prenatal echocardiographic characteristics of RAA-ALSA :in three-vessel-aortic arch view ,the first branch of the aortic arch was the left carotid artery ,which ran in front of the trachea ,and ALSA ran behind the trachea and esophagus . The prenatal echocardiographic characteristics of RAA-MB :the first branch of the aortic arch was the brachiocephalic trunk ,which ran in front of the trachea and was divided to the left carotid artery and the left subclavian artery . Conclusions Prenatal ultrasound can qunickly and accurately diagnose anomalies of the right aortic arch and its branch type according to the direction ,thickness and secondary branches of the first branch of the aortic arch . The location of arterial duct is helpful to judge the formation of vascular ring .

Prenatal ultrasound diagnosis and clinical follow-up analysis of fetal isolated double aortic arch / 中华超声影像学杂志

Objective To investigate the value of clinical follow-up in prenatal diagnosis of isolated double aortic arch (DAA) . Methods The clinical follow-up materials were retrospectively reviewed in 17 fetuses . Of all the isolated DAA fetuses ,the accuracy rate of prenatal diagnosis was confirmed by CT ,MRI , autopsy or echocardiography ,and pregnant outcomes were summarized . Results A total of 17 fetuses had a sonographic diagnosis of isolated DAA in our centers at a mean gestational age of 23 -32(27 ± 3) weeks , with mother mean age 19 -44 (28 ± 6) years old . One case of DAA type-A was misdiagnosed ,15 cases were delivered with 2 cases occurred respiratory distress or mild dysphagia ,who received surgical treatment , and 13 cases clinical findings were unremarkable at the fellow-up of 24 months ,the silent-rate of clinical symptoms was 86％ . Termination of pregnancy happened in 2 cases ,with 1 (6％ ) had additional ventricular septal defects ,another ( 6％ ) had additional anomalies of congenital high airway obstruction syndrome . In 17 cases of fetuses with isolated DAA ,there were 15 ( 88％ ) cases with dominant right-sided arch ,1 case (6％ ) with dominant left arch ,and 1 case (6％ ) with equal arches in size .Karyotyping prenatal testing was offered to 15 parents with normal results . Conclusions Prenatal ultrasound can accurately diagnose isolated DAA by multiple sections scan ,expanding diagnostic ideas by combination with other medical imaging data to prevent apparent life-threatening event ,or to guide for ex-utero intrapartum treatment . Isolated DAA clinical follow-up results in good outcome .

Arco aórtico derecho con subclavia izquierda aberrante y divertículo de Kommerell. Una causa de anillo vascular / Right-side aortic arch with aberrant left subclavian artery and Kommerell's diverticulum. A cause of vascular ring

Resumen: El arco aórtico derecho puede estar asociado a subclavia izquierda aberrante, en algunos casos esta se origina de una dilatación aneurismática que se conoce como divertículo de Kommerell. Se presentan 2 casos de anillo vascular formado por un arco aórtico derecho, subclavia izquierda anómala con divertículo de Kommerell y persistencia del conducto arterioso izquierdo con una revisión de la literatura acerca del desarrollo embriológico y los métodos de imagen que ayudan al diagnóstico de esta rara anomalía vascular.

Abstract: The right-side aortic arch may be associated with aberrant left subclavian artery, in some cases this artery originates from an aneurismal dilation of the aorta called Kommerell's diverticulum. A report is presented on 2 cases of vascular ring formed by a right-side aortic arch, anomalous left subclavian artery, Kommerell's diverticulum and left patent ductus arteriosus. A review the literature was also performed as regards the embryological development and the imaging methods used to help in the diagnosis of this rare vascular anomaly.

Anillos vasculares en pediatria: presentación de 2 casos / Pediatric vascular rings: case reports

Vascular rings are uncommon congenital anomalies that result from anomalous embryological development of the mediastinum main arteries (aortic arch and its branches, pulmonary artery). Such anomalous vascular structures may produce compression of the trachea and / or esophagus, with consequent obstructive respiratory and digestive symptoms. Vascular rings can be complete or incomplete. They can be asymptomatic or manifest with persistent or recurrent respiratory and / or digestive symptoms. The study should include chest X-ray, barium swallow, flow-volume loop, fiberoptic bronchoscopy, chest computed tomography, angiotomography or magnetic resonance. Symptomatic patients often need surgery

Los anillos vasculares son el resultado de anomalías del desarrollo embrionario de grandes troncos vasculares del mediastino, tanto del cayado aórtico y sus ramas, como de la arteria pulmonar. Dichas estructuras vasculares anómalas pueden producir compresión de la tráquea y/o del esófago, con la consiguiente sintomatología obstructiva respiratoria y digestiva. En algunas ocasiones forman un anillo completo y en otras incompleto. El diagnóstico puede ser casual cuando son silentes o resultado del estudio de síntomas respiratorios y/o digestivos persistentes o recurrentes. El estudio debe incluir radiografía de tórax, esofagograma, curva flujo/volumen, fibrobroncoscopía, angiotomografía computada o angioresonancia magnética de tórax. En pacientes sintomáticos se debe recurrir a la cirugía, en cambio los asintomáticos u oligosintomáticos deben ser observados

Study on the Diastolic Effect and Mechanism of Hui Medicine Hexin Oil Solution on Isolated Thoracic Aor-tic Vascular Rings of Rats / 中国药房

OBJECTIVE:To study the diastolic effect and mechanism of Hui medicine Hexin oil solution on isolated thoracic aortic vascular rings of rats,and provide reference for its treatment for cardiovascular diseases. METHODS:Thoracic aortic vascu-lar rings of rats were taken and then soaked in Kelvin's nutrient solution(K-H). Using 1×10-6 mol/L norepinephrine(PE)or 60 mmol/L potassium chloride (KCl) for inducing the contraction of vascular rings,biological signal acquisition and analysis system was used to determine the diastolic effect and mechanism of Hexin oil solution with concentrations of 0.0204,0.0408,0.0612, 0.0816,0.1020 mg/mL on vascular rings,and diastolic rate was calculated. After culturing vascular rings by 0.1 mmol/L nitric ox-ide synthase inhibitor L-nitro-arginine methyl ester (L-NAME),cyclooxygenase inhibitor indomethacin (INDO),and potassium ion channel blocker glibenclamide(Gli)for 20 min,the diastolic effects of above-mentioned 5 mass concentrations of Hexin oil so-lution on the contraction of vascular rings pre-contracted by PE were determined,and diastolic rate was calculated. The test was based on K-H solution as blank control. RESULTS:Compared with blank control,Hexin oil solution with concentration of 0.0204-0.1020 mg/mL had obvious diastolic effect on the contraction of vascular rings induced by PE and KCl (P<0.05 or P<0.01), showing concentration-dependent relationship. INDO pre-treatment can relieve the diastolic effect of Hexin oil solution on vascular rings pre-contracted by PE;and compared with blank control group,the diastolic rate had no statistical significance (P>0.05). While the pre-treatment of Gli,L-NAME did not affect the diastolic effect of Hexin oil solution on vascular rings pre-contracted by PE;and compared with blank control group,diastolic rate was obviously increased(P<0.05 or P<0.01). CONCLUSIONS:Hex-in oil solution can concentration-dependently conduct the relaxation of thoracic aortic vascular rings pre-contracted by PE,KCl. The mechanism may be associated with activation of cyclooxygenase pathway.

Study on the Diastolic Effect and Mechanism of Hui Medicine Hexin Oil Solution on Isolated Thoracic Aor-tic Vascular Rings of Rats / 中国药房

OBJECTIVE:To study the diastolic effect and mechanism of Hui medicine Hexin oil solution on isolated thoracic aortic vascular rings of rats,and provide reference for its treatment for cardiovascular diseases. METHODS:Thoracic aortic vascu-lar rings of rats were taken and then soaked in Kelvin's nutrient solution(K-H). Using 1×10-6 mol/L norepinephrine(PE)or 60 mmol/L potassium chloride (KCl) for inducing the contraction of vascular rings,biological signal acquisition and analysis system was used to determine the diastolic effect and mechanism of Hexin oil solution with concentrations of 0.0204,0.0408,0.0612, 0.0816,0.1020 mg/mL on vascular rings,and diastolic rate was calculated. After culturing vascular rings by 0.1 mmol/L nitric ox-ide synthase inhibitor L-nitro-arginine methyl ester (L-NAME),cyclooxygenase inhibitor indomethacin (INDO),and potassium ion channel blocker glibenclamide(Gli)for 20 min,the diastolic effects of above-mentioned 5 mass concentrations of Hexin oil so-lution on the contraction of vascular rings pre-contracted by PE were determined,and diastolic rate was calculated. The test was based on K-H solution as blank control. RESULTS:Compared with blank control,Hexin oil solution with concentration of 0.0204-0.1020 mg/mL had obvious diastolic effect on the contraction of vascular rings induced by PE and KCl (P<0.05 or P<0.01), showing concentration-dependent relationship. INDO pre-treatment can relieve the diastolic effect of Hexin oil solution on vascular rings pre-contracted by PE;and compared with blank control group,the diastolic rate had no statistical significance (P>0.05). While the pre-treatment of Gli,L-NAME did not affect the diastolic effect of Hexin oil solution on vascular rings pre-contracted by PE;and compared with blank control group,diastolic rate was obviously increased(P<0.05 or P<0.01). CONCLUSIONS:Hex-in oil solution can concentration-dependently conduct the relaxation of thoracic aortic vascular rings pre-contracted by PE,KCl. The mechanism may be associated with activation of cyclooxygenase pathway.