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Objective To investigate the safety and longterm outcomes of prophylactic autologous pericardium tricuspid valve annuloplasty(TVA)in patients with rheumatic heart disease(RHD). Methods A total of 832 patients with RHD were enrolled in this study ,including 146 patients with mild FTR but without TVA(observation group);434 patients with mild FTR underwent TVA(control group A)and 434 patients with moderate or severe FTR underwent TVA(control group B). Propensity score and survival analysis were used to evaluate perioperative safety ,FTR progression ,CHF and MACCE incidence after prophylactic TVA. Results A total of 192 patients were successfully matched. There was no significant difference in the perioperative complications between the observation group and the control groups(P>0.05). The progression rate of FTR in the observation group was significantly lower than that in the control groups (P = 0.005 & 0.032 ). There was no significant difference in the incidence of CHF and MACCE events between the observation group and the control groups (P > 0.05). Conclusions The treatment strategy of prophylactic autologous pericardium TVA at the time of left heart valve surgery for patients with RHD doesn′t increase operation costs ,perioperative complications and mortality ,but effectively prevent postoperative FTR recurrence or progression.
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Objective To observe the influence of congenital heart disease(atrial septal defect,ASD)to intervene closure on the right structure of children(0.05 ).The complication rate of children and adults were 25.0% and 21.3% respectively,and there were no significantly difference(P >0.05),and was no serious complications.Conclusion Congenital heart disease intervention of atria septal defects can improve heart right structure,which can benefit both children and adult,there is no difference in complication rates.All of these have less serious complications,high safety,curative effect affirmation.
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Objective To evaluate the right ventricular (RV) function in patients with acute inferior wall myocardial infarction ( AIMI ) with tissue Doppler imaging and M-mode echocardiography. Methods There were 50 cases of AIMI, 34 males and 16 females. And 50 healthy persons were as control group, 30 males and 20 males. From the echocardiographic apical 4- chamber views, the systolic, early and late diastolic motion (SD, DED, DAD) of the tricuspid annulus were recorded at the RV free wall with the use of two-dimentional guided M-mode recordings. Peak systolic, early and late diastolic velocities (Sm, Em, Am) of the tricuspid annulus were also recorded at the same site by tissue Doppler imaging. The ratios of DAD/DAD and Em/Am were calculated. Results SD, DED, Sm and Em of the tricuspid annulus at the RV free wall, as well as the ratios of DED/DAD and Em/Am, were reduced significantly in patients with AIMI as compared with health control [SD: (18.7±5.5) mmvs. (24.9±2.8) mm; DED: (10.9±3.4) mmvs. (16.6±3.4) mm;Sm: (12.9±2.8) cm/s vs. (15.9±2.7) cm/s; Em: (12.3±3.4) cm/s vs. (16.7±4.7) cm/s;DED/DAD: (1.5±0.6) vs. (2.3±0.9); Em/Am: (0.9±0.4) vs. (1.1±0.3); t=18.711,19. 055, 11. 851, 14. 781, 6.068, 2. 127; P＜0. 01 or 0. 05, respectively]. There were no statistically significant differences in DAD and Am between two groups [DAD: (8. 8±1.9) mm vs. (7.7±2.1)mm; Am: (17.5±4.8) cm/s vs. (16.6±5.2) cm/s; t=0.414, 0.649; both P＞0.05].Conclusions The systolic and diastolic functions of RV are impaired in patients with AIMI.
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Objective To investigate the change of the carotid artery function in the end-stage renal disease(ESRD)patients using high-frequency ultrasound.Methods 60 cases(30 cases of hemodialysis patients,30 cases of non-dialysis patients)of ESRD patients and 30 cases of control persons with normal renal function were checked by the high-frequency color Doppler ultrasonography.Two-dimentional ultrasound was used to observe the intima-mediathickness(IMT);M-mode ultrasound was used to record the movement extent change between systolic and diastolic period of the anterior and the posterior wall of common carotid artery;the diameters of systolic and diastolic period,the stiffness index,distensibility and compliance,acceleration and deceleration which were corrected with pluse pressure and heart rates(ACi and DCi),were calculated.Results Compared with the control group,the ESRD groups have thicker IMT,higher stiffness index,lower disensibility,compliance,ACi and DCi in each ESRD group(?0.05).IMT correlated with stiffness index,distensibility,compliance,ACi and DCi.Conclusion High-frequency ultrasound plays an important role in evaluating change of the carotid artery function in ESRD patients.