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Objective To evaluate the influnce of atrial fibrillation(AF)/atrial flutter on the mortality and prognosis of patients with AMI. Methods A total of 297 consecutive patients were studied from Jan.2001 to Dec. 2005 and were categorized into 2 groups according to the presence or absence of AF/atrial flutter. The 30 d and 6 mo mortalities, Killip Grades, cardiogenic shock, arrhythmia and left ventricular ejectory functional (LVEF) 6 months after AMI with Doppler US between the 2 groups were compared. Results The incidence of AF/atrial fluttler was 12.5% with older age, higher Killip Gorade, higher CPK peak, higher rates of previous myocardial infarction and multivascular involvement than those without AF/atrial flutter. The short and medium-term mortalities in AF/atrial flutter group were both significantly higher than those of non-AF/atrial flutter group(P
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Objective To compare the safety and recent efficacy between transcatheter and surgical closure of secondum atrial septal defect over 50 years of age. Methods Retrospective analysis was done on 66 patients over 50 years of age who underwent transcatheter (30 cases) and surgical (36 cases) closure of secondum atrial septal defect.The median age was 60.8?7.1 years old in the transcatheter closure group and (57.5?6.3) years old in the surgical closure group( P=0.04).The median sizes of atrial septal defect in the transcatheter and the surgical closure group were 24.9?7.2 mm and 30.4?11.0 mm respectively (P=0.02). We compared the recent efficacy、 complications and prognosis between two groups. Results The instant procedural success rate was 93.3% for the transcatheter closure group and 100% for the surgical group (P=0.85). 2 procedures in the transcatheter closure group failed, 1 patient (2.6%) in the surgical group died during hospitalization and 9 patients (25.0%) underwent Devage tricuspid annuloplasty. Newly onset atrial arrhythmias occurred in 3.3% in the transcatheter closure group and 22.2% in the surgical closure group (P=0.03). After the procedures, right atrial and ventricular dimensions were decreased from 38.0?9.0 mm to 35.2?10.1 mm and from 44.2?8.6 mm to 36.2?9.0 mm in the transcatheter closure group whereas in the surgial group, the atrial and ventricular sizes fell from 44.1?8.2 mm to 38.2?9.5 mm and 49.0?10.2 mm to 37.1?11.0 mm respectively (P
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Objective To elucidate the efficacy and safety of transcatheter closure of secondary atrial septal defect (ASD) with Amplatzer septal occluder (ASO) in people over 50 years of age. Methods Retrospective comparison of 41 patients (14 males, 27 females) with ASD over 50 years of age ranging from 50 to 75(mean age 55.5?7.6, elder group) was conducted with 132 patients younger than 50 years(control group). After diagnosis of ASDs and evaluation of pulmonary artery systolic pressure and right atrial and ventricular dimensions by transthoracic echocardiography (TTE), all patients underwent transesophageal echocardiography (TEE) for complete assessment of ASD size, margins and anatomic relationship of the defect before closure of ASD. Each case was treated with ASO through the percutaneous transcatheter procedure under fluoroscopy and TTE or TEE. Early follow up(3 months) by echo was taken after the intervention. Results There was no difference of mean defect diameter measured by TEE and the balloon-stretched defect diameter of the ASDs between 2 groups. Pulmonary artery pressures in elder group were higher than those in younger group(P
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Objective To analyze the efficacy and experience of coil embolization in patients with pulmonary arteriovenous malformations(PAMV). Methods Seven patients (2 males and 5 females, age range from 11 to 52 years; mean age 31 years) were admitted including 4 single saccular, 2 multiple saccular, 1 diffuse capillary pulmonary arteriovenous malformations. Results Coil embolization of pulmonary arteries was successful in all 7 patients. The mean arterial oxygen saturation rate increased from 87% to 96% in patients with saccular PAMV. Transient chest pain occurred in a case of diffuse capillary PAMV during the procedure, after undergoing multiple coil embolization, the arterial oxygen saturation rate increased from 79% to 87%. All patients were followed up for 6 months to 5 years, arterial oxygen saturation declined slightly,and mild to moderate tricuspid regurgitation was found by echocardiography only in the patient with diffuse capillary PAMV.Conclusion Coil embolization is an effective and safe method of treatment for saccular PAMV. But it is only a palliative therapy for diffuse capillary PAMV.