Outcome of transcatheter closure of perimembranous ventricular septal defect with modified double-disk occluder device / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and adverse effects of transcatheter closure of perimembranous ventricular septal defect (pmVSD) with modified double-disk occluder device (MDVO).</p><p><b>METHODS</b>Clinical data including clinical examination, electrocardiography daily after the procedure for a week, chest-X-rays and TTE before discharge and at 3-5 days after the procedure were analyzed from 604 patients underwent percutaneous closure of a pmVSD with MDVO at our department between December 2001 and December 2008.</p><p><b>RESULTS</b>Procedure was successful in 576 out of 604 patients (95.4%) and 583 VSD occluders were placed. Endocarditis, thromboembolism, or deaths were not observed after procedure. Conduction block occurred in 81 patients (56 RBBB, 14 LBBB) and transient nonparoxysmal ventricular tachycardia in 31 patients after the procedure. Complete heart block occurred in 11 patients, 9 of them recovered in 3 weeks, permanent pacemaker was implanted in 2 patients (one had transient III degrees AVB before the procedure, the other underwent simultaneous closure of ventricular septal defect and atrial septal defect). Trivial/small residual shunts were found in 69 patients (12.0%). The residual shunts disappeared in 31 patients and remained unchanged in 38 patients (6.6%) 7 days after procedures. Aortic regurgitation developed in 5 patients (2 trivial/small, 3 small/moderate), and tricuspid regurgitation was present in 35 patients (32 trivial/small, 3 moderate). Five patients developed haemolysis (device retrieved via catheter in 1 patient due to persistent haemolysis, the other 4 patients recovered 3-14 days post procedure). Pseudoaneurysm of femoral artery occurred in 1 patient, and disappeared by pressure dressing. Device was successfully replaced in 2 patients with either device embolization (n = 1) or device misplacement (n = 1) after device retrieval by catheter.</p><p><b>CONCLUSION</b>It is safe and effective to close congenital perimembranous ventricular septal defect with domestic-made occluder device.</p>

Possible induction of diabetes by treatment of hypertension with indapamide (with four case reports).

OBJECTIVE: To study therapy with indapamide impairing carbohydrate metabolism in essential hypertension patients and achieve earlier prevention, diagnoses and treatment of diabetes induced by indapamide. METHODS: Four cases of essential hypertension patients (1 male and 3 females) were observed through process of therapy with indapamide and laboratory investigations. RESULTS: After 4- to 14-month period of therapy with the combination of indapamide (2.5 mg/day) and fosinopril (10 mg/day) in three patients and 6-month period of monotherapy with indapamide (2.5 mg/day) in one patient, glucose levels of all patients increased and achieve criteria of diabetes diagnoses. After 3- to 13-month period of therapy without indapamide, glucose levels of all patients decreased and diabetes disappeared. CONCLUSION: Therapy with indapamide may induce diabetes in essential hypertension patients. After stopping indapamide, glucose tolerance impairing may be reversed.