Association between maternal dietary patterns during pregnancy and risk of ventricular septal defect in offspring / 上海交通大学学报（医学版）

Objective·To examine the association of maternal dietary patterns during pregnancy with the risk of ventricular septal defect (VSD) in offspring.Methods · Seventy-three children with VSD were selected as cases from June 1,2016 to December 1,2016;another 73 children without congenital heart or other defects were selected as controls during the corresponding period.VSD was diagnosed by clinical examination and echocardiography figure.Both cases and controls were recruited from Shanghai Children's Medical Center.All the children's mothers were interviewed using a structured questionnaire,which includes information on demographic characteristics and food frequency during pregnancy.Dietary patterns were defined by the factor analysis module of SPSS 23.0.The association between dietary patterns during pregnancy and VSD risk was analyzed by Logistic regression model.Results · Four dietary patterns were obtained by the factor analysis,i.e.vegetable-fruit-high-quality protein pattern,animal food pattern,high sodium and high fat pattern and aquatic product pattern.After adjusting for possible confounding factors,it was demonstrated that the vegetablefruit-high-quality protein pattern and aquatic product pattern were negatively associated with VSD risk in offspring (P＜0.05).Conclusion · Maternal dietary patterns during pregnancy that are rich in high-quality protein,vegetables,fruit and aquatic products may be helpful for decreasing VSD risk in offspring.

Percutaneous valve stent insertion to correct the pulmonary regurgitation: an animal feasibility study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pulmonary regurgitation leads to progressive right ventricular dysfunction, susceptibility to arrhythmias, and sudden cardiac death. Percutaneous valve replacement has been developed in recent years, providing patients with an alternative option. Percutaneous pulmonary valve replacement has been recently introduced into clinical practice. The goal of this study was to evaluate the feasibility of percutaneous valve stent insertion to correct the pulmonary regurgitation in sheep using a cup-shaped valve stent.</p><p><b>METHODS</b>Pulmonary regurgitation was created by percutaneous cylindrical stent insertion in native pulmonary annulus of 8 sheep. One month after the initial procedure, the sheep with previous cylindrical stent implanted underwent the same implantation procedure of pulmonary valve stent. The valve stent consisted of a cup-shaped stent and pericardial valves. Hemodynamic assessments of the bioprosthetic pulmonary valve were obtained by echocardiography at immediately post-implant and at 2 months follow up.</p><p><b>RESULTS</b>Successful transcatheter cylindrical stent insertion was performed in 7 sheep but failed in 1 sheep because the cylindrical stent was released to right ventricle outflow tract. After one month the 7 sheep with pulmonary regurgitation underwent valve stent implantation successfully. Echocardiography confirmed the stents were in desired position during the follow-up. No evidence of pulmonary valve insufficiency occurred in any animals. Echocardiography showed all heart function markers were normal.</p><p><b>CONCLUSIONS</b>Percutaneous cylindrical stent insertion to induce significant pulmonary regurgitation in sheep was feasible, simple and reproducible. Percutaneous pulmonary valve stent implantation can reduce pulmonary regurgitation in a sheep model. Further development of animal model and clinical trials are warranted.</p>

Percutaneous establishment of tricuspid regurgitation: an experimental model for transcatheter tricuspid valve replacement / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Valve replacement or repair is recommended in patients with tricuspid regurgitation when deterioration of their clinical status occurs as a consequence of right ventricular dysfunction. Percutaneous valve replacement was developed in recent years. To investigate the feasibility, effectiveness and long-term results of percutaneous tricuspid valve replacement, an experimental model with tricuspid regurgitation is needed. We developed a simple and reproducible percutaneous approach for the creation of tricuspid regurgitation in sheep.</p><p><b>METHODS</b>A specially designed grasping forceps were used to grasp chordae tendineae or the tricuspid valve leaflets through a catheter. Transcatheter creation of tricuspid regurgitation was performed on 7 healthy sheep. These sheep were followed up shortly after the procedure and at 6th month post-procedure with echocardiography. Additionally, all the sheep were sacrificed for anatomic evaluation at 6th month after the procedure.</p><p><b>RESULTS</b>Creation of tricuspid regurgitation was successfully accomplished in all sheep. Necropsy confirmed that damage was done to the tricuspid valve apparatus in all animals (tearing of the anterior leaflet of the tricuspid valve in five animals and posterior leaflet of the tricuspid valve in two animals). At the six-month follow-up, there was no significant increase in the right ventricle dimension and ejection fraction measured by echocardiography. Autopsy examinations demonstrated the tearing of tricuspid valve leaflets.</p><p><b>CONCLUSIONS</b>The creation of an animal model of tricuspid regurgitation via a percutaneous approach using forceps to sever one or more tricuspid leaflets is feasible and will allow investigation of devices designed replace the tricuspid valve via a percutaneous approach. Despite significant tricuspid regurgitation, the hemodynamics did not change during the follow-up period in this model.</p>