Zhu Xianyang

GW28-e1159 Monitoring of cardiac function before and after percutaneous balloon dilation in patients with rheumatic mitral stenosis and small left ventricle

To investigate the recovery of cardiac function after percutaneous mitral stenosis (PBMV) in patients with rheumatic mitral stenosis (MS) with small left ventricle. 41 cases of rheumatic heart disease (MS) were selected, and the prerequisite conditions were consistent with the indications of PBMV.

ASSA14-14-03 Clinical analysis of Down's syndrome with congenital heart diseases

Background To analyse congenital heart deformity and haemodynamic data of Down’s syndrome. Methods We diagnosed 36 patients of congenital heart disease patients with Down syndrome by transthoracic two-dimensional echocardiography, colour Doppler flow imaging and right heart catheterization or angiocardiography from July 2008 to October 2012. This article analysed 36 cases of clinical data of Down’s syndrome with congenital heart disease and its hemodynamics. Results Among 36 cases, including VSD 10 cases, AVSD 6 cases, PDA 6 cases, ASD 2 cases, ASD + PDA 2 cases, ASD + VSD 1 case, ASD + PDA + VSD 1 case, VSD + PDA 4 cases, PDA + BAV 1 case, TOF 2 cases, TOF + ASD 1 case in which 18 patients had pulmonary hypertension, including 5 cases of resistant pulmonary arterial hypertension. Conclusions In cardiovascular malformations with Down syndrome, VSD (28%), AVSD (17%) and PDA (17%) are most common and were often associated with ASD or TOF. In patients absent of pulmonary artery stenosis, there were half of them combined with pulmonary artery hypertension.

GW24-e2160 Clinical feature of cor triatriatum in 23 cases

Objectives To summarise the data of clinical feature, accompanied abnormities and imaging diagnosis of cor triatriatum in 23 cases enlisted in the study. Methods From January 1993 to June 2005, twenty-three patients, 13 males and 10 females with a mean age of (9.6 ± 10.0) years (range 0.3 from 38 years) were studied. All cases were cor triatriatum laevus. Twenty-one of 23 patients were identified in surgery. Complete cor triatriatum in 15 case and incomplete cor triatriatum in 6. Electrocardiogram show that right unsymmetrical cardial axle was in 18 patients and nomal cardial axle in 4. Eight cases had lung congestion in x-ray. Results Echocardiogram diagnosed 12 in 23 cases before surgery. Heart catheter exam diagnosed 4 in 10 cases. sixteen of 21 cases accompanied other abnormities. Main malformations included atrial septal defeat (n = 14), partial anomalous pulmonary venous drainage (n = 6), pulmonary stenosis (n = 3), persistent left superior vena cava (n = 3). Seven of 21 patients had no atrial septal defeat. Conclusions Cor triatriatum had great variation in clinical feature and complicated other malformations in high ratio. Color doppler imaging has high worthiness of diagnosis of cor triatriatum, but misdiagnosis and missed diagnosis rate is high in cor triatriatum accompanied other malformations. Heart catheter exam have missed diagnosis to cor triatriatum, but have higher diagnosis rate to accompanied abnormities. Surgical exploration is very important in cor triatriatum accompanied other malformations.

GW24-e2161 Expressions of endothelin-1 in primary cultured atrial myocytes after rapid electrical-field stimulation

Objectives To study the expressions of endothelin-1 at early stages of atrial fibrillation in a rapid paced primary cultured atrial myocyte model. Methods Primary rat atrial myocytes were cultured and a rapid paced cell model was established. The polymerase chain reaction (RT-PCR) and Enzyme-Linked Immunosorbent Assay (ELISA) were applied to detect the messenger ribonucleic acid (mRNA) expression and secretion of endothelin-1. Results mRNA expression of endothelin-1 increased after 6 h of rapid pacing and continued to elevate in a time dependent manner. Similarly, changes of endothelin-1 secretion were paralleled. Conclusions Expressions of endothelin-1 increased in early phase of rapid paced atrial myocytes. It implicated the endothelin-1 was implicated in pathological remodelling of atrial fibrillation.

GW24-e2150 The value of colour doppler echocardiography in occlusion of elderly with atrial septal defect

Objectives To investigate the value of colour Doppler echocardiography (CDE) in occlusion of elderly with atrial septal defect (ASD). Methods In total of 64 cases of elderly ASD, observe the location, size and residual edge using two-dimensional echocardiography (2DE), observe the atrial septal colourful shunt bunch flow signal and the heart valve colourful regurgitation bunch flow signal using colour Doppler flow imaging (CDFI) and measure the pulmonary artery pressure using continuous Doppler (CW) before the occlusion. If the patient had atrial fibrillation or multiple ASDs, transesophageal echocardiography (TEE) examination should be used to screen the patients according to the indication of ASD occlusion. During the procedure of occlusion of ASD, 2DE was used to monitor the position of occluder, CDFI was used to monitor residual shunt through the atrial septum and CDE was used to determine the efficacy of occlusion. Results According to the results of CDE, we selected 64 cases of elderly ASD, the implementation of all ASD occlusion were successful and the efficacy was satisfactory. Conclusions CDE plays a important role in ASD occlusion. Before ASD occlusion, 2DE is recommedated to observe the location, size and residual edge, CW is recommedated to measure the pulmonary artery pressure. TEE is the key to screen according to the indications of ASD occlusion for the patients with atrial fibrillation or multiple ASDs. All elderly patients with ASD should undergo coronary angiography before the occlusion to exclude the patients with coronary artery disease who can’t treat by stenting.

GW24-e2145 Effect of deanxit on patients with heart failure secondary to valvular heart disease combined anxiety and depression

Objectives To investigate the effect of deanxit on subjects with heart failure secondary to valvular heart disease combined anxiety and depression. Methods After 60 patients being evaluated by HAMA and HAMD, the positive subjects were followed up for 2 weeks. According to baseline assessments, the patients were randomly divided into experimental group (basic drug trerapy and Deanxit) and control group (only basic drug trerapy). Cardiac function parameters and score of HAMA and HAMD were compared. Results Compared with control group, Cardiac function improved markedly, the scores of HAMA and HAMD in experiment groups were significantly lower than those before treatment while little changes in the scores of HAMA and HAMD was found in those of the control group. Conclusions To use Deanxit combined anti - heart failure drugs could gain better synergic effect in the patients of heart failure secondary to valvular heart disease with anxiety and depression.

GW24-e2152 Value of colour doppler echocardiography in occlusion of rupture of aortic sinus aneurysm

Objectives To evaluate the value of colour Doppler echocardiography (CDE) in occlusion of rupture of aortic sinus aneurysm (RASA). Methods Fifteen patients with RASA were indicated for interventional occlusion by CDE. CDE take part in all the process as monitoring in the occlusion operation, judging the effect after occlusion and follow-up. Results According to the characteristics images of CDE, we correctly confirmed the ruptured sinus and the chamber it ruptured into, any complications, and successfully occluded the ruptures in all 15 cases. Conclusions CDE plays very important roles in case of RASA occlusion. It can defined the ruptured sinus of aorta and the ruptured-into chamber, the diameter of the rupture, and rule out complications as ventricular septal defect before operation which is the most essential for the success of the occlusion. CDE can be used to monitor the correct implantation of the occluder, evaluate the residual shunt signals and the impingement on the aortic valve during the procedure and follow-up.

GW24-e2167 Transcatheter closure greater than or equal 10mm membraneous ventricular septal defects

Objectives To evaluate the feasibility of transcatheter closure ≥ ventricular septal defect (VSD). Methods 379 cases with ≥ 10 mmVSDs underwent attempted transcatheter closure with various devices in this study. Of those,166 were male and 213 were female. The age ranged from 3 to 70 (16.5 ± 14.3) years. Physical exam showed an accentuated pulmonic second heart sound and a grade 3 to 4 systolic murmur over the left third or fourth intercostal space. The left ventricular diameter of the defect on echocardiography ranged from 3 to 15 (4.6 ± 1.2) mm. Results VSDs was successfully closed in 376 of 379 patients (99.0% closure rate). The size of defect ranged from 10 to 32 (13.2 ± 3.3) mm at left ventricular side and from 3 to 16 (5.1 ± 2.5) mm at right ventricular side with distance from 0 to 11 (3.0) mm between aortic valve and the upper margin of the defect. Associated abnormalities were membraneous aneurysm in 318, PDA in7, ASD in 3 and PFO in 1 patients. The devices used to close VSDs and associated abnormalities were domestic-made devices including symmetrical VSD devices (n = 104), unsymmetrical VSD devices (n = 247), inequilateral VSD devices (n = 14), PDA devices (n = 7), ASD devices (n = 4), and foreign devices including Amplatzer unsymmetrical VSD devices (n = 10) and PDA devices (n = 1). The diameter of VSD devices ranged from 4 to 16 (7.55 ± 2.17) mm. The associated ASD and PDA were closed after VSD closure, while the muscular VSD were closed simultaneously with membraneous VSDs. Check cardiac angiography after device deployment showed complete closure in 350 (93.2%), trace residual shunt in 9 (2.5%) and small residual shunt in 17 (4.3%), but only 3 had residual shunt at discharge which were still at follow-up. Four patients developed third degree A-V block, which resolved itself in 3 but did not in one patient until the device was surgically taken out. Twelve patients developed transient complete left bundle branch block after the procedure, which resolved in 10 patients or developed incomplete left bundle branch block at follow up. Conclusions Large VSD is the relative indications for interventional therapy. Preoperative UCG must be strictly conducted to select the patients. The patients who had membranous aneurysm, the distance >2 mm from upper rim of VSD to the right aortic valve cusp or elder patients may have a higher success rate of interventional therapy. Standardised operational procedures, professional skills, multiple occlusion apparatus, short operation time, avoiding repetitive manipulations and reducing complications are the guarantee of success in interventional therapy of ≥10 mmVSDs.

ASSA14-14-05 Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug I

Objectives Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses (PDA). The Amplatzer vascular plug (Plug) has not been licensed for use for closure of PDA. We report our initial experience to occluding special type PDA with the Plug. Methods Patients referred with small and long Krichenko E PDA 1–3 mm in diameter underwent occlusion using this Plug I, this is a single lobe device of single layer Nitinol mesh for short vessel landing zones. All cases underwent pre-, intra- and post-procedural echocardiography at the completion of the procedure the next day and at a 30-day follow-up visit. Device sizing for device waist diameter and length was based on aortography. Results 26 patients with a median age of 5 years (range 6 months – 32 years) and a median weight of 19 kg (range 7–67 kg) underwent successful PDA closure. The median ductus diameter was 2.2 mm (range 1–3 mm). Both transpulmonary (22/26) and transaortic approaches (4/26) were used. No persistent patency was observed after 24 hours and one month. Conclusions The Plug I Makes it easy to close some Krichenko E PDAs. Smaller delivery catherter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E PDA 1-3 mm in diameter and small patients through transaortic approaches. Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.

ASSA13-17-9 Clinical Feature of Cor Triatriatum in 23 Cases

Objective To summarise the data of clinical feature, accompanied abnormities and imaging diagnosis of cor triatriatum in 23 cases enlisted in the study. Methods From January 1993 to June 2005, twenty-three patients, 13 males and 10 females with a mean age of (9.6 ± 10.0) years (range 0.3 from 38 years) were studied. All cases were cor triatriatum laevus. Twenty-one of 23 patients were identified in surgery. Complete cor triatriatum in 15 case and incomplete cor triatriatum in 6. Electrocardiogram show that right unsymmetrical cardial axle was in 18 patients and nomal cardial axle in 4. Eight cases had lung congestion in x-ray. Results Echocardiogram diagnosed 12 in 23 cases before surgery. Heart catheter exam diagnosed 4 in 10 cases. sixteen of 21 cases accompanied other abnormities. Main malformations included atrial septal defeat (n = 14), partial anomalous pulmonary venous drainage (n = 6), pulmonary stenosis (n = 3), persistent left superior vena cava (n = 3). Seven of 21 patients had no atrial septal defeat. Conclusions cor triatriatum had great variation in clinical feature and complicated other malformations in high ratio. Color doppler imaging has high worthiness of diagnosis of cor triatriatum, but misdiagnosis and missed diagnosis rate is high in cor triatriatum accompanied other malformations. Heart catheter exam have missed diagnosis to cor triatriatum, but have higher diagnosis rate to accompanied abnormities. Surgical exploration is very important in cor triatriatum accompanied other malformations.