Objective To explore the short axial strain of left ventricle in patients with atrial septal defect(ASD)before and after the transcatheter closure by using two-dimensional speckle tracking imaging (2D-STI).Methods A total of 30 patients with ASD underwent echocardiography before and after the transcatheter closure.The procedure was performed to obtain the peak of circumferential strain(Sc)and radial stain(Sr)of left ventricle by 2D-STI.Thirty healthy volunteers were enrolled as controls.Results ①Compared with the control group,regional myocardial Sc of ASD group decreased(P <0.05).Sc of anterior septum (AS),anterior wall (AW),laterior wall (LW)and posterior wall (PW)increased (P <0.05)at 2-days after the transcatheter closure and those parameters were higher than control group.At the six-months after the transcatheter closure,those parameters reduced to the normal level (P <0.05).Sc of inferior wall (IW)and mid-posterior septum (MP-Sept)increased to the normal level at 2-days after the closure surgery (P <0.05).②Compared with control group,regional myocardial Sr of ASD group decreased(P <0.05 ) except PW,two-days after the transcatheter closure these parameters increased to the normal level.Sr of PW in ASD group increased compared with control group(P <0.05),and there were no statistical changes at 2-days after the transcatheter closure.Sr of PW in ASD decreased (P <0.05 )to normal level until 6-months after the transcatheter closure.③ Global circumferential strain (GCS)of left ventricular in ASD group were lower than control group (P <0.05 ).At two-days after undergoing transcatheter closure the GCS increased (P <0.05)and those parameters were higher than control group (P <0.05).Six-months after the transcatheter closure those parameters reduced to the normal level (P < 0.05 ).There were no statistical differences of left ventricular global radial strain (GRS)between control group and ASD group. However,the GRS of ASD group increased (P < 0.05 )and those parameters were higher than control group (P <0.05)after 2-days undergoing the transcatheter closure.At six-months after the transcatheter closure those parameters were reduced to normal level (P <0.05 ).Conclusions 2D-STI can quantitative evaluate left ventricular circumferential strain and radial strain in patients with ASD before and after the transcatheter closure.

Objective To evaluate the clinical effect of talonavicular arthrodesis and the influence of adjacent joints use trephine percutaneous osteotomy in the treatment of talonavicular arthralgia.Methods From June 1999 to June 2009,24 patients were performed talonavicular arthrodesis due to a variety of painful disorder of talonavicular joint with trephine percutaneous osteotomy.There were 13 males and 11 females,with an average age of 45 years(range,37-72 years).The indications for the procedure included 15cases with posttraumatic arthritis,6 cases with rheumatoid arthritis,and 3 cases with degenerative arthritis.AOFAS system and visual analogue scale(VAS)were used to evaluate the change of function and arthralgia.Graves score system was used to evaluate the influence of adjacent joints.Results All patients were followed up 10-120 months,with the mean of 48 months.Only one case suffered skin brim necrosis of incision and got delayed healing after 3 weeks.The average AOFAS ankle-hind foot score improved from 45.2 points preoperatively to 84.5 points postoperatively.The excellent and good rate was 87.5%.VAS pain scores decreased from 8.1 to 2.4 postoperatively.Twenty-three patients were satisfied and one dissatisfied with the results.Postoperative radiology showed the union evidence in 23 patients at 6 months postoperatively(successful fusion rate of 95.8%).One joint nonunion occurred and required revision arthrodesis with iliac crest bone graft.There was an increase of Ⅰ grade in arthritic scores for 8 cases and Ⅱ grade for 1 case.Conclusion Talonavicular arthrodesis with trephine percutaneous osteotomy has the advantages of low trauma,high successful fusion rate and can acquire satisfactory clinical effect in the treatment of painful malalignment of talonavicular joints.