Objective To establish a method for the isolation and culture of bone marrow derived mesenchymal stem cells (MSCs) from patients with coronary artery disease and investigated its biological characteristics. Methods Bone marrow was extracted from patients' sternum when they were operated for coronary artery bypass graft. MSCs were separated from bone marrow by density gradient centrifugation in Percoll solution and seeded in culture medium supplemented with 10% fetal bovine serum. The morphology and growth characteristic of MSCs were observed in primary and passage generation culture with inverted microscope. The cell phenotype and cell cycle of MSCs were analyzed by flow cytometry. The growth curves were compared between different passages and ages. Results Most adherent MSCs showed spindle morphology whatever passages they were. The MSCs could be expanded for 15 passages. The proliferative potential of MSCs over the fifth passage or from old patients decreased gradually. The MSCs in primary and passage were positive for CD29 and CD44, but negative for CD34 and CD45. Analysis for cell cycle showed most MSCs in G_0/G_1 phase. Conclusion The method of isolation and culture of sternum bone marrow derived MSCs from patients with coronary artery disease is feasible, the MSCs have self-renewal capacity and might be ideal for cellular cardiomyoplasty.

Objective To study the change of the structural and biological properties of the cardiovascular tissue after cell extracting. Methods The native and treated pulmonary cusp and pulmonary artery wall were evaluated by HE stain, ETVG stain, immunochemistry stain and scan electron microscopy. The contents of the main macro-molecules were measured. The content and position of calcium was investigated by subcutaneous implantation in a rat model. Results The acellularization procedure resulted in an almost complete removal of the original cells while the construction of the matrix remained. The contents of colleagen and elastin increased while soluble GAG reduced. The content of calcium in acellular tissue by xenogenic implantation was less obviously than that in fresh one. Conclusion A suitable acellularization procedure can remove all cells and most soluble proteins, and matrix remains nearly intact, so as to alleviate obviously calcification via xenogenic implantation in vivo.

Objective To establish a standardized mouse myocardial infarction model,and non-invasively evaluate its cardiac function by using the echocardiography.Methods A total of 20 wild male mice were enrolled into this study.The left anterior descending coronary was ligated through the left fourth intercostal space after intubation.The echocardiographic assessment of myocardial infarction and heart function was performed 3 days preoperatively and 2 weeks postoperatively.The shortening fraction(FS),end systolic dimension(ESD),and end diastolic dimension(EDD) was recorded and analyzed.Results The acute and one-week mortality rates were 20%(4/20) and 40%(8/20),respectively.The echocardiography showed that the myocardial infarction model was successfully established in 10 mice.The heart function of the mice was markedly impaired.The FS significantly decreased from(50.23?8.36)% to(25.41?0.97)%(t=16.18,P

Objective: To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction (MI) by nerve remodeling.
Methods: The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor (NGF) were measured by western blot analysis and the cardiac endothelin-1 (ET-1) level was evaluated by ELISA.
Results: Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia (3.5 ± 1.2) vs (0.9 ± 0.2), improved electrical transduction (1.5 ± 0.2) mV vs (3.4 ± 0.3) mV and decreased capture threshold (5.5 ± 0.3) mV vs (2.2 ± 0.2) mV, all P<0.05. Compared with Isolated MI group, immunihistochemisty indicated that Omentopexy group had decreased new and sympathetic nerves in MI border zone, as for GAP43:(1388.4 ± 244.9)μm2/mm2 vs (768.6 ± 144.1)μm2/mm2, for TH:(1552.4 ± 270.3)μm2/mm2 vs (1018.5 ± 124.7)μm2/mm2, all P<0.05. Western blot analysis showed that Omentopexy group had the lower NGF expression and higher connexin43 expression;ELISA demonstrated that Omentopexy group had the lower ET-1 expression, P<0.05.
Conclusion: Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.

Objective: To explore the effect of low-level laser irradiation (LLLI) preconditioning on milieu of infarcted myocardium in experimental rats.
Methods: The myocardial infarction (MI) model was established by left anterior descending (LAD) artery ligation in female rats. 3 weeks later, the qualified MI rats were randomly divided for 3 groups: ① LLLI preconditioning group, the rats received thoracotomy for LLLI by a 635nm, 5mW diode laser with the energy density of 0.96 J/cm2 for 150 seconds, n=26. ② Control group, the rats received thoracotomy for daylight irradiation, n=27. ③ Sham operation group, the rats received thoracotomy without LAD ligation, n=24. The Expressions of myocardial vascular endothelial growth factor (VEGF), glucose-regulated protein 78 (GRP78), superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluate by real time-PCR, Western blot analysis and other relevant laboratory test at 1 hour, 1 day and 1 week after treatment. The myocardial cell apoptosis was examined by TUNEL staining, and left ventricular function was detected by echocardiography.
Results: LLLI preconditioning obviously increased the myocardial VEGF, GRP78 expression and SOD activity, decreased MDA production; while it could not really improve the myocardial cell apoptosis at peri-infarcted area and left ventricular function in experimental rats.
Conclusion: LLLI preconditioning may improve the milieu of infarcted myocardium via decreasing the oxidative stress in experimental rats.

Objective: To explore the effect of omentopexy combining autologous atrial tissue patch cardiomyoplasty for treating the chronic myocardial infarction (MI) in experimental rats.
Methods:The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 4 groups for the 2nd operation. ① Control group, the rats only received re-thoracotomy, ② Atrial appendage group, the autologous atrial tissue patch was harvested from left atrial appendage of rats and transplanted to infarcted zone, ③ Omentum group, the omentum of rats was transplanted to infarcted zone through diaphragm and ④ Combination group, the left atrial appendage tissue and omentum were transplanted to infarcted zone together. 4 weeks after the 2nd operation, the cardiac function was evaluated by echocardiography, the size and scar thickness of the infarction were examined by Masson staining, the survival of transplanted atrial tissue and angiogenesis were measured by immunohistochemistry, the protein expressions of VEGF, MMPs and TIMP-3 were examined by Western blot analysis, and the activities of MMPs were
identiifed by gelatin zymography.
Results:4 week after the 2nd operation, transplanted left atrial appendage tissue only survived in Combination group. The areas of infarction were similar among different groups, P>0.05. Compared with Control group, Combination group had the increased scar thickness (329 ± 33)μm vs (391±31)μm, improved LVEF (47.5 ± 4.5)%vs (57.9 ± 5.8)%, improved LVFS (20.7 ± 2.0)%vs (25.2 ± 3.6)%, all P<0.05. Compared with Control group, both Omentum group and Combination group demonstrated higher density of angiogenesis at infracted area (33/0.2) mm2 vs (49/0.2) mm2 and (33/0.2) mm2 vs (48/0.2) mm2, all P<0.01. Combination group had decreased protein expressions of MMPs, while the expressions of TIMP-3 were similar among different groups, the activities of MMP-2 and MMP-9 were decreased by 68%, P=0.002 and 64%, P=0.016 respectively.
Conclusion:Omentopexy could improve the angiogenesis and support the survival of transplanted autologous atrial tissue patch, therefore improve the cardiac function in experimental rats with chronic MI.

Objective:To retrospectively analyze the data of patients undergoing extracorporeal membrane oxygenation (ECMO) during perioperative period of cardiac transplantation and provide objective and reliable evidence for further clinical promotion.Methods:Collect the clinical data of patients undergoing heart transplantation and ECMO support in Fuwai Hospital, analyze the duration of ECMO support, combined use of aortic balloon counterpulsation (IABP), and complications during the supporting period. All statistical analyses were processed by SPSS 23.0 software. Independent sample Student's test was employed for normal distribution and Mann-Whitney U test for abormal distribution. χ2 or Fisher exact test was utilized for comparinge the classification data between groups. Results:All ECMO support models were intravenous-arterial ECMO (V-A ECMO). Eight patients successfully bridging heart transplantation through VA-ECMO. Sixty-one patients (89.7%) who had undergone cardiac transplantation were successfully weaned from ECMO while 48 patients (70.5%) survived and discharged. The most common complications during circulation support are bleeding, acute renal insufficiency, and pulmonary infection. Patients with ECMO support in the operating room had a better rate of survival and weaning off(95.6%, 84.4%) than those with ECMO at the bedside of ICU(72.2%, 27.8%).Conclusions:ECMO can provide adequate circulation and respiratory function support for heart transplant patients, and it is an indispensable treatment for patients to go through the perioperative period of heart transplant surgery smoothly. It is advocated to use IABP combined with ECMO in the early stage and at the same time to increase the perfusion of vital organs, improve the prognosis of patients and obtain good outcomes.

Objective The aim of this study was to summarize the characteristics of rheumatic tricuspid valve disease ( RTVD) and to evaluate the mid-term outcomes in patients undergoing tricuspid valve repair with RTVD. Methods Between January 2009 and June 2016, 251 consecutive patients with rheumatic heart disease( RHD) underwent left-sided valvular re-placement by a single surgeon. We analyzed 39 patients with RTVD which was diagnosed during the operation. Among them, 32 patients, with moderate or higher tricuspid regurgitation( TR) , were compared with other 59 patients of functional tricuspid regurgitation( FTR) for a better understanding of the features of the RTVD. A total of 39 patients were categorized into 2 groups:Ring annuloplasty group(n=33) and non-Ring annuloplasty group(n=6) which consisted of modified De Vega annu-loplasty for 4 patients and edge-to-edge repair for 2. Meanwhile, 13 of them underwent concomitant tricuspid commissurotomy and 1 patient had a tricuspid leaflet augmentation procedure. We analyzed the mid-term outcomes of 22 patients( follow-up du-ration>1 year)with a mean follow-up duration of(45.5 ±25.1) months. Results Compared with FTR, patients with RTVD had higher preoperative TR grade(3.1 ±0.8 vs. 2.6 ±0.7, P=0.004) but with lower preoperative PASP[(53.8 ±19.4) mmHgvs.(63.6±21.5)mmHg,P=0.037)](1mmHg=0.133kPa) andtricuspidannulusdiameter(TAD) thatobserved bothinpreoperativeechocardiogramtests[(37.0±5.7)mmvs.(41.9±6.7)mm,P=0.018)]andintraoperativedetection [(35.6±4.1)mmvs.(39.9±6.5)mm,P=0.000)] . TherewasnoearlymortalityandresidualmoderateorhigherTR grades in either group. Compared with patients in non-ring annuloplasty group, patients in ring annuloplasty group showed low-er postoperative TR grade(0. 2 ± 0. 4 vs. 0. 7 ± 0. 5, P=0. 039) and acceptable TR grade(0. 8 ± 0. 5 vs. 1. 3 ± 1. 9, P>0. 050) during the mid-term follow-up. PASP, the peak diastolic velocity and pressure gradient across tricuspid valve were not different between groups in preoperative, postoperative and follow-up. Conclusion Compared with FTR, Patients with RTVD had lower preoperative PASP and TAD, but with a higher preoperative TR grade. In our study, ring annuloplasty showed simi-lar mid-term outcomes compared with other procedures.

An implantable axial blood pump was designed according to the circulation assist requirement of severe heart failure patients of China. The design point was chosen at 3 L/min flow rate with 100 mm Hg pressure rise when the blood pump can provide flow rates of 2-7 L/min. The blood pump with good hemolytic and anti-thrombogenic property at widely operating range was designed by developing a structure that including the spindly rotor impeller structure and the diffuser with splitter blades and cantilevered main blades. Numerical simulation and particle image velocimetry (PIV) experiment were conducted to analyze the hydraulic, flow fields and hemolytic performance of the blood pump. The results showed that the blood pump could provide flow rates of 2-7 L/min with pressure rise of 60.0-151.3 mm Hg when the blood pump rotating from 7 000 to 11 000 r/min. After adding the splitter blades, the separation flow at the suction surface of the diffuser has been reduced efficiently. The cantilever structure changed the blade gap from shroud to hub that reduced the tangential velocity from 6.2 m/s to 4.3-1.1 m/s in blade gap. Moreover, the maximum scalar shear stress of the blood pump was 897.3 Pa, and the averaged scalar shear stress was 37.7 Pa. The hemolysis index of the blood pump was 0.168% calculated with Heuser's hemolysis model. The PIV and simulated results showed the overall agreement of flow field distribution in diffuser region. The blood damage caused by higher shear stress would be reduced by adopting the spindle rotor impeller and diffuser with splitter blades and cantilevered main blades. The blood could flow smoothly through the axial blood pump with satisfactory hydraulics performance and without separation flow.
China ; Computer Simulation ; Equipment Design ; Heart Failure ; therapy ; Heart-Assist Devices ; Hemolysis ; Humans ; Models, Cardiovascular