Objective: To evaluate the biocompatibility of self made nitinol alloy ventricular septal defect occluder. Methods: Six nitinol alloy ventricular septal defect occluder were implanted in the ventricular septum by catheter in 6 normal anaesthetized open chest pigs, and the animals were observed for 45 to 120 d(2 animals). Results: One deaths resulted from hemorrhage and another from embolization of occluder in abdominal aorta during the placement procedure. Successful placement of the occluder was achieved in 4 animals. Four animals were killed at 45, 60 and 120 d. Postmortem gross and microscopic examination of 4 devices 45 to 120 d after placement showed that both the right and left ventricular discs of the occluder were completely covered by a smooth, shiny, glistening thin layer of neoendocardium, and the surface of neoendocardium was covered by a monolayer of endothelium like cells. The inflammatory infiltrate around the occluder was found at 45 d, and disappeared and fibrosis formed at 120 d. These appeared as a repair process of the injury. Embolization in lung,liver, spleen, kidney, intestinal and colon were not found. Conclusion: These suggest that the self made nitinol alloy ventricular septal defect occluder has good biocompatibility. [

AIM: To observe the role of ox-LDL in rabbit endothelium/circulating monocyte adhesion in vitro and the effect of vitamin E. METHODS: Cultured rabbit's endothelial cells were incubated with different concentrations of ox-LDL, then incubated with rabbit's monocytes to observe cell's adhesion. With Northern blotting, endothelial VCAM-1 mRNA expression was measured. By using vitamin E incubation before ox-LDL, above steps were repeated to observe the effect of vitamin E. RESULTS: When ox-LDL concentrations were 2 5 mg/L, 5 mg/L, 10 mg/L, monocytes adhesive to endothelium per microscope field were 132 8?20 2, 350 0?37 2, 502 6?78 8, respectively They were all significantly higher than that of control group (51 2?7 7, P

Objective To assess the immediate efficacy of transcatheter closure of patent ductus arteriosus(PDA) using the angled duct occluder(ADO). Methods 9 patients(1 male, 8 female) underwent transcatheter closure of PDA using the ADO. The mean PDA diameter at its narrowest segment was (5.8?1.9) mm, ranging 3 to 10 mm. A 6-9F long sheath was used for the delivery of ADO. Results The devices were deployed successfully in all patients. Angiographies showed no shunt across the device 15 min after the implatation of ADO. Within 1 week, echocardiography revealed complete closure in all patients. There were no complications. Conclusions The transcatheter closure of PDA using ADO is an effective and safe procedure. The device matches with the shape of aortic cavity much more precisely than Amplatzer duct occluder.

Objective To evaluate the possibility, methods and efficiency of simultaneous transcatheter therapy for perimembranous ventricular septal defect(PMVSD) combined with atrial septal defect(ASD).Methods Four patients with PMVSD combined with ASD, including 3 males and 1 female, age ranging from 12 to 26 years; underwent simultaneous attempted transcatheter therapy. The diameters of PMVSD were 3-6 mm and the distances from the defect rim to aortic valve were 2-6 mm by the echocardiography before the precedure. The stretched diameter of ASD was 6-10 mm. PMVSD were occluded using homemade two-disc PMVSD occluder first and the ASD were occluded later on. Results All patients were treated successfully at one time. The diameter of PMVSD were 3.5-10.0 mm, the diameters of occluder was 4-12 mm. The stretched diameter of ASD was 6-10 mm and the occluder diameter was 6-12 mm. No residual shunt was found by the transthoracic echocardiography and left ventriculography after the occluders deployed. No complication occurred. Conclusion Simultaneous transcatheter therapy for PMVSD combined with ASD is feasible, safe and effective.

Objective To evaluate the feasibility and efficacy of transcatheter perimembranous ventricular septal defects (VSD) occlusion with home-made nitinol occluder.Methods Transcatheter closure was attempted in 196 patients with perimembranous VSD. The diameter of VSD measured by echocardiography was 3 to 15 mm, mean (4.94?2.23) mm. The angiographic diameter of the VSD was 3 to 6 mm, mean (3.92?1.44) mm. A 7-10F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein to deploy the occluder with the guidance of echocardiography and fluoroscopy. The device diameter selected was from 4 to 20 mm, mean (6.68?2.76) mm. Left ventriculography and transthoracic echocardiography were repeated to assess the closure of the defects 15 min after the procedure. Continuous electrocardiogram monitoring lasted for 5 days. The echocardiography and electrocardiogram examination were scheduled for 1, 6, and 12 months of follow-up. Results The occluders were successfully deployed in 191 patients. There were five procedural failures, two with device-related aortic insufficiency, and three of inability to pass through VSD. After deployment of the devices, there were no residual shunt in 180 of 191 patients, 11 patients with a trivial residual shunt that disappeared in 8 patients after one month of follow up. 3 patients developed mild tricuspid insufficiency. 12 developed transient complete right bundle branch block, and 5 transient complete left bundle branch block, and 2 transient complete atrioventricular block. There were repetitive nonparoxysmal ventricular tachycardia in 4 patients 1 week after the procedure. One patient had a detached device embolized into the left pulmonary artery but with a successful catheter retrieval by snare and transcatheter closure. The devices were similarly applied to patients with VSD associated with patent ductus arteriosus, and 4 patients with VSD complicated by atrial septal defects. The fluoroscopy time for the procedure was (13.2?7.7) min(range from 5 to 60 min). The procedure time was (59.5?18.2) min(range, 39 to 160 min). On follow-up evaluation of 1 month to 2 years, there were no episodes of endocarditis, thromboembolism and hemolysis. Conclusion Transcatheter closure of membranous ventricular septal defects with homemade nitinol occluder is effective, easy and safe.

Objective To evaluate the efficacy and safety of transcatheter closure of perimembranous ventricular septal defects (VSD) using home-made nitinol asymmetric two-disk occluder.Methods Trans-catheter closure was attempted in 16 patients with perimembranous ventricular septal defect at a mean age of (16.8 ?11.2) years (range from 5 to 37 years). All patients were diagnosed by the physical examination, echocardiography and left ventriculography. The mean VSD narrowest diameter was (4.31 ?1.35)mm (range from 3 to 8mm) by echocardiography. A 6—8F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein approach. Left ventriculography and transthoracic echocardiography were repeated to assess the efficacy of the closure, 15min after the procedure. Results The mean VSD narrowest diameter was (4.63 ?1.59)mm (range from 3 to 8 mm) measured by left ventriculography. The distance of upper rim of VSD to aortic valve was 1? ?.6 ( 3.31 ?1.9) mm. The devices were successfully deployed in all patients. The diameter of occluder was (6.19 ?1.91)mm (range from 4 to 10mm). There were a trivial residual shunt in 2 patients by left ventriculography and the transthoracic echocardiography after the procedure. No shunt was found by the transthoracic echocardiography 1 week after the procedure. No complication occurred in all patients. Conclusion Transcatheter closure of membranous VSD with home made nitionol asymmetric two-disk occluder is safe and effective. The long-term efficacy is still to be determined by follow-up.

Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect(SVSD)with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD(n=22)and SVSD(n=6) at a age of 12.44?5.86 years (ranged from 3 to 34 years of age) The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the waist. The devices were deployed via the femoral vein using 7-10 Fr sheaths with the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD diameter was 4.54 ?1.93 mm (ranged 2 to 12 mm). the distance of VSD to aortic valve was 0.35?045 mm (range 0 to 1 mm )。The connecting waist diameter of device was 7.65?3.11 mm(ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. There was a trivial aortic regurgtation in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD, with having large defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07?5.19 min (range 9 to 40 min). The procedure time was 59.81?17.76 min (range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe.Longer follow-up is required to assess long-term efficacy.

Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect (SVSD) with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD (n=22) and SVSD (n=6) at an average of 12.44 ?5.86 years (ranged from 3 to 34 years of age). The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the diameter of the waist. The devices were depolyed via the femoral vein using 7-10 Fr sheaths under the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD average diameter was 4.54 ?1.93mm (ranged 2 to 12 mm) with the distance of VSD to aortic valve averaging 0.35 ?0.45mm (range 0 to 1 mm) and the connecting waist diameter of device of 7.65 ?3.11 mm (ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. A trivial aortic regurgitation occurred in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD having large septal defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07 ?5.19 min (range 9 to 40 min) and the whole procedure time was 59.81 ?17.76min(range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe. Longer term follow-up is necessary for assessing the efficacy.

Objective: To explore the dignositic characteristics of coronary heart disease (CHD) in perimenopausal women. Methods: The clinical data of 180 patients suspected of CHD were retrospectively analyzed. The risk factors of CHD,clinical characteristics of chest pain, routine electrocardiography,ambulatory electrocardiography and coronary artery angiography (CAA) were compared between perimenopause group and control group. Results: The incidence of CHD increased significantly in control group(13.5%, 10/76) compared to perimenopause group (43.3%, 45/104, P

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.