Objective To analyze the occurrence and prognosis of congenital heart disease interventional therapy related arrhythmias, and to discuss the prevention and treatment. Methods We retrospectively analyzed the occurrence and prognosis of congenital heart disease interventional therapy related arrhythmias among a total of 223 cases admitted for in terventional therapy between February 2014 to January 2015. Resu1ts 8 cases developed different degree and nature of arrhythmias after the interventional therapy. Among these cases, 3 of them had arrhythmias after ASD occlusion, including one was frequent atrial contraction, one was paroxysmal atrial tachycardia, and one was sinus bradycardia with accelerated junctional rhythm. All of them converted back to sinus rhythmm spontaneously from 2-3 hours to maximum 1 week after operation. 4 cases had arrhythmias after VSD occlusion, including one case of ventricular tachycardia, one case of Ⅰ° degree atrioventricular block who recovered spontaneously after surgery, one case of Ⅲ° degree atrioventricular block and one case of intermittent complete left bundle branch block who retruned to sinus rhythmn after 1 week of symptomatic treatment. One case had ventricular fibrillation after pulmonary valve balloon dilatation and was treated by defibrillation and temperany pacing to convent to sinus. Conc1usions Arrhythmias is a common complication of congenital heart disease after interventional therapy, and most of them are temporary and transient changes. However, once serious arrhythmias happened, the success rate of surgery and postoperative curative effect can be directly effected, or may even lead to mortality.

Objective To study the feasibility and safety of interventional closure for the treatment of infant’s perimembranous ventricle septal defect (PmVSD). Methods During the period from Jan. 2012 to Jan. 2013, a total of 229 single PmVSD infants less than three years of age were admitted to authors ’ hospital. The infantile patients were divided into intervention group (n = 88) and surgery group (n = 141). Patients in the intervention group underwent interventional closure procedure , while patients in the surgery group received conventional cardiac surgery. The operation success rate , the main and minor complication rates, the operation time, the postoperative hospitalization days, the incidence of postoperative pulmonary infection and the medical cost were recorded , and the results were compared between the two groups. Results No statistically significant differences in the operation success rate, the main complication rate, the postoperative hospitalization days and the medical cost existed between the two groups (P > 0.05). But the minor complication rate and the operation time of the intervention group were better than those of the surgery group. In the surgery group, the minor complication was mainly the respiratory infection, which was manifested as higher leukocyte count, higher C-reactive protein level, higher myocardial damage marker level as well as higher vasoactive drug scores in 24 hours after the operation , and the above items were significantly higher than those in the intervention group. Conclusion For the treatment of infant’s perimembranous ventricle septal defect, percutaneous transcatheter closure is clinically feasible. This technique is safe and reliable with obvious advantages when the indication is strictly observed and the procedure is carefully manipulated. This treatment can partly replace the conventional surgery.

Objective To summarize the clinical effects of one stop hybrid approach for treating the tetralogy of fallot complicated with aorta pulmonary collateral arteries. Methods From Janu 2008 to June 2013, 79 cases of tetralogy of fallot were complicated with aorta pulmonary collateral arteries with mean age (5.4±3.9) years and weight (18.2±5.7) kg. All patients were diagnosed by echocardiography examination and accepted 64-row CT for demonstration of no dysplasia in pulmonary ressels, McGoon index was (1.7±0.6) and Nakata index was (176.7±7.3). 76 cases had aorta pulmonary collateral arteries for preliminary screening, and accepted cardiovascular angiography before operation. 3 cases were misdiagnosed before surgery and were confirmed by cardiovascular angiography after operation. Results There were 4 deceased cases with an operative mortality of 5.1%. 1 case died of lung infection and 3 cases died of refractory heart failure. In all aorta pulmonary collateral arteries, the smallest diameter was 2.5 mm, the largest was 9.4 mm, average (5.3±2.1) mm. 2 to 21 coils were implanted in respective case with an average of 10.2 coils per case. The maximum number of coils implanted in 1 single ressel was 9. The average number of ressels occluded was 3.7 (range from 1 to 11 ressels) in each case. One case received second closure due to re-open of collateral arteries on neo-vasculanigation. 14 cases had lung infection and 3 cases had pulmonary edema post operation. 75 cases were followed up for 3-72 months. 4 cases with post operative heart function of NYHA gradeⅢtoⅣand all other cases with gradeⅡon higher. Conclusions Peri-operative hybrid management for aorta-pulmonary collateral arteries can increase the operative success rates and reduce complications.

Objective To investigate the safety and effectiveness of percutaneous balloon pulmonary valvuloplasty (PBPV) in the treatment of pulmonary stenosis (PS). Methods The subjects were 52 patients with PS from 2007 to 2012, including 24 male and 28 female. Their age ranged from 1 year old to 56 year old and mean age was 9.2±7.6 years old. Their body weight ranged from 10 kg to 60 kg and mean weight was 17.3±8.9 kg. All patients were assessed with electrocardiogram (ECG), chest X-ray, right heart catheterization and right ventricular angiagraphy before the procedure. Results All 52 patients received PBPV successfully. Comparing the transvalvular pressure gradient before and after the operation, it decreased from 86.3±27.6 mmHg (1 mmHg=0.133 kPa) to13.8±7.7 mmHg, and statistically difference (P<0.01). Among these patients, one patient occurred ventricular fibrillation and Aspen syndrome (hypoxie-ischemic encephalopathy), one patient occurred respiratory and cardiac arrest, 24 patients occurred transient arrhythmia, one patient had hypotension, one patient had bradycardia and one patient showed desaturation. All these symptoms resolved after appropriate treatment during the PBPV. Two patients had hematoma in the puncture point and 2 patients had reactive infundibular stenosis after PBPV. Conclusions Performing the percutaneous balloon pulmonary valvoplasty on the patients with pulmonary stenosis is safe and effective. PBPV causes less pain and can be used as the preferred treatment for pulmonary stenosis.

Heart Defects, Congenital ; therapy ; Humans ; Hypertension, Pulmonary ; therapy

Objective To explore whether the PDA patients in the early stage of Eisenmenger syndrome can accept interventional surgery. Methods Three patients were choose from the “National Multicenter Prospective Registration Study on Pulmonary Artery Hypertension”, Clinical assessment, as well as examinations and registrations associated with PAH, was conducted in accordance with relevant provisions of the registration study within 1 wk prior to surgery. The way of the interventional treatment were right heart catheterization and pulmonary vasodilator testing (a capsule of iloprost solution for inhalation), and measurement of the pulmonary arterial pressure, descending aortic pressure, ratio of pulmonary to systemic blood flow, ratio of pulmonary to systemic blood pressure, pulmonary capillary wedge pressure [mean≤15 mmHg(1 mmHg=0.133 kPa)], before and after testing. After clear the results of pulmonary vasodilator test all patients underwent transcatheter closure testing, if it was positive,the amplatzer was released if her family members’ approved;Conversely, the amplatzer was quickly withdrawn with negative results, and symptomatic treatment was conducted based on the patient’s clinical symptoms. Results The first cases pulmonary vasodilator test was negative, but positive in transcatheter closure testing. Satisfaction immediate effect of surgery, and the occluder was released with her family members’ approval. patients of Example 2 and Example 3 were negative in pulmonary vasodilator testing and transcatheter closure testing, can not released the occluder. Conclusions Some Patents Ductus Arteriosus (PDA) patients in early stage of Eisenmenger syndrome is feasible to accept interventional therapy , try plugging test is may be an important indicator of prognostic assessment.

For decades,there have been no systematic studies on the reference intervals of Chinese populations.With the support of the Ministry of Health,the Chinese Society of Laboratory Medicine launches a research project investigating the Chinese reference intervals for common clinical laboratory tests.Up to now,the first batch of reference intervals for common liver function,electrolytes and blood cell analysis have been published in forms of healthy professional standards.Medical institutions are suggested to use these new reference intervals in clinical practice.

Objective To determine the brain natriuretic peptide(BNP) levels and the effects of endothelin receptor antagonist(ERA) on BNP levels in patients with tetralogy of Fallot(TOF) recently surgical repaired.Methods During January 2010 to January 2012,32 cases of TOF after surgical repaired in hospital were selected.There are 20 males and 12 females,Aged 4 years to 18 years [mean age (7.64 ± 3.75) years] in age.All patients underwent enhanced CT to evaluate the pulmonary vessels and left ventricular before surgery arrangements.As the surgeries done,the patients were grouped randomly as either A or B.All 14 patients in group A started to follow the recommended dosage of bosentan within 3 days after surgery.Meanwhile,all 18 in group B had not taken bosentan or any other ERAs since the surgeries.Both group was evaluated and examined with echocardiography and blood test at the 10th day after surgery.Results None of the patients died within 10 days after surgery.BNP levels of group A was significantly lower than of group B.Inotropic score of group A was markedly lower,too.However,although group A showed mildly advantages in tricuspid regurgitation,pulmonary regurgitation,ratio of RV/LV end-systolic dimension and liver functions,there was no statistically significant difference.Conclusion For patients with tetralogy of Fallot,early use of ERAs after surgical repaired could reduce the use of inotropic agents and significantly decrease the BNP levels when discharged.

Objective To study on the evaluation of haemodynamics in the normal and pulmonary hypertensive mouse hearts using pressure volume loops measured by electric catheter.Methods Compared the difference in haemodynamics between mice exposed to chronic hypoxia for 10 days,which causes hypoxia-induced pulmonary hypertension (experimental group,n =8),and mice raised under normal atmospheric pressure (control group,n =8).The right carotid artery was cannulated with a 1.2 F catheter and advanced into the ascending aorta,then punctured towards the right ventricular apex.A 1.2 F admittance pressure-volume catheter was introduced using a 20-gauge needle to obtain the pressure-volume measurements and calculate hemodynamic parameters.Results There were no significant differences in average by weight,ratio of right atrial weight to body weight,left atrial weight/body weight,left ventricular free wall and septum weight/body weight between the 2 groups(all P ＞ 0.05).The ratio of right rentricle/left rentricle and septum weight as well as right rentricular weight/body weight was increased in the experimental group and of significant difference when compared to the control.The mice in in the experimental group had a 61％ mean decrease in cardiac output,a 55％ decrease in ejection fraction,and a 63％ decrease in ventricular compliance(P ＜0.05).The increase in dP/dtmax-EDVand PRSWfound in the experimental group reflected significant increase in myocardial contractility.Increase in Ees was observed but without significant difference as compared to the control.Ea significantly increased in the experimental group resulting in significant decrease in Ees/Ea from (0.71 ±0.27) to (0.35 ±0.17) (P＜ 0.005).Conclusion This study demonstrates the feasibility of obtaining RV pressure-volume measurements in mice using electric catheter.These measurements provide insight into right ventricular-pulmonary artery interactions in healthy and diseased conditions.