Objective To compare the clinical efficacy of BalMedic bovine jugular vein conduit (BalMedic) with homograft in right ventricular outflow tract reconstruction.Methods Totally 10 patients were implanted homograft to reconstruct right ventricular outflow tract,while 14 patients were implanted BalMedic from January 2003 to July 2009,and the function of the implanted conduit was evaluated by Doppler echocardiography one year after operation.Results 9 patients in group Homograft were cured,while 1 patient died of multiple organ failuie caused by infective endocarditis,which was confirmed associated to the conduit.13 patients in group BalMedic were cured,while 1 patient died of heart failure 2 days after operation,which no independent with the conduit.No stenosis of the pulmonary valve and further stoma had been found in both two groups,and they were no significant different( P ＞0.05 ).There were no thrombus aud aneurysm in both two groups.Two patients in group Homograft had low-grade regurgitation with pulmonary valve,while one had middle-grade regurgitation.And 4 patients in group BalMedic had low-grade regurgitation with pulmonary valve,no else became worse.Conclusion Both homograft and BalMedic can be used in reconstruction of right ventricular outflow tract.BalMedic may have better prospect.

Objective To study the effect of intracoronary adenovirus vector-mediated transforming growth factor ?_1 (Ad.TGF-?_1) gene transfer on discordant cardiac xenograft in the setting of acute vascular rejection. Methods In a cervical heterotopic cardiac transplantation model by cuff technique, after harvest, guinea pig donor hearts’coronary arteries were perfused ex vivo with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart of Ad.TGF-?_1, then implanted in the necks of complement depleted and immunosuppressed rat recipients. As controls, other hearts were perfused with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart adenoviral blank-vector or with virus-free Stanford University solution by the same method.Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The number of inflammatory cells and macrophages and nature killer cell infiltration in the cardiac xenografts of Ad.TGF-?_1 infected grafts was less than that of other groups (P

Objective To summarize the early effect of orthotopic heart transplantation for 5 patients with end-staged coronary heart disease.Methods Orthotopic heart transplantations were performed on 1 patient with left ventricular mechanic circulatory support for 25 months after twice acute myocardial infarction, 3 patients with failing heart after acute myocardial infarction, 1 patient with failing heart after PTCA and CABG.Results Five patients recovered well. No any severe acute rejection and infection have been found. All survivors had good life quality and good heart function (NYHA I).Conclusion Orthotopic heart transplantation is an effective treatment for patients with end-staged coronary heart disease. Proper donor heart, excellent donor myocardial conservation, suitable immurosuppression treatment and appropriate control of hypertension, hyperglycemia, hypercholesterolemia and uricacidemia are key measures of successful orthotopic heart transplantation for patients with end-staged coronary heart disease.

Objective To study the effects of intracoronary transfer of adenovirus vector-mediated transforming growth factor ?_1 gene on acute rejection of cardiac allograft in rats. Methods In a cervical heterotopic cardiac transplantation model, donor hearts coronary arteries were perfused ex vivo after harvest with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart of donor heart of Ad. TGF-?_1, then implanted in the necks of recipients. As controls, other hearts were perfused with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart adenoviral bland-vector or with virus-free Stanford University solution by the same method. Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The expression of CD_ 68 and the apoptosis index in the cardiac allografts of Ad. TGF-?_1 group were less than that of other two groups (P

Objective To observe cardiac structural and functional alterations one year following orthotopic heart transplantation. Methods In 23 patients with orthotopic heart transplantation, the end-diastolic diameter of the atria and the ventricles(LAD, RAD, LVEDD and RVED), the thickness of interventricular septum,left ventricular posterior wall and right ventricular anterior wall(IVS,LVPW and RVAW),and pericardial effusion(PE) were measured by M- and B-mode echocardiography, ventricular early and late diastolic filling peak velocities(E, A and E/A) and systolic peak pulmonary artery pressure(PAP) were assessed by Doppler techniques. Results PAP, RAD and RVED increased at 2 week following heart transplantation and gradually returned normal at one month. At 1-2 month after operation, IVS, LVPW and RVAW increased, and E decreased with a reversed E/A. PE was detected in moderate amount at 1-2 week, in small amount at 1-3 month, and disappeared at 6 month following the transplantation. Conclusions The structures and functions of the transplanted heart undergo serially adaptive changes postoperatively, and evaluation of these alterations echocardiographically may be helpful to identifying allograft rejection.

Kaneko's rahbit heart-lung transplant model was used xo investigate the effect of low flow perfusion(LFP)on rabbit heart-lung preservation.Thirty-two healthy rabbits were randomly divided into control group and experimental group.The donors in the experimental group were continuously perfused via aorta and pulmonary artery at low flow rate with the same perfusates during preservation.After heart-lung transplanted, the donors' LVsp, LVedp, RAP and Paw, and PaO2 were measured every 30 min for 90 min to evaluate the function of heart and lung.After finishing the trial, the contents of MDA in heart and lung were determined and the water weight gain calculated.The results showed that the rabbits in the experimental group had a significantly lower water weight gain and better cardiac and pulmonary function than in the control group.The experimental group produced less levels of MDA in heart and lung than did the control group.It is concluded that LFP is more effective than cold storage on rabbit heart-lung preservation.

Orthotopic heart transplantation was performed on two critical patients with end-stage dilated cardiomyopathy on Oct.14, 1996 and March 20, 1997 respectively.One case of pre-operative hepatic-renal failure died of systemic organs failure and severe circulation failure in oper-ation, and the other case of severe pulmonary hypertension preoperatively died of right heart fail-ure and pulmonary hypertension crisis on the seventh day after operation.Operating time and indi-cations of heart transplantation, preoperative evaluation for the patients with pulmonary hyperten-sion, and management of right heart failure after heart transplantation were detailedly discussed.

Orthotopic heart transplantation was successfully performed on one patients with endstage dilated cardiomyopathy.The patient has been survived for more than 1 year until today and is now living well.The immunosuppressive therapy and the acute rejective surveillance for 1 year after operation were detailedly introduced and discussed in this paper.In the second week and sixteenth week after operation,two episodes of acute cardiac rejection occurred and were promptly treated well with methylprednisolone.

Objective To investigate plasma homocystein (Hcy) level in cardiac transplant patients.Methods Fourteen cases of heart transplant patients were recruited in this study. Plasma Hcy levels were measured by using high-performance liquid chromatography with fluorescence detection and flow-mediated dilatation in brachial arteries detected with high-resolution ultrasound in all patients, while coronary artery angiography were performed in 7 patients.Results In 2 cases of heart transplant who had single coronary artery stenosis, the plasma Hcy levels were above 12 ?mol/L. The average plasma Hcy levels in heart transplant patients were higher than in health volunteers [( 13.47? 2.78) ?mol/L vs (9.26? 3.57) ?mol/L], and flow-mediated dilatation in brachial arteries of heart transplant patients was lower than that of health volunteers [( 8.2? 3.7) % vs ( 12.5? 1.6) %]. There was a linear correlation between levels of plasma Hcy and flow-mediated dilatation (r= -0.804). Conclusion Endothelial dysfunction in the heart transplant patents might be contributed to hyperhomocysteinemia which may be potential cause of transplant coronary artery disease.

AIM and METHODS: To investigate the cardioprotective effect of adenosine infusion before ischemic preconditioning on immature myocardial reperfusion injury in rabbit heart. Isolated perfused working heart model were performed, all hearts were subjected to 2-hour global hypothermic ischemia and received intermittent cold cardioplegia perfusion. RESULTS:During reperfusion, the recovery of left ventricular systolic pressure, left ventricular end-diastolic pressure, +d p /d t max, and -d p /d t max of hearts received adenosine infusion before ischemic preconditioning were significantly improved, myocardial adenosine triphosphate and adenosine diphosphate content and superoxide dismutase activity were higher, the leakage of myocardial creatine kinase and the malondialdehyde content were lower, and myocardial water content was obviously less. CONCLUSION: These results suggest adenosine infusion before ischemic preconditioning enhances cardioprotection of ischemic preconditioning against immature myocardial reperfusion injury in the rabbit heart.