Down Syndrome ; complications ; Humans ; Infant, Newborn ; Male ; Pleural Effusion ; complications ; congenital

OBJECTIVE: To observe the structural and hemodynamic changes after the reconstruction of right ventricular outflow tract (RVOT) with valved bovine jugular vein conduit (BJVC) in the canine model by color Doppler echocardiography (UCG). METHODS: BJVC was used in the reconstruction of RVOT of 32 canines. UCG was used to observe the structure of the right ventricle and RVOT. The structure and hemodynamics were observed, and the diameter, width, blood velocity and pressure gradient (PG) were measured between the right ventricle and the conduits. RESULTS: In the first stage, UCG showed that PG between the right ventricle and BJVC was high in 5 canines, and a few anastomosis in BJVCs with main pulmonary artery was small. Blood velocity quickened and PG increased, and color Doppler showed that the bloodstream was very bright. In the second stage, 7 canines survived for 1 year after the implantation. One year after the operation, UCG showed that the valve closed well, no graft kinking or obvious regurgitation of the valve was observed. The PG of the valve was low. The BJVCs were unobstructed and there was no thrombus.All the valves of BJVC opened well except one. In the third stage, 20 canines survived for 1 year after the implantation. UCG showed that the valve motion was good, no graft kinking or obvious regurgitation of the valve was observed. No neoplasm was observed. CONCLUSION UCG is one of the most useful measurements in the structural and hemodynamic study of RVOT reconstruction by BJVC in the canine model. The good evaluation of UCG implies that it is important for the study and clinical practice.
Animals ; Blood Vessel Prosthesis ; Cattle ; Dogs ; Echocardiography, Doppler, Color ; Female ; Heart Ventricles ; diagnostic imaging ; surgery ; Hemodynamics ; Jugular Veins ; diagnostic imaging ; transplantation ; Male ; Pulmonary Artery ; diagnostic imaging ; surgery

OBJECTIVE: To summarize the clinical application of bioprosthetic valve replacement. METHODS: Fifty two patients, aged 13-73(52.4+/-14.0) years, underwent cardiac valve replacement with biovalves from June 2002 to June 2006 in our hospital. Fifty three tissue valve replacements combined with 8 mechanical valve replacements were performed. Other procedures were also carried out if appropriate, including bidirectional Glenn shunt in 1 patient with double outlet of right ventricle and pulmonary artery stenosis; interruption of accessory pathway in 1 patient with Wolff-Parkinson-White syndrome; coronary artery bypass graft in 5 with severe coronary artery disease; and atrial or ventricular repair in 4 with congenital septum defects. RESULTS: One patient died in hospital due to multiple organ failure. The hospital mortality rate was 1.9%. The mean follow-up was 25 months. Two patients lost follow-up and the follow-up rate was 96%. Forty one patients returned to NYHA class I, 9 to class II, and 1 to class III. Echocardiography showed the implanted bioprosthesis functioned well without stenosis or regurgitation. There was no structural deterioration with freedom from thromboembolism and anticoagulant hemorrhage in all patients. CONCLUSION The efficacy of biovalves in heart valve replacement is satisfactory.
Adolescent ; Adult ; Aged ; Bioprosthesis ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Retrospective Studies ; Tricuspid Valve ; surgery

OBJECTIVE: To evaluate the therapeutic effect of remaining integrated mediastinal pleura upon the aortic arch and performing the anastomosis at the left cervix in radical operation for esophageal carcinoma. METHODS: Ninety-eight patients with esophageal carcinoma were treated with the operation mentioned above. Among them, 56 patients had cancer in the middle, 12 in the upper-middle, 24 in the lower-middle segments, and 6 had double-primary tumors, with carcinoma length of (5.2+/- 2.4) cm. The TNM stages were 6 of Stage I and 92 of Stages II-III. All cases were squamous cell carcinomas. RESULTS: All patients had satisfactory operation processes, without perioperative death, chylothorax, dyspnea, gastric retention, incision infection, and severe gastro-esophageal reflux. The life quality of the patients was improved. CONCLUSION The radical operation with remaining integrated mediastimal pleura upon the aortic arch and anastomosis at the cervix for treating esophageal carcinomas is of minimal invasion with fewer complications, and may be used in clinical practice.
Aged ; Anastomosis, Surgical ; methods ; Aorta, Thoracic ; surgery ; Carcinoma, Squamous Cell ; surgery ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pleura ; surgery ; Thoracic Surgical Procedures ; methods

OBJECTIVE: To summarize the surgical treatment of total anomalous pulmonary venous connection (TAPVC). METHODS: We retrospectively analyzed 49 patients with TAPVC as follows: 37 patients with supra-cardiac type in which 35 received anastomoses between the rear wall of the left atrium and the common pulmonary vein and the other 2 received anastomoses between the rear edge of the left atrium roof and the common pulmonary vein; another 12 patients with cardiac type who were incised the upper edge of coronary sinus, connected the common junction of pulmonary veins with the left atrium to form a new left atrium, and repaired the atrial septal defect with a pericardial patch. RESULTS: Forty-six patients recovered and 3 patients died. Thirty-eight patients were followed-up from 3 months to 8 years. The rest patients got fluent pulmonary vein drainage and their heart function resumed to NYHA I. CONCLUSION TAPVC patients should be operated on immediately at definite diagnosis. The fluency of the common pulmonary vein-left atrium anastomoses and proper postoperative care can ensure a satisfactory outcome.
Adolescent ; Adult ; Anastomosis, Surgical ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pulmonary Veins ; abnormalities ; surgery ; Retrospective Studies ; Young Adult

Adolescent ; Adult ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Double Outlet Right Ventricle ; surgery ; Female ; Humans ; Infant ; Male

The purpose of this study was to explore the expression characteristics of SDF-1 receptor, CXCR4, in mesenchymal stem cells (MSC) of different passages derived from human umbilical cord (hucMSC). The hucMSC were isolated from Wharton's jelly tissue of human umbilical cord by tissue culture. The expressions of specific marker in hucMSC were detected by flow cytometry. The adipogenic and osteogenic induction of hucMSC were detected by alizarin bordeaux and Oil red O staining. The expressions of CXCR4 protein in hucMSC of 2nd-5th passages were detected by flow cytometry, and cxcr4 mRNA levels in hucMSC of 2nd-5th passages were evaluated by real-time quantitative PCR. The results showed that the expression of CD44, CD13, CD71 were positive while CD38, CD117, HLA-DR were negative. After induced by osteogenic and adipogenic inductors, the lipid droplets and calcium nodals appeared in hucMSC, hucMSC stained with oil red O and alizarin red were shown to be positive. The cxcr4 was found in hucMSC of 2nd-5th passages, and their expressions were (89.82 ± 0.62)%, (86.87 ± 1.32)%, (80.50 ± 4.46)%, (70.10 ± 0.68)% respectively. The cxcr4 mRNA was found in hucMSC of 2nd-5th passages, and expression of cxcr4 of 3rd-5th passages were 0.5585 ± 00875, 0.6205 ± 0.1377, 0.4634 ± 0.0447 times of expression of 2nd passage respectively. It is concluded that the cxcr4 mRNA expresses in hucMSC of 2nd-5th passages, and declines when the number of passages increases. Compared with 2nd passage, cxcr4 mRNA levels in hucMSC of 3rd-5th passages decline, but the expression level of cxcr4 mRNA between hucMSC of 3rd-5th passages is stable.
Cell Differentiation ; Cells, Cultured ; Flow Cytometry ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Receptors, CXCR4 ; metabolism ; Umbilical Cord ; cytology ; metabolism

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Hepatitis B ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Young Adult

OBJECTIVE: To summarize the experience of surgical treatments of partial atrioventricular septal defect in 60 patients. METHODS: From April 1999 to April 2004, 60 patients of partial atrioventricular septal defect were operated. Fifty-eight patients were performed with suture of the cleft of mitral valve and the other 2 were given mitral valve replacement; For closure of primum ASD, 53 patients with pericardial patches and 7 with Dacron patches. Coronary sinus was baffled to left atrium with kirklin procedure in 35 cases and baffled to right atrium with McGoon procedure in other 25 cases. Correct the accompanying cardiac deformity at the same time. RESULTS: The hospital mortality was 3.3% (2/60) due to low cardic output syndrome. The incidence rate of complete atrioventricular block was 8.00% (2/ 35) in the group with Kirklin procedure and 6.06% (2/25) in the group with McGoon procedure. There was no statistical significance between the 2 groups (P > 0.05). The follow-up was from 1 month to 5 years, and there was no late death. All cardiac function were improved except middle mitral regurgitation in 1 patient. CONCLUSION Reasonable operative design, refined procedures, avoiding damage to conducting bundles and proper perioperative management are the key points in improving theraeutic effect.
Adolescent ; Adult ; Cardiac Surgical Procedures ; methods ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: To summarize the experience of diagnosis and surgical treatment of ventricular septal defect with patent ductus arteriosus. METHODS: We retrospectively analyzed the clinical data of 102 cases of ventricular septal defect combined with patent ductus arteriosus who underwent surgical treatment. Preoperative ultrasonic cardiogram (UCG) showed ventricular septal defect combined with patent ductus arteriosus in 82 cases and ventricular septal defect in 20 cases. RESULTS: The hospital mortality was 4.9% (5/102). The reasons for death included low cardiac output syndrome (1 case), pulmonary hypertension crisis (2 cases) and respiratory failure (2 cases). In the remaining patients,the perioperative complications included lung infection (7 cases), pulmonary atelectasis (5 cases), hydrothorax (1 case), and pulmonary hypertension crisis (2 cases); and all the 15 patients recovered lastly. The pulmonary hypertension of all living patients decreased to some degree. The therapeutical effectiveness was satisfactory. CONCLUSION Ventricular septal defect with patent ductus arteriosus is easy to be confused with ventricular septal defect clinically. At the same time,it is diffcult to form a correct diagnosis in some patients by UCG preoperatively. To prevent the occurrence of perfusive lung, it is important to reinforce preoperative diagnosis and exploration during operation. Because pulmonary hypertension in patients with ventricular septal defect with patent ductus arteriosus emerges early and develops quickly, it tends to result in organic pulmonary hypertension which can make patients lose operation chances and influence the long-term therapeutical effect. Surgical operation should be performed as soon as possible. Optimal operative timing and proper perioperative management play important roles in surgical results.
Abnormalities, Multiple ; diagnosis ; surgery ; Adolescent ; Adult ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; diagnosis ; surgery ; Female ; Heart Septal Defects, Ventricular ; diagnosis ; surgery ; Humans ; Infant ; Male ; Retrospective Studies