Objective To summarize the operative experience of ventricular septal defect(VSD) with severe pulmonary hypertension(PH).Methods 37 patients with VSD complicated with severe PH,who underwent surgical repair were treated combinatively in perioperative period including resting,oxygen inhalation,and administration of captoprill and prostaglandin E 1(PGE 1).All of the patients were operated by cardiopulmonary bypass with moderate hypothermia.Arterial oxygen saturation(SaO 2),pulmonary arterial pressure and cardiac function were observed before and after operation,and progression of cardiac function and mortality were followed-up after discharged.Results 2 patients died of low cardiac output syndrome(LCOS) and one patient died of respiratory failure,and the operative mortality was 8 1%.one patient was diad after 8 months and the cardiac function of 33 patients markedly improved.Conclusions Reasonable treatment in perioperative period and holding the indications for the operation strictly are the keys to decrease the mortality of the operation,and SaO 2 could be a simple measurement to identify the indication of operation and the prognosis of the patient with VSD complicated with severe PH.

ObjectiveTo approach the value of diagnosis with the 256-slice spiral CT in severe tetralogy of Fallot of infant.MethodsFrom January 2008 to December 2010,48 cases (severe tetralogy of Fallot of infant) were examined with 256-slice spiral CT preoperatively.All cases were then analyzed in workspace with maximum intensity projection(MIP),multiplanar reconstruction(MPR) and volume rendering (VR),while compared with transthoracic echocardiography (TTE) and surgical results.Results CT examination found that TTE misdiagnosis 4 cases of patent ductus arteriosus and 6 cases of aortic coarctation.Meanwhile,CT showed 6 aorta pulmonary collateral arteries in 5 cases.In 48 cases,surgical results confirmed 47 cases by 256-shce spiral CT,while 33 cases by TTE.The diagnosis accuracy rate of 256-slice spiral CT and TTE was 97.9％ (47/48) and 68.8％ (33/48) respectively.There was statistically significant difference of the two inspections in diagnostic accuracy (P ＜ 0.05).ConclusionThe inspection of 256-slice spiral CT can benefit the preoperative diagnosis and operation program in severe tetralogy of Fallot of infant.

Objectives:To study the pathological behavior and the value of transforming growth factor β1(TGF-β1) in predicting prognosis in pulmonary hypertension associated with congenital heart disease.　Methods:Lung tissues from 29 patients with congenital heart diseases associated with pulmonary hypertension were examined by surgical biopsy of the lung. All samples were examined for the expression and localization of TGF-β1 by immunohistochemical technique with anti-TGF-β1 antibody.　Results:Twenty-six out of 29 showed positive staining of intracellular endotheliocyte TGF-β1(89.65%),16 samples showed extracellular matrix TGF-β1 staining(55.17%).Statistically, there was significant difference between Ⅰ～Ⅱ and Ⅲ～Ⅵ pathological degrees in extracellular matrix(P<0.05).　Conclusions: TGF-β1 plays an important biological role in the formation of pulmonary hypertension after congenital heart disease. It is conductive in predicting prognosis.