Transthoracic Balloon Pulmonary Valvuloplasty for Treatment of Congenial Pulmonary Atresia Patients with Intact Ventricular Septum.

BACKGROUND To summarize our clinical experience in performing transthoracic balloon pulmonary valvuloplasty for the treatment of patients suffering from congenial pulmonary atresia with intact ventricular septum (PA/IVS). MATERIAL AND METHODS Between April 2009 and April 2016, 38 patients with PA/IVS underwent transthoracic balloon pulmonary valvuloplasty in our hospital. All of them were combined with patent ductus arteriosus, tricuspid insufficiency, and atrial septal defect or patent foramen ovale. The valvuloplasty was performed from the right ventricular outflow tract through a median sternotomy incision under TEE guidance for all cases. RESULTS Thirty-five patients were successfully discharged, and 3 patients died after the operation. The 35 surviving patients were followed up. Spo2 in the 35 patients was 88-96% after the operation. The transpulmonary valvular gradient pressure was less than or equal to 30 mmHg in 31 patients and between 36 and 52 mmHg in the other 4 patients. After the surgery, tricuspid regurgitation was significantly reduced. We found only 4 patients with moderate regurgitation, 5 patients with mild to moderate regurgitation, and mild regurgitation in the remaining 26 patients. Five patients underwent a second-stage operation, including biventricular repair in 4 patients and ligation of ductus arteriosus in 1 patient. CONCLUSIONS The application of transthoracic balloon pulmonary valvuloplasty for the treatment of PA/IVS is minimally invasive and safe, which has great significance for improving the curative effect for this condition and reducing operation mortality.

[Distribution of Moxibustion-induced Thermosensitive Acupoints of Yangming Meridians in Patients with Perennial Allergic Rhinitis].

OBJECTIVE: To examine the distribution of heat-sensitive acupoints below the elbow and knee joints of the Yangming Meridians in patients with perennial allergic rhinitis (PAR)．. METHODS: A total of 27 PAR volunteers 16－55 years in age were recruited in the present study. In a quiet room, the patient was ordered to take a recumbent or sitting position, and the operator held an ignited moxa-stick to make a circling (about 2 min), sparrow-pecking (2 min) and forwards-backwards moving (1 min) moxibustion perpendicularly over the skin (about 3 cm away) along the running course of the Large Intestine Meridian of Hand Yangming below the elbow joints and the Stomach Meridian of Foot Yangming below the knee joints on both sides. The procedures were repeated again and again until the moxibustion sensation disappeared. The patient was asked to carefully perceive the heat diffusion, diathermic, extending, athermal (cool and itching) feelings, at the heated loci. If one or more of the feelings appeared, it was considered as the thermosensitive phenomenon and that spot was marked as the "thermosensitive spot" or "thermosensitive acupoint"．. RESULTS: In those 27 PAR patients, the thermosensitive response was found at Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Sanjian (LI 3), and Zusanli (ST 36), constituting 59.25% (16/27), 85.18% (23/27), 44.44% (12/27), 55.55% (15/27), and 11.11% (3/27), respectively, being 92.59% in total. Of the 27 patients, 2, 2, 9, 8, 5 and 1 cases had 0, 1, 2, 3, 4 and 5 thermosenitive acupoints appeared, accounting for 7.41%, 7.41%, 33.33%, 29.63%, 18.52% and 3.70%, respectively. CONCLUSION: There is a certain occurrence rate of the thermosensitive acupoints below the elbow and knee joints of the Yangming Meridians in PAR patients, which may provide a target-point for treating PAR.