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@#Objective To investigate the early clinical results of MitraClip system in domestic patients. Methods We retrospectively analyzed the clinical data of 36 patients who underwent transcatheter edge-to-edge repair procedure using MitraClip system in Beijing Fuwai Hospital, Shenzhen Fuwai Hospital and Fuwai Yunnan Cardiovascular Hospital between January and June 2021. There were 24 males and 12 females, with a median age of 70 (47-86) years. Ten (27.8%) patients had 3+ mitral regurgitation (MR) and 26 (72.2%) patients had 4+ MR preoperatively. Results All procedures were successfully performed. The reduction in MR was 2+ at least immediately after surgery, and 91.7% of patients had MR≤2+ at 3 days postoperatively. There was no statistical difference in left ventricular ejection fraction change postoperatively. Forward velocity and peak gradient of mitral valve were increased after the procedure. Mean gradient of mitral valve were increased at 3 days postoperatively than immediately after surgery (P<0.001). Two patients had acute pericardial effusion intraoperatively, and received pericardial puncture and drainage immediately. Conclusion MitraClip system has been applied well in domestic patients and can significantly improve MR. This sutdy has a good consistency with foreign studies, and the early results are satisfactory.
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@#Objective To investigate the best anatomical classification, surgical timing, procedure and clinical outcomes of congenital vascular ring. Methods The clinical data of 58 patients who underwent congenital vascular ring surgery in Pediatric Surgery Center, Fuwai Hospital between 2014 and 2019 were retrospectively analyzed. There were 32 (55.2%) males and 26 (44.8%) females with a median age of 16.5 (2-73) months. Preoperative symptoms, imaging examinations, anatomical classifications, surgical procedures and postoperative recovery were assessed. Results There were 20 (34.5%) patients of double aortic arch, 22 (37.9%) patients of right aortic arch with left arterial duct or ligament, 15 (25.9%) patients of left aortic arch with aberrant right subclavian artery, and 1 (1.7%) patient of circumflex aorta with cervical aorta arch. The median ventilator supporting time was 6.0 (0-648) h, and the median hospital stay time was 14.5 (7-104) d. One patient with coarctation of aorta died of severe pulmonary infection during perioperative period, and the others survived without symptoms and reoperation after discharge. The median follow-up time was 7.0 (1-62) months. Conclusion For children with unexplained dyspnea and dysphagia, or with right aortic arch, preoperative imaging examinations such as computed tomography or magnetic resonance imaging are required to confirm the diagnosis of vascular ring. Surgical correction of congenital vascular ring is safe and reliable, and can effectively relieve symptoms. The mortality rate and reoperation rate are low, and the follow-up results are satisfactory.
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@#Congenital heart disease (CHD) is a birth defect with the highest incidence in China. In September 2020, Annual Report on Cardiovascular Health and Diseases in China (2019) was published by National Center for Cardiovascular Diseases. The present situation of prevention and treatment of CHD was briefly summarized in this report. In this paper, we presented the main opinions of Annual Report on Cardiovascular Health and Diseases in China (2019), supplied with relevant data, such as epidemiology, surgical treatment and interventional treatment of CHD, to further expand and explain this report.
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@#Objective To explore the clinical effect of mitral valvuloplasty on children with Barlow disease combined with moderate to severe or severe mitral regurgitation. Methods The clinical data of 10 patients with Barlow disease combined with moderate to severe or severe mitral regurgitation in Fuwai Hospital from January 2014 to August 2019 were analyzed retrospectively, including 3 males and 7 females, with a mean age of 8.7±7.9 years. Echocardiography before and during the operation confirmed that the mitral valve leaflets were long and swinging, the valve leaflets and the opposite edge protruded into the left atrium and were higher than the level of the mitral valve rings, the mitral valve rings were dilated, the papillary muscles and tendons were long, and the pathological changes after the operation showed mucoid degenertion of the valve leaflets and tendons, and some fibrous foci hyperplasia. Mitral valve repair included implantation of artificial valve ring, implantation of artificial tendon, posterior leaflets sliding, partial resection of posterior leaflets (excluding sliding), valve leaflets folding, tendon folding, papillary muscle splitting and annular valve contraction (excluding artificial valve ring implantation). The technique of mitral valve repair, early clinical results and follow-up echocardiographic data were analyzed. Results All the patients successfully completed the mitral valve repair. The mean time of aortic occlusion was 73.2±17.4 min, and cardiopulmonary bypass time was 99.5±19.8 min. At the same time, 4 patients received tricuspid valve repair and 1 funnel chest correction. There was no reoperation in perioperative period. The 1-year and 5-year survival rates were 100.0% and 100.0%, respectively. The incidence of below moderate mitral regurgitation was 90.0% at postoperative 1 year and 72.0% at postoperative 5 years. Conclusion For the young children who have Barlow disease and mitral regurgitation, considering the characteristics of heavy lesions, small operation space, and the need to meet the growth and development of valve, it is suggested to adopt the surgical techniques different from those of older children, such as valve ring retraction and tendon folding, if necessary, to adopt "edge to edge" suture, which can shorten aortic occlusion time and achieve good early effects, and its long-term effects still need further follow-up observation. Mitral valvuloplasty technique for Barlow disease similar to that of adults can be used in older children, including implantation of artificial valve ring and implantation of artificial tendon, etc.
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Objective·To construct C-shaped cartilage rings by rabbit auricular cartilage-derived chondrocytes combing with both electrospun gelatin/ polycaprolactone(GT/PCL) nanofibrous membranes and 3D printed supporters for repairing tracheal cartilage defects.Methods·Primary chondrocytes were isolated from rabbit auricular cartilage with methods of trypsin enzyme digestion and collagenase enzyme digestion.After proliferation in vitro,the chondrocytes of passage 2 were harvested for further experiments.Ultrafine composite fibers of GT/PCL were fabricated via electrospinning.The electrospun GT/PCL membranes were tailored into rectangle shape,the length of which is 12 cm and the width is 2.5 cm.Chondrocytes were seeded on membrane at a density of 1 × 108 cells/mL.Then the membrane were rolled onto a 3D printed supporter of poly(DL-lactide-ε-caprolactone) (PLCL) material to construct a C-shaped cartilage-like complex.After 8 weeks of subcutaneous incubation in vivo,gross inspection and paraffin section staining were applied for evaluation.Results·After 8 weeks of culture in vivo,mature cartilage-like tissue were formed with open-cylindrical bellow appearance and pecific mechanical property.C-shaped rings arranged at regular intervals on the inner surface of tissue,which were similar to the normal structure of tracheal cartilages.Histological and immunohistological staining showed a large number of typical lacunar structures and extracellular matrix secretions.Conclusion·It is feasible to construct tissue engineered C-shaped cartilage tissue by combing chondrocytes with GT/PCL membrane and 3D printed PLCL supporter for tracheal cartilage repair.