[Effect and prognosis of new type of re-dilated stent in the treatment of pulmonary artery bifurcation stenosis].

the early and med-term follow-up results and technical points of new re-dilated stent in the treatment of pulmonary artery bifurcation opening stenosis, and explore its feasibility and advantages. From March 2019 to October 2020, 10 children [5 males, mean age (7±3) years], mean weight 18.75(13.35,23.05) kg with pulmonary artery bifurcation opening stenosis were treated with new re-dilated stents in the Central China Fuwai Hospital. Including 5 cases of tetralogy of Fallot, 4 cases of pulmonary atresia, 1 case of anomalous origin of coronary artery, all children were given new re-dilated stent implantation. Echocardiography, chest X-ray and electrocardiogram were performed 1 day, 3, 6, 12 months after intervention. Pulmonary artery CTA was performed after 6 or 12 months to evaluate the results, including restenosis, malposition and rupture. A total of 16 stents were implanted in 10 children, 5 cases had simultaneous stenosis of bifurcation openings of pulmonary arteries, and 1 stent was implanted in each of the left and right pulmonary artery openings. The pressure of right ventricular and gradient was significantly decreased immediately after intervention, from preoperative (38-80) mmHg(1 mmHg=0.133 kPa) to postoperative (0-22) mmHg, only one patient's pressure gradient is over 20 mmHg (22 mmHg), and all cases discharged successfully. Stent restenosis, malposition, fracture and other abnormalities were not observed in follow-up. Stents implantation for patients with pulmonary artery bifurcation opening stenosis is very more difficult. A good strategy can ensure that the intervention is safe and effective. It not only avoids the risk of repeated surgery, but also achieves good med-term follow-up results.

[Short- and mid-term outcomes of percutaneous balloon mitral valvuloplasty under the guidance of ultrasound].

Objective: To evaluate the safety, short- and mid-term outcomes of percutaneous balloon mitral valvuloplasty (PBMV) guided by the ultrasound. Methods: In this retrospective study, medical data of 15 patients [9 males and 6 females, with an age of (53±13) years] with PBMV under the guidance of ultrasound in Heart Center of Henan Provincial People's Hospital between December 2016 and January 2019 were collected and reviewed. The short-and mid-term outcomes were analyzed. Results: PBMV was successfully performed in all the patients. One patient underwent surgical valve replacement due to severe mitral regurgitation, and the other 14 patients were all followed up successfully. The average follow-up time was (13.8±4.6) months. Comparisons of preoperative and postoperative data showed significant differences in valve area [(1.84±0.43) cm2 vs (0.89±0.24) cm2], left atrial pressure [(11.9±4.5) mmHg (1 mmHg=0.133 kPa) vs (21.9±6.0) mmHg] and mean mitral valve pressure gradient [(10.9±3.2) mmHg vs (20.1±3.6) mmHg](all P<0.01), with no significant differences in mitral regurgitation area (P=0.67). Postoperative follow-up showed that there were no significant differences in mitral valve area, regurgitation area and N-terminal pro-B-type natriuretic peptide (NT-proBNP) between short-and mid-term postoperatively (all P>0.05). There was no secondary operation due to mitral stenosis in 14 patients, and 3 patients with moderate or severe tricuspid regurgitation showed significant improvement, with gradually recovered cardiac function, and there were no deaths in these patients. Conclusion: PBMV guided by the ultrasound is feasible and effective, and exhibits favorable short-and mid-term outcomes.

[Effect of miR-19b on the proliferation and apoptosis of P19CL6 cells during the late-stage of cardiac differentiation].

Objective: To explore the effect of miR-19b on the function of P19CL6 cells and its molecular mechanism. Methods: Overexpression of miR-19b was carried out by transfecting miR-19b plasmid into the P19CL6 cells. MTT assay and flow cytometry were used to determine cell growth and apoptosis, respectively. Western blot was used to detect the expression level of Sox6 in P19CL6 cells. ELISA assay was used to detect the expression levels of apoptosis-related genes (Bax, Bcl-2) in P19CL6 cells at late-stage cardiac differentiation. Further online software TargetScan was used to predict the target genes of miR-19b and verified by dual luciferase reporter assay. Results: Our data showed that overexpression of miR-19b in P19CL6 cells significantly increased the cell growth rates and the apoptosis inhibition rates. The ratio of apoptosis-related proteins (Bax/Bcl-2) was significantly reduced. Results from the TargetScan and dual luciferase reporter showed that Sox6 is the direct target of miR-19b. Conclusions: We conclude that miR-19b might promote cell proliferation and inhibits cell apoptosis during the late-stage of cardiac differentiation by targeting Sox6 expression.

[Feasibility of retrograde approach for percutaneous closure of ventricular septal defect under solely guidance of transesophageal echocardiography].

OBJECTIVE: To evaluate the feasibility of retrograde transcatheter closure of ventricular septal defects (VSD) under trans-esophageal echocardiography (TEE). METHODS: Twelve patients with VSD, with 4 residual shunt, treated by transcatheter VSD closure under solely guidance of TEE were summarized. Mean age, body weight and average diameter of VSD in 12 cases were (11.58±6.57) years, (31.85±13.28) kg, (5.50±2.20) mm, respectively. All patients were treated by retrograde transcatheter closure under solely guidance of TEE. The post-operative efficiency was estimated by TEE immediately. Patients were followed up by echocardiography, X-ray examination and electrocardiogram at 24 hours, 1, 3 and 6 months after the procedures. RESULTS: All 12 patients were treated successfully under solely guidance of TEE. The diameter of devices were 5-14 mm. There were 1 case with trivial residual shunt after the procedures immediately. No patients suffered from residual shunt, occluder malposition, peripheral vascular injury and pericardial effusion during the follow-up. CONCLUSION: Percutaneous transcatheter closure of VSD completely guided by TEE is safe and effective. This method could avoid the radiation and contrast media reaction, and also could simplify the procedure.