Trans-esophageal echocardiography guided closure of ventricular septal defect with 2 occluders from different incisions simultaneously: A case report.

INTRODUCTION: Ventricular septal defect (VSD) accounts for up to 40% of all congenital cardiac malformations. Transthoracic closure of VSDs has been well described in literature. In the current report, we described a procedure to successfully close a VSD with 2 occluders from different incisions simultaneously under the guidance of trans-esophageal echocardiography (TEE), to save the patient from undergoing another surgery. PATIENT CONCERNS: A 52-year-old man was referred to our clinic for repeating palpitations for 6 months without chest pain and polypnea after activity. DIAGNOSIS: The diagnosis of VSD was established due to the findings of a juxtatricuspid VSD with a left-to-right shunt at ventricular level and mild mitral regurgitation by TTE. INTERVENTIONS: A transcatheter VSD closure was firstly performed but failed to repair the VSD. After the failure of transcatheter VSD closure, the patient received transthoracic closure of VSD operated by a cardiac surgeon. The VSD was closed with 2 occluders from different incisions (median thoracic skin incision and subxiphoid incision) simultaneously under the TEE guidance. OUTCOMES: The patient was extubated in intensive care unit and was discharged 4 days after the operation. During the follow up, there were no significant clinical nor laboratory side-effects of the procedure found as compared to the patient's condition before the procedure. CONCLUSION: VSD can be closed with 2 occluders from different incisions simultaneously under the TEE guidance to save the patient from undergoing repeated surgeries. Meanwhile, TEE plays a significant role in cardiac surgery.

Construction of porcine growth hormone eukaryotic expression vector and its transfection mediated by cationic liposome in mice.

The present study was designed to construct the eukaryotic expression vector for pGH mature peptide (mpGH) and to investigate its transfection mediated by cationic liposome (CLs) in COS-7 cells and mice. The cDNA of mpGH ORF was successfully cloned by reverse transcription-PCR (RT-PCR) using the adult pig pituitary gland RNA. The recombinant eukaryotic expression vector, VmpGH, was constructed by ligating the cDNA fragment to the vector VR1020. The successful construction was confirmed by restriction enzyme digestion, and the expression of mpGH was confirmed by RT-PCR, immunofluorescence analyses (IFA), and ELISA in COS-7 cells. The VmpGH and VR1020 plasmids were entrapped with CLs, and four experimental groups of male Kunming mice were administrated with VmpGH / lipoplex or naked VmpGH plasmids at two dosages (0.5 and 1.0 mg/kg), while the mice injected with VR1020-lipoplex at the dosage of 0.5 mg/kg body weight (BW) were used as control. The BWs of the mice administrated with VmpGH-lipoplex at both dosages were significantly higher than not only those of the control (P < 0.01) but also those of mice injected with naked plasmids (P < 0.01), from 30 to 60 days post-transfection. The transcription of VmpGH was detected by RT-PCR in six tissues, including the liver, kidney, spleen, heart, muscle, and blood, of the mice injected with VmpGH-lipoplex, but not in the same tissues of control mice. Furthermore, the mice injected with VmpGH-lipoplex showed higher plasma GH contents than the control mice (P < 0.05), although their IgG contents did not show much difference. Our study demonstrates that the VmpGH plasmids' transfection mediated by CLs can significantly promote the growth of mice, which may be used to improve the livestock production.