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find Author "刘宇航" 5 results
  • Minimally invasive experiences and medium-long-term results of perventricular device closure of ventricular septal defects in 783 children: A retrospective analysis in a single center

    ObjectiveTo summarize the minimally invasive experiences and medium-long-term results of perventricular device closure of ventricular septal defects (VSD) under transesophageal echocardiography (TEE) guidance.MethodsWe retrospectively analyzed the clinical data and medium-long-term follow-up results of 783 patients who undertook perventricular device closure under TEE guidance in Dalian Children’s Hospital from July 2011 to January 2020, in which perimembrane VSD were found in 598 patients, VSD with aortic valve prolapse in 135 patients and muscular VSD in 2 patients. There were 463 males and 320 females at age of 5 months to 13 years with average age of 3.3±1.2 years, and body weight of 5.9-51.0 (15.9±8.3) kg. The left ventricular defect diameter of the VSD ranged from 5.0 to 11.0 mm, with an average of 6.3±1.2 mm. The right ventricular defect diameter of the VSD ranged from 2.3 to 8.0 mm, with an average of 4.3±0.9 mm.ResultsThe procedures were completed successfully in 753 patients. The device of 1 patient (0.1%) fell off and embedded in the right pulmonary artery after the operation, and the occluder was taken out and the VSD was closed with cardiopulmonary bypass (CPB) in the secondary operation. One patient (0.1%) appeared Ⅲ degree atrioventricular block in 2 years after operation. The device was taken out and VSD was closed with CPB in the secondary operation, and the patient gradually reached to sinus rhythm in post-operation. Eight patients (1.1%) presented delayed pericardial effusion in 1 week after operation, and were cured by pericardiocentesis with ultrasound-guided. Symmetric occluders were used in 580 patients, eccentric occleders were used in 171 patients and muscular occluders were used in 2 patients. The follow-up time was 9 months to 9 years. The rate of loss to follow-up was 96.7% (704/728). No residual shunt, occlude-loss or arrhythmia was found during follow-up. Conclusion The minimally invasive penventricular device closure of VSD guided by TEE is safe and availabe. Medium-long-term follow-up results are satisfactory, it is worthy of clinical promotion, and longer term follow-up is still needed.

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  • Efficacy of percutaneous intervention for patent ductus arteriosus guided by transesophageal echocardiography in obese teenagers

    ObjectiveTo explore the safety and efficacy of transesophageal echocardiography (TEE)-guided percutaneous intervention for patent ductus arteriosus (PDA) in obese teenagers.MethodsFrom January 2018 to June 2019, 21 obese teenagers with PDA treated with femoral artery occlusion guided by TEE in the Department of Cardiac Surgery, Dalian Children's Hospital of Dalian Medical University were included in this study, including 13 males and 8 females aged 12.8-17.3 (15.1±1.7) years, with an average weight of 51.0-89.0 (73.4±10.1) kg. The operative effect was evaluated. ResultsAll patients successfully received the surgery, and none was changed to radiation-guided or thoracotomy ligation. The average operating time was 23.9±6.8 min, the average postoperative hospitalization time was 3.8±0.6 d. No peripheral vascular injury, intracardiac infection or pericardial effusion occurred. The mean follow-up time was 19.5±4.9 months, and the results of all reexaminations were good.ConclusionFor some PDA children with obesity, emphysema or thoracic malformation, it is difficult to block PDA by transthoracic ultrasound-guided percutaneous intervention, and TEE can avoid the interference of chest wall and lung qi, or other factors. It is an effective supplementary guidance method worthy of promotion.

    Release date:2020-05-28 10:21 Export PDF Favorites Scan
  • 新生儿室间隔完整型肺动脉闭锁 Hybrid 手术预后分析

    目的 探讨室间隔完整型肺动脉闭锁(pulmonary atresia with intact ventricular septum,PA/IVS)新生儿行 Hybrid 手术的预后。 方法 回顾性分析 2015 年 7 月至 2017 年 11 月我院行 Hybrid 手术(食管超声引导下经胸切口右室流出道途径球囊扩张肺动脉瓣联合 BT 分流术) 9 例 PA/IVS 新生儿的临床资料,其中男 6 例、女 3例,手术年龄23(17~29)d。 结果 9 例新生儿手术顺利,手术时间 112(95~147)min。1 例死于肺部严重感染,余 8 例均顺利出院。8 例存活患儿机械通气时间 31(22~47)h,住院时间 17(12~23)d,出院时 8 例平均血氧饱和度升至 87.5%,平均右室收缩压降至 49 mm Hg,肺动脉瓣跨瓣压降至 28(21~46)mm Hg。1 例术后发生短暂的室上性心动过速,5 例患儿因为术中失血给予了输血,3 例患儿出现肺动脉瓣少量反流,1 例患儿出现肺动脉瓣中量反流,无 1 例患儿发生心脏穿孔、主肺动脉瘤或低心排血量综合征。随访时间为 17.5(7~26)个月。5 例患儿已完成根治手术,3 例患儿等待行根治手术。 结论 相对传统外科手术和经皮介入术,Hybrid 手术治疗可作为一种安全有效的替代治疗手段,对于条件合适的 PA/IVS 新生儿可获得满意的预后。

    Release date:2018-09-25 04:15 Export PDF Favorites Scan
  • Application of adjustable curved sheath in transcatheter closure of atrial septal defect with internal jugular vein solely guided by transthoracic echocardiography: A case report

    A case of a 4-month-old child with an aortopulmonary fenestration weighing 6.6 kg who underwent successful transthoracic minimally invasive occlusion in our hospital was reported in this article. The child was transferred from the intensive care unit (ICU) to the general ward 1 day after surgery and discharged 5 days later. Compared with conventional ligation or repair of extracorporeal circulation for the aortopulmonary fenestration, the transthoracic minimally invasive occlusion is characterized by less trauma and faster recovery. However, it requires strict surgical indications and is not suitable for all patients with aortopulmonary fenestration.

    Release date:2021-03-05 06:30 Export PDF Favorites Scan
  • Minimally invasive techniques for treatment of special cardiac malformations

    ObjectiveTo share the experience of treating special cardiac malformations by applying minimally invasive techniques.MethodsEight children with special cardiac malformations admitted to our hospital from July 2014 to September 2020 were recruited, including 3 males and 5 females, aged 0.8-1.2 (1.1±0.4) years, and weighted 7.8-11.5 (9.6±2.9) kg. There were 2 patients of huge muscular ventricular septal defect (VSD), 3 perimembranous cribriform VSD, 1 right coronary-right atrial fistula, 1 right coronary-right ventricular fistula, and 1 young, low-weight child with large aortopulmonary. All were treated with minimally invasive techniques using transesophageal echocardiography (TEE) as a guiding tool. All children received intraoperative TEE immediately to evaluate the curative effect of the surgery, and all went to outpatient clinic for reexamination of echocardiography, electrocardiogram and chest X-ray after discharge.ResultsEight children underwent minimally invasive surgery successfully without any incision infection, intracardiac infection, arrhythmia or pericardial effusion. None of the 8 children were lost to follow-up, and the results of all reexaminations were satisfactory.ConclusionThe application of minimally invasive techniques is a bold and innovative attempt for the treatment of a few special types of cardiac malformations. It has significant advantages in reducing trauma and medical costs in some suitable patients, and has certain clinical reference values.

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