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Transthoracic Salus Valve Feasibility Study: Short-Term Outcomes of a Transcatheter Self-Expandable Pulmonary Valve

Cardiology Discovery 2023年第2期3卷 67-77页

作者： Jun Dong junwu su Aijun Liu Jing Du Jing Yang Qiangqiang Li Bin Li Ming Yang Zhijun Wang Qian Bao Department of Pediatric Cardiac Center Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China Department of Radiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China.

Objective:The size and morphology of the right ventricular outflow tract(RVOT)in patients suffering from long-term pulmonary regurgitation(PR)after native RVOT(NRVOT)reconstruction are important factors affecting the feasibility,safety,and effectiveness of transcatheter pulmonary valve replacement.The purpose of this study was to evaluate the feasibility,safety,and effectiveness of a transthoracic Salus valve(Balance Medical Technology Co.,Ltd,Beijing,China)in patients with moderate-to-severe PR after NRVOT reconstruction.Methods:Patients with moderate-to-severe PR after NRVOT reconstruction were selected between June 2021 and November 2021 at Beijing Anzhen Hospital.Demographic data as well as preoperative,intraoperative,and follow-up data were reviewed.Results:Ten patients with moderate-to-severe PR after NRVOT reconstruction underwent physical examination,transthoracic echocardiography,and cardiovascular magnetic resonance imaging.Seven patients were selected for transthoracic Salus valve replacement.Six patients underwent implantation of the Salus valve successfully.One valve migrated and was embolized during recovery of the delivery device;the Salus valve was surgically explanted and sutured to the inner wall of the main pulmonary artery.At a mean follow-up of(5.5±1.1)months,dysfunction or migration of the Salus valve embolism was not observed.Conclusions:This early feasibility study demonstrates the feasibility,safety,and effectiveness of transthoracic implantation of a Salus valve in patients with moderate-to-severe PR after NRVOT reconstruction.The short-term effectiveness is clear,medium and long-term effectiveness requires longer follow-up.

关键词： Feasibility study Pulmonary regurgitation Right ventricular outflow tract Transthoracic transcatheter pulmonary valve replacement

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surgical treatment of interrupted aortic arch associated with ventricular septal defect and patent ductus arteriosus in patients over one year of age

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Chinese Medical Journal 2014年第9期127卷 1684-1690页

作者： Li Zhiqiang Li Bin Fan Xiangming su junwu Zhang Jing He Yan Liu Yinglong Department of Pediatric Heart Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background Interrupted aortic arch （IAA） is a rare congenital anomaly affecting 1.5％ of infants with congenital heart disease.Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion.However,in China,patients with IAA associated with ventricular septal defect （VSD） and patent ductus arteriosus （PDA） over one year of age are common.So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.Methods From January 2009 to December 2012,19 patients with IAA have undergone complete single-stage repair.The patients＇ mean age was 4.4 years,ranging 1 to 15 years; and their mean weight was 12.8 kg,ranging 4.2 to 36.0 kg.Fifteen IAA were type A,four were type B.Preoperative cardiac catheterization data were available from all patients.Mean pulmonary arterial pressure （mPAP） and pulmonary vascular resistance （PVR） were measured.The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case.All patients underwent echocardiographic examinations before discharged from the hospital.In addition,cardiac catheterization and echocardiographic examinations were performed during follow-up.Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients.Mean follow-up was （1.6±0.8） years.Results There were two hospital deaths （2/19,11％）.One patient died of pulmonary hypertension crisis,and another died of postoperative low cardiac output.Five cases had other main postoperative complications but no postoperative neurologic complications.Seventeen survivors were followed up,and there were no late deaths or reoperation.Mean cross-clamp duration was （85±22） minutes and selective brain perfusion duration was （34±11） minutes.Two patients required delayed sternal closure at two days postoperatively.Intensive care unit and hospital stays were （9±8） days and （47±24） days,respectively.Pressure gradients across the anastomosis at most recent follow up were less than 22 m

关键词： interrupted aortic arch ventricular septal defect pulmonary hypertension

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Midterm results of diagnostic treatment and repair strategy in older patients presenting with nonrestrictive ventricular septal defect and severe pulmonary artery hypertension

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Chinese Medical Journal 2014年第5期127卷 839-844页

作者： Liu Aijun Li Zhiqiang Li Xiaofeng Fan Xiangming su junwu Zhang Jing He Yan Liu Yinglong Department of Pediatric Heart Center Beijing Anzhen HospitalCapital Medical University Beijing 100029 China

Background Congenital heart disease with severe pulmonary arterial hypertension （SPAH）,previously thought to have irreversible pulmonary vascular disease （PVD）,has been recently successfully corrected using diagnostic treatment and repair strategy by our surgery team.This study aimed to evaluate the midterm results of a selected cohort of older patients with nonrestrictive ventricular septal defect （VSD） and SPAH using diagnostic treatment and repair strategy.Methods The records of 56 patients older than six years with nonrestrictive VSD and SPAH undergoing diagnostic treatment and repair strategy from 2006 to 2012 were retrospectively reviewed.All patients received advanced pulmonary arterial hypertension （PAH） therapy and radical repairs were performed when transcutaneous oxygen saturation （SPO2） increased up to 93％.Results There were no operative deaths.SPO2 and baseline six-minute walk test （SMWT） distance of all selected patients increased significantly and mean pulmonary artery pressure （MPAP） regressed significantly after diagnostic treatment and at late follow-up （P ＜0.01）.The incidence of late postoperative PAH was seen in six （10.7％） patients and by Logistic regression analysis,early postoperative PAH was an independent risk factor related to late postoperative PAH.Conclusions Diagnostic treatment and repair strategy was effective and safe for treatment of nonrestrictive VSD and SPAH and the midterm results were excellent.Diagnostic treatment strategy was effective in assessing the reversibility of SPAH in older patients associated with nonrestrictive VSD and the PVD in these selective patients is generally reversible.

关键词： pulmonary hypertension congenital heart disease ventricular septal defect therapy

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Expert Consensus on Nutritional support for Children with Congenital Heart Disease(2023 Edition)

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Congenital Heart Disease 2023年第6期18卷 571-593页

作者： Xuming Mo Wei Cai Jirong Qi Zhuoming Xu Ying Wang Weihui Yan Shoujun Li Nianguo Dong Xinxin Chen Jinfen Liu Qiang Shu Jimei Chen Haibo Zhang Hao Zhang Quansheng Xing Qi An Xiaofeng Li Xu Wang Yan He junwu su Taibing Fan Teng Ming Weibing Tang Li Hong Jinghao Zheng Ming Ye Guocheng sun Yiqun Ding Liang Tao Yifeng Yang Zhongshi Wu Hua Cao Qiang Wang Keming Yang Libing Zhang Ping Wen Yanqin Cui Bo Zhai Yong Zou Qingya Tang Rui Chen Chun Wu Zhiyu Feng Caixia Liu Yaping Mi Rufang Zhang Ke Lin Xin Li Mingan Pi Xiangming Fan Shanshan Shi Peng Huang Zhengxia Pan Jiafeng Qi Renwei Chen Shuguang Tao Yaqin Shu Huifeng Zhang Lan Jiang Min Da Nishant Patel Liang Hu Cardiac surgery Group of Pediatric surgery Society of Chinese Medical Association and Parenteral Enteral Nutrition Society of Chinese Medical Association Department of Cardiothoracic surgery Children’s Hospital of Nanjing Medical UniversityNanjing210008China Department of Pediatric surgery and Nutrition Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200092China Department of Cardiothoracic surgery Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghai200127China Division of Pediatric Gastroenterology and Nutrition Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200092China Pediatric Cardiac surgery Center Fuwai HospitalNational Centre for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing100037China Department of Cardiovascular surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China Cardiovascular Center Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou510623China Department of Cardiac surgery Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center for Child HealthHangzhou310052China Department of Cardiovascular surgery Guangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesSouthern Medical UniversityGuangzhou519041China Heart Center and Shanghai Institue of Pediatric Congenital Heart Disease Shanghai Children’s Medical CenterNational Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityShanghai200127China Heart Center Qingdao Women and Children’s HospitalQingdao266034China Department of Cardiovascular surgery West China HospitalSichuan UniversityChengdu610041China Department of Cardiac surgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijing100045China Department of Pediatric Intensive Care Unit Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing100037China Depar

The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following theﬁrst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.

关键词： Congenital heart disease nutrition enteral parenteral expert consensus

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特殊类型房室间隔缺损的超声心动图诊断

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中华超声影像学杂志 2022年第11期31卷 946-952页

作者：马艳春李文秀耿斌苏俊武山西省儿童医院综合检查科太原030013 首都医科大学附属北京安贞医院小儿心脏中心北京100029

目的:探讨特殊类型房室间隔缺损(AVSD)的超声心动图特征,提高对AVSD的认识,减少临床漏诊及误诊。方法:回顾性分析总结2011年11月至2021年11月首都医科大学附属北京安贞医院小儿心脏中心诊断并经手术证实的特殊类型AVSD患者的超声心动图... 详细信息

目的:探讨特殊类型房室间隔缺损(AVSD)的超声心动图特征,提高对AVSD的认识,减少临床漏诊及误诊。方法:回顾性分析总结2011年11月至2021年11月首都医科大学附属北京安贞医院小儿心脏中心诊断并经手术证实的特殊类型AVSD患者的超声心动图资料,根据是否存在室间隔缺损(VSD)将特殊类型AVSD分为两种,即房间隔(原发间隔)完整的AVSD和房间隔(原发间隔)及室间隔均完整的AVSD,总结该病的超声心动图特征。结果:超声心动图共诊断25例特殊类型AVSD。其中手术确诊13例,包括房间隔(原发间隔)完整的AVSD 12例,房间隔(原发间隔)及室间隔均完整的AVSD 1例;无手术适应证5例;因VSD小继续观察1例;1例合并复杂畸形仅行肺动脉环缩术,未处理心内畸形;其他4例膜周部VSD及1例部分型AVSD超声误诊为特殊类型AVSD。患者术前均存在轻至重度左侧房室瓣反流,左侧房室瓣成形术后多残存不同程度的反流。特殊类型AVSD超声心动图特征表现为:①原发房间隔连续完整,无原发孔缺损;②左右房室瓣叶附着点位于同一水平;③左侧房室瓣三叶化,并附着于室间隔上,即形成所谓的"前叶裂";④左心室两组乳头肌改变了正常的前外侧、后内侧的排列,而呈前后关系(逆钟向转位);⑤存在VSD时,VSD位于膜周部偏流入道肌部;⑥CDFI显示收缩期左侧房室瓣可见源自裂隙不同程度的反流信号;⑦可合并其他复杂畸形。结论:超声心动图可对特殊类型的AVSD作出明确诊断,该畸形预后与左侧房室瓣密切相关,成形效果取决于左侧房室瓣发育及反流情况。

关键词：超声心动描记术房室间隔缺损心内膜垫缺损室间隔缺损二尖瓣前叶裂

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儿童Shone综合征22例疾病特点与手术效果分析

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中华实用儿科临床杂志 2022年第6期37卷 443-445页

作者：曹跃丰李磊苏俊武范祥明首都医科大学附属北京安贞医院小儿心脏中心北京100029

目的分析儿童Shone综合征的疾病特点与外科手术效果,探讨本病外科治疗策略与技术关键。方法回顾性研究。收集2013年5月至2019年6月首都医科大学附属北京安贞医院小儿心脏中心收治的Shone综合征并接受手术治疗的患儿,统计患儿基本特征、... 详细信息

目的分析儿童Shone综合征的疾病特点与外科手术效果,探讨本病外科治疗策略与技术关键。方法回顾性研究。收集2013年5月至2019年6月首都医科大学附属北京安贞医院小儿心脏中心收治的Shone综合征并接受手术治疗的患儿,统计患儿基本特征、手术信息等资料。数据比较采用Student t检验。结果共纳入22例患儿,其中男15例(68.2%),女7例(31.8%);完全型Shone综合征6例(27.3%),不完全型Shone综合征16例(72.7%);无患儿死亡。二尖瓣术后流速[(149.7±38.2)cm/s]较术前[(234.9±34.0)cm/s]明显下降(t=7.341,P<0.05);左心室流出道术后流速[(202.0±105.0)cm/s]较术前[(328.6±120.3)cm/s]明显下降(t=6.575,P<0.05);主动脉弓缩窄处术后流速[(186.1±60.9)cm/s]较术前[(347.9±100.8)cm/s]明显下降(t=7.630,P<0.05)。随访1年、3年及5年,分别有100.0%、91.7%及80.2%的患儿未发生并发症,2例患儿需再次手术。结论Shone综合征手术治疗效果满意,早诊断、早干预使患儿获益较大,但需长期随访,患儿远期面临再次手术的风险。

关键词： Shone综合征二尖瓣瓣上环降落伞二尖瓣左心室流出道狭窄

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二维经胸超声心动图诊断小儿二尖瓣裂的价值

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中华医学超声杂志（电子版） 2023年第11期20卷 1186-1192页

作者：李文秀杨爽吴江耿斌苏俊武首都医科大学附属北京安贞医院小儿心脏中心 100029

目的探讨经手术证实的小儿二尖瓣裂的二维经胸超声心动图(2D-TTE)特征,以减少2D-TTE对二尖瓣裂的漏诊及误诊。方法回顾性分析2009年7月至2022年5月首都医科大学附属北京安贞医院小儿心脏中心经手术证实的108例二尖瓣裂患儿的手术结果及2... 详细信息

目的探讨经手术证实的小儿二尖瓣裂的二维经胸超声心动图(2D-TTE)特征,以减少2D-TTE对二尖瓣裂的漏诊及误诊。方法回顾性分析2009年7月至2022年5月首都医科大学附属北京安贞医院小儿心脏中心经手术证实的108例二尖瓣裂患儿的手术结果及2D-TTE图像资料,总结该病的2D-TTE特征、发病特点;根据Carpentier提出的二尖瓣命名法,采用多切面、多角度的扫查方法结合彩色多普勒成像(CDFI)对二尖瓣裂进行分区定位,记录瓣叶裂累及程度并评估反流程度,采用校正χ2检验比较手术前后二尖瓣反流程度变化,通过与手术所见对比超声心动图诊断的准确性。结果108例二尖瓣裂患儿中,单纯性瓣叶裂47例,合并心内畸形者61例;手术显示二尖瓣前叶A2区不完全性裂最为多见(37例),后叶以P2区不完全性裂多见(10例),2D-TTE对前叶A2区及A2-A3区瓣叶裂诊断准确率较高,分别为76.9%(40/52)及62.5%(5/8),对后叶裂及前后叶多发细小裂隙诊断准确率极低,仅为2.5%(1/40),对二尖瓣裂(前叶及后叶)总的诊断准确率为41.7%(45/108)。术前二尖瓣大量、中量反流者占63.8%(69/108)、26.9%(29/108),二尖瓣成型术后反流明显改善,无大量反流的病例,中量反流病例仅有3.7%(4/108),术后二尖瓣反流均明显改善,手术前后不同程度反流组间比较,差异均具有统计学意义(P均<0.05)。二尖瓣裂2D-TTE特征:(1)左心室二尖瓣短轴切面显示二尖瓣前叶回声中断,呈“裂隙”状;(2)左心室二尖瓣短轴切面可明确前叶裂的位置和宽度,但不能明确前叶裂的形态;(3)胸骨旁左心室长轴切面可显示前叶裂累及的范围和程度;(4)二尖瓣前叶A2、A2-A3区的前叶裂容易显示,对后叶的裂隙显示困难;(5)CDFI显示收缩期源自二尖瓣裂处不同程度反流信号;(6)前叶裂容易合并二尖瓣瓣叶脱垂、增厚、卷曲;(7)可合并其他心内畸形。结论小儿二尖瓣裂容易合并其他的心内畸形,2D-TTE主要特征为瓣叶回声中断,呈“裂隙”状,其二尖瓣反流信号源自裂隙处,2D-TTE对二尖瓣A2区、A2-A3区的前叶裂诊断准确率较高,对后叶裂及细小前叶裂容易漏诊,二尖瓣成形术可明显改善二尖瓣反流。

关键词：超声心动描记术二尖瓣裂二尖瓣关闭不全小儿房室间隔缺损

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心下型完全肺静脉异位引流的心内法与上翻法的手术比较

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中华胸心血管外科杂志 2022年第7期38卷 413-416页

作者：吴永涛王栋金灿王执一程沛苏俊武首都医科大学附属北京安贞医院小儿心脏科北京100029

目的分析不同手术方式治疗心下型完全肺静脉异位引流的手术效果,探讨心下型完全肺静脉异位引流的最佳手术入路。方法2011年7月至2019年8月,20例心下型完全肺静脉异位引流患儿完成矫治术,按随机数字表法分为两组,采用不同手术方式:A组心... 详细信息

目的分析不同手术方式治疗心下型完全肺静脉异位引流的手术效果,探讨心下型完全肺静脉异位引流的最佳手术入路。方法2011年7月至2019年8月,20例心下型完全肺静脉异位引流患儿完成矫治术,按随机数字表法分为两组,采用不同手术方式:A组心脏上翻法,12例;B组心内法,8例。比较两组体外循环、主动脉阻断、ICU滞留、机械通气、术后天数以及术后吻合口流速等数据。结果两组体外循环、主动脉阻断、ICU滞留和机械通气差异均无统计学意义。A组术后住院天数明显低于B组[(14.7±2.9)天对(16.1±6.2)天,P120 cm/s者显著多于B组(7例对1例,P<0.05)。A组住院死亡2例,B组无住院死亡。18例生存患儿顺利出院,均定期随访,随访10~96个月。B组1例术后2个月死于误吸,余无死亡。随访超声心动图示均无吻合口流速增快。结论心脏上翻法和心内法治疗心下型完全肺静脉异位引流的手术入路无显著差异,但心内法原位吻合,术后肺静脉梗阻概率低,可以优先选择。

关键词：先天性心脏病完全肺静脉异位引流心下型

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双冠状动脉异常起源肺动脉的诊治1例

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中华胸心血管外科杂志 2022年第2期38卷 113-114页

作者：曹跃丰李磊金戈张巍范祥明苏俊武首都医科大学附属北京安贞医院小儿心脏中心北京市心肺血管疾病研究所北京100029

冠状动脉异常起源肺动脉是一种非常罕见的先天性冠状动脉疾病。本文报道1例3岁4个月成功接受手术矫治的病例。患儿左、右冠状动脉共同起自肺动脉右窦的一条主干,行冠状动脉旁路移植术后,患儿随访半年结果良好。

关键词：右冠状动脉冠状动脉异常起源肺动脉手术矫治冠状动脉旁路移植术后先天性冠状动脉疾病

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Sophora davidii： A Native Shrub Used for Rocky Desertification Control and Development

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Meteorological and Environmental Research 2018年第2期9卷 20-22页

作者： Chen Qiang Zeng Yongyun Huang Chunliang su junwu sun Zhigang Zhang Qing Liu Yonggang Yunnan Academy of Forestry Kunming 650204 China Brigade of Forest Inventory and Planning of Honghe Prefecture Mengzi 661100 China Jianshui Forestry Bureau Jianshui 654300 China

Sophora davidii has strong adaptability and is tolerant of cold,drought,barren soil,fire,trampling,mowing,etc. Besides,it has good ecological benefit and a variety of uses. It is an excellent native shrub species for the control of rocky desertification,as well as the preferred tree species for the ecological control of mountainous areas with severe and extremely severe rocky desertification and shallow soil. It has wide prospects in the follow-up development of the controlled rock desertification regions. The afforestation technology of planting bimonthly seedlings in small ponds has low cost and good effect,so S. davidii is an ideal tree species to replace Dodonaea viscosa in afforestation.

关键词： Sophora davidii Ecological adaptability Afforestation technology Ecological economic benefit

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