Time filter

Source Type

Chen W.,Fujian Medical University | Yan X.,Fujian Medical University | Huang Y.,Fujian Medical University | Sun X.,Fujian Medical University | And 6 more authors.
Pediatric Cardiology

The conventional transcatheter closure of patent ductus arteriosus (PDA) requires femoral artery puncture and angiography for duct anatomic and shunting estimation. If such estimation can be replaced by transthoracic echocardiography (TTE), the procedure will be further simplified, with fewer invasions. This study aimed to examine whether TTE can serve as an alternative to aorta angiography and as a major guidance for transcatheter duct closure. The study enrolled 298 consecutive patients (71 males and 227 females) with PDA. In the study, TTE with combined two-dimensional echocardiography (2DE) imaging and color-coded flow imaging (CDFI) was performed to measure the minimal shunting width (MSW) as the estimated minimal duct size for selection of an Amplatzer duct occluder (ADO) and to monitor the transcatheter duct closure intraprocedurally. The MSW was validated against the duct-stretched diameter (SDD), against the minimal waist diameter of the conical part of a released occluder measured by X-ray spot picture after successful duct closure (SDC), and against the size of the finally used ADO (SADO). Good correlation was found between MSW and SDD [SDD (mm) = 1.31 MSW; r = 0.89; p < 0.01] and between MSW and SADO [SADO (mm) = 1.71 MSW; r = 0.88; p < 0.01]. Of 296 patients who received occlusion using MSW as the reference for selection of the occluder, SDC was attained in 288 (97.3 %), 5 (1.7 %), and 2 (0.7 %) patients, respectively, at the first, second (1 ADO replacement), and third (2 ADO replacements) occluding attempt. Acute occluder dislodgement occurred in one patient (0.3 %). At the 12-month follow-up assessment, no major complications were found, and the total immediate or 12-month SDC was 99.7 %. Echocardiography as an alternative major guidance to angiography for transcatheter duct closure is technically feasible, and TTE guidance can further simplify the procedure, with fewer invasions and potential complications. © 2014 Springer Science+Business Media New York. Source

Fang J.,Fujian Medical University | Fang J.,Fujian Institute of Coronary Heart Disease | Chen L.,Fujian Medical University | Chen L.,Fujian Institute of Coronary Heart Disease | And 12 more authors.
Journal of Molecular and Cellular Cardiology

Ischemic postconditioning (IPC) is cardioprotective against ischemia-reperfusion injury which impairs the myocardial micro-environment and reduces the survival of transplanted cells. We tested the hypothesis that IPC may improve the survival of transplanted cells and enhance their therapeutic effects. In this study, bone marrow-derived mesenchymal stem cells (BMSCs) from Sprague-Dawley rats were infected with lentivirus carrying green fluorescent protein (GFP) gene. The left main coronary arteries of rats were occluded for a 30-min ischemia, followed by a 72h or 28d reperfusion. IPC was induced by 3 cycles of 10s reperfusion and 10s ischemia before sustained reperfusion. GFP-BMSCs were intramyocardially injected at 2h reperfusion. At 70h after transplantation, IPC treatment increased the level of interleukin-10, B-cell leukemia-lymphoma-2 (BCL-2), and vascular endothelial and basic fibroblast growth factor (VEGF and bFGF), and decreased the level of tumor necrosis factor-α, interleukin-1β and BCL-2-associated X protein by ELISA or PCR or western blotting. The BMSCs therapy with IPC produced more surviving GFP-positive cells than the BMSCs therapy alone by fluorescent staining [at 70h, (90±14)/mm 2 vs. (61±12)/mm 2, and at 28days, (55±14)/mm 2 vs. (26±8)/mm 2, P<0.01, respectively]. At 28days, it, when compared with the Control, IPC treatment, and BMSCs therapy, demonstrated higher left ventricular ejection fraction by echocardiography (62%±8%, 69%±6%, and 75%±4% vs. 82%±4%, P<0.05, respectively), higher expression of VEGF and bFGF by western blotting and PCR, less myocardial fibrosis by Masson's trichrome staining, and higher capillary density by immunohistochemistry. These results suggest that ischemic postconditioning promotes the survival of transplanted cells and enhances their repair of infarcted myocardium through paracrine mechanisms. © 2011 Elsevier Ltd. Source

Fang J.,Fujian Medical University | Fang J.,Fujian Institute of Coronary Heart Disease | Fan L.,Fujian Medical University | Fan L.,Fujian Institute of Coronary Heart Disease | And 6 more authors.
Scandinavian Cardiovascular Journal

Objectives. Mesenchymal stem cells are sensitive to hypoxia under myocardial micro-environment of ischemia and reperfusion. Ischemic postconditioning, which is cardioprotective against ischemia-reperfusion injury, enhances in-vivo survival and therapeutic effects of transplanted stem cells. In this study, we investigated the effects of coronary effluent from postconditioned rat hearts on proliferation and survival of mesenchymal stem cells in vitro under hypoxia. Design. Isolated perfused rat hearts were divided into three groups (n = 6): The Sham group-receiving a 90 min perfusion; the Control group-receiving a 30 min global ischemia followed by a 60 min reperfusion; the ischemic postconditioning group-before sustained reperfusion, 3 cycles of 30 s reperfusion and 30 s ischemia were performed. Inflammation-related factors in coronary effluent were assessed by ELISA. Mesenchymal stem cells from bone marrow of Sprague-Dawley rats were cultured with coronary effluent under hypoxia (95% nitrogen, 5% carbon dioxide, and < 1% oxygen) for 6- or 18 h. Cell proliferation was determined by methyl thiazolyl tetrazolium. Survival rate was measured by Annexin V/PI. Results. Compared with ischemia-reperfusion treatment alone, postconditioning treatment increased the level of interleukin-10 and decreased the level of tumor necrosis factor-α and interleukin-1β in coronary effluent (P < 0.01). Stem cells cultured with postconditioned effluent, compared with those with ischemia-reperfusion effluent, had a higher proliferation (optical density value), more surviving cells, and less necrosis (P < 0.01). Conclusions. Coronary effluent from postconditioned hearts may promote the proliferation and survival of mesenchymal stem cells under hypoxia, and the suppression of inflammation may be involved in this process. © 2014 Informa Healthcare. Source

Chen L.-Y.,Fujian Institute of Coronary Heart Disease | Chen L.-Y.,Fujian Medical University | Cai P.,Fujian Institute of Coronary Heart Disease | Cai P.,Fujian Medical University | And 9 more authors.
Journal of Invasive Cardiology

Objective: This study compared the clinical outcome of the transvenous versus transthoracic approach for closure of patent ductus arteriosus (PDA). BACKGROUND: There are no data regarding the results of transvenous versus transthoracic catheter-based device closure of PDA with Amplatzer duct occluder (ADO) despite their increasing use as alternatives to conventional surgery. METHODS: In this observational study, a total of 150 consecutive patients with PDA were allocated either to the transvenous approach (group A, n ≤ 108) and the transthoracic approach (group B, n ≤ 42) by using ADO between January 2010 and April 2012. Echocardiography was performed to evaluate the prespecified initial and 6-month success of PDA closure. The technical indices and procedure-related major acute and chronic complications were documented. RESULTS: There were similar initial success rates (98.2% vs 100%; P>.05) and 6-month success rates (99.1% vs 100%; P>.05) between groups, and group A had fewer major acute complications (3.7% vs 85.7%; P<.001), shorter operating time (1.3 hours vs 2.1 hours; P<.001), Intensive Care Unit stay (0 hours vs 23.0 hours; P<.001), and recovery time (3.8 days vs 9.5 days; P<.001), and lower rates of general anesthesia (36.1% vs 100%; P<.001), blood transfusion (0.9% vs 71.4%; P<.001), and extra use of antibiotics (27.8% vs 78.6%; P<.001), and lower total cost of hospitalization ($3815.78 vs $5730.21; P<.001). CONCLUSIONS: Despite similar efficacy for duct closure with ADO, transvenous approach was associated with fewer acute complications, more periprocedural comfort, and lower cost; thus, transthoracic approach should not be a reasonable choice for duct closure except for particular indications. Source

Discover hidden collaborations