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Jian X.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2012

To summarize the experience with surgical correction of tetralogy of Fallot in adults over 40 years of age. From November 1985 to July 2008, 9 male and 11 female patients aged 41-53 years (mean 46.3±3.5 years) underwent total surgical correction for tetralogy of Fallot. Twelve patients had preoperative NYHA class III cardiac function. The common comorbidities included infective endocarditis, cerebral abscess, cerebral infarction, renal dysfunction, and tricuspid insufficiency. Surgical corrections were carried out at the anatomical or physiological level. Nineteen patients received right ventriculotomy to relieve right ventricular outflow obstruction and for ventricular septal defect closure, and 1 patient had Fontan operation. Two patients died after the surgery for heart failure and ventricular fibrillation. The average cardiopulmonary bypass time, aortic clamp time, and postoperative ventilation time was 142.9±36.3 min, 89.9±25.1 min, and 72.0±17.5 h, respectively. Postoperative low cardiac output syndrome occurred in 5 cases, septic shock in 1 case, secondary renal failure in 1 case, and bleeding in 2 cases. Echocardiography showed a significant postoperative reduction of the mean right ventricular outflow tract velocity from 4.29±1.36 m/s to 2.13±0.83 m/s (P<0.01); the right ventricular longitudinal dimension exhibited no significant changes postoperatively (57.1±6.7 mm vs 55.1±7.0 mm, P=0.65). Surgical correction of the tetralogy of Fallot in patients over 40 years is highly risky and requires appropriate management of cardiac failure, careful myocardial protection, and thorough intracardiac lesion correction to decrease surgical complications. Source

Li X.-F.,Guangdong Provincial Cardiovascular Institute
Chinese Critical Care Medicine | Year: 2011

Objective: To investigate the effect of NAC treatment on lipopolysaccharide (LPS) treated human embryonic lung fibroblasts (HELF), in regard to oxidant injury and changes in indexes related to pulmonary fibrosis in ARDS. Methods: Four groups of cultured HELF were treated with, vehicle, LPS (1 μg/ml), NAC (1 mmol/L)+LPS (1 μg/ml) and dexamethasone (DEX, 1 μmol/L)+LPS (1 μg/ml) for 24 hours. The content of collagen and the γ- glutamylcysteinylglycine (GSH) in the cells were determined. Results: As compared to the control group, the collagen content (μg/mg: 78.97±1.79 vs. 72.90±1.70) and GSH content (μg/mg: 23.27±0.92 vs. 26.34±0.83) in LPS group were significantly (P<0.05) higher and lower, respectively; NAC and DEX both suppressed the effect of LPS on collagen content (72.23±1.35, 73.64±1.89 vs. 78.97±1.79); and GSH content (26.52±0.62, 25.85±0.60 vs. 23.27±0.92) significantly (P<0.05 or P<0.01) in the treated cells. No significant difference was found between NAC+LPS and DEX+LPS group, either in the content of collagen or GSH. Conclusion: NAC can inhibit oxidant injury and pulmonary fibrosis in ARDS. Source

Chen D.L.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2010

To study the relationship between angiotensin-converting enzyme 2 (ACE2) gene polymorphisms and the risk factor for essential hypertension (EH) with concurrent ischemic stroke in southern Chinese population. The G9570A polymorphism in ACE2 gene were detected in 139 patients with EH and stroke using polymerase chain reaction-restriction fragment length polymorphism. Detailed clinical and biochemistrical data of the patients, including the pulse pressure, high sensitivity C-reactive protein (hsCRP), intima-media thickness (IMT), high-density lipoprotein cholesterol (HDL-C) and uric acid levels, were collected to study the relationship between ACE2 gene and the risk factor of EH and stroke. The levels of hsCRP (OR=1.022), uric acid (OR=1.224), IMT and pulse pressure was positively correlated to the incidence of EH and stroke. The pulse pressure, hsCRP, IMT, and HDL-C levels in male stroke patients carrying A allele was significantly higher than those in patients carrying G allele (P<0.05). In female stroke patients, the pulse pressure, hsCRP, IMT, and HDL-C levels were also significantly different with regard to the genotype of ACE2 gene (P<0.05). The patients with EH and ischemic stroke carrying the A/AA allele of ACE2 gene have higher risks than those carrying other allele, and can be also more vulnerable to stroke recurrence. Source

Liu L.,Guangdong Provincial Cardiovascular Institute
Nan fang yi ke da xue xue bao = Journal of Southern Medical University | Year: 2013

To evaluate the clinical effect of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death. According to ACC/AHA Guideline of ICD implantation (2005), 35 patients successfully received ICD/CRT-D implantation for primary prevention of sudden cardiac death in our hospital from January 2006 to December 2009. All the patients were followed up for a mean of 2 years. During the follow up, 11 (31.43%) patients experienced ventricular arrhythmic episodes, for which 16 defibrillation therapies and 75 anti-tachycardia pacing (ATP) therapies were delivered without mistaken shock or death. The incidence rate of NVM was 100%, that of PVT was 66.67%, Brugada syndrome 50%, HCM 25% and DCM 16.67%. Of these episodes, the incidence of VF episodes among PVC patients was 87.5% (14 beats), ventricular tachycardia PVC was 82.28% (65 times), 5 beats in NVM patients, 4 beats in HCM and Brugada syndrome patients, and 1 beat in DCM patients. No ICD implantation-related complication was detected, and no ventricular tachycardia induced syncope occurred in these cases. All patients showed improved quality of life after the implantation. ICD implantation can prevent malignant ventricular arrhythmia episodes, especially for PVT, NVM and Brugada syndrome in high risk SCD patients, demonstrating the value of implantation of ICD as a primary prevention in high-risk SCD patients. Source

Zhang B.,Guangdong Provincial Cardiovascular Institute
Catheterization and Cardiovascular Interventions | Year: 2011

Coronary chronic total occlusions (CTO) remain one of the most challenging lesions in percutaneous coronary intervention (PCI). Retrograde approach is an advanced PCI technique and can improve success rate in CTO intervention. Although success rate of this technique is high in experienced hands, there are still limitations in this approach, e.g., failure of wire to cross lesions. We report an easy and reliable new method of wire crossing in CTO lesions. In this technique, when both the antegrade and retrograde wires are in the subintimal space, balloons catheters are delivered in both directions to the site of the CTO. The balloons are then inflated simultaneously to create a common subintimal space (the confluent of subintimal space) which will allow crossing of wire to true lumen, either antegradely or retrogradely. This technique may improve the success rate of wire crossing and successful CTO intervention. Copyright © 2011 Wiley-Liss, Inc. Source

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