Objective To analyze the growth of anastomotic stoma of aortic(AO) and pulmonary artery (PA) after arteries switch operation(ASO) so as to assess the longterm efficacy of ASO . Methods The data of 331 patients who had undergone ASO in Shanghai Children’s Medical Center of Jiaotong University from December 1999 to December 2007 was analysed retrospectively. One hundred eleven patients had complete transposition of great arteries complicated with intact ventricular septum(TGA/IVS), 123 had complete transposition of great arteries complicated with ventricular septal defect(TGA/VSD), 73 had TaussigBing complicated with ventricular septal defect and pulmonary hypertension, and 24 underwent StageSwitch. Of the 331 patients 228 were followedup, and the followup time was 20.4±18.6 months. There were 752 ultrasonic cardiograph reports, 3.3per patient on average. The growth of anastomosis was analysed according to the diameters of AO and PA. Results The AO and PA anastomosis diameters of TGA/IVS patients(before discharge 0.74±0.17 cm and 0.65±0.13 cm, latest followup 1.09±0.31cm and 0.84±0.21 cm), TGA/VSD patients (before discharge 0.76±0.20 cm and 0.63±0.14 cm, latest followup 1.09±0.24 cm and 0.82±0.22 cm) and TaussigBing patients(before discharge 0.84±0.25 cm and 0.74±0.20 cm, latest followup 1.05±0.30 cm and 0.85±0.24 cm) growed significantly(Plt;0.05). The AO anastomotic stoma diameters of patients who had underwent StageSwtich (before discharge 0.93±0.19 cm, latest followup 1.19±0.29 cm) growed significantly(Plt;0.05). The PA anastomotic stoma diameter growed(before discharge 0.90±0.27 cm, latest followup 1.00±0.32 cm), but had no statistical significance (P>0.05). Till November 2008, Six patients needed reoperation because of the right or left ventricle outflow tract obstruction. After reoperation, 3 had no residual obstruction, 3 had residual obstruction. Conclusion After the section and suture of ASO, aortic and pulmonary artery can grow with age, but sometimes stenosis happens to some patients. During the followingup, some patients need reoperation.
Objective To evaluate the feasibility of preservation of arteriesby vitrification and the effectiveness of vitrified arteries as allografts. Methods Sixty rabbits were used in the research. Forty-eight femoral arteries wereharvested from 24 rabbits as the transplanted materials,and 24 femoral arteries were preserved by vitrification, 24 by freezing for 14 days,respectively. Theother 36 rabbits were used as the transplanted subjects,and were divided into three groups, 12 rabbits including 24 femoral arteries per group: Group A(fresharterial autografts), Group B(vitrified arterial allografts) and Group C(frozen arterial allografts). The morphologic changes of arterial grafts were observed macroscopically and histologically. The patent rate of arterial grafts were measured by angiography, and the rabbits were sacrificed on the 14th day, the 30th day, the 60th day and the 120th day after transplantation respectively. Arterial grafts were harvested to observe the morphological changes,and the immunological rejection was evaluated by measuring the ratio of tunica intima and tunica media. The results were compared between these groups. Results Before transplantation,theintegrated rate of Group B was 91.67%,which was significantly better than that of Group C(54.17%, Plt;0.01). After transplantation, the accumulative patent rate of Group B was 87.50%,which was significantly better than that of Group C(66.67%, Plt;0.05). There was statistically significant difference in the ratioof tunica intima and tunica media between Group B and Groups A, C(Plt;0.05).Conclusion The above results show that vitrification does less damage to cells and tissues because of ice-free in the process of cryopreservation. So vitrification can be used to preserve arteries, and the arterial allografts preserved by vitrification are better than those preserved by freezing.
Objective lt;brgt;To evaluate the efficacy of arteriovenous sheathotomy on treatment of branch retinal vein occlusion (BRVO). lt;brgt; lt;brgt;Methods lt;brgt;Six consecutive patients (6 eyes) with BRVO underwent par plana vitrectomy, po lt;brgt;sterios vitreous cortex separation, arteriovenous sheathotomy for BRVO. The foll lt;brgt;owup period was within 3~12 months. Postoperative examinations included color fundus photography, fundus fluorescein angiography(FFA), optical coherence tomography(OCT) and multifocal electroretinography (mERG). lt;brgt; lt;brgt;Results lt;brgt;Increasing downstream blood flow in proximal past of compressed venule was promptly observed during the procedures of incision of the advential sheath of blood vessel, and separating and elevating the ateriole from the venule in all the operations in this series. Visual acuities improved postoperatively in 5 patients, and the best corrected visual acuity was 1.5. The examination of FFA showed obvious absorption of retinal hemorrhage, and leakage of dye was reduced, while large areas of capillary closure in retinas distal to the sheathotomy site were found 3 months after operation in 3 patients. OCT revealed disappearance or lightening of macular edema. mERG showed that the response amplitude of retina including the macular area was obviously higher after the operation. There was recurrent vitreous hemorrhage necessitating further surgery in one patient. lt;brgt; lt;brgt;Conclusion lt;brgt;The operation of arteriovenous sheathotomy for the treatment of BRVO is much beneficial to improve patient′s visual acuity, downstream blood flow and macular affections, although the improvement of retinal reperfusion of the retina is not obvious. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis,2002,18:6-9)
Accurately evaluating the local biomechanics of arterial wall is crucial for diagnosing and treating arterial diseases. Indentation measurement can be used to evaluate the local mechanical properties of the artery. However, the effects of the indenter’s geometric structure and the analysis theory on measurement results remain uncertain. In this paper, four kinds of indenters were used to measure the pulmonary aorta, the proximal thoracic aorta and the distal thoracic aorta in pigs, and the arterial elastic modulus was calculated by Sneddon and Sirghi theory to explore the influence of the indenter geometry and analysis theory on the measured elastic modulus. The results showed that the arterial elastic modulus measured by cylindrical indenter was lower than that measured by spherical indenter. In addition, compared with the calculated results of Sirghi theory, the Sneddon theory, which does not take adhesion forces in account, resulted in slightly larger elastic modulus values. In conclusion, this study provides parametric support for effective measurement of arterial local mechanical properties by millimeter indentation technique.