Atypical Abnormal Pulmonary Vein Drainage with Atrial Septal Defect: Surgical Treatment

Sinus venosus atrial septal defect (SV‐ASD) usually coexists with partial anomalous pulmonary vein connection (PAPVC). It is a difficult diagnosis in transthoracic echocardiography (TTE) due to eccentric position of defects. We present a rare case of atypical anatomical variation in PAPVC, which was never described before. Two right pulmonary veins drained into superior vena cava, which overrode SV‐ASD and interatrial septum, a third pulmonary vein into the right atrium. Complete diagnosis could not be set after TTE, nor transesophageal echocardiography, whereas angio‐CT was finally conclusive. This diagnostic approach allowed the surgical planning.     

Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV)

This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.     

同型半胱氨酸与绝经后女性颈动脉粥样硬化的相关性研究

目的 研究同型半胱氨酸(homocysteine,Hcy)是否为绝经后女性颈动脉粥样硬化的独立风险因素。 方法 对2017年12月—2018年12月北京协和医院健康体检的1 204名55岁以上绝经后女性,进行Hcy检测和颈动脉超声检查。使用多变量logistic回归方法分析Hcy及其他传统风险因素对颈动脉粥样硬化的影响。 结果 Hcy平均值(12.4±3.3)μmol/L,高Hcy血症176人(14.62%)。Hcy与年龄和BMI正相关(分别r=0.19,P<0.001;r=0.11, P<0.001)。颈动脉粥样硬化患者的Hcy显著升高(Z=-2.56,P=0.011)。logistic回归显示,对于颈动脉粥样硬化只有年龄(OR=1.11,95%CI:1.09~1.14)和收缩压(OR=1.02,95%CI:1.01~1.02)是独立风险因素;对颈动脉斑块形成年龄(OR=1.10,95%CI:1.08~1.12)、收缩压(OR=1.02,95%CI:1.01~1.03)、糖化血红蛋白(OR=1.27,95%CI:1.07~1.50)和高血压病史(OR=1.40,95%CI:1.06~1.87)是独立危险因素。 结论 在绝经后女性,Hcy不是动脉粥样硬化发生的独立风险因素,筛查高Hcy血症在预防该人群颈动脉粥样硬化的意义仍需进一步证明。     

Ex vivo identification of atherosclerotic plaque calcification by a 31P solid-state magnetic resonance imaging technique.

Calcified tissue is a common component of atherosclerotic plaques, and occurs most often in mature plaques. The process of calcification is a poorly understood risk factor that may contribute to a plaque's vulnerability to sudden rupture. In this study a solid-state imaging sequence, termed single-point imaging (SPI), was used to observe calcification directly in ex vivo atherosclerotic plaques. Standards were used to validate the ability of (31)P SPI to detect and differentiate calcification from crystalline cholesterol, phospholipids, and other plaque components. After suitable experimental parameters were found, human carotid specimens obtained by endarterectomy were imaged ex vivo by (31)P solid-state imaging and standard (1)H methods. In contrast to (1)H imaging methods, (31)P imaging detected only the calcification in the plaque.     

喉罩全麻在颈动脉狭窄造影及介入治疗术中的应用

目的：观察喉罩全麻下行颈动脉狭窄的造影诊断及介入治疗术的临床效果。方法：择期DSA下颈动脉狭窄患者23例，年龄42-78岁，无明显肺部疾患及喉罩禁忌症患者，异丙酚（Pmpofol）泵入静脉全麻下插入喉罩完成手术，观察其不同时段的BP（MAP）、SpO2、HR、ECG（ST-Ⅱ）。结果：各时段的BP（MAP）、Sp02、HR、ECG（ST-Ⅱ）比较无显著性差异。结论：喉罩全麻在行颈动脉狭窄的造影诊断及介入治疗术的临床效果是肯定的。喉罩全麻颈动脉狭窄造影介入治疗     

血管内支架成形术治疗症状性椎动脉起始部狭窄的疗效分析

目的研究血管内支架成形术治疗症状性椎动脉起始部狭窄的安全性及有效性。方法对16例症状性椎动脉起始部狭窄的患者行支架成形术治疗。16例患者均成功植入球囊扩张支架。结果术后11例患者恢复正常管径;5例患者狭窄程度明显改善,残余狭窄均小于20%。无1例发生严重并发症。在6个月的临床随访中,16例患者均无脑缺血发作及再狭窄发生。结论血管内支架成形术是治疗症状性椎动脉起始部狭窄的安全、有效方法,其长期疗效还需进一步随访研究。     

Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA)

Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.