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1.
Gary E. Stapleton Benjamin W. Eidem Ricardo H. Pignatelli Karina M. Carlson Charles E. Mullins Ronald G. Grifka 《Congenital heart disease》2006,1(3):116-119
Background. A persistent patent ductus arteriosus (PDA) may delay closure of a coexisting atrial septal defect (ASD) due to volume loading and enlargement of the left atrium. The purpose of this study was to investigate the natural history of ASD size in patients with a PDA following transcatheter PDA occlusion. Methods. All patients with an ASD and a PDA who underwent transcatheter PDA occlusion at Texas Children’s Hospital were identified. Patients with ASD diameter <3 mm, or additional cardiac defects were excluded. Eight patients (7 females) with small‐ to moderate‐sized ASDs and a PDA were identified. Patient demographics, echocardiographic data, and cardiac catheterization data were recorded. Data were analyzed by 1‐tailed t‐test. Results. Following PDA occlusion, ASD diameter decreased in 6 of 8 patients by a mean of 3.8 mm (±2.3 mm), including 2 that closed. The median duration of follow‐up was 689 days. One ASD remained unchanged and 1 increased in size. The mean maximum ASD diameter decreased from 6.4 mm (±2.2 mm) to 3.9 mm (±3.4 mm) (P = .03). Two patients underwent subsequent transcatheter ASD occlusion. Conclusion. Following transcatheter PDA occlusion, small‐ to moderate‐sized ASDs have significant probability to decrease in size, and possibly close. In infants and children, we recommend transcatheter PDA occlusion, and serial follow‐up of the size of the ASD. This will allow many small‐ to moderate‐sized ASDs to either close, or become smaller, obviating the need for future intervention. 相似文献
2.
经左颈静脉肝内门腔静脉支架分流术(附12例报告) 总被引:4,自引:0,他引:4
为解决肝硬变门脉高压患者在经颈静脉肝内门腔静脉支架分流术中右颈静脉窄或闭的难题,我们做了经左颈静脉途径完成肝内门腔分流术的尝试。自1993年7月至1995年8月,共178例TIPSS操作中发现12例右颈静脉狭窄或闭塞。其方法为经左颈内静脉穿刺、插管入路。 相似文献
3.
对30例成人心标本进行解剖,测得冠状窦口的纵径为17.79±4.66mm,横径为8.75±3.39mm。发现冠状窦口朝向上或水平方向者占70.00%;向下者占30.00%,冠状窦瓣有新月状、半月状、网状、筛状和嵴状等五种形态。瓣高5.31±4.18mm,宽8.62±2.44mm。冠状窦的长度为31.33±10.22mm,最窄径为5.60±1.05mm;并有成角、缩窄和发育不良现象。其属支中有73.33%的心中静脉和10.00%的心小静脉开口于冠状窦口处。本文并就冠状窦心导管术插管的成败因素进行了讨论。 相似文献
4.
目的:探讨内科急危重患为进行静脉营养,休克救治及中心静脉压监测,肿瘤的系统化疗,建立静脉通路最人选择与术后护理。方法:42例中选择锁骨下静脉置管术11例,选择腋静脉末端置管术31例。结果:术后经X检查,导管前端到达上腔静脉39例,到位率为92.8%,到达颈内静脉3例(占7.14%),无气胸、血胸、空气栓塞等并发症。结论:内科危重症患及肺心病、肺癌、脓胸、扩张型心肌病建立静脉通道可选用腋静脉末端 相似文献
5.
6.
目的探讨婴幼儿先天性心脏病合并室缺的肺动脉压测定与连续波多普勒法相关性的临床研究。方法40例婴幼儿先天性心脏病合并室缺患者分为两组,以室缺合并平均肺动脉压〉20mmHg为观察组,室缺合并平均肺动脉压〈20nm、Hg为对照组,应用连续波多普勒法与术前用导管法所测肺动脉压进行比较。结果观察组连续波多普勒法测出肺动脉压与导管所测肺动脉压显著相关(r=0.70,P〈0.01),可达到定量诊断肺动脉高压的目的;对照组不紧密相关(r=0.65,P〉0.05)。结论连续波多普勒法对婴幼儿先天性心脏病合并室缺的患儿的肺动脉压评估可靠。 相似文献
7.
The aim of this study is to provide decision support with artificial intelligence for tendon tissue engineering strategies. The experimental data of tissue-engineered tendons were integrated and standardized with a centralized database, and a decision support system was developed using both artificial neural networks and decision trees. The decision support system was trained with existing cases in the database, and then was used to generate tissue engineering schemes for new experimental animals. Following the schemes generated by the artificial intelligent system, we cured 28 of the 30 experimental animals. In conclusion, artificial intelligence is a powerful method for decision support in the tendon tissue engineering realm. 相似文献
8.
Objective The aim of this study is to investigate the safety and effectiveness of Excimer laser-assisted lead extraction. Methods Consecutive lead extraction in 16 patients using the excimer laser sheath from Veterans Administration Medical Center, University of Minnesota between March 2008 and December 2009 were analyzed retrospectively. The clinical characteristics including basic disease, cardiac function, indication and reason for lead removal, lead characteristic, and complication were summarized. Results Thirty one leads ( laser sheaths were used in 25 leads) in 16 patients [mean age (67.4 ±9. 1 )years, range 54-82 years] were extracted. All leads were extracted successfully without complication.Most patients had severe heart diseases with left ventricular ejection fraction of 20% -60% (mean 36. 4% ±13.4% ). Mean implant time was (73.9 ±62. 9)months (range 3 -251 months). Nine patients had Class Ⅰ indications for lead extraction, 7 patients for Class Ⅱ indications. Atrial lead fractured in one patient during lead extraction, the remaining part of the lead was taken out from femoral vein by a snare-catheter apparatus. Another patient developed CS dissection and small pericardium perfusion during LV lead implantation (upgrade to BiV-ICD ) post successful lead extraction and patient discharged without complication. Conclusion Our single center experience suggests that Excimer Laser Sheath Lead Removal System is safe and effective in extracting pacemaker and ICD leads. 相似文献
9.
史树利 《医药高职教育与现代护理》2020,3(2):221-224
摘要 目的 观察三种不同时机下术前导尿配合手术室护理对全身麻醉(全麻)手术患者苏醒期躁动的影响。方法 选择2017年1月~2018年12月于我院行择期全麻手术的患者100例,根据术前导尿时机分为3组:A组(手术当日清晨在病房导尿,33例)、B组(麻醉前在手术室导尿,30例)、C组(麻醉平稳后在手术室导尿,37例)。记录并比较3组麻醉时间、术中输液量、术中出血量、苏醒时间及导尿前后收缩压(SBP)、舒张压(DBP)及心率(HR)变化,比较3组一次性导尿成功率、术后导尿管适应度及苏醒期躁动发生情况,采用自拟问卷调查患者护理满意度。结果 3组麻醉时间、术中输液量、术中出血量及苏醒时间比较,差异无统计学意义(P>0.05);A组导尿后SBP、DBP、HR较导尿前均显著升高(P<0.05),B组和C组SBP、DBP、HR与导尿前比较,差异无统计学意义(P>0.05);A组一次性导尿成功率显著低于B组和C组,术后导尿管适应度显著差于B组和C组(P<0.05);A组苏醒期躁动发生率显著高于C组,苏醒期躁动分级显著高于C组P<0.05);A组护理满意度评分显著低于B组和C组,差异有统计学意义(P<0.05)。结论 在麻醉前后于手术室进行导尿的效果明显优于手术当日清晨在病房导尿,配合手术室护理干预可有效提高患者术后对导尿管的适应度,降低苏醒期躁动发生率,提高患者护理满意度。 相似文献
10.