Three dimensional rotational angiography imaging of double aortic arch vascular ring

Three dimensional (3D) rotational angiography is a technique used increasingly for imaging in congenital heart disease. Here the use of this technique for imaging of double aortic arch vascular ring is described and the advantages of this modality. are discussed. 3D rotational angiography is an excellent tool for imaging of various vascular anomalies. It provides high quality accurate images through a quick and safe procedure.peer-reviewe

795-6 Comparison Between Three-Dimensional Reconstruction and Two-Dimensional Imaging for Evaluating Regurgitant Jets: An In Vitro Study

The aim of our study was to investigate the applicability of the 3D reconstruction for evaluating color Doppler regurgitant jet imaging compared to conventional 20 color Doppler flow mapping.MethodsSteady flows (20–80cc/sec) were driven through a rectangular orifice (24mm2, length=8×width) using a steady flow pump. The regurgitant jets were imaged using 3 different Nyquist velocities (35, 52 and 78cm/sec)with an Interspec ultrasound system and analyzed using 3D reconstruction with a Tomtec computer. An oblique “birds eye” view from above the orifice plane gave a side view of the flattened jet. Volumes of 3D regurgitant jets were measured and were compared to the conventional color Doppler 2D maximal jet area.ResultsThe 3D reconstructions showed characteristically elongated and flaring jet propagation for all flow conditions (Figure). Jet areas sliced parallel to the orifice plane provided the most quantifiable jet propagation pattern. A linear relationship between flow rates and 3D jet volumes was obtained (r=0.91, P<0.001) whereas conventional 20 maximal jet areas showed a less well defined relationship with actual flow rates (r=0.87, p<0.01). The consistency of the relationship between flow rates and jet area in 3D volume over the various Nyquist units was also better for 3D volumes.ConclusionOur study suggests that three-dimensional jet volume methods should provide more accurate approaches for quantifying regurgitant jets than the conventional 2D jet area measurement

Transcatheter Versus Surgical Closure of Perimembranous Ventricular Septal Defects in Children A Randomized Controlled Trial

ObjectivesThe objective of this study was to evaluate the safety and efficacy of the surgical versus transcatheter approach to correct perimembranous ventricular septal defects (pmVSDs) in a prospective, randomized, controlled clinical trial.BackgroundpmVSD is a common congenital heart disease in children. Surgical closure of pmVSD is a well-established therapy but requires open-heart surgery with cardiopulmonary bypass. Although the transcatheter approach is associated with significant incidence of complete atrioventricular block, it may provide a less invasive alternative. Critical comparison of the safety and efficacy of the 2 interventions necessitates a prospective, randomized, controlled trial.MethodsBetween January 2009 and July 2010, 229 children with pmVSD were randomly assigned to surgical or transcatheter intervention. Clinical, laboratory, procedural, and follow-up data over a 2-year period were compared.ResultsNeither group had mortality or major complications. However, statistical analysis of the 2 groups demonstrated significant differences (p < 0.001) in minor adverse events (32 vs. 7), quantity of blood transfused, duration of the procedure, median hospital stay, median intensive care unit stay, median hospitalization cost, and median blood loss. During a median follow-up of 2 years, the left ventricular end-diastolic dimension of both groups returned to normal and there was no difference in closure rate, adverse events, and complications between groups.ConclusionsTranscatheter device closure and surgical repair are effective interventions with excellent midterm results for treating pmVSD in children. Transcatheter device closure has a lower incidence of myocardial injury, less blood transfused, faster recovery, shorter hospital stay, and lower medical expenses. (Transcatheter Closure Versus Surgery of Perimembranous Ventricular Septal Defects; NCT00890799

Haematoporphyrin Based Photodynamic Therapy Combined with Hyperthermia Provided Effective Therapeutic Vaccine Effect against Colon Cancer Growth in Mice

<p>Photodynamic therapy (PDT) has become an attractive option used in tumor treatment via its direct tumoricidal activities or its immune-boosting activities. On the other hand, heat shock protein 70 has been found to be largely associated with the establishment of anti-tumor activities offered by hyperthermia treated tumor cells. In the present study, we found that injection of tumor-bearing mice with colon cancer cell line CT-26 treated with haematoporphyrin based photodynamic therapy (hematoporphyrin monomethyl ether based PDT, HMME-PDT) together with hyperthermia demonstrated the most effective therapeutic effects against tumor growth, followed by cells treated by hyperthermia alone. CT-26 cells treated only with HMME-PDT failed to provide any therapeutic effects, although significant cell death was induced by HMME-PDT. Compared to hyperthermia treatment, HMME-PDT induced more efficient surface localization of HSP70 on CT-26 cells which correlated with efficient activation of cytolytic CD8 T cells and with effective anti-tumor responses. Thus, our study demonstrated that the surface expression of HSP70 may play a more important role than the total expression or release of this molecule in the activation of immune responses. And our study offered a novel modified PDT approach to the treatment of tumor cells intrinsically low on HSP70 expression.</p