Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch morphologies

ObjectiveTo study the differences in computed tomography angiography (CTA) imaging of gothic arches, crenel arches, and romanesque arches in children with Aortic Coarctation (CoA), and to apply computational fluid dynamics (CFD) to study hemodynamic changes in CoA children with gothic arch aorta.MethodsThe case data and CTA data of children diagnosed with CoA (95 cases) in our hospital were retrospectively collected, and the morphology of the aortic arch in the children was defined as gothic arch (n = 27), crenel arch (n = 25) and romanesque arch (n = 43). The three groups were compared with D1/AOA, D2/AOA, D3/AOA, D4/AOA, D5/AOA, and AAO-DAO angle, TAO-DAO angle, and aortic arch height to width ratio (A/T). Computational fluid dynamics was applied to assess hemodynamic changes in children with gothic arches.ResultsThere were no significant differences between D1/AOA and D2/AOA among gothic arch, crenel arch, and romanesque arch (P > 0.05). The differences in D3/AOA, D4/AOA, and D5/AOA among the three groups were statistically significant (P < 0.05), D4/AOA, D5/AOA of the gothic arch group were smaller than the crenel arch group, and the D3/AOA and D5/AOA of the gothic arch group were smaller than the romanesque arch group (P < 0.05). The difference in AAO-DAO angle among the three groups was statistically significant (P < 0.05), and the AAO-DAO angle of gothic arch was smaller than that of romanesque arch and crenel arch group (P < 0.05). There was no significant difference in the TAO-DAO angle between the three groups (P > 0.05). The difference in A/T values among the three groups was statistically significant (P < 0.05), and the A/T values: gothic arch > romanesque arch > crenel arch (P < 0.05). The CFD calculation of children with gothic arch showed that the pressure drop between the distal stenosis and the descending aorta was 58 mmHg, and the flow rate at the isthmus and descending aorta was high and turbulent.ConclusionGothic aortic arch is common in CoA, it may put adverse effects on the development of the aortic isthmus and descending aorta, and its A/T value and AAO-DAO angle are high. CFD could assess hemodynamic changes in CoA

Surgical treatment of rare pediatric cardiac myxomas:12 years clinical experience in a single institution

Abstract Background Primary cardiac tumors are rare, and cardiac myxoma (CM) accounts for the majority of these tumors. Most of the reports in the literature are case reports. This study summarizes our clinical experience in the surgical treatment of CM over the past 12 years. Methods We retrospectively analyzed the clinical data of 23 children with CM(8 boys, 15 girls; median age: 8.92 months, range: 2 years 5 months-12 years 9 months; body weight: 11-45 kg, median body weight: 28.21 kg) admitted to our hospital in the previous 12 years, and we statistically analyzed their clinical manifestations and surgical methods. Results 23 cases underwent myxoma excision under cardiopulmonary bypass(CPB). The follow-up period was 0.2 to 12.6 years (mean:7.2 years). Two patients could not be traced, and the follow-up completion rate was 91.30%. One patient (4.35%) died of myocardial infarction early after surgery with low continuous cardiac output. There were no cerebral embolism, acute heart failure, atrioventricular block and other related complications in 19 cases. A patient with cerebral infarction complicated with right hemiplegia recovered well after rehabilitation treatment. There was no recurrence of CM in 19 cases and all patients recovered after surgery. One patient relapsed 5 years after surgery, and no tumor recurrence was observed after the second surgery. Among the 20 long-term survivors, 13 (65.00%) were NYHA Class I patients and 7(35.00%) were NYHA Class II patients. Conclusions Although CM in children is rare, it may cause cerebral infarction and other multi-organ embolism. Once CM is found and removed as soon as possible, it can reduce serious complications. If the complete resection is possible, surgery provides better palliation. Follow-up echocardiographic should be paid attention to after surgery

Surgical treatment of congenital diaphragmatic hernia in a single institution

Abstract Background This study aimed to evaluate the effectiveness of video-assisted thoracic surgery for the treatment of congenital diaphragmatic hernia (CDH) in a larger series compared with conventional open surgery. Additionally, we summarized the experience of thoracoscopic surgery in the treatment of CDH in infants. Methods We retrospectively analysed the clinical data of 109 children with CDH who underwent surgical treatment at the Department of Cardiothoracic Surgery of Children’s Hospital of Chongqing Medical University from January 2011 to January 2021. According to the surgical method, the children were divided into an open group (62 cases) and a thoracoscopy group (47 cases).Patients who underwent surgical correction had the diaphragmatic defect size graded (A–D) using a standardized system. We compared the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay, postoperative CCU admission time and other surgical indicators as well as the recurrence rate, mortality rate and complication rate of the two groups of children. Results The index data on the operation time, intraoperative blood loss, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better in the thoracoscopy group than in the open group. The difference between the two groups was statistically significant (P < 0.05). We compared the number of incision infections, lung infections, atelectasis, pleural effusion, and chylothorax between the two groups. There were more children in the open group than in the thoracoscopy group. The overall incidence of postoperative complications in the open group (51.61%) was higher than that in the thoracoscopy group (44.68%).The recurrence rate of the thoracoscopy group (8.51%) was higher than that of the open group (3.23%). In the open group, 7 patients died of respiratory distress after surgery, and no patients died in the thoracoscopy group. Conclusions Thoracoscopic surgery and open surgery can effectively treat CDH. Compared with conventional open surgery, thoracoscopy has the advantages of shorter operation time, less trauma, faster recovery and fewer complications. We believe that thoracoscopic surgery for type A/B diaphragmatic defect has certain advantages, but there is a risk of recurrence

III&ndash;V Microwires with Reversed Ridge Waveguides Selectively Grown on Pre-Patterned Si Substrates

To construct functional photonic integrated circuits, an efficient and compact laser is expected to be incorporated into the complementary metal&ndash;oxide&ndash;semiconductor platform. Monolithic integration of III&ndash;V lasers on pre-patterned Si substrates by the aspect ratio trapping method is a promising solution. Here, microwires with reversed ridge waveguides (RRWs) on pre-patterned Si substrates were reported. By metal&ndash;organic chemical vapor deposition, high-quality InP microwires with RRWs were obtained, and InGaAs/InGaAsP multi-quantum-well structures with InGaAsP separate confinement hetero structure (SCH&ndash;MQW) were successfully achieved. The SCH&ndash;MQW structure was buried in the InP microwire, which was beneficial for transferring the heat generated in the active region. The micron size also contributes to the efficiency of thermal diffusion. Further, simulation results showed that the metal absorption loss could be less than 4 dB/cm by properly controlling the contact area between metal electrodes and microwires. This proposed structure opens up an alternative pathway for electrically driven III&ndash;V lasers seamlessly interfaced with Si-photonics

III–V Microwires with Reversed Ridge Waveguides Selectively Grown on Pre-Patterned Si Substrates

To construct functional photonic integrated circuits, an efficient and compact laser is expected to be incorporated into the complementary metal–oxide–semiconductor platform. Monolithic integration of III–V lasers on pre-patterned Si substrates by the aspect ratio trapping method is a promising solution. Here, microwires with reversed ridge waveguides (RRWs) on pre-patterned Si substrates were reported. By metal–organic chemical vapor deposition, high-quality InP microwires with RRWs were obtained, and InGaAs/InGaAsP multi-quantum-well structures with InGaAsP separate confinement hetero structure (SCH–MQW) were successfully achieved. The SCH–MQW structure was buried in the InP microwire, which was beneficial for transferring the heat generated in the active region. The micron size also contributes to the efficiency of thermal diffusion. Further, simulation results showed that the metal absorption loss could be less than 4 dB/cm by properly controlling the contact area between metal electrodes and microwires. This proposed structure opens up an alternative pathway for electrically driven III–V lasers seamlessly interfaced with Si-photonics

Selective Growth of Energy-Band-Controllable In_1−xGa_xAs_yP_1−y Submicron Wires in V-Shaped Trench on Si

The In1−xGaxAsyP1−y submicron wires with adjustable wavelengths directly grown by metalorganic chemical vapor deposition on a V-groove-patterned Si (001) substrate are reported in this paper. To ensure the material quality, aspect ratio trapping and selective area growth methods are used. By changing the parameters in the epitaxy process, we realize the adjustment of the material energy band of In1−xGaxAsyP1−y submicron wires. By further optimizing the growth conditions, we realize high-quality submicron wires. The morphology of the submicron wires is characterized by scanning electron microscopy and transmission electron microscopy. Through high-resolution X-ray diffraction measurement, it is disclosed that the lattice of the optimized In1−xGaxAsyP1−y part matches that of InP. A PL spectrum test shows that the PL spectrum peak is from 1260 nm to 1340 nm. The In1−xGaxAsyP1−y can be used as a well material or barrier material in a quantum well, which would promote the development of silicon-based lasers

Selective Growth of Energy-Band-Controllable In1&minus;xGaxAsyP1&minus;y Submicron Wires in V-Shaped Trench on Si

The In1&minus;xGaxAsyP1&minus;y submicron wires with adjustable wavelengths directly grown by metalorganic chemical vapor deposition on a V-groove-patterned Si (001) substrate are reported in this paper. To ensure the material quality, aspect ratio trapping and selective area growth methods are used. By changing the parameters in the epitaxy process, we realize the adjustment of the material energy band of In1&minus;xGaxAsyP1&minus;y submicron wires. By further optimizing the growth conditions, we realize high-quality submicron wires. The morphology of the submicron wires is characterized by scanning electron microscopy and transmission electron microscopy. Through high-resolution X-ray diffraction measurement, it is disclosed that the lattice of the optimized In1&minus;xGaxAsyP1&minus;y part matches that of InP. A PL spectrum test shows that the PL spectrum peak is from 1260 nm to 1340 nm. The In1&minus;xGaxAsyP1&minus;y can be used as a well material or barrier material in a quantum well, which would promote the development of silicon-based lasers

Academic performance in children with pectus excavatum: a real-world research with propensity score matching

Background: The optimal timing of surgery for pectus excavatum (PE) is controversial. A large proportion of children will not undergo surgery before puberty. However, untimely surgery may lead to a decline in the children’s social adaptation and competitiveness because the children have already developed psychological and physiological impairments due to PE at an early age. The study retrospectively compared the academic performance in PE children undergoing the Nuss procedure versus nonsurgical observation. Methods: This retrospective real-world research study included 480 PE patients with definite surgical indications, in whom it was first recommended that they undergo surgery between the ages of 6 and 12 years old. Academic performance was collected at baseline and 6 years later. A generalized linear regression was calculated to screen the factors affecting the performance. A propensity score matching (PSM) analysis was conducted to reduce the potential for confounding factors between surgical and nonsurgical PE patients. Results: Haller index (HI) and pulmonary function were recognized as factors affecting baseline performance according to the generalized linear regression. For PE children with surgical indications, their academic performance significantly declined after 6 years of nonsurgical observation (52.1% ± 17.1% versus 58.3% ± 16.7%, p  = 0.042). The academic performance in the surgery group was better than that in the nonsurgery group 6 years after PSM (60.7% ± 17.7% versus 52.1% ± 17.1%, p  = 0.008). Conclusions: The severity of PE will affect the academic performance of children. For PE children with definite surgical indications between the ages of 6 and 12 years old, surgical intervention rather than nonsurgical observation is more conducive to the development of children’s academic performance

Potential association of long noncoding RNA HA117 with tetralogy of Fallot

Tetralogy of Fallot (TOF) is a congenital heart disease characterized by abnormal cardiomyocyte differentiation in the right ventricular outflow tract (RVOT), and HA117 is a novel long noncoding RNA (lncRNA) with anti-differentiation roles.To investigate the potential association of HA117 with TOF, we collected 84 RVOT tissues from patients with TOF. We determined the expression of HA117 in RVOT samples from TOF patients and collected clinical data to conduct a cross-sectional and short-term follow-up study.McGoon ratio, Nakata index, and left ventricular end-diastolic volume index (LVEDVI) were negatively correlated with the expression of HA117 based on subgroup analysis, correlation analysis and logistic regression analysis. Additionally, cardiopulmonary bypass (CPB) time and ICU stay were longer in patients with higher expression of HA117 than in patients with lower expression of HA117. Furthermore, percentage improvement in SPO2 was significantly reduced in patients with increased HA117 expression at 6 months after surgery.Our results suggested that the increased expression of the novel lncRNA HA117 is a risk factor for unfavorable McGoon ratio, Nakata index and LVEDVI in TOF patients. Additionally, an increased expression of HA117 might lead to adverse short-term outcomes in TOF patients. Keywords: HA117, Tetralogy of Fallot, Long noncoding RNA, McGoon ratio, Nakata inde