Pulmonary arterial hypertension PAH is a progressive disease characterized by an increase in pulmonary arterial pressure and resistance. It often complicates congenital heart disease with a left-to-right shunt. The ob...Pulmonary arterial hypertension PAH is a progressive disease characterized by an increase in pulmonary arterial pressure and resistance. It often complicates congenital heart disease with a left-to-right shunt. The objective of this study is to evaluate the evolutionary profile of the pulmonary pressures of children with congenital heart disease with left-to-right shunt and to identify the factors favoring an evolution towards PAH. This is a retrospective, descriptive and analytical study over a period of four years and six months (from January 1, 2016 to June 30, 2020) at the Center National d’Enfant Albert Royer in Dakar on a series of 87 cases. The hospital frequency was 3.98 per thousand, and the incidence of PAH was 9.44%. The sex ratio of 0.74. The average age was 44.76 months. The average time between the onset of symptoms and the diagnosis of heart disease is 78.81 days. Dyspnea was found in 70.11% of cases, the burst of pulmonary B2 was found in 55%. Global heart failure was noted in 39.08% of cases. Cardiomegaly was found in 89.66% and pulmonary hypervascularization was found in 57.72% of cases. CIV was present in 54.02% of cases, followed by PCA in 21.14% and CAVc in 18.39% of cases. furosemide was used in 97.70% of cases and Captopril in 74.71% of cases. Sildenafil was used in 10.34% of patients, and 12.64% of patients benefited from surgical management. Eisenmenger syndrome was found in 12.64% of patients. PAH in these heart diseases is a formidable and frequent complication, due to an increase in precapillary flow. The major improvement in mortality and morbidity is early surgical management, in the first months of life, to prevent pulmonary vascular disease.展开更多
AIM:To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect(ASD)closure in adults.METHODS:All patients who underwent percutaneous closure of an ASD in th...AIM:To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect(ASD)closure in adults.METHODS:All patients who underwent percutaneous closure of an ASD in the St.Antonius Hospital,Nieuwegein,The Netherlands,between February 1998 and December 2006 were included.Percutaneous closure took place under general anaesthesia and transesophageal echocardiographic moni toring.Transthoracic echocardiography(TTE)was performed 24 h post-procedure to visualize the device position and to look for residual shunting using color Doppler.All complications were registered.All patients were invited for an outpatient visit and contrast TTE more than 5-years after closure.Efficacy was based on the presence of a residual right-to-left shunt(RLS),graded as minimal,moderate or severe.The presence of a residual left-to-right shunt(LRS)was diagnosed using color Doppler,and was not graded.Descriptive statistics were used for patients'characteristics.Univariate analysis was used to identify predictors for residual shunting.RESULTS:In total,104 patients(mean age 45.5±17.1 years)underwent percutaneous ASD closure using an Amplatzer device(ASO)in 76 patients and a Cardioseal/Starflex device(CS/SF)in 28 patients.The mean follow-up was 6.4±3.4 years.Device migration occurred in 4 patients of whom two cases occurred during the index hospitalization(1 ASO,1 CS/SF).The other 2 cases of device migration occurred during the first 6 mo of follow-up(2 CS/SF).The recurrent thrombo-embolic event rate was similar in both groups:0.4%per follow-up year.More than 12 mo post-ASD closure and latest follow-up,new-onset supraventricular tachyarrhythmia's occurred in 3.9%and 0%for the ASO and CS/SF group,respectively.The RLS rate at latest follow-up was 17.4%(minimal 10.9%,moderate 2.2%,severe 4.3%)and 45.5%(minimal 27.3%,moderate 18.2%,severe 0%)for the ASO-and CS/SF groups,respectively.There was no residual LRS in both groups.CONCLUSION:Percutaneous ASD closure has good long-term safety and efficacy profiles.The residual RLS rate seems to be high more than 5 years after closure,especially in the CS/SF.Residual LRS was not observed.展开更多
Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enc...Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.展开更多
Carlitz and Scoville(1974)introduced the polynomials An(x,y|α,β),which we refer to as the(α,β)-Eulerian polynomials.These polynomials count permutations based on Eulerian-Stirling statistics,including descents,asc...Carlitz and Scoville(1974)introduced the polynomials An(x,y|α,β),which we refer to as the(α,β)-Eulerian polynomials.These polynomials count permutations based on Eulerian-Stirling statistics,including descents,ascents,left-to-right maxima and right-to-left maxima.Carlitz and Scoville(1974)obtained the generating function for An(x,y|α,β).In this paper,we introduce a new family of polynomials,Pn(u,v,w,z|α,β),defined on descent-Stirling statistics of permutations including valleys,exterior peaks,right double descents,left double ascents,left-to-right maxima and right-to-left maxima.By employing the grammatical calculus introduced by Chen(1993),we establish a connection between the generating function for Pn(u,v,w,z|α,β)and the generating function for An(x,y|α,β).Using this connection,we derive the generating function for Pn(u,v,w,z|α,β),which can be specialized to obtain(α,β)-extensions of generating functions for peaks,left peaks,double ascents,right double ascents and left-right double ascents given by David and Barton(1962),Elizalde and Noy(2003),Entringer(1969),Gessel and Zhuang(2018),Kitaev(2007),and Zhuang(2016).Moreover,we establish two relations between Pn(u,v,w,z|α,β)and An(x,y|α,β),which enable us to derive(α,β)-extensions of results obtained by Stembridge(1997),Petersen(2006),Brändén(2008)and Zhuang(2017),respectively.We also establish the left peak version of Stembridge’s formula and the peak version of Petersen’s formula,along with their respective(α,β)-extensions,by utilizing these two relations.Specializing(α,β)-extensions of Stembridge’s formula and the left peak version of Stembridge’s formula allows us to derive(α,β)-extensions of the tangent and secant numbers.展开更多
文摘Pulmonary arterial hypertension PAH is a progressive disease characterized by an increase in pulmonary arterial pressure and resistance. It often complicates congenital heart disease with a left-to-right shunt. The objective of this study is to evaluate the evolutionary profile of the pulmonary pressures of children with congenital heart disease with left-to-right shunt and to identify the factors favoring an evolution towards PAH. This is a retrospective, descriptive and analytical study over a period of four years and six months (from January 1, 2016 to June 30, 2020) at the Center National d’Enfant Albert Royer in Dakar on a series of 87 cases. The hospital frequency was 3.98 per thousand, and the incidence of PAH was 9.44%. The sex ratio of 0.74. The average age was 44.76 months. The average time between the onset of symptoms and the diagnosis of heart disease is 78.81 days. Dyspnea was found in 70.11% of cases, the burst of pulmonary B2 was found in 55%. Global heart failure was noted in 39.08% of cases. Cardiomegaly was found in 89.66% and pulmonary hypervascularization was found in 57.72% of cases. CIV was present in 54.02% of cases, followed by PCA in 21.14% and CAVc in 18.39% of cases. furosemide was used in 97.70% of cases and Captopril in 74.71% of cases. Sildenafil was used in 10.34% of patients, and 12.64% of patients benefited from surgical management. Eisenmenger syndrome was found in 12.64% of patients. PAH in these heart diseases is a formidable and frequent complication, due to an increase in precapillary flow. The major improvement in mortality and morbidity is early surgical management, in the first months of life, to prevent pulmonary vascular disease.
文摘AIM:To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect(ASD)closure in adults.METHODS:All patients who underwent percutaneous closure of an ASD in the St.Antonius Hospital,Nieuwegein,The Netherlands,between February 1998 and December 2006 were included.Percutaneous closure took place under general anaesthesia and transesophageal echocardiographic moni toring.Transthoracic echocardiography(TTE)was performed 24 h post-procedure to visualize the device position and to look for residual shunting using color Doppler.All complications were registered.All patients were invited for an outpatient visit and contrast TTE more than 5-years after closure.Efficacy was based on the presence of a residual right-to-left shunt(RLS),graded as minimal,moderate or severe.The presence of a residual left-to-right shunt(LRS)was diagnosed using color Doppler,and was not graded.Descriptive statistics were used for patients'characteristics.Univariate analysis was used to identify predictors for residual shunting.RESULTS:In total,104 patients(mean age 45.5±17.1 years)underwent percutaneous ASD closure using an Amplatzer device(ASO)in 76 patients and a Cardioseal/Starflex device(CS/SF)in 28 patients.The mean follow-up was 6.4±3.4 years.Device migration occurred in 4 patients of whom two cases occurred during the index hospitalization(1 ASO,1 CS/SF).The other 2 cases of device migration occurred during the first 6 mo of follow-up(2 CS/SF).The recurrent thrombo-embolic event rate was similar in both groups:0.4%per follow-up year.More than 12 mo post-ASD closure and latest follow-up,new-onset supraventricular tachyarrhythmia's occurred in 3.9%and 0%for the ASO and CS/SF group,respectively.The RLS rate at latest follow-up was 17.4%(minimal 10.9%,moderate 2.2%,severe 4.3%)and 45.5%(minimal 27.3%,moderate 18.2%,severe 0%)for the ASO-and CS/SF groups,respectively.There was no residual LRS in both groups.CONCLUSION:Percutaneous ASD closure has good long-term safety and efficacy profiles.The residual RLS rate seems to be high more than 5 years after closure,especially in the CS/SF.Residual LRS was not observed.
文摘Presented in this paper are 3 cases of hemorrhage of ascending aorta and left ventricle after open heart surgery treated by extracardial bypass in our hospital from Oct. 1994 to Dec. 1995. Remained aneurysmal wall enclosing conduit graft was used as a sac bypassed to right atrium to form a extracardial left-toright shunt in order to control bleeding and the results turned out to be satisfactory. The bypass and hemodynamically ignorable shunt can close spontaneously without complications with recovery of coagulation system. The technique may find wide application in clinical practice.
基金supported by National Natural Science Foundation of China(Grant No.12171358).
文摘Carlitz and Scoville(1974)introduced the polynomials An(x,y|α,β),which we refer to as the(α,β)-Eulerian polynomials.These polynomials count permutations based on Eulerian-Stirling statistics,including descents,ascents,left-to-right maxima and right-to-left maxima.Carlitz and Scoville(1974)obtained the generating function for An(x,y|α,β).In this paper,we introduce a new family of polynomials,Pn(u,v,w,z|α,β),defined on descent-Stirling statistics of permutations including valleys,exterior peaks,right double descents,left double ascents,left-to-right maxima and right-to-left maxima.By employing the grammatical calculus introduced by Chen(1993),we establish a connection between the generating function for Pn(u,v,w,z|α,β)and the generating function for An(x,y|α,β).Using this connection,we derive the generating function for Pn(u,v,w,z|α,β),which can be specialized to obtain(α,β)-extensions of generating functions for peaks,left peaks,double ascents,right double ascents and left-right double ascents given by David and Barton(1962),Elizalde and Noy(2003),Entringer(1969),Gessel and Zhuang(2018),Kitaev(2007),and Zhuang(2016).Moreover,we establish two relations between Pn(u,v,w,z|α,β)and An(x,y|α,β),which enable us to derive(α,β)-extensions of results obtained by Stembridge(1997),Petersen(2006),Brändén(2008)and Zhuang(2017),respectively.We also establish the left peak version of Stembridge’s formula and the peak version of Petersen’s formula,along with their respective(α,β)-extensions,by utilizing these two relations.Specializing(α,β)-extensions of Stembridge’s formula and the left peak version of Stembridge’s formula allows us to derive(α,β)-extensions of the tangent and secant numbers.
