Non-invasive Imaging in the Evaluation of Cardiac Shunts for Interventional Closure

Multimodality imaging provides important information to guide patient selection and pre-procedural decision making for shunt lesions in CHD. While echocardiography, CT, and CMR are well-established, 3D printing and now virtual reality imaging are beginning to show promise.

Prediction of arrhythmia after intervention in children with atrial septal defect based on random forest

Background Using random forest to predict arrhythmia after intervention in children with atrial septal defect. Methods We constructed a prediction model of complications after interventional closure for children with atrial septal defect. The model was based on random forest, and it solved the need for postoperative arrhythmia risk prediction and assisted clinicians and patients’ families to make preoperative decisions. Results Available risk prediction models provided patients with specific risk factor assessments, we used Synthetic Minority Oversampling Technique algorithm and random forest machine learning to propose a prediction model, and got a prediction accuracy of 94.65 % and an Area Under Curve value of 0.8956. Conclusions Our study was based on the model constructed by random forest, which can effectively predict the complications of arrhythmia after interventional closure in children with atrial septal defect.

Acute anterior myocardial infarction complicated by a large ventricular septal defect

Post-Infarction Ventricular Septal Defect (PIVSD) are a rare complication of Acute Myocardial Infarction (AMI). According to clinical guidelines, surgical repair of a PIVSD is the recommended acute-stage course of treatment. Nevertheless, thoracotomy is not always clinically suggested for patients with unstable hemodynamics and otherwise at high risk. Currently, percutaneous interventional closure of a PIVSD represents an alternative therapy, and an attractive option for particular patients [1,2]. Here we report a 67-year-old man was transferred to Shenzhen Sun yat-sen Cardiovascular Hospital to evaluate a PIVSD and undergo repair. Echocardiography confirmed a large Ventricular Septal Defect (VSD) and significant left-to-right shunt (Figure 1a). Few reports of the closure of a PIVSD at an acute/subacute stage have been previously published. An interventional closure treatment (Amplatzer Septal Occluder device) was successfully performed after bridging to a subacute stage through use of mechanical circulatory backup (Figure 1b).

Inadequate Dosage May Lead to the Recurrence of Postoperative Pulmonary Hypertension in Patients With Congenital Heart Disease

Background: Pulmonary arterial hypertension (PAH) associated with congenital heart disease (PAH-CHD) occurs predominantly among patients with uncorrected congenital heart disease (CHD). It is an intractable problem to control PAH continuously and stably after an operation.Methods: 1) OPLS-DA combined with S-plot was used to retrospectively analyze the results of preoperative and postoperative PAH and 39 biochemical indicators of 235 patients admitted to Fuwai Yunnan Cardiovascular Hospital from January 2019 to December 2020. 2) Combined with Meta-analysis, the recurrence in postoperative PAH was analyzed in terms of operation factors, doses administered, and age factors.Results: 1) 4 indicators (PAH, RBC, HGB, and CO2) that reflect the prognosis of patients had been found by OPLS-DA combined with S-plot. 2) The recurrence rate of postoperative PAH was 37.02%. The comprehensive therapeutic effect of interventional closure was better than that of surgical operation. PAH was not significantly higher again in patients who received either the instruction dose or the literature dose. Postoperative combination therapy (bosentan and sildenafil) was more effective than bosentan alone. Recovery after treatment was better in infants than in the other four age groups.Conclusion: OPLS-DA combined with S-plot was used for the first time to analyze clinical examination data. In this study, this method proved to be a feasible method for analyzing clinical data We recommend interventional closure as the first choice for patients with PAH-CHD. For postoperative oral therapy, we recommend the combination therapy (bosentan with sildenafil). To prevent the recurrence, the dose should be strictly prescribed according to the instructions, literature, or body surface area converted. Moreover, we recommend treatment at a young age in these patients.

Prediction of Arrhythmia After Intervention in Children With Atrial Septal Defect Based on Random Forest

Background Using random forest to predict arrhythmia after intervention in children with atrial septal defect. Methods We constructed a prediction model of complications after interventional closure for children with atrial septal defect. The model was based on random forest, and it solved the need for postoperative arrhythmia risk prediction and assisted clinicians and patients' families to make preoperative decisions. Results Available risk prediction models provided patients with specific risk factor assessments, we used Synthetic Minority Oversampling Technique algorithm and random forest machine learning to propose a prediction model, and got a prediction accuracy of 94.65% and an Area Under Curve value of 0.8956. Conclusions Our study was based on the model constructed by random forest, which can effectively predict the complications of arrhythmia after interventional closure in children with atrial septal defect.