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GW28-e0251 Experimental Study on human venous blood preparation of thrombus with the platelets and fibrin
C170
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 70, NO. 16, SUPPL C, 2017
GW28-e0251 Experimental Study on human venous blood preparation of thrombus with the platelets and fibrin Lina Guan,1 Peipei Mai,1 Xiaoyu Wang,1 Min Di,1 Weiliang Huang,1 Yuming Mu1 1 Department of Echocardiography, The First Affiliated Hospital of Xinjiang Medical University OBJECTIVES To investigate human venous blood in the preparation of mixed thrombus which platelets and fibrin for providing a stable and simple method for thrombolysis in vitro. METHODS Venous blood was taken from healthy blood a donor that was per person 8-10ml, who had not been treated with anticoagulants or platelet function inhibitors within 2 weeks. The thrombus was prepared in vitro, then divided into four groups, venous blood (group A), venous bloodþADPþthrombinþCaCl2 (group B), venous bloodþCaCl2 (group C) and intracoronary thrombus in acute myocardial infarction patients within 2 hours as control group (Group D). The platelet and cellulose in the thrombus were detected by HE staining, immunohistochemistry and scanning electron microscope. Extracorporeal circulation device was used to simulate 180mmHg to detect the stability of thrombosis. Recombinant tissue type plasminogen activator (rt-PA) was dissolved Thrombin vitro, and the lysis rates of thrombosis was calculated. RESULTS Compared with the control group, only the B group showed a large number of platelets and beam formation with HE staining, platelet aggregation distribution with immunohistochemical staining, a large number of platelets, fibrous reticular structures and few red blood cells were observed under scanning electron microscope. Under the extracorporeal circulation device of 180mmHg, the thrombus was not dissolved in 4 hours In the B group, but the A and C groups were almost completely dissolved within 1min under the pressure of 120mmHg, the lysis rate of the A and C groups were 35%4% and 39%6% compared with which were higher than B group 71%5% in vitro (P<0.05). CONCLUSIONS The venous bloodþADPþthrombinþCaCl2 group is most likely to form mixed thrombus with platelets and fibrin, which has a better stability, higher cracking rate, thus, it can provide a stable and simple thrombus model for thrombolysis in vitro. GW28-e0253 Single institution experience with comprehensive echocardiographic assessments of interrupted aortic arch for surgical decision making Ling Li,1 Shuangshuang Kong,1 Mingxing Xie1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
1
OBJECTIVES To evaluate the value of echocardiography in diagnosis of different types of Interrupted aortic artery (IAA) METHODS We report our institutional (one of top10 largest institution in china) experience and correlated echocardiography diagnosis with surgical and angiographic findings. From July 2006 to September 2014, 40 patients were diagnosed with IAA. Of the patients, 31 underwent surgical repair and 27 had angiography. Preoperative diagnosis was made exclusively by echocardiography. Accuracy of echocardiographic diagnosis was evaluated retrospectively by comparing preoperative studies with angiography and surgical reports. We then investigated whether echocardiographic diagnosis of IAA type and co-existing cardiac defects might influence the timing of initial operation and type of surgical procedures. RESULTS Using Celoria and Patton classification system for IAA, type A was seen in 65% (26/40) of patients (likely most common in Chinese population), type B was seen in 32.5% (13/40) (reported most common in literature) and type C was seen in 2.5% (1/40). Our accuracy rate for IAA type was 82.5%, which was confirmed by operative notes and angiographic reports. The accuracy of echocardiography in diagnosing the associated cardiac malformation was 99%. Twelve associated cardiac malformation were found in these patients. The patent ductus arteriosus (97.5%) and ventricular septal defect (85%) are most commonly associated with simple IAA. Other cardiovascular abnormalities were seen including atrial septal defect or patent foramen ovale (50%), aortopulmonary septal defect (10%), anomalous origin of right pulmonary artery from the ascending aorta (7.5%), double-outlet
right ventricle (7.5%), transposition of the great arteries (5%), truncus arteriosus (5%), aortic valvular malformation (2.5%), cor triatriatum (2.5%), stenosis of right upper pulmonary vein inlet (2.5%) and anomalous origin of the left circumflex artery from the right coronary sinus (2.5%). One adult patient with type A IAA doesn’t have any intracardiac malformation. Five patients were misdiagnosed as coarctation of aorta, one missed case was associated with truncus arteriosus, and another missed was an adult without intracardiac malformation, but these did not influence the surgical procedure and outcome. Echocardiographic measurements of diameter of the ascending aorta, distance between the interrupted segments and associated cardiovascular defects had great influence on the methods of surgical repair. Intracardiac abnormalities were accurately diagnosed by echocardiography in almost all cases except one with missing anomalous origin of the left circumflex artery from the right coronary sinus. CONCLUSIONS Echocardiography can accurately diagnose and characterize the various forms of IAA and associated intracardiac defects for preoperative surgical decision making. GW28-e0261 Congenital Left Atrial Appendage Aneurysm: Diagnosis and Management Bin Wang,1 He Li,1 Mingxing Xie1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology 1
OBJECTIVES Aneurysm of the left atrial appendage is rare. We sought to review the published literature on left atrial appendage aneurysm(LAAA) to address its epidemiology, pathology, clinical symptoms, diagnosis and management METHODS We reviewed PubMed from 1962 to 2016 to find relevant LAAA cases using medical subject heading (MESH) terms “atrial appendage” and “aneurysm” as search terms. Statistical analysis was done using Minitab 17.0. RESULTS One hundred and one cases of LAAA were identified. The symptoms do not arise until the second to the fourth decades of life. Palpitation, dyspnea and chest pain were common clinical symptoms. Echocardiography is considered to be the primary method of diagnosis. Other imaging modalities such as cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are useful for ruling out the differential diagnoses. Surgical treatment is often recommended even in asymptomatic patients for prevention the thromboembolic complications. Seventy-four patients (73.2%) reported in the literatures were treated by surgical treatment. The prognosis is favorable, for freedom from recurrent symptoms and arrhythmia has been reported from 10 days to 8 years follow-up. CONCLUSIONS Echocardiography is considered the initial diagnostic tool for LAAA. The associated high risk of life-threatening complications and the relative ease of surgical removal suggest that prompt evaluation should be considered in patients with lesions adjacent to the left heart border. GW28-e0331 A pulmonary artery aneurysm with patent arterial duct and secondary to infection Qing Lv,1 Li Zhang1 1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Provincial Key Laboratory of Molecular Imaging OBJECTIVES A twenty-year-old woman was admitted for patent arterial duct (PDA) ligation surgery in Oct 2014. She was hospitalized 8 months earlier due to high fever, cough, exertional dyspnea, staphylococcal aureus endocarditis, and received antibiotic treatment. In the recent admission, a grade 3/6 continuous murmur was heard at the left sternal border, and the other physical examination was normal. METHODS An echocardiography showed a PDA in Feb 2014. In Oct 2014, an echo showed a 0.44cm width left-to-right PDA shunt, with peak velocity of 5.6m/s. A saccular main pulmonary artery aneurysm (PAA) was detected, with 3.8cm in width and 2.6cm in depth. It originated from the left side of the pulmonary trunk and 1.5cm above the pulmonary valve annulus. We identified the PDA jet flow unrestrictedly flowing into the aneurysm and swirling within it. The pulmonary artery computed tomographic
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 70, NO. 16, SUPPL C, 2017
GW28-e0251 Experimental Study on human venous blood preparation of thrombus with the platelets and fibrin Lina Guan,1 Peipei Mai,1 Xiaoyu Wang,1 Min Di,1 Weiliang Huang,1 Yuming Mu1 1 Department of Echocardiography, The First Affiliated Hospital of Xinjiang Medical University OBJECTIVES To investigate human venous blood in the preparation of mixed thrombus which platelets and fibrin for providing a stable and simple method for thrombolysis in vitro. METHODS Venous blood was taken from healthy blood a donor that was per person 8-10ml, who had not been treated with anticoagulants or platelet function inhibitors within 2 weeks. The thrombus was prepared in vitro, then divided into four groups, venous blood (group A), venous bloodþADPþthrombinþCaCl2 (group B), venous bloodþCaCl2 (group C) and intracoronary thrombus in acute myocardial infarction patients within 2 hours as control group (Group D). The platelet and cellulose in the thrombus were detected by HE staining, immunohistochemistry and scanning electron microscope. Extracorporeal circulation device was used to simulate 180mmHg to detect the stability of thrombosis. Recombinant tissue type plasminogen activator (rt-PA) was dissolved Thrombin vitro, and the lysis rates of thrombosis was calculated. RESULTS Compared with the control group, only the B group showed a large number of platelets and beam formation with HE staining, platelet aggregation distribution with immunohistochemical staining, a large number of platelets, fibrous reticular structures and few red blood cells were observed under scanning electron microscope. Under the extracorporeal circulation device of 180mmHg, the thrombus was not dissolved in 4 hours In the B group, but the A and C groups were almost completely dissolved within 1min under the pressure of 120mmHg, the lysis rate of the A and C groups were 35%4% and 39%6% compared with which were higher than B group 71%5% in vitro (P<0.05). CONCLUSIONS The venous bloodþADPþthrombinþCaCl2 group is most likely to form mixed thrombus with platelets and fibrin, which has a better stability, higher cracking rate, thus, it can provide a stable and simple thrombus model for thrombolysis in vitro. GW28-e0253 Single institution experience with comprehensive echocardiographic assessments of interrupted aortic arch for surgical decision making Ling Li,1 Shuangshuang Kong,1 Mingxing Xie1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
1
OBJECTIVES To evaluate the value of echocardiography in diagnosis of different types of Interrupted aortic artery (IAA) METHODS We report our institutional (one of top10 largest institution in china) experience and correlated echocardiography diagnosis with surgical and angiographic findings. From July 2006 to September 2014, 40 patients were diagnosed with IAA. Of the patients, 31 underwent surgical repair and 27 had angiography. Preoperative diagnosis was made exclusively by echocardiography. Accuracy of echocardiographic diagnosis was evaluated retrospectively by comparing preoperative studies with angiography and surgical reports. We then investigated whether echocardiographic diagnosis of IAA type and co-existing cardiac defects might influence the timing of initial operation and type of surgical procedures. RESULTS Using Celoria and Patton classification system for IAA, type A was seen in 65% (26/40) of patients (likely most common in Chinese population), type B was seen in 32.5% (13/40) (reported most common in literature) and type C was seen in 2.5% (1/40). Our accuracy rate for IAA type was 82.5%, which was confirmed by operative notes and angiographic reports. The accuracy of echocardiography in diagnosing the associated cardiac malformation was 99%. Twelve associated cardiac malformation were found in these patients. The patent ductus arteriosus (97.5%) and ventricular septal defect (85%) are most commonly associated with simple IAA. Other cardiovascular abnormalities were seen including atrial septal defect or patent foramen ovale (50%), aortopulmonary septal defect (10%), anomalous origin of right pulmonary artery from the ascending aorta (7.5%), double-outlet
right ventricle (7.5%), transposition of the great arteries (5%), truncus arteriosus (5%), aortic valvular malformation (2.5%), cor triatriatum (2.5%), stenosis of right upper pulmonary vein inlet (2.5%) and anomalous origin of the left circumflex artery from the right coronary sinus (2.5%). One adult patient with type A IAA doesn’t have any intracardiac malformation. Five patients were misdiagnosed as coarctation of aorta, one missed case was associated with truncus arteriosus, and another missed was an adult without intracardiac malformation, but these did not influence the surgical procedure and outcome. Echocardiographic measurements of diameter of the ascending aorta, distance between the interrupted segments and associated cardiovascular defects had great influence on the methods of surgical repair. Intracardiac abnormalities were accurately diagnosed by echocardiography in almost all cases except one with missing anomalous origin of the left circumflex artery from the right coronary sinus. CONCLUSIONS Echocardiography can accurately diagnose and characterize the various forms of IAA and associated intracardiac defects for preoperative surgical decision making. GW28-e0261 Congenital Left Atrial Appendage Aneurysm: Diagnosis and Management Bin Wang,1 He Li,1 Mingxing Xie1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology 1
OBJECTIVES Aneurysm of the left atrial appendage is rare. We sought to review the published literature on left atrial appendage aneurysm(LAAA) to address its epidemiology, pathology, clinical symptoms, diagnosis and management METHODS We reviewed PubMed from 1962 to 2016 to find relevant LAAA cases using medical subject heading (MESH) terms “atrial appendage” and “aneurysm” as search terms. Statistical analysis was done using Minitab 17.0. RESULTS One hundred and one cases of LAAA were identified. The symptoms do not arise until the second to the fourth decades of life. Palpitation, dyspnea and chest pain were common clinical symptoms. Echocardiography is considered to be the primary method of diagnosis. Other imaging modalities such as cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are useful for ruling out the differential diagnoses. Surgical treatment is often recommended even in asymptomatic patients for prevention the thromboembolic complications. Seventy-four patients (73.2%) reported in the literatures were treated by surgical treatment. The prognosis is favorable, for freedom from recurrent symptoms and arrhythmia has been reported from 10 days to 8 years follow-up. CONCLUSIONS Echocardiography is considered the initial diagnostic tool for LAAA. The associated high risk of life-threatening complications and the relative ease of surgical removal suggest that prompt evaluation should be considered in patients with lesions adjacent to the left heart border. GW28-e0331 A pulmonary artery aneurysm with patent arterial duct and secondary to infection Qing Lv,1 Li Zhang1 1 Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Provincial Key Laboratory of Molecular Imaging OBJECTIVES A twenty-year-old woman was admitted for patent arterial duct (PDA) ligation surgery in Oct 2014. She was hospitalized 8 months earlier due to high fever, cough, exertional dyspnea, staphylococcal aureus endocarditis, and received antibiotic treatment. In the recent admission, a grade 3/6 continuous murmur was heard at the left sternal border, and the other physical examination was normal. METHODS An echocardiography showed a PDA in Feb 2014. In Oct 2014, an echo showed a 0.44cm width left-to-right PDA shunt, with peak velocity of 5.6m/s. A saccular main pulmonary artery aneurysm (PAA) was detected, with 3.8cm in width and 2.6cm in depth. It originated from the left side of the pulmonary trunk and 1.5cm above the pulmonary valve annulus. We identified the PDA jet flow unrestrictedly flowing into the aneurysm and swirling within it. The pulmonary artery computed tomographic