龚黎
中国医学科学院阜外医院 重症医学科
OBJECTIVES:Surgical intervention is the main treatment for a ruptured congenital sinus of Valsalva aneurysm (SVA). However, reports on the surgical experience are scarce. We retrospectively analysed the cases of our centre to summarize our 10-year experience.METHODS:A total of 286 patients who were diagnosed with a congenital ruptured SVA and underwent surgical repair between 2007 and 2016 were identified for the analysis. Follow-up data (mean ± standard deviation: 49.6 ± 34.9 months) were obtained from outpatient department records and telephone calls.RESULTS:The SVAs originated from the right coronary sinus (79.7%), the non-coronary sinus (19.6%) and the left coronary sinus (0.7%) but ruptured into the right ventricle (58.4%) and the right atrium (41.3%). The most commonly associated deformities were a ventricular septal defect (46.3%), aortic valve regurgitation (33.2%) and tricuspid regurgitation (20.3%). The SVA defect was closed by direct suturing (9.1%) or patching (90.9%) through an incision in the cardiac chamber involved or a transaortic approach. The mean postoperative hospital stay duration was 7.2 days, and 98.6% of the patients were discharged in New York Heart Association functional class I or II. The incidence rate of short-term complications was 5.7%. There were 4 late deaths, and 9 patients required rehospitalization due to surgery-related events. The estimated 10-year survival rate was greater than 90% according to the Kaplan-Meier survival curve.CONCLUSIONS:Surgical repair is an effective and safe treatment for a ruptured SVA. The majority of patients who undergo surgical repair can survive for a long time.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 2019
The major epigenetic features of mammalian cells include DNA methylation, posttranslational histone modifications and RNA-based mechanisms including those controlled by small non-coding RNAs (microRNAs (miRNAs)). An important aspect of epigenetic mechanisms is that they are potentially reversible and may be influenced by nutritional-environmental factors and through gene-environment interactions. Studies on epigenetic modulations could help us understand the mechanisms involved in essential hypertension and further prevent it's progress. This review is focused on new knowledge on the role of epigenetics, from DNA methylation to miRNAs, in essential hypertension.
Journal of human hypertension 2015
