Perpulmonary Device Closure of Patent Ductus Arteriosus with Minimum Diameter More Than 4 mm in Infants

Background:Closure of large patent ductus arteriosus(PDA)in older children has been accomplished using surgical and percutaneous techniques with remarkable outcomes.However,outcomes amongst infants have been variable with several drawbacks.Here we describe a novel minimally invasive technique,a product of mini-thoracotomy and traditional percutaneous technique skills,accomplished exclusively under echocardiography guidance.Methods:Symptomatic infants with a significant left-to-right shunt from PDA measuring more than 4 mm were selected.The symptoms were varying degrees of tachypnea,tachycardia,heart failure,failure to thrive,recurrent respiratory tract infections,or intensive care unit treatment for a longer duration.Through a left parasternal mini-thoracotomy,two parallel purse-string sutures were placed on the pulmonary trunk.After purse-string circle puncture,under exclusively transesophageal echocardiography guidance,a device secured to the safety-suture was implanted on the ascending aorta via pulmonary trunk using a specially designed set.The safety-suture prevented device migration in case of dislocation.The basic demographics,PDA size,device size and type,intrapulmonary manipulation time,operation time,PDA parameters(length,diameter,type of duct),redeployment of the device,residual shunt,and retention of safety-suture were all recorded and analyzed.The follow-up was done with transthoracic echocardiography on the 2^(nd)postoperative day,1,3,6,and 12 months,and yearly thereafter.Results:Fifty-two infants with a mean age of 8 months±2.8 months(Interquartile range=0)underwent Perpulmonary device closure of PDA.Successful PDA occlusion was accomplished event-free in all subjects.The mean PDA,mean device,and mean operation time were 5.6 mm±1.4 mm,7.9 mm±1.7 mm,and 61.2 min±12.9 min,respectively.The immediate acceptable residual shunt was noted among 3 subjects and disappeared at a 1-month follow-up.Eighteen infants had retained safety-suture for added safety.There were no reports of the device or procedure-related complications.Conclusion:Perpulmonary device closure is an effective and safe approach to PDA with a diameter measuring>4 mm among infants.The safety-suture,in case of dislocation,prevents migration and associated complications.

Voxel modeling and association of ubiquitous spatiotemporal information in natural language texts

The ubiquitous spatiotemporal information extracted from Internet texts limits its application in spatiotemporal association and analysis due to its unstructured nature and uncertainty.This study uses ST-Voxel modeling to solve the problem of structured modeling and the association of ubiquitous spatiotemporal information in natural language texts.It provides a new solution for associating ubiquitous spatiotemporal information on the Internet and discovering public opinion.The main contributions of this paper include:(1)It proposes a convolved method for ST-Voxel,which solves the voxel modeling problem of unstructured and uncertain spatiotemporal objects and spatiotemporal relation in natural language texts.Experiments show that this method can effectively model 5 types of spatiotemporal objects and 16 types of uncertain spatiotemporal relation founded in texts;(2)It realizes the unknown event discovery based on voxelized spatiotemporal information association.Experiments show that this method can effectively solve the aggregation of ubiquitous spatiotemporal information in multi-natural language texts,which is conducive to discovering spatiotemporal events.The selection of convolution parameters in voxel modeling is also discussed.A parameter selection method for balancing the discovery capability and discovery accuracy of spatiotemporal events is given.