Objective To evaluate the efficacy of minimally invasive perventricular device closure of ventricular septal defect(VSD). Methods Between September 2011 and February 2013, we collected 40 patients who underwent perven...Objective To evaluate the efficacy of minimally invasive perventricular device closure of ventricular septal defect(VSD). Methods Between September 2011 and February 2013, we collected 40 patients who underwent perventricular closure via a small lower sternal incision(minimally invasive group), aged 15.5±3.5 years(12 months to 32 years) with a body weight of 24.2±7.5 kg(10.8-58.0 kg). The mean size of VSD was 5.6±0.5 mm(2-14 mm). Another 40 patients were included as the surgical group, receiving the conventional surgical repair of VSD. The device of the minimally invasive group was released under the guidance of transesophageal echocardiography. Success rate, cardiac indicators, and clinical outcomes of the 2 groups were compared. Results The patients in the surgical group and those in the minimally invasive group showed similar results in success rate(both 97.5%). The procedure time, intensive care unit stay, hospital stay, and postoperative recovery time in the minimally invasive group were significantly shorter than those in the surgical group(58±21 minutes versus 145±26 minutes, 2±1 days versus 8±3 days, 5±1 days versus 16±6 days, 3±1 days versus 90±20 days, all P<0.05). The minimally invasive group had a higher incidence of conduction anomalies(17.5% versus 2.5%, P<0.05). In the follow-up period of 3-12 months, there was no new residual shunt, noticeable aortic regurgitation, significant arrhythmias, or device failure except for new complications in the surgical group. Conclusions The success rate of minimally invasive perventricular device closure of VSD under transesophageal echocardiography guidance is similar to that of conventional surgical repair, but the short-term outcomes of the minimally invasive approach is much better. Long-term follow-up is necessary to confirm the effectiveness of this technique.展开更多
Internal arcs cause a rapid increase in pressure in electrical installations. The type of insulation gas has influence on pressure development. Typically SF6 is used incompact metal-clad switchgear, however, it has a ...Internal arcs cause a rapid increase in pressure in electrical installations. The type of insulation gas has influence on pressure development. Typically SF6 is used incompact metal-clad switchgear, however, it has a high global warming potential. Because of this, the replacement of SF6 by alternative gases such as CO2 is under discussion. The pressure developments in a closed vessel filled with air, SF6 and CO2 are measured and compared. During internal arcing in gas-insulated switchgear, overpressure causes a rupture of a burst plate and hot gas escapes into the surrounding room mixing with air. In order to predict the pressure development in electrical installations reliably, the portion of energy causing pressure rise, arc voltage as well as reliable gas data i.e., thermodynamic and transport properties, must be known in a wide range of pressure and temperature. These data are up to now not available for CO2/air mixtures. The thermodynamic properties are directly calculated from the number densities, internal partition functions and enthalpies of formation. The transport coefficients are deduced using the Chapman-Enskog method. Comparing measured and calculated pressure developments in a test arrangement demonstrates the quality of the calculation approach.展开更多
文摘Objective To evaluate the efficacy of minimally invasive perventricular device closure of ventricular septal defect(VSD). Methods Between September 2011 and February 2013, we collected 40 patients who underwent perventricular closure via a small lower sternal incision(minimally invasive group), aged 15.5±3.5 years(12 months to 32 years) with a body weight of 24.2±7.5 kg(10.8-58.0 kg). The mean size of VSD was 5.6±0.5 mm(2-14 mm). Another 40 patients were included as the surgical group, receiving the conventional surgical repair of VSD. The device of the minimally invasive group was released under the guidance of transesophageal echocardiography. Success rate, cardiac indicators, and clinical outcomes of the 2 groups were compared. Results The patients in the surgical group and those in the minimally invasive group showed similar results in success rate(both 97.5%). The procedure time, intensive care unit stay, hospital stay, and postoperative recovery time in the minimally invasive group were significantly shorter than those in the surgical group(58±21 minutes versus 145±26 minutes, 2±1 days versus 8±3 days, 5±1 days versus 16±6 days, 3±1 days versus 90±20 days, all P<0.05). The minimally invasive group had a higher incidence of conduction anomalies(17.5% versus 2.5%, P<0.05). In the follow-up period of 3-12 months, there was no new residual shunt, noticeable aortic regurgitation, significant arrhythmias, or device failure except for new complications in the surgical group. Conclusions The success rate of minimally invasive perventricular device closure of VSD under transesophageal echocardiography guidance is similar to that of conventional surgical repair, but the short-term outcomes of the minimally invasive approach is much better. Long-term follow-up is necessary to confirm the effectiveness of this technique.
文摘Internal arcs cause a rapid increase in pressure in electrical installations. The type of insulation gas has influence on pressure development. Typically SF6 is used incompact metal-clad switchgear, however, it has a high global warming potential. Because of this, the replacement of SF6 by alternative gases such as CO2 is under discussion. The pressure developments in a closed vessel filled with air, SF6 and CO2 are measured and compared. During internal arcing in gas-insulated switchgear, overpressure causes a rupture of a burst plate and hot gas escapes into the surrounding room mixing with air. In order to predict the pressure development in electrical installations reliably, the portion of energy causing pressure rise, arc voltage as well as reliable gas data i.e., thermodynamic and transport properties, must be known in a wide range of pressure and temperature. These data are up to now not available for CO2/air mixtures. The thermodynamic properties are directly calculated from the number densities, internal partition functions and enthalpies of formation. The transport coefficients are deduced using the Chapman-Enskog method. Comparing measured and calculated pressure developments in a test arrangement demonstrates the quality of the calculation approach.
