Thyristor valve is one of the key equipments for ultra high voltage direct current(UHVDC) power transmission projects.Before being installed on site,they need to be tested in a laboratory in order to verify their oper...Thyristor valve is one of the key equipments for ultra high voltage direct current(UHVDC) power transmission projects.Before being installed on site,they need to be tested in a laboratory in order to verify their operational performance to satisfy the technical specification of project related.Test facilities for operational tests of thyristor valves are supposed to enable to undertake more severe electrical stresses than those being applied in the thyristor valves under test(test objects).On the other hand,the stresses applied into the test objects are neither higher nor lower than specified by the specification,because inappropriate stresses applied would result in incorrect evaluation of performance on the test objects,more seriously,would cuase the damage of test objects with expensive cost losing.Generally,the process of operational tests is complicated and performed in a complex synthetic test circuit(hereafter as STC),where there are a lot of sensors used for measuring,monitoring and protection on line to ensure that the test circuit functions in good condition.Therefore,the measuring systems embedded play a core role in STC,acting like "eyes".Based on the first project of building up a STC in China,experience of planning measuring systems is summarized so as to be referenced by related engineers.展开更多
Summary: The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three...Summary: The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three cases undergoing heart valve replacement with cardiopulmonary bypass (CPB) were randomly allocated into two groups: L-carnitine group (n=12, 12 g/L L-carnitine was put in the ST. Thomas cardioplegia) and control group (n=11, identical to the L-carnitine group except that normal saline was administered instead of L-carnitine). Serum cardial troponin I (cTnI) levels, the left ventricular ejection fraction (LVEF), and cardiac index (CI) were measured perioperatively. A bit of myocardial tissue obtained from right atria was taken before CPB and by the end of intracardiac procedure to undergo electron microscopy examination and estimate apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). From the end of CPB to 3 days after operation, the serum levels of cTnI in the L-carnitine group was significantly lower than that in the control group (P〈0.05). Heart color ultrasonogram showed that the CI index and LVEF at 7th day postoperatively in the L-carnitine group were significantly higher than in the control group (P〈0.05). Compared to the control group, L-carnitine significantly alleviated the morphologic changes of cardiac muscle cells (electron microscopy examination) and decreased the amounts of apoptotic cardiac muscle cells (TUNEL). Furthermore, the dosage of vasoactive drugs used after operation was significantly less in the L-carnitine group (P〈0.01). It was concluded that L-carnitine cardioplegia solution could improve cardiac function in patients undergoing heart valve replacement operation and alleviate CPB-mediated apoptosis of cardiac muscle cells.展开更多
With the growth of capacity of high voltage direct current(HVDC) transmission lines,the ratings of thyristor valves,which are one of the most critical equipments,are getting higher and higher.Verification of performan...With the growth of capacity of high voltage direct current(HVDC) transmission lines,the ratings of thyristor valves,which are one of the most critical equipments,are getting higher and higher.Verification of performance of thyristor valves particularly designed for HVDC project plays an important role in the handover of products between the manufacturer and the client.Conventional test facilities based on philosophy of direct test cannot meet the requirements for modern thyristor valves.New test facilities with high ratings are necessarily built based on philosophy of synthetic test.Over the conventional direct test circuit,the later is an economical and feasible solution with less financial investment and higher test capability.However,the equivalency between the synthetic test and the direct test should be analyzed technically in order to make sure that the condition of verification test in a synthetic test circuit should satisfy the actual operation condition of thyristor valves existing in a real HVDC project,just as in a direct test circuit.Equivalency analysis is focused in this paper,covering the scope of thyristor valves' steady state,and transient state.On the basis of the results achieved,a synthetic test circuit of 6 500 A/50 kV for operational tests of thyristor valves used for up to UHVDC project has newly been set up and already put into service in Xi'an High Voltage Apparatus Research Institute Co.,Ltd.(XIHARI),China.Some of the results have been adopted also by a new national standard of China.展开更多
The oxidization resistance of the Ni76Cr19A1Ti alloy was studied by a static oxidization experiment at 600-800℃. The results show that the oxidation behavior of the alloy can be explained by a kinetic equation: (△...The oxidization resistance of the Ni76Cr19A1Ti alloy was studied by a static oxidization experiment at 600-800℃. The results show that the oxidation behavior of the alloy can be explained by a kinetic equation: (△m/S)2 = Kpt + C, where Kp is a kinetic constant of the nickel-base alloy. The higher the experimental temperature, the higher the value of Kp. It is discovered that the microstructure of the oxide scales is compact and the thickness of it is less than 10 μm The oxidization of the alloy is in the first grade. It is also found that the oxide scales are mainly composed of Cr2O3 and TiO2. Chrome and titanium react more easily with oxygen at temperatures under the operating mode.展开更多
A new type regulating valve with the cooling mode of constant temperature difference water supply, temperature difference self operated regulating valve, was introduced into blast furnace cooling system to overcome s...A new type regulating valve with the cooling mode of constant temperature difference water supply, temperature difference self operated regulating valve, was introduced into blast furnace cooling system to overcome shortcomings of the cooling mode of constant flow rate water supply. The results show that the temperature difference between inlet and outlet water of cooling wall can be decreased greatly and steadily, and the water supply for blast furnace cooling can be reduced considerably.展开更多
Mitral valve reconstruction was performed on 41 patients from 1980 to 1991. Two died early and one died later.38 survivals were followed up in 3 to 108 months,35 cases'heart function improved to grades 1~2,3 case...Mitral valve reconstruction was performed on 41 patients from 1980 to 1991. Two died early and one died later.38 survivals were followed up in 3 to 108 months,35 cases'heart function improved to grades 1~2,3 cases to grade 3,they need small dose medication support.The operative indicationcontra-indication and the surgical technique are discussed.It is concluded that mitral valve reconstruction is suitable for membranaceous or simple thickness, but mitral valve replacement should be chosen when severe valve calcificatlon or sub-valve diseases are present.展开更多
Objectives:To establish long-term outcome of surgical pulmonary valve replacement(PVR)in congenital heart disease(CHD)and to identify risk factors for overall mortality,operative mortality,and repetitive PVR.Methods:T...Objectives:To establish long-term outcome of surgical pulmonary valve replacement(PVR)in congenital heart disease(CHD)and to identify risk factors for overall mortality,operative mortality,and repetitive PVR.Methods:This is a retrospective study of 375 surgical PVR in 293 patients who underwent surgical PVR for CHD between January 2000 and May 2020.We only included patients with index PVR with previous open-heart surgery regardless of the number of PVRs.The previous surgical history of patients who underwent PVR during the study period was also included.Patients who underwent the Rastelli operation,and those who underwent single PVR without previous open-heart surgery were excluded.Results:The median age of the patients at the time of surgical PVR was 14.9 years(Interquartile range,IQR,11.0–22.0).The median follow-up duration was 10.5 years(IQR,5.5–14.8 years).There were 3 patients with operative mortality(1.0%)and 15 patients with overall mortality(5.1%).The survival rate was 95.1%over 20 years follow-up period.Multivariate analysis demonstrated that more than 3 times of previous open-heart surgeries before surgical PVR,older age at the first operation,longer cardiopulmonary bypass(CPB)time and longer intensive care unit(ICU)stay were predictors for overall mortality.Patients who underwent surgical PVR after more than 3 times of previous open-heart surgeries had significantly higher mortality than those who underwent open-heart surgeries less than 3 times(P<0.001).Age younger than 10 years,male,multiple valve problems and longer ICU stay were significant predictors for repetitive PVR by multivariate analysis.Conclusions:Though surgical PVR has excellent long-term outcome,it should be performed with caution for those who previously underwent multiple open-heart surgeries,especially if patient received more than 3 times of open-heart surgeries.展开更多
The work-class remotely-operated-underwater-vehicles(ROVs) are mainly driven by hydraulic propulsion system,and the effeciency of hydraulic propulsion system is an important performance index of ROVs.However,the eff...The work-class remotely-operated-underwater-vehicles(ROVs) are mainly driven by hydraulic propulsion system,and the effeciency of hydraulic propulsion system is an important performance index of ROVs.However,the efficiency of traditional hydraulic propulsion system controlled by throttle valves is too low.Therefore,in this paper,for small and medium ROVs,a novel propulsion system with higher efficiency based on high speed on/off valve control hydraulic propeller is proposed.To solve the conflict between large flow rate and high frequency response performance,a two-stage high speed on/off valve-motor unit with large flow rate and high response speed simultaneously is developed.Through theoretical analysis,an effective fluctuation control method and a novel pulse-width-pulse-frequency-modulation(PWPFM) are introduced to solve the conflict among inherently fluctuation,valve dynamic performance and system efficiency.A simulation model is established to evaluate the system performance.To prove the advantage of system in energy saving,and test the dynamic control performance of high speed on/off valve control propeller,a test setup is developed and a series of comparative experiments is completed.The smimulation and experiment results show that the two-stage high speed on/off valve has an excellent dynamic response performance,and can be used to realize high accuracy speed control.The experiment results prove that the new propulsion system has much more advantages than the traditional throttle speed regulation system in energy saving.The lowest efficiency is more than 40%.The application results on a ROV indicate that the high speed on/off valve control propeller system has good dynamic and steady-state control performances.Its transient time is only about 1 s-1.5 s,and steady-state error is less than 5%.Meanwhile,the speed fluctuation is small,and the smooth propeller speed control effect is obtained.On the premise of good propeller speed control performance,the proposed high speed on/off valve control propeller can improve the effeciency of ROV propulsion system significantly,and provides another attractive ROV propulsion system choice for engineers.展开更多
Background: Small aortic annulus during aortic valve replacement can lead to implanting a smaller sized valve compared to the body surface area thereby causing patient prosthesis mismatch. Various aortic root enlargem...Background: Small aortic annulus during aortic valve replacement can lead to implanting a smaller sized valve compared to the body surface area thereby causing patient prosthesis mismatch. Various aortic root enlargement techniques have been described depending on anterior or posterior approach. Konno procedure uses anterior approach for aortic root enlargement. In this study, we reviewed results of Konno procedure done from 2011 to 2019 by a single surgeon. Methods: 12 adult patients who underwent aortic valve replacement along with Konno procedure for small aortic root by a single surgeon at a single center between 2011 and 2019 were reviewed. Echocardiographic and demographic data and post-operative data were obtained from medical records. Symptomatic profile was assessed as per New York Heart Association Classification. Intraoperative findings and post-operative period findings were noted. Follow up symptom profile was assessed for these patients. Results: 12 patients underwent Konno procedure between 2011 and 2019 for small aortic root along with valve replacement. The main indication for surgery was aortic stenosis with small aortic annulus, with or without involvement of the mitral valve. Preoperatively, 3 patients had NYHA class II and 9 patients had NYHA class III symptoms. Mean age at operation was 26.42 years, minimum age 10 years, and maximum age 39 years. 3 were females and 9 were males. Mean bypass time was 106.4 minutes and aortic cross clamp time was 80.67 minutes. Mechanical aortic valves were implanted in all patients. Mean post-operative blood loss was 134.2 ml and duration of ventilation before extubation was 14.5 hours. Mean duration of intensive care unit (ICU) stay was 2.83 days and hospital stay was 9.1 days. Mean gradient in the post-operative period was 10.75 mm Hg. There was no mortality in these 12 patients and no reoperation was needed in the follow up period. Follow up in the outpatient department suggested all patients had NYHA class I symptoms and anticoagulation with warfarin adjusted to prothrombin time— International normalised ratio. Conclusion: Konno procedure is effective for managing small aortic root as bigger outflow orifice area through the larger valve prosthesis improves ventricular outflow and hence, improves the outcomes.展开更多
Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated ri...Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation(d-TGA/AtS).Methods:Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS(age 42±6 years old,56%male)between 2015–2019.Echocardiography data included mitral apparatus anatomy,and CT/MRI data included biventricular dimensions,function,and Haller index(HI)for pectus deformity.Results:Patients with leaflet SAM(n=6)compared to patients without SAM(n=13)had higher MV protrusion height(2.3±0.5 vs.1.5±0.4 cm,p≤0.01)and longer anterior MV leaflet length(3.1±0.4 cm vs.2.6±0.3 cm p≤0.05),when compared to those without.CT/MRI showed higher sub-pulmonic left ventricular ejection fraction(LVEF)in the SAM group(71%±8%vs.54%±7%,respectively).RV size and function,significant chest deformity(HI>3.5),presence of a ventricular lead pacemaker,and septal thickness did not play a role in development of SAM.Conclusions:An elongated mitral apparatus is associated with the development of SAM,and the development of left ventricular outflow tract obstruction(LVOTO),in d-TGA/AtS.LV hyperkinesia is associated with SAM.Systemic RV dimensions,septal thickness,and degree of chest deformity did not differ significantly between subjects with SAM and those without.展开更多
基金Project Supported by National Development and Reform Commission(No.[2006]2709)
文摘Thyristor valve is one of the key equipments for ultra high voltage direct current(UHVDC) power transmission projects.Before being installed on site,they need to be tested in a laboratory in order to verify their operational performance to satisfy the technical specification of project related.Test facilities for operational tests of thyristor valves are supposed to enable to undertake more severe electrical stresses than those being applied in the thyristor valves under test(test objects).On the other hand,the stresses applied into the test objects are neither higher nor lower than specified by the specification,because inappropriate stresses applied would result in incorrect evaluation of performance on the test objects,more seriously,would cuase the damage of test objects with expensive cost losing.Generally,the process of operational tests is complicated and performed in a complex synthetic test circuit(hereafter as STC),where there are a lot of sensors used for measuring,monitoring and protection on line to ensure that the test circuit functions in good condition.Therefore,the measuring systems embedded play a core role in STC,acting like "eyes".Based on the first project of building up a STC in China,experience of planning measuring systems is summarized so as to be referenced by related engineers.
文摘Summary: The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three cases undergoing heart valve replacement with cardiopulmonary bypass (CPB) were randomly allocated into two groups: L-carnitine group (n=12, 12 g/L L-carnitine was put in the ST. Thomas cardioplegia) and control group (n=11, identical to the L-carnitine group except that normal saline was administered instead of L-carnitine). Serum cardial troponin I (cTnI) levels, the left ventricular ejection fraction (LVEF), and cardiac index (CI) were measured perioperatively. A bit of myocardial tissue obtained from right atria was taken before CPB and by the end of intracardiac procedure to undergo electron microscopy examination and estimate apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). From the end of CPB to 3 days after operation, the serum levels of cTnI in the L-carnitine group was significantly lower than that in the control group (P〈0.05). Heart color ultrasonogram showed that the CI index and LVEF at 7th day postoperatively in the L-carnitine group were significantly higher than in the control group (P〈0.05). Compared to the control group, L-carnitine significantly alleviated the morphologic changes of cardiac muscle cells (electron microscopy examination) and decreased the amounts of apoptotic cardiac muscle cells (TUNEL). Furthermore, the dosage of vasoactive drugs used after operation was significantly less in the L-carnitine group (P〈0.01). It was concluded that L-carnitine cardioplegia solution could improve cardiac function in patients undergoing heart valve replacement operation and alleviate CPB-mediated apoptosis of cardiac muscle cells.
基金Project Supported by National Development and Reform Commission(No.[2006]2709)
文摘With the growth of capacity of high voltage direct current(HVDC) transmission lines,the ratings of thyristor valves,which are one of the most critical equipments,are getting higher and higher.Verification of performance of thyristor valves particularly designed for HVDC project plays an important role in the handover of products between the manufacturer and the client.Conventional test facilities based on philosophy of direct test cannot meet the requirements for modern thyristor valves.New test facilities with high ratings are necessarily built based on philosophy of synthetic test.Over the conventional direct test circuit,the later is an economical and feasible solution with less financial investment and higher test capability.However,the equivalency between the synthetic test and the direct test should be analyzed technically in order to make sure that the condition of verification test in a synthetic test circuit should satisfy the actual operation condition of thyristor valves existing in a real HVDC project,just as in a direct test circuit.Equivalency analysis is focused in this paper,covering the scope of thyristor valves' steady state,and transient state.On the basis of the results achieved,a synthetic test circuit of 6 500 A/50 kV for operational tests of thyristor valves used for up to UHVDC project has newly been set up and already put into service in Xi'an High Voltage Apparatus Research Institute Co.,Ltd.(XIHARI),China.Some of the results have been adopted also by a new national standard of China.
文摘The oxidization resistance of the Ni76Cr19A1Ti alloy was studied by a static oxidization experiment at 600-800℃. The results show that the oxidation behavior of the alloy can be explained by a kinetic equation: (△m/S)2 = Kpt + C, where Kp is a kinetic constant of the nickel-base alloy. The higher the experimental temperature, the higher the value of Kp. It is discovered that the microstructure of the oxide scales is compact and the thickness of it is less than 10 μm The oxidization of the alloy is in the first grade. It is also found that the oxide scales are mainly composed of Cr2O3 and TiO2. Chrome and titanium react more easily with oxygen at temperatures under the operating mode.
文摘A new type regulating valve with the cooling mode of constant temperature difference water supply, temperature difference self operated regulating valve, was introduced into blast furnace cooling system to overcome shortcomings of the cooling mode of constant flow rate water supply. The results show that the temperature difference between inlet and outlet water of cooling wall can be decreased greatly and steadily, and the water supply for blast furnace cooling can be reduced considerably.
文摘Mitral valve reconstruction was performed on 41 patients from 1980 to 1991. Two died early and one died later.38 survivals were followed up in 3 to 108 months,35 cases'heart function improved to grades 1~2,3 cases to grade 3,they need small dose medication support.The operative indicationcontra-indication and the surgical technique are discussed.It is concluded that mitral valve reconstruction is suitable for membranaceous or simple thickness, but mitral valve replacement should be chosen when severe valve calcificatlon or sub-valve diseases are present.
文摘Objectives:To establish long-term outcome of surgical pulmonary valve replacement(PVR)in congenital heart disease(CHD)and to identify risk factors for overall mortality,operative mortality,and repetitive PVR.Methods:This is a retrospective study of 375 surgical PVR in 293 patients who underwent surgical PVR for CHD between January 2000 and May 2020.We only included patients with index PVR with previous open-heart surgery regardless of the number of PVRs.The previous surgical history of patients who underwent PVR during the study period was also included.Patients who underwent the Rastelli operation,and those who underwent single PVR without previous open-heart surgery were excluded.Results:The median age of the patients at the time of surgical PVR was 14.9 years(Interquartile range,IQR,11.0–22.0).The median follow-up duration was 10.5 years(IQR,5.5–14.8 years).There were 3 patients with operative mortality(1.0%)and 15 patients with overall mortality(5.1%).The survival rate was 95.1%over 20 years follow-up period.Multivariate analysis demonstrated that more than 3 times of previous open-heart surgeries before surgical PVR,older age at the first operation,longer cardiopulmonary bypass(CPB)time and longer intensive care unit(ICU)stay were predictors for overall mortality.Patients who underwent surgical PVR after more than 3 times of previous open-heart surgeries had significantly higher mortality than those who underwent open-heart surgeries less than 3 times(P<0.001).Age younger than 10 years,male,multiple valve problems and longer ICU stay were significant predictors for repetitive PVR by multivariate analysis.Conclusions:Though surgical PVR has excellent long-term outcome,it should be performed with caution for those who previously underwent multiple open-heart surgeries,especially if patient received more than 3 times of open-heart surgeries.
基金supported by National Hi-tech Research and Development Program of China (863 Program, Grant No.2006AA09Z215)
文摘The work-class remotely-operated-underwater-vehicles(ROVs) are mainly driven by hydraulic propulsion system,and the effeciency of hydraulic propulsion system is an important performance index of ROVs.However,the efficiency of traditional hydraulic propulsion system controlled by throttle valves is too low.Therefore,in this paper,for small and medium ROVs,a novel propulsion system with higher efficiency based on high speed on/off valve control hydraulic propeller is proposed.To solve the conflict between large flow rate and high frequency response performance,a two-stage high speed on/off valve-motor unit with large flow rate and high response speed simultaneously is developed.Through theoretical analysis,an effective fluctuation control method and a novel pulse-width-pulse-frequency-modulation(PWPFM) are introduced to solve the conflict among inherently fluctuation,valve dynamic performance and system efficiency.A simulation model is established to evaluate the system performance.To prove the advantage of system in energy saving,and test the dynamic control performance of high speed on/off valve control propeller,a test setup is developed and a series of comparative experiments is completed.The smimulation and experiment results show that the two-stage high speed on/off valve has an excellent dynamic response performance,and can be used to realize high accuracy speed control.The experiment results prove that the new propulsion system has much more advantages than the traditional throttle speed regulation system in energy saving.The lowest efficiency is more than 40%.The application results on a ROV indicate that the high speed on/off valve control propeller system has good dynamic and steady-state control performances.Its transient time is only about 1 s-1.5 s,and steady-state error is less than 5%.Meanwhile,the speed fluctuation is small,and the smooth propeller speed control effect is obtained.On the premise of good propeller speed control performance,the proposed high speed on/off valve control propeller can improve the effeciency of ROV propulsion system significantly,and provides another attractive ROV propulsion system choice for engineers.
文摘Background: Small aortic annulus during aortic valve replacement can lead to implanting a smaller sized valve compared to the body surface area thereby causing patient prosthesis mismatch. Various aortic root enlargement techniques have been described depending on anterior or posterior approach. Konno procedure uses anterior approach for aortic root enlargement. In this study, we reviewed results of Konno procedure done from 2011 to 2019 by a single surgeon. Methods: 12 adult patients who underwent aortic valve replacement along with Konno procedure for small aortic root by a single surgeon at a single center between 2011 and 2019 were reviewed. Echocardiographic and demographic data and post-operative data were obtained from medical records. Symptomatic profile was assessed as per New York Heart Association Classification. Intraoperative findings and post-operative period findings were noted. Follow up symptom profile was assessed for these patients. Results: 12 patients underwent Konno procedure between 2011 and 2019 for small aortic root along with valve replacement. The main indication for surgery was aortic stenosis with small aortic annulus, with or without involvement of the mitral valve. Preoperatively, 3 patients had NYHA class II and 9 patients had NYHA class III symptoms. Mean age at operation was 26.42 years, minimum age 10 years, and maximum age 39 years. 3 were females and 9 were males. Mean bypass time was 106.4 minutes and aortic cross clamp time was 80.67 minutes. Mechanical aortic valves were implanted in all patients. Mean post-operative blood loss was 134.2 ml and duration of ventilation before extubation was 14.5 hours. Mean duration of intensive care unit (ICU) stay was 2.83 days and hospital stay was 9.1 days. Mean gradient in the post-operative period was 10.75 mm Hg. There was no mortality in these 12 patients and no reoperation was needed in the follow up period. Follow up in the outpatient department suggested all patients had NYHA class I symptoms and anticoagulation with warfarin adjusted to prothrombin time— International normalised ratio. Conclusion: Konno procedure is effective for managing small aortic root as bigger outflow orifice area through the larger valve prosthesis improves ventricular outflow and hence, improves the outcomes.
文摘Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation(d-TGA/AtS).Methods:Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS(age 42±6 years old,56%male)between 2015–2019.Echocardiography data included mitral apparatus anatomy,and CT/MRI data included biventricular dimensions,function,and Haller index(HI)for pectus deformity.Results:Patients with leaflet SAM(n=6)compared to patients without SAM(n=13)had higher MV protrusion height(2.3±0.5 vs.1.5±0.4 cm,p≤0.01)and longer anterior MV leaflet length(3.1±0.4 cm vs.2.6±0.3 cm p≤0.05),when compared to those without.CT/MRI showed higher sub-pulmonic left ventricular ejection fraction(LVEF)in the SAM group(71%±8%vs.54%±7%,respectively).RV size and function,significant chest deformity(HI>3.5),presence of a ventricular lead pacemaker,and septal thickness did not play a role in development of SAM.Conclusions:An elongated mitral apparatus is associated with the development of SAM,and the development of left ventricular outflow tract obstruction(LVOTO),in d-TGA/AtS.LV hyperkinesia is associated with SAM.Systemic RV dimensions,septal thickness,and degree of chest deformity did not differ significantly between subjects with SAM and those without.