The rapid development of magnetic materials provides the possibility for the application of permanent magnet stirring (PMS). Numerical and experimental investigations were employed with respect to the solidification process of the Al-2Sc alloy controlled by a novel PMS using NdFeB permanent magnets under various rotation speeds (0, 50, 100 and 150 r/min). The simulated results reveal that the maximum electromagnetic force increases proportionally from 4.14 to 12.39 kN/m3 and the maximum tangential velocity increases from 0.13 to 0.36 m/s when the rotation speed of PMS enhances from 50 to 150 r/min in the ingot melt. Besides, the experimental results demonstrate that PMS can achieve a uniform distribution of blocky Al3Sc precipitated phase in the longitudinal direction under the impact of a forced fluid flow. Moreover, increasing rotation speed of PMS is beneficial to refining aluminum grain size significantly and decreasing the texture intensity in the alloy. In addition, the Brinell hardness of Al-2Sc alloy is increased by 33% to 27.8 HB and the tensile strength is enhanced by 34% to 128.2 MPa, due to the improved distribution of the strengthening Al3Sc phase and the grain refinement of Al matrix under the impact of PMS. This work provides an effective application of NdFeB permanent magnets in the metal cast field.

Synovial sarcoma of the heart is a rare tumor. Herein we would like to report a case of giant intrapericardial cardiac synovial sarcoma that originated from the right ventricle and grew outward near the diaphragm. After making adequate preoperative preparation, we performed the surgery as quickly as possible and resected the tumor completely. Based on the identification of the translocation on chromosome 18 rearrangement, the tumor can be diagnosed as a primary cardiac synovial sarcoma. Through this study, we aim to afford more information about cardiac synovial sarcomas as well as a reference for similar cases.

Background:Multiple myxomas are rare and often associated with Carney syndrome. We present a giant left atrial myxoma that passes through a patent foramen ovale (PFO), mimicking biatrial myxoma.Case summary:A 46-year-old female was admitted to the hospital with a cardiac neoplasm without symptoms. The physical examination did not reveal any abnormalities in the skin and endocrine system. Transthoracic echocardiography revealed a large, hypoechoic mass attached to the atrial septum, occupying both the left and right atria. This mass appeared as a bilateral atrial mass on echocardiography. Contrast-enhanced echocardiography revealed a slight enhancement in the mass. The patient was scheduled for surgery without any contraindications. During the operation, a large jelly-like mass originating from the left atrial side of the fossa ovale was found, extending to the right atrium through a PFO. The entire mass was successfully removed, and the atrial septum was repaired. Histopathology confirmed the diagnosis of cardiac myxoma. At the 3-month follow-up, no cardiac abnormalities were observed.Discussion:Multiple myxomas have been reported in certain cases of Carney syndrome. A single left atrial myxoma that passes through an atrial septal defect or a PFO can sometimes be misdiagnosed as a bilateral atrial myxoma. Echocardiography plays a crucial role in providing diagnostic information by accurately identifying the location of the myxoma pedicle.

BACKGROUND:Metastasis of malignant tumors to the cardiac endocardium is rare and mainly involves the right side of the heart. It is extremely rare to involve the left cardiac endocardium, especially when there is neither pulmonary metastasis nor primary lung cancer, which we call "isolated" left cardiac endocardium metastasis in this paper. Few such cases previously reported in the literature were not screened for patent foramen ovale (PFO). CASE PRESENTATION:This article reports a case of a young woman with a history of surgery for cervical cancer, who was transferred to our hospital with a suspected diagnosis of PFO after recent recurrent multiple cerebral infarctions. On admission, transthoracic echocardiography revealed multiple stringy vegetations in the left ventricle, which were subsequently removed surgically, with intraoperative confirmation of a patent foramen ovale and closure of it simultaneously. According to her medical history and pathological results, she was diagnosed with left ventricular metastasis of cervical cancer, a rare case of isolated left heart endocardium metastasis without previous pulmonary metastasis, presumably through the patent foramen ovale. CONCLUSION:PFO may play an important role in the process of isolated left heart endocardium metastasis in patients with distant malignancies and paradoxical embolism. Screening for PFO in high-risk patients may have significant clinical significance.

Ex vivo lung perfusion (EVLP) is a promising technology that allows the re-evaluation of donor lungs and has the potential to improve marginal lung reconditioning. The present study focused on the effects of milk fat globule epidermal growth factor 8 (MFG-E8) on the function of donation after circulatory death (DCD) lungs during EVLP and transplant reperfusion. Domestic swine were assigned to 4 groups. In the control group, the donor lungs lacking warm ischemia were preserved in Perfadex for 4 h. The swine in the other three groups underwent hypoxic arrest, followed by 1 h of warm ischemia. The DCD lungs were procured and randomly divided into three groups: cold static preservation (DCD-CSP) group, DCD-EVLP group, and DCD-MFG-E8 group. The left lung of all groups was transplanted and reperfused. During EVLP and reperfusion, lung functions and pathological evaluations were performed. Treatment with MFG-E8 resulted in significantly improved blood oxygenation. The mean pulmonary artery pressure, peak airway pressure, and expression of IL-1 beta, IL-6, and IL-12 were significantly lower but IL-10 was higher in the DCD -MFG-E8 group. Furthermore, the lung injury severity score, pulmonary edema, and wet-to-dry weight ratio were also reduced in MFG-E8-treated lungs. However, the pulmonary vascular resistance and expression of TNF-alpha did not differ from the DCD -EVLP group but were significantly lower than in the DCD -CSP group. Adding MFG-E8 into the perfusate during EVLP obtains optimal graft function of lungs from DCD. This finding, if confirmed clinically, can be applied to recondition grafts and expanded use of DCD lungs.

Background: The hybrid aortic repair consisting of root replacement and endovascular arch repair is an optimal alternative for patients unfit for circulatory arrest. However, an artificial aortic valve prosthesis might impede the endovascular procedure. This study aims to present our experience with the branching retrograde externalized guidewire (BREG) technique in such situations, and discuss its utility and efficiency. Methods: From January 2015 to June 2021, a total of 112 patients underwent aortic root/valve replacement combined with aortic arch repair. Among them, the BREG technique was adopted on 24 patients, and the traditional frozen elephant trunk (FET) technique was used for 88 patients. The indication of the BREG was as follows: high-risk patients not suitable for traditional open surgery; meanwhile, the aortic disease required extended repair, and the aortic valve needed to be replaced concomitantly. The data of the 2 groups were compared. Results: The cardiopulmonary bypass time (213.5 ± 73.6 min vs. 246.5 ± 46.2 min, P = 0.046) and cross-clamped time (109.0 ± 27.6 min vs. 139.0 ± 24.6 min, P < 0.001) were significantly shorter in the BREG group than that in the FET group. Less operative red blood cell consumption was achieved in the BREG group (6.6 ± 5.7 vs. 9.4 ± 8.0 U, P = 0.046). The 30-day mortality was similar between the 2 groups (8.3% BREG vs. 9.1% FET, P > 0.999). Conclusion: The BREG technique facilitated the advancement of endovascular stent graft, avoided impeding the aortic valve prosthesis in hybrid aortic surgery with aortic valve replacement, and may benefit high-risk patients.

目的 从活性氧簇(ROS)/核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体信号通路探讨乳脂球表皮生长因子8(MFG-E8)抗移植肺缺血再灌注损伤的作用机制.方法 健康雄性SD大鼠50只,随机分为对照组、移植组和MFG-E8组,袖套改良法建立大鼠左肺移植模型.MFG-E8组受体鼠术前30min经尾静脉注射rhMFG-E8 20 μg/kg,对照组和移植组受体大鼠尾静脉注射同等量生理盐水.肺移植再灌注2 h后阻断右肺门5min,全自动血气分析检测仪检测动脉血中氧分压(Pa02)和二氧化碳分压(PaCO2).苏木精-伊红(HE)染色观察移植肺组织显微病理改变,原位缺口末端标记法(TUNEL)染色检测移植肺组织细胞凋亡指数.组织活性氧检测试剂盒(DHE)检测肺组织中ROS水平,干/湿法测量肺湿质量/干质量(W/D)比.蛋白免疫印迹(Western blot)法检测肺组织NLRP3、半胱氨酸天冬氨酸特异性蛋白酶-1(Caspase-1)、和凋亡相关的斑点样蛋白(ASC)蛋白表达水平.酶联免疫吸附法(ELISA)检测肺泡灌洗液(BALF)中白细胞介素-1β(IL-1β)和白细胞介素-18(IL-18)表达水平.组间比较使用 t检验,多组比较采取单因素方差分析.结果 再灌注2h后,HE染色可见移植组肺组织明显炎性细胞浸润、肺泡结构破坏、肺水肿、肺泡腔内渗出明显伴有一些红细胞;MFG-E8组肺组织炎性细胞浸润明显减少,未见明显肺水肿,肺泡结构基本完整.再灌注2h后,MFG-E8组动脉Pa02/Fi02显著高于移植组[(314.35±58.13)mmHg 比(212.76± 42.19)mmHg,t=4.473,P＜0.05];MFG-E8组肺组织ROS水平、细胞凋亡指数和W/D值均明显低于移植组[102.37±20.78 比 145.72±29.34、(20.36±5.37)％比(28.13±4.64)％、6.15±1.23比 8.51±1.83,t=3.813、3.462、3.385,P＜0.05].移植组大鼠肺组织 NLRP3、Caspase-1 和 ASC 蛋白水平表达明显高于对照组(0.42±0.18比0.20±0.11、0.28±0.12比0.12±0.10、0.65±0.15比0.40±0.13,t=3.298、3.239、3.983,P＜0.05);MFG-E8 组大鼠肺组织 NLRP3、Caspase-1 和 ASC 蛋白水平表达显著低于移植组(0.25±0.12 比 0.42±0.18、0.15±0.10)比(0.28±0.12、0.44±0.10比0.65±0.15,t=2.485、2.632、3.684,P＜0.05).移植组大鼠肺泡灌洗液中IL-Iβ和IL-18蛋白水平表达明显高于对照组[(105.74±34.73)pg/ml 比(70.8±7.25)pg/ml、(128.56±23.82)pg/ml比(93.48±14.53)pg/ml,t=3.114、3.975,P＜0.05];MFG-E8组大鼠肺泡灌洗液中 IL-1β 和 IL-18蛋白水平表达显著低于移植组[(80.16±8.35)pg/ml比(105.74±34.73)pg/ml、(95.50± 13.18)pg/ml 比(128.56±23.82)pg/ml,t=2.265、3.840,P＜0.05].结论 MFG-E8 可能通过下调ROS/NLRP3信号通路,抑制NLRP3炎症小体活化,减轻氧化应激和免疫炎性反应,发挥抗移植肺缺血再灌注损伤作用.

病人,男性,37岁.因呼吸困难1个月余,加重伴胸痛2天,于2022年6月7日入院.入院前因呼吸困难就诊于外院,查CT肺动脉造影(computed tomo-graphy pulmonary angiography,CTPA)示肺动脉广泛栓塞,给予抗凝、溶栓等对症治疗,无明显缓解.2天前出现呼吸困难加重,不能平卧,伴右侧胸痛.

Ex vivo lung perfusion (EVLP) is a promising technology that allows the re-evaluation of donor lungs and having the potential to improve marginal lungs reconditioning. The present study focused on the effects of milk fat globule epidermal growth factor 8 (MFG‐E8) on the function of non–heart-beating donor lungs during EVLP and transplant reperfusion. Domestic swine were assigned in 4 groups. In the control group, the donor lungs lacking warm ischemia were preserved in Perfadex for 4 hours. The swine in the other three groups underwent hypoxic arrest, followed by 1 hour of warm ischemia. The NHBD lungs were procured and randomly divided into three groups: cold static preservation (NHBD-CSP) group, NHBD-EVLP group, and NHBD-EVLP+MFG-E8 group. The left lung of all groups was transplanted and reperfused. During EVLP and reperfusion, lung functions and pathological evaluations were performed. Treatment with MFG-E8 resulted in significantly improved blood oxygenation. The mean pulmonary artery pressure, peak airway pressure and expression of IL-1β, IL-6 and IL-12 were significantly lower but IL-10 was higher in the NHBD-EVLP+MFG-E8 group. Furthermore, the lung injury severity score, pulmonary edema and wet-to-dry weight ratio were also reduced in MFG-E8-treated lungs. However, the pulmonary vascular resistance and expression of TNF-α did not differ from the NHBD-EVLP group but were significantly lower than in the NHBD-CSP group. Adding MFG-E8 into the perfusate during EVLP obtains optimal graft function of lungs from NHBD. This finding, if confirmed clinically, can be applied to recondition grafts and expanded use of non-heart beating donor lungs.

目的 研究细丝蛋白B(FLNB)在钙化性心脏瓣膜中的表达及其临床意义.方法 2021年8月～2022年1月在我院手术切除的钙化性主动脉瓣标本9例,同期因主动脉夹层行手术切除的正常主动脉瓣膜标本8例作为对照.组织切片茜素红染色观察瓣膜钙化结节.采用免疫组化分析方法对瓣膜中细丝蛋白B的表达进行分析.利用冰冻组织标本进行蛋白质免疫印迹检测,验证相应分子表达水平间差异.结果 钙化瓣膜切片经茜素红染色可以看见明显钙化结节.免疫组化检查显示细丝蛋白B表达于细胞质,钙化瓣膜高于正常瓣膜,钙化组平均光密度为(6.57±1.65)％;对照组为(0.91±0.52)％,两组比较差异有统计学意义(P<0.05),蛋白质免疫印迹结果与之一致.结论 细丝蛋白B在钙化瓣膜中表达增高,可能参与了瓣膜钙化的病理进程.

Background:Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with a variety of presentations, from being asymptomatic to potentially serious complications such as systemic thromboembolism and atrial tachyarrhythmia.Case Presentation:We report a case of congenital giant LAAA in a 35-year-old man presenting with acute massive cerebral infarction and atrial fibrillation (AF) with rapid ventricular rate. The AF was refractory to conventional antiarrhythmic agents, such as amiodarone and electrical cardioversion, but restored and maintained sinus rhythm after surgical resection of LAAA. The patient remained free of events and was in sinus rhythm during half-year follow-up.Conclusion:Giant LAAA has the potential causing serious complications and should be managed surgically in most cases.

Metformin is widely used for the treatment of gestational diabetes. Although some meta-analyses are conducted on the efficacy and safety of metformin, none of them are focused on the Chinese population. The efficacy and safety of metformin in the Chinese GDM population are unknown. The study aimed to compare metformin to insulin regarding the safety and efficacy in Chinese GDM patients using randomized controlled trials (RCTs) conducted in China. Chinese databases (Wanfang, CNKI, VIP, and CBM), PubMed, Embase, Cochrane library, and Scopus were searched for RCTs. The last search date was October 18, 2021. Fifty RCTs (4663 patients) were included in this study after screening. Six outcomes were analyzed. In the main analysis, metformin had lower risk of respiratory distress syndrome (RDS, OR, 0.28; 95

BACKGROUND:To investigate the outcomes and effectiveness of different types of hybrid aortic arch repair for aortic dissection involving the aortic arch. METHODS:From 2013 to 2020, 168 patients underwent hybrid aortic arch repair for dissection involving the aortic arch. We collected data from our electronic medical records, including the presenting pathology, perioperative details, and postoperative outcomes. We included the following types of hybrid aortic arch repair: classic type I, type II, and type III hybrid aortic arch repair, as well as the new type IV hybrid aortic repair. We defined type IV hybrid aortic arch repair as revascularization of supra-aortic branches through extra-anatomy bypass without sternotomy, followed by stent-graft placement. RESULTS:There were 23, 82, and 63 patients who underwent type I, type II, and type IV hybrid aortic arch repair, respectively. There were no type III hybrid aortic repairs performed. Forty-nine cases were performed urgently. The technical success rate was 99.4%. The early mortality rates of the total group, type I group, type II group, and type IV group were 6.5%, 4.3%, 8.5%, and 4.8%, respectively. Postoperative complications mainly included tracheotomy (8.9%), stroke (6%), wound infection (4.2%), renal insufficiency (8.9%), and endoleak (7.7%). With a mean follow-up of 45.1 ± 28.5 months, the total 1-year and 5-year actual survival rates were 93.5% and 89.0%, respectively. At 6 months, the aortic diameter at the level of the diaphragm decreased significantly (30.8 ± 4.9 mm vs. 28.5 ± 6.3 mm, P = 0.012), and the rate of thrombosis of the false lumen at the level of pulmonary bifurcation and diaphragm were 95.7% and 83.1%. Ten patients underwent reintervention of the aorta, including 7 endovascular reinterventions, 2 total thoracoabdominal aortic aneurysm repairs, and 1 open total arch replacement. For the total group, the free from aorta reintervention rate at 5 years was 91.4%. CONCLUSION:Our results with hybrid aortic arch repair for aortic dissection involving the aortic arch are acceptable. The hybrid aortic arch repair could promote thrombosis of the distal false lumen while excluding intimal tears in the aortic arch.

The spirurid nematode Protospirura muricola Gedoelst, 1916 is redescribed from Acomys dimidiatus (Desmarest) from the St Katherine Protectorate, Sinai, Egypt. Egyptian material closely resembled specimens of P. muricola from African mammals re-examined in this study, as well as conforming to published reports of this species. P. muricola with two denticles on each lateral lobe of the pseudolabia and six pairs of postanal papillae is closest to P. pseudomuris Yokohata & Abe, 1989, but can be readily distinguished in having the right spicule shorter than the left. The significance of the characteristics of the head and mouth, and of the male spicules, in characterising Protospirura Seurat, 1914 is evaluated. P. muricola, an African parasite of rodents, appears to have spread globally with synanthropic rat final hosts and possibly with the cosmopolitan dermapteran intermediate host Leucophaea maderae (Fabr.).

Objectives To investigate the effectiveness of modified stent-grafts (SGs) for the management of ascending aortic pathologies. Materials and Methods From January 2015 to December 2019, 31 individuals were treated by ascending aortic endovascular repair with a back-table modified SG for acute (n=4) or chronic (n=1) type A aortic dissections, penetrating aortic ulcers (n=18), pseudoaneurysms (n=2), anastomotic fistula (n=1), and endoleaks after thoracic endovascular aortic repair (TEVAR) (n=5). The commercially available thoracic aortic SGs were modified with a fenestration or truncation technique on the back-table according to aortography during the operation. Results The 30-day mortality and aorta-related mortality rates were 12.9% and 6.5%, respectively. There were 2 strokes, 3 respiratory insufficiencies, and 6 endoleaks during hospitalization. During a mean follow-up of 28.8±16.6 months, the overall survival rates at 1 year and 3 years were both 80.6%. Free from adverse event rates at 1 year and 3 years were 88.9% and 84.7%, respectively. There were 2 deaths during follow-up: One patient died of cachexia 1 month after discharge, and the other patient died of acute myocardial infarction 3 months after discharge. One patient with a pseudoaneurysm underwent open ascending aorta replacement 3 months after discharge for a type Ia endoleak. Another patient suffered from cerebellar infarction 17 months after discharge. Conclusion The modified SG for endovascular repair of the ascending aorta is a practicable alternative and presents acceptable outcomes in high-risk patients.

Objective: To investigate the expression pattern of tropomyosin 2(TPM2) in aorta of patients with aortic dissection and explore its clinical implication. Methods: Thirteen cases with acute type A aortic dissection(TAAD) diagnosed by transabdominal aortic angiography from 2015 in Tongji Hospital were included. During the operation, the aortic wall tissues of these patients were collected. Ten patients with heart transplantation were selected as control group, and normal aortic wall tissues were taken. The hematoxylin-eosin (HE) and Verhoeff's Van Gieson (EVG) staining were performed to observe the morphological changes of aorta. The mRNA expression level of TPM2 was measured by real-time fluorescent quantitative-PCR, and the protein levels of TPM2 were detected by Western blot and immunohistochemical staining. Image The J software was used to collect the optical density values of each point on the image, obtain the integrated optical density(IOD) value, and calculate the average density(%, IOD/area of the target distribution area). Results: HE and EVG staining revealed medial degeneration and broken elastic fiber in aorta of TAAD patients. The mRNA expression levels of TPM2 were significantly upregulated in aorta of TAAD patients as compared to the control group (P<0.05), so as the TPM2 protein expression levels ((9.73±1.20)% vs. (0.11±0.04)%, P<0.05). And TPM2 was mainly expressed in cytoplasm. Conclusion: The increased expression of TPM2 in TAAD patients hints that TPM2 might be involved in the pathogenesis of aortic dissection.

目的 探讨Clusterin基因在主动脉夹层患者主动脉壁中的表达及其临床意义.方法 选择明确诊断为急性Stanford A型主动脉夹层(TAAD)的患者主动脉壁标本13例(夹层组),9例对照组主动脉壁标本来自无主动脉夹层的心脏移植受体.采用苏木素-伊红染色(HE)和EVG弹性纤维染色观察组织形态和弹力纤维断裂情况,实时荧光定量PCR(qRT-PCR)方法检测两组标本中Clusterin基因的mRNA表达水平,采用免疫印迹法(Western blot)和免疫组化法检测两组标本中Clusterin的蛋白表达水平,所有数据采用SPSS 23.0统计学软件分析,采用Pearson法将Clusterin基因mRNA表达水平与主动脉直径进行相关性分析.结果 与对照组比较,夹层组主动脉壁中平滑肌细胞明显减少、弹力纤维断裂增多,且夹层组主动脉壁中Clusterin基因的mRNA表达水平显著升高(P=0.03);此外,Western blot和免疫组化的结果均显示Clusterin蛋白在夹层组主动脉壁中显著升高,且Clusterin主要定位于细胞质及细胞外基质中;相关性分析显示Clusterin基因的mRNA表达水平与降主动脉、腹主动脉直径呈正相关.结论 TAAD患者主动脉壁组织中Clusterin的mRNA和蛋白水平较对照组显著升高,提示Clusterin可能促进主动脉夹层的发生发展,且Clusterin可能是潜在的治疗主动脉夹层的新靶点.

目的 检测DJ-1在主动脉夹层患者主动脉壁中的表达,并探讨其与主动脉夹层发生的关系.方法 选取13例主动脉夹层患者和11例无主动脉夹层患者的主动脉壁,通过苏木精-伊红(HE)染色和弹性纤维(EVG)染色检测主动脉夹层与正常主动脉壁的形态学差异,进一步通过实时荧光定量PCR检测在主动脉壁中DJ-1 mRNA的表达水平,并通过Pearson相关分析研究DJ-1表达量与主动脉夹层患者主动脉直径的相关性.结果 HE和EVG染色显示,主动脉夹层患者的主动脉壁结构紊乱,炎症细胞广泛浸润,弹性纤维大量断裂且减少;与无主动脉夹层患者比较,主动脉夹层患者主动脉壁中的DJ-1 mRNA水平显著下调(0.31倍,t=2.64,P=0.02),但DJ-1表达量与主动脉直径并无显著相关性(P>0.05).结论 DJ-1 mRNA在主动脉夹层患者中表达水平显著降低,可能促进主动脉夹层的发生发展,其有望成为新型治疗靶点.

目的 探讨Stanford A型主动脉夹层患者主动脉壁中簇集素(Clusterin)的表达水平及其临床意义.方法 选择13例Stanford A型主动脉夹层患者为病例组,9例扩张型心肌病或冠心病患者为对照组.收集两组患者的主动脉壁标本,测量病例组患者各段主动脉直径.通过苏木精-伊红染色及EVG染色观察两组组织形态和弹力纤维断裂情况;检测两组标本中Clusterin mRNA和蛋白的表达水平;分析病例组患者Clusterin mRNA表达水平与各段主动脉直径的相关性.结果 与对照组比较,病例组主动脉壁中平滑肌细胞明显减少、弹力纤维断裂增多,Clusterin mRNA和蛋白的相对表达水平均升高(均P<0.05).免疫组化染色显示,Clusterin主要定位于细胞质及细胞外基质中,病例组主动脉壁中Clusterin的相对表达水平亦高于对照组(均P<0.05).病例组患者Clusterin基因的相对表达水平与降主动脉、腹腔干处主动脉直径均呈正相关(均P<0.05).结论 Stanford A型主动脉夹层患者主动脉壁中Clusterin的基因和蛋白水平均升高;Clusterin表达水平上调可能与主动脉夹层的发生和发展均相关.

患儿女,1岁1个月.因"发现心脏杂音1个月余"入院.既往无特殊.体格检查:胸骨右缘第二肋间可闻及Ⅳ级收缩期喷射样杂音.经胸超声心动图检查:二维超声显示主动脉瓣下可见一条带状回声,收缩期脱入左室流出道;三维超声清晰显示膜状纤维束连接于二尖瓣前叶与室间隔近心尖段室壁上;CDFI示收缩期左室流出道呈五彩镶嵌血流信号;频谱多普勒示左室流出道收缩期峰值血流速度4.4 m/s,压差78 mm Hg (1 mm Hg=0.133 kPa);左室射血分数60％.见图1.患儿在全麻下行左室流出道疏通术,术中见:膜状纤维束附着在左室流出道近二尖瓣前瓣处,切除纤维束,用10 mm探条测试流出道通畅后常规完成手术.术后1周复查超声心动图:主动脉瓣下条带状组织消失;频谱多普勒示左室流出道收缩期峰值血流速度1.6 m/s,压差10 mm Hg(图2).