Background: The 3D printing technology in congenital cardiac surgery has been widely utilized to improve patients’ understanding of their disease. However, there has been no randomized controlled study on its usefulness in surgical consent for congenital heart disease repair.Methods: A randomized controlled study was performed during consent process in which guardians of candidates for ventricular septal defect repair were given detailed explanation of the anatomy, indication for surgery and potential complication and risks using 3D print ventricular septal defect model (n = 20) versus a conventional 2D diagram (n = 20). A questionnaire was finished by each guardian of the patients. Data collected from questionnaires as well as medical records were statistically analyzed.Results: Statistically significant improvements in ratings of understanding of ventricular septal defect anatomy (p = 0.02), and of the course of procedure and potential complications (p = 0.02) were noted in the group that used the 3D model, though there was no difference in overall ratings of the consent process (p = 0.09). There was no difference in questionnaire score between subjects with different education level. The clinical outcomes, as represented by the duration of intensive care unit stay, intubation duration was comparable between the two groups.Conclusions: The results indicated that it was an effective tool which may be used to consent for congenital heart surgery. Different education levels do not affect guardians’ understanding in consent. The impact of 3D printing used in this scenario on long term outcomes remains to be defined.
Objective: Pulmonary artery denervation (PADN) can reduce sympathetic nervous system (SNS) activity in patients with pulmonary hypertension (PH), reduce pulmonary artery pressure (PAP) in PH patients, and improve the quality of life in PH patients. We conducted a systematic meta-analysis of the effectiveness of PADN in the treatment of PH patients. Methods: All public clinical trials investigating the effects of PADN on PH. Outcomes were average pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), cardiac output (CO), right ventricular (RV) Tei index, 6-minute walk distance (6MWD), and New York Heart Association (NYHA) cardiac function grading. Results: A total of eight clinical studies including 213 PH patients with PADN were included. Meta-analysis showed that after PADN, mPAP (MD -12.51, 95% CI -17.74 to -7.27, P<0.00001) (mmHg) and PVR (MD = -5.17, 95% CI -7.70 to -2.65, P <0.0001) (wood unit) decreased significantly, CO (MD 0.59, 95% CI 0.32 to 0.86, P<0.0001) (L/min) and 6MWD (MD 107.75, 95% CI 65.64 to 149.86, P <0.00001) (meter) increased significantly, and RV Tei index (MD -0.05, 95% CI -0.28 to 0.17, P = 0.63) did not change significantly. And after PADN, the proportion of NYHA cardiac function grading (RR = 0.23, 95% CI 0.14 to 0.37, P <0.00001) III and IV decreased significantly.Conclusion: This meta-analysis supports PADN as a potential new treatment for PH. Further high-quality randomized controlled studies are needed.
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