Objective: It is very important to accurately assess the transannular patch (TAP) in the surgical treatment of tetralogy of Fallot（TOF）. Methods: 130 patients who were diagnosed with TOF and underwent TOF repair. 112 cases were included in this study. They were divided into TAP group and no TAP group; the values of pulmonary annulus and aortic annulus were measured. GA ratio, PAI, PAAI, the pulmonary annulus Z-score and main pulmonary artery (MPA) Z-score were calculated to do statistically analyze. Results: A total of 112 patients were included in the study.62 cases (55.8%) did not transannular patch, 50 cases (44.2%) undergoing transannular patch. The pulmonary annulus Z-score, main pulmonary artery Z-score and PAI in TAP group were smaller than those in no TAP group (P < 0.05). ROC analysis showed that when the cutoff value of pulmonary annulus at -1.98 ,the area under curve (AUC) was 0.88, the sensitivity was 80%, the specificity was 71%; when the cut-off value of PAI at 0.53 ,AUC was 0.85, the sensitivity was 75%, the specificity was 80%; when the cutoff value of GA ratio at 0.55 ,AUC was 0.85, the sensitivity was 76%, and the specificity was 80%. The area under the PAAI curve (AUC) was 0.85, the sensitivity was 76%, and the specificity was 79%. Conclusion: The predictive effect of pulmonary annulus index as a simple and effective predictor of TAP in TOF radical operation is the same as that of pulmonary annulus Z-score.

Objective: This study aimed to evaluate the long-term outcome of patients with PDA associated with UAPA. Methods: Patients diagnosed with PDA associated with UAPA were retrospectively enrolled from January 2005 to June 2019. Clinical data, treatment and follow-up information were evaluated. Results: 11 patients (5 males and 6 females) were diagnosed with PDA associated with UAPA. Percutaneous closure was conducted in 9 patients successfully. The median age was 37 months. The mean diameter of the PDA and occluders were 5.3±1.8mm (range 2-8.1 mm), 11.5±3.9 mm (4-16 mm) respectively. The median in 5 patients with the pulmonary: systemic flow ratio (Qp:Qs) was 1.41(1.28-8.7) and total lung resistance was 12 wood (1.8-13.6) . The mean systolic pulmonary artery pressure was 68.3±19.1mmHg（42-105mmHg). In 5 patients with pre- and post-procedure catheter data, the systolic pulmonary arterial pressure decreased significantly after closure 77.0±20.2 v 58.8±17.5 mmHg (p = 0.024), and so was the mean pulmonary arterial pressure 58.2±14.6 v 39.0±14.1 mmHg (p = 0.18). The pulmonary artery pressure and heart size gradually decreased to normal in 8 patients, and the quality of life was significantly improved. The ratio of lung to systemic circulation pressure in all these patients was less than 0.75. Conclusions: In appropriate patients with PDA associated with UAPA, transcatheter closure of PDA has the potential to improve the pulmonary artery hypertension. The ratio of lung to systemic circulation pressure less than 0.75 may be important reference index for predicting whether the pulmonary artery pressure could be reduced to normal after occlusion.