Aims: Left atrial appendage (LAA) occlusion for Atrial fibrillation (AF) is an invasive therapy to reduce stroke incidence and death. Cardiac rehabilitation based on exercise training has become part of the standard care for patients with heart disease. Studies are needed to evaluate the effects of cardiac rehabilitation on exercise capacity, cardiac function, quality of life (QoL), residual permeability, device endothelialization and safety in AF patients with LAA occlusion. Methods: A single-center, three-month randomized controlled trial comparing an exercise-based cardiac rehabilitation program with a control group was conducted. AF patients underwent LAA occlusions were randomized to exercise-based cardiac rehabilitation (rehabilitation group) versus usual care (control group). All patients received assessments of echocardiography, cardiac CT, scale survey, physical function and exercise capacity. All analyses were performed using SPSS 19.0. Results: Finally, 33 patients in control group and 30 patients in rehabilitation group entered final analysis. The six-minute walk distance, handgrip strength, leg strength and left ventricular systolic function increased significantly after the study period in the rehabilitation group compared with baseline, which have significant interactions with control group. Significant differences between groups were found for the mental and physical component summary scales on SF-36, also in all of the 8 subscales. The incidence of peri-device leak and incomplete endothelialization in cardiac rehabilitation group were both significantly lower than that in control group. There was no significant difference in the incidence of adverse events between the two groups. Conclusion: Cardiac rehabilitation could promote device endothelialization and reduce peri-device leak in AF patients with LAA occlusion, which also has benefits in QoL, exercise capacity, physical function and systolic left ventricular function.

To summarize and describe the clinical presentations, diagnostic approaches, and airway management techniques in children with laryngotracheal (LT) trauma. Methods: We retrospectively reviewed clinical data related to LT trauma diagnosed and treated at XXX Children’s Hospital between January 2013 and July 2018. Disease diagnosis, treatment, management, and outcomes were detailed. Results: A total of 13 cases were enrolled, with an average age 6 years, 9 months. There were seven cases of penetrating LT trauma, of which four cases were injured by knife stabbings and three by dog bites. Tracheostomy was performed for two of these patients, and one with persistent left vocal cord paralysis. The six cases of blunt LT trauma were caused by knocking on hard objects. Two of these six patients underwent tracheostomy. One case had a dislocation of the cricoarytenoid joint and underwent a closed reduction surgery. In all cases, voice, airway, and swallowing outcomes were graded as good, except for one patient who had residual paralysis of the vocal cords. Conclusion: We have summarized a large series of pediatric LT trauma cases. In our experience, examinations by flexible fiberoptic laryngoscopy and computed tomography imaging can play important roles in the diagnostic approach to LT trauma. In addition, the airway should be kept safe and, if necessary, opened by tracheal intubation or tracheotomy. We have proposed our own recommendations for managing pediatric LT trauma cases in order to inform the development of standardized clinical guidelines.