Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-0814-00270
Y. Xue, Qing Zhou, Shuchun Li, Dongjin Wang
1例严重主动脉瓣关闭不全合并Stanford B型主动脉夹层的69岁男患者，接受一期经心尖经导管主动脉瓣置换术和经股动脉胸主动脉腔内修复术。使用单分支覆膜支架，近端锚定区为Zone 2，微创Castor支架覆盖左锁骨下动脉同时单分支重建。左前胸外侧切口，经心尖经导管主动脉瓣置换术治疗主动脉瓣关闭不全，术前CT评估选择27 mm J-Valve瓣膜，释放过程中未发生瓣膜移位等问题。患者术后恢复良好，病情平稳。CT及超声心动图复查均显示良好的结果。
1例严重主动脉瓣关闭不全合并Stanford B型主动脉夹层的69岁男患者，接受一期经心尖经导管主动脉瓣置换术和经股动脉胸主动脉腔内修复术。使用单分支覆膜支架，近端锚定区为Zone 2，微创Castor支架覆盖左锁骨下动脉同时单分支重建。左前胸外侧切口，经心尖经导管主动脉瓣置换术治疗主动脉瓣关闭不全，术前CT评估选择27 mm J-Valve瓣膜，释放过程中未发生瓣膜移位等问题。患者术后恢复良好，病情平稳。CT及超声心动图复查均显示良好的结果。
{"title":"Single stage trans-apical TAVR and trans-femoral TEVAR for severe AR concomitant with Stanford type B aortic dissection","authors":"Y. Xue, Qing Zhou, Shuchun Li, Dongjin Wang","doi":"10.3760/CMA.J.CN112434-0814-00270","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-0814-00270","url":null,"abstract":"1例严重主动脉瓣关闭不全合并Stanford B型主动脉夹层的69岁男患者，接受一期经心尖经导管主动脉瓣置换术和经股动脉胸主动脉腔内修复术。使用单分支覆膜支架，近端锚定区为Zone 2，微创Castor支架覆盖左锁骨下动脉同时单分支重建。左前胸外侧切口，经心尖经导管主动脉瓣置换术治疗主动脉瓣关闭不全，术前CT评估选择27 mm J-Valve瓣膜，释放过程中未发生瓣膜移位等问题。患者术后恢复良好，病情平稳。CT及超声心动图复查均显示良好的结果。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"369 1","pages":"191-192"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76409217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20190806-00263
Jian Li, W. Qin, C. Su, F. Huang
Objective To summarize the surgical treatment and it’s results of patients with acute type A aortic dissection with cerebral malperfusion. Methods We collected and analyzed the clinical date of 16 patients, who were hospitalized and underwent operation Between January 2010 to June 2019, presented cerebral malperfusion due to acute type A aortic dissection. All of them showed preoperative newly developed neurologic deficits, left hemiplegia in 8 cases, left paraparesis in 5 cases and right paraparesis in 3 cases. Results Aortic valve was involved in 5 patients, 2 of whom underwent AVR surgery, 2 cases of CABG and 2 cases of artificial graft bypass were performed at the same time, 1 case underwent left leg amputation postoperatively. Seven patients died after surgery. Conclusion The results of surgical management of acute type A aortic dissection with cerebral malperfusion demonstrated high hospital mortality, which needs us to restore the cerebral perfusion as soon as possible. The specific method should be decided according to the patients' condition. Key words: Acute type A aortic dissection; Cerebral malperfusion
{"title":"Surgical management of acute type A aortic dissection with cerebral malperfusion","authors":"Jian Li, W. Qin, C. Su, F. Huang","doi":"10.3760/CMA.J.CN112434-20190806-00263","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190806-00263","url":null,"abstract":"Objective \u0000To summarize the surgical treatment and it’s results of patients with acute type A aortic dissection with cerebral malperfusion. \u0000 \u0000 \u0000Methods \u0000We collected and analyzed the clinical date of 16 patients, who were hospitalized and underwent operation Between January 2010 to June 2019, presented cerebral malperfusion due to acute type A aortic dissection. All of them showed preoperative newly developed neurologic deficits, left hemiplegia in 8 cases, left paraparesis in 5 cases and right paraparesis in 3 cases. \u0000 \u0000 \u0000Results \u0000Aortic valve was involved in 5 patients, 2 of whom underwent AVR surgery, 2 cases of CABG and 2 cases of artificial graft bypass were performed at the same time, 1 case underwent left leg amputation postoperatively. Seven patients died after surgery. \u0000 \u0000 \u0000Conclusion \u0000The results of surgical management of acute type A aortic dissection with cerebral malperfusion demonstrated high hospital mortality, which needs us to restore the cerebral perfusion as soon as possible. The specific method should be decided according to the patients' condition. \u0000 \u0000 \u0000Key words: \u0000Acute type A aortic dissection; Cerebral malperfusion","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"28 1","pages":"171-174"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86195171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20190618-00206
Maimaiti Tuerxunayi, Aimaiti Abulikemu, M. Ning, Jia-rong Xu, Jiazheng Xu, Hai-ping Ma
Objective To evaluate lung protection of remote limb ischemic preconditioning after pulmonary resection. Methods Methods sixty adult patients scheduled for elective pulmonary resection, were randomly divided into control group(group C, 30 cases) and remote limb ischemic preconditioning(group RLIP, 30 cases) using a random number table. Before one-lung-ventilation(T0), at 30 minites, 1 hour and 2 hours of OLV(T1, 2, 3), 15minites after re-expansion of the collapsed lung(T4), blood samples were drawn from the radial artery and vein for blood gas analysis, alveolar-arterial oxygen gradient(A-aDO2)、pulmonary shunt ratio(Qs/Qt)were calculated. Extraction time of closed thoracic drainage tube, length of hospital stay, the incidence of in-hospital complications after operation were recorded. Results Compared to T0 , each group at T1-T4, A-aDO2 were obviously increased. We found that at T3, A-aDO2 of group C increased much more higher and statistically significant(P 0.05). Conclusion Remote limb ischemic preconditioning had some protective effect after pulmonary resection, which mechanism may be related to enhancing autophagy in the operated 1ung tissues of the patients. Key words: Ischemic preconditioning; One-lung ventilation; Autophagy; Lung protection; Pulmonary shunt
{"title":"Lung protection of remote limb ischemic preconditioning after pulmonary resection","authors":"Maimaiti Tuerxunayi, Aimaiti Abulikemu, M. Ning, Jia-rong Xu, Jiazheng Xu, Hai-ping Ma","doi":"10.3760/CMA.J.CN112434-20190618-00206","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190618-00206","url":null,"abstract":"Objective \u0000To evaluate lung protection of remote limb ischemic preconditioning after pulmonary resection. \u0000 \u0000 \u0000Methods \u0000Methods sixty adult patients scheduled for elective pulmonary resection, were randomly divided into control group(group C, 30 cases) and remote limb ischemic preconditioning(group RLIP, 30 cases) using a random number table. Before one-lung-ventilation(T0), at 30 minites, 1 hour and 2 hours of OLV(T1, 2, 3), 15minites after re-expansion of the collapsed lung(T4), blood samples were drawn from the radial artery and vein for blood gas analysis, alveolar-arterial oxygen gradient(A-aDO2)、pulmonary shunt ratio(Qs/Qt)were calculated. Extraction time of closed thoracic drainage tube, length of hospital stay, the incidence of in-hospital complications after operation were recorded. \u0000 \u0000 \u0000Results \u0000Compared to T0 , each group at T1-T4, A-aDO2 were obviously increased. We found that at T3, A-aDO2 of group C increased much more higher and statistically significant(P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Remote limb ischemic preconditioning had some protective effect after pulmonary resection, which mechanism may be related to enhancing autophagy in the operated 1ung tissues of the patients. \u0000 \u0000 \u0000Key words: \u0000Ischemic preconditioning; One-lung ventilation; Autophagy; Lung protection; Pulmonary shunt","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"32 1","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78719671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To summarize cardiac function feature and its support method after ALCAPA(anomalous origin of left coronary arteries from pulmonary artery) operation. Analysis its early outcome and risk factors of its mortality. Methods Review the clinical data of 108 ALCAPA cases treated in Shanghai Children Center between January 2005 and December 2017. All the cases were divided into two groups according to their ages when they received the surgery: group 1 1yr. Adopted LVEF(left ventricle ejection fraction) and LVEDD(left ventricle end-diastolic diameter) Z-score as a parameter to describe the cardiac function change after operation. Summarize the selection and application of vasoactive agents and its score(VIS) after operation, indirectly reflect the post-operative cardiac function. Analysis the opportunityofinitiation and termination of mechanical circulation support and the timefor mechanical ventilationevacuation. Adopt the logistic analysis to find the risk factors of early death risk factors after ALCAPA operation. Results Cardiac function had little improve in early period after ALCAPAoperation, did not attained normal range in fifth day post-operative, LVEF was 0.42 in group 1 and 0.45 in group 2, respectively. The application of vasoactive agents tended to choose α, β receptor-agonist, which epinephrine and norepinephrine is the preferred and VIS score was high in early period. Mechanical circulation support was used in 18 cases. 12 cases died in our group, mortality was 11%. Logistic regression analysis implied that low age and low level of LVEF before operation is the risk factor for mortality. Conclusion Cardiac function was still in low level in early period after ALCAPA operation, depended on higher dosage of vasoactive agents and mechanical circulation support if necessary. We recommend the LVEF index for evacuated from mechanical circulation support and mechanical ventilation is over 0.40 and 0.35 respectively, and other clinical sign should be considered simultaneously. Low age and low LVEF level before operation is the risk factors for early death after ALCAPA operation. Key words: Congenital heart disease; ALCAPA; Vasoactive agents; Mechanical circulation support
{"title":"Cardiac function support after ALCAPA operation and its early outcome","authors":"Zhihao Li, Jiming Cai, Zhuoming Xu, Haibo Zhang, Jinghao Zheng","doi":"10.3760/CMA.J.CM112434-20190212-00034","DOIUrl":"https://doi.org/10.3760/CMA.J.CM112434-20190212-00034","url":null,"abstract":"Objective \u0000To summarize cardiac function feature and its support method after ALCAPA(anomalous origin of left coronary arteries from pulmonary artery) operation. Analysis its early outcome and risk factors of its mortality. \u0000 \u0000 \u0000Methods \u0000Review the clinical data of 108 ALCAPA cases treated in Shanghai Children Center between January 2005 and December 2017. All the cases were divided into two groups according to their ages when they received the surgery: group 1 1yr. Adopted LVEF(left ventricle ejection fraction) and LVEDD(left ventricle end-diastolic diameter) Z-score as a parameter to describe the cardiac function change after operation. Summarize the selection and application of vasoactive agents and its score(VIS) after operation, indirectly reflect the post-operative cardiac function. Analysis the opportunityofinitiation and termination of mechanical circulation support and the timefor mechanical ventilationevacuation. Adopt the logistic analysis to find the risk factors of early death risk factors after ALCAPA operation. \u0000 \u0000 \u0000Results \u0000Cardiac function had little improve in early period after ALCAPAoperation, did not attained normal range in fifth day post-operative, LVEF was 0.42 in group 1 and 0.45 in group 2, respectively. The application of vasoactive agents tended to choose α, β receptor-agonist, which epinephrine and norepinephrine is the preferred and VIS score was high in early period. Mechanical circulation support was used in 18 cases. 12 cases died in our group, mortality was 11%. Logistic regression analysis implied that low age and low level of LVEF before operation is the risk factor for mortality. \u0000 \u0000 \u0000Conclusion \u0000Cardiac function was still in low level in early period after ALCAPA operation, depended on higher dosage of vasoactive agents and mechanical circulation support if necessary. We recommend the LVEF index for evacuated from mechanical circulation support and mechanical ventilation is over 0.40 and 0.35 respectively, and other clinical sign should be considered simultaneously. Low age and low LVEF level before operation is the risk factors for early death after ALCAPA operation. \u0000 \u0000 \u0000Key words: \u0000Congenital heart disease; ALCAPA; Vasoactive agents; Mechanical circulation support","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"31 1","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77589359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20191126-00420
Feng Yang, Jun Fan, Junyi Tianzhou, Fan Yang, Yun Li, Xianping Liu, Jian-feng Li, G. Jiang, Jun Wang
Objective To investigate the application of low-dose chest CT(LDCT) in the screening of pulmonary subsolid nodules in population and the application value of artificial intelligence. Methods People who received chest LDCT screening between January 2015 and December 2017 were included. A retrospective study was developed to analyze the enrolled population features , detection of pulmonary subsolid nodules and independent predictors of subsolid nodules , and to evaluate the accuracy of the artificial intelligence reading method. Results Result of three cross-sectional studies reveals that the detection rates of pulmonary subsolid nodules were 0.42%, 0.69% and 0.92% in three rounds. 726 cases who completed the three rounds of screening were included in the cohort study. The cohort population was predominantly male(83.2%), with a median age of 43 years, and nearly half of the subjects(47.0%) had a history of smoking. GEE revealed that the patient's family history of lung cancer(OR=8.753, 95%CI: 1.877-40.816, P=0.006) was an independent predictor of the detection of subsolid nodules. In the 110 kVp tube voltage group, AUC of AI model was 0.740, and AUC of the manual reading method was 0.721, no significant differences were observed(P=0.502); when the preseted cutoff value of AI model was 0.75, the NRI was -0.15, indicating the accuracy of AI model was inferior to manual method(P=0.006). In the 130 kVp tube voltage group, AUC of the model was 0.888, and AUC of the manual reading method was 0.756, no significant differences were observed(P=0.128); and the NRI was 0.19, indicating the accuracy of AI model was not inferior to manual method(P=0.123). Conclusion This population' s detection rates of pulmonary subsolid nodules were 0.42%-0.92%. Family history of lung cancer was an independent predictor of subsolid pulmonary nodules. The result of AI pulmonary nodule detection model could be a reference when the training set data parameters match the actual application parameters. Key words: Lung neoplasms; Cancer screening; Multidetector computed tomography; Subsolid nodule; Artificial intelligence
{"title":"Population-based research of pulmonary subsolid nodule CT screening and artificial intelligence application","authors":"Feng Yang, Jun Fan, Junyi Tianzhou, Fan Yang, Yun Li, Xianping Liu, Jian-feng Li, G. Jiang, Jun Wang","doi":"10.3760/CMA.J.CN112434-20191126-00420","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20191126-00420","url":null,"abstract":"Objective \u0000To investigate the application of low-dose chest CT(LDCT) in the screening of pulmonary subsolid nodules in population and the application value of artificial intelligence. \u0000 \u0000 \u0000Methods \u0000People who received chest LDCT screening between January 2015 and December 2017 were included. A retrospective study was developed to analyze the enrolled population features , detection of pulmonary subsolid nodules and independent predictors of subsolid nodules , and to evaluate the accuracy of the artificial intelligence reading method. \u0000 \u0000 \u0000Results \u0000Result of three cross-sectional studies reveals that the detection rates of pulmonary subsolid nodules were 0.42%, 0.69% and 0.92% in three rounds. 726 cases who completed the three rounds of screening were included in the cohort study. The cohort population was predominantly male(83.2%), with a median age of 43 years, and nearly half of the subjects(47.0%) had a history of smoking. GEE revealed that the patient's family history of lung cancer(OR=8.753, 95%CI: 1.877-40.816, P=0.006) was an independent predictor of the detection of subsolid nodules. In the 110 kVp tube voltage group, AUC of AI model was 0.740, and AUC of the manual reading method was 0.721, no significant differences were observed(P=0.502); when the preseted cutoff value of AI model was 0.75, the NRI was -0.15, indicating the accuracy of AI model was inferior to manual method(P=0.006). In the 130 kVp tube voltage group, AUC of the model was 0.888, and AUC of the manual reading method was 0.756, no significant differences were observed(P=0.128); and the NRI was 0.19, indicating the accuracy of AI model was not inferior to manual method(P=0.123). \u0000 \u0000 \u0000Conclusion \u0000This population' s detection rates of pulmonary subsolid nodules were 0.42%-0.92%. Family history of lung cancer was an independent predictor of subsolid pulmonary nodules. The result of AI pulmonary nodule detection model could be a reference when the training set data parameters match the actual application parameters. \u0000 \u0000 \u0000Key words: \u0000Lung neoplasms; Cancer screening; Multidetector computed tomography; Subsolid nodule; Artificial intelligence","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"52 1","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84705902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20200222-00065
Xingjian Hu, N. Dong, Jiawei Shi, J. Xia
Severe acute respiratory infection caused by a novel coronavirus(SARS-CoV-2), WHO named COVID-19, is the major clinical concern globally. Both the world health organization and the National Health Commission have issued interim guidelines and management strategy for the diagnosis and treatment of COVID-19. These comprehensive guidelines establish the basic norms for the clinical practice. However, cardiovascular diseases have their special pathophysiological characteristics. The surgical treatment strategies for emergency and critical cardiovascular diseases requires specific recommendations or guidelines. From 16 January to 12 February 2020, the department of cardiovascular surgery in Wuhan Union Hospital had performed 15 emergency cardiovascular operations. The perioperative success rate is 100%. Based on our clinical practice, we summarized the relevant experience as a complement to the WHO and National Health Commission guidelines, hope to provide references for the cardiovascular surgeons. Key words: COVID-19; Cardiovascular surgery; Emergency operation; Therapeutic strategy
{"title":"Strategies for emergency cardiovascular surgery under the epidemic of COVID-19","authors":"Xingjian Hu, N. Dong, Jiawei Shi, J. Xia","doi":"10.3760/CMA.J.CN112434-20200222-00065","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20200222-00065","url":null,"abstract":"Severe acute respiratory infection caused by a novel coronavirus(SARS-CoV-2), WHO named COVID-19, is the major clinical concern globally. Both the world health organization and the National Health Commission have issued interim guidelines and management strategy for the diagnosis and treatment of COVID-19. These comprehensive guidelines establish the basic norms for the clinical practice. However, cardiovascular diseases have their special pathophysiological characteristics. The surgical treatment strategies for emergency and critical cardiovascular diseases requires specific recommendations or guidelines. From 16 January to 12 February 2020, the department of cardiovascular surgery in Wuhan Union Hospital had performed 15 emergency cardiovascular operations. The perioperative success rate is 100%. Based on our clinical practice, we summarized the relevant experience as a complement to the WHO and National Health Commission guidelines, hope to provide references for the cardiovascular surgeons. \u0000 \u0000Key words: \u0000COVID-19; Cardiovascular surgery; Emergency operation; Therapeutic strategy","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"39 1","pages":"135-139"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72903188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To analyze clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge. Methods A retrospective cohort study was conduct to review the clinical date of 29 patients who underwent surgical myotomy from January 2014 to January 2018 in the Second Hospital of Lanzhou University. A total of 11 patients(incision group) were experienced traditional myotomy on myocardial bridge that the myocardium was longitudinally incised along the direction of the coronary artery, while 18 patients(tearing group) were treated by myocardial incision combined with tearing that longitudinally incised myocardium and deeply tissue tearing. The operation time of surgical myotomy, the amount of bleeding, the number of branches of vascular injury and the number of ventricular ruptures during operation were compared between the two groups. After followed up half a year to one year, the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested were collected. Results The operation time of surgical myotomy, the amount of bleeding patients and the number of branches of vascular injury during operation in the incision group were higher than those in the tearing group(P 0.05). After followed up half a year to one year, there was no significant difference in the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested(P>0.05). Conclusion Myocardial incision combined with tearing is a surgical procedure with short operation time and low bleeding risk, which is more beneficial than the traditional longitudinally incised for the myocardial bridge. Key words: Myocardial bridge; Myotomy; Clinical outcome
{"title":"The clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge","authors":"Yong Mao, Wensheng Chen, Yalin Wei, Xinqiang Guan, Yanchun Zhang, Xiangyang Wu","doi":"10.3760/CMA.J.CN112434-20190601-00183","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190601-00183","url":null,"abstract":"Objective \u0000To analyze clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge. \u0000 \u0000 \u0000Methods \u0000A retrospective cohort study was conduct to review the clinical date of 29 patients who underwent surgical myotomy from January 2014 to January 2018 in the Second Hospital of Lanzhou University. A total of 11 patients(incision group) were experienced traditional myotomy on myocardial bridge that the myocardium was longitudinally incised along the direction of the coronary artery, while 18 patients(tearing group) were treated by myocardial incision combined with tearing that longitudinally incised myocardium and deeply tissue tearing. The operation time of surgical myotomy, the amount of bleeding, the number of branches of vascular injury and the number of ventricular ruptures during operation were compared between the two groups. After followed up half a year to one year, the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested were collected. \u0000 \u0000 \u0000Results \u0000The operation time of surgical myotomy, the amount of bleeding patients and the number of branches of vascular injury during operation in the incision group were higher than those in the tearing group(P 0.05). After followed up half a year to one year, there was no significant difference in the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested(P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Myocardial incision combined with tearing is a surgical procedure with short operation time and low bleeding risk, which is more beneficial than the traditional longitudinally incised for the myocardial bridge. \u0000 \u0000 \u0000Key words: \u0000Myocardial bridge; Myotomy; Clinical outcome","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"1 1","pages":"168-170"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89531167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20190831-00291
C. Dai, B. Guo, Y. Ling, Lingxiao Chen, M. Jin
Objective To observe and follow up the effect of transcatheter occlusion of the azygos/hemiazygos veins in patients with complex congenital heart diseases and venous stealing after bidirectional Glenn procedure, who had not meet the criteria of total cavopulmonary connection(TCPC) or corrective operation. Methods This article analyzed retrospectively and followed up the effect of transcatheter occlusion of the azygos/hemiazygos vein in patients after bidirectional Glenn procedure hospitalized during February 2012 to September 2017. Results Transcatheter occlusions of azygos veins were performed in 21 patients and left superior vena cava(LSVC) was occluded in one of patients meanwhile. Azygos veins and hemiazygos veins were both occluded in two patients. One patient had the hemiazygos vein occluded. Aortic-to-pulmonary collaterals were occluded in 6 patients in the meantime. Atrial septal defect occluders were applied in the transcatheter occlusions of azygos veins, hemiazygos veins and LSVC, except one patient with an azygos vein which was 5.5 mm in diameter. Saturation was increased from 0.78 to 0.85 through occlusion(P 0.05). No complications associated with interventional procedures occurred. There was no significant decrease in blood oxygen saturation. Facial and upper limb edema, varicose veins in the chest and abdominal wall, pleural effusion and peritoneal effusion did not happen during follow up of 2 years. Two patients underwent TCPC operation one year and five years after interventional occlusion separately. Conclusion Transcatheter occlusion of azygos/hemiazygos vein or PLSVC was feasible in patients with complex congenital heart diseases and venous stealing after bidirectional Glenn procedure on the premise of choosing suitable indications. Suitable indications meant that the pressure of pulmonary artery and superior vena cava was less than 20 mmHg in the basal state, and the pressure of superior vena cava was also less than 20 mmHg before the release of the occluder. Occlusions may increase the oxygen saturation of patients, improve the quality of life, and even promote the development of pulmonary vascular bed, so as to achieve the indications of TCPC operation in some patients. Key words: Azygos vein; Hemiazygos vein; Transcatheter closure; Bidirectional Glenn procedure
{"title":"Effect of transcatheter occlusion of azygos/hemiazygos vein in patients with venous stealing after the bidirectional Glenn procedure-analysis of 24 cases","authors":"C. Dai, B. Guo, Y. Ling, Lingxiao Chen, M. Jin","doi":"10.3760/CMA.J.CN112434-20190831-00291","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190831-00291","url":null,"abstract":"Objective \u0000To observe and follow up the effect of transcatheter occlusion of the azygos/hemiazygos veins in patients with complex congenital heart diseases and venous stealing after bidirectional Glenn procedure, who had not meet the criteria of total cavopulmonary connection(TCPC) or corrective operation. \u0000 \u0000 \u0000Methods \u0000This article analyzed retrospectively and followed up the effect of transcatheter occlusion of the azygos/hemiazygos vein in patients after bidirectional Glenn procedure hospitalized during February 2012 to September 2017. \u0000 \u0000 \u0000Results \u0000Transcatheter occlusions of azygos veins were performed in 21 patients and left superior vena cava(LSVC) was occluded in one of patients meanwhile. Azygos veins and hemiazygos veins were both occluded in two patients. One patient had the hemiazygos vein occluded. Aortic-to-pulmonary collaterals were occluded in 6 patients in the meantime. Atrial septal defect occluders were applied in the transcatheter occlusions of azygos veins, hemiazygos veins and LSVC, except one patient with an azygos vein which was 5.5 mm in diameter. Saturation was increased from 0.78 to 0.85 through occlusion(P 0.05). No complications associated with interventional procedures occurred. There was no significant decrease in blood oxygen saturation. Facial and upper limb edema, varicose veins in the chest and abdominal wall, pleural effusion and peritoneal effusion did not happen during follow up of 2 years. Two patients underwent TCPC operation one year and five years after interventional occlusion separately. \u0000 \u0000 \u0000Conclusion \u0000Transcatheter occlusion of azygos/hemiazygos vein or PLSVC was feasible in patients with complex congenital heart diseases and venous stealing after bidirectional Glenn procedure on the premise of choosing suitable indications. Suitable indications meant that the pressure of pulmonary artery and superior vena cava was less than 20 mmHg in the basal state, and the pressure of superior vena cava was also less than 20 mmHg before the release of the occluder. Occlusions may increase the oxygen saturation of patients, improve the quality of life, and even promote the development of pulmonary vascular bed, so as to achieve the indications of TCPC operation in some patients. \u0000 \u0000 \u0000Key words: \u0000Azygos vein; Hemiazygos vein; Transcatheter closure; Bidirectional Glenn procedure","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"57 1","pages":"156-161"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84003104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.3760/CMA.J.CN112434-20190818-00273
Weipeng Shao, Jingjing Huang, J. Zhang, Shanwu Ma, Hongxiang Feng, Hongliang Sun, Yanhong Ren, Xiaowei Wang, Zhen-rong Zhang, Deruo Liu
Objective To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients. Methods We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed. Results There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex(P=0.023), ILD(P=0.001), COPD(P=0.027) were independent risk factors for postoperative morbidity. ILD(P=0.023) and postoperative morbidity(P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients. Key words: ILD; Pulmonary resection; AE-ILD; Morbidity; 60-day mortality
{"title":"Impact of interstitial lung disease on postoperative morbidity and 60 day mortality after pulmonary resection for lung cancer","authors":"Weipeng Shao, Jingjing Huang, J. Zhang, Shanwu Ma, Hongxiang Feng, Hongliang Sun, Yanhong Ren, Xiaowei Wang, Zhen-rong Zhang, Deruo Liu","doi":"10.3760/CMA.J.CN112434-20190818-00273","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190818-00273","url":null,"abstract":"Objective \u0000To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients. \u0000 \u0000 \u0000Methods \u0000We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed. \u0000 \u0000 \u0000Results \u0000There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex(P=0.023), ILD(P=0.001), COPD(P=0.027) were independent risk factors for postoperative morbidity. ILD(P=0.023) and postoperative morbidity(P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. \u0000 \u0000 \u0000Conclusion \u0000Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients. \u0000 \u0000 \u0000Key words: \u0000ILD; Pulmonary resection; AE-ILD; Morbidity; 60-day mortality","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"48 1","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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