Objective To summarize the clinical characteristics of coarctation of the aorta(CoA) associated with intracardiac anomalies in infants. Methods The data from August 2009 to August 2017 of 86 infants who were diagnosed with CoA associated with intracardiac anomalies. Preoperative diagnosis, surgical findings and post-operation follow-up were analyzed retrospectively. There were 56 boys an 30 girls, aqed(95.1±78.0) days, weight(4.6±1.2) kg. Anatomical types included 37 cases of pre-ductal CoA, 44 cases of peri-ducutal CoA, and 5 cases of post-ductal CoA. And this group also included 73 infants complicating VSD, 59 infants complicating ASD, 2 infants complicating DORV, and 1 infant complicating TAPVC. Results All of the included patients underwent single-stage repair of CoA associated with intracardiac anomalies. Mean operative time was(279.0±56.4) min, mean cardiopulmonary bypass time was(162.3±51.0) min, and mean aorta cross-clamp time was(74.7±25.2) min. Mean length of ICU stay and ventilation time were(7.4±4.7) days and(101.1±75.4) hours, respectively. The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly [(42.3±17.7) mmHg vs.(22.1±9.4)mmHg, P<0.001], and 7 early deaths were observed after surgery. The mean follow-up time of 79 hospital survivors was(31.0±27.4) months, and no late death was found. Transcoarctation gradient of hospital survivors in the last time follow-up was(21.2±11.0)mmHg. Transcoarctation gradient of 29 cases was higher than 20 mmHg, however, only 4 cases with significant clinical symptom of lower limbs retardation were recommended for ballon angioplasty consultant. The cumulative recoarctation-free survival in 2-year follow-up was 69.2%. Conclusion To avoid early second-stage operations, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes of early to mid term follow-up were satisfactory. Key words: Congenital heart disease Coarctation of the aorta Surgery Infants
{"title":"One-stage surgical treatment of 86 cases of aortic coarctation combined with intracardiac malformation","authors":"Yuhao Wu, Yuehang Zhou, X. Jin, Hongyu Kuang, Yonggang Li, Chun Wu","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.005","url":null,"abstract":"Objective \u0000To summarize the clinical characteristics of coarctation of the aorta(CoA) associated with intracardiac anomalies in infants. \u0000 \u0000 \u0000Methods \u0000The data from August 2009 to August 2017 of 86 infants who were diagnosed with CoA associated with intracardiac anomalies. Preoperative diagnosis, surgical findings and post-operation follow-up were analyzed retrospectively. There were 56 boys an 30 girls, aqed(95.1±78.0) days, weight(4.6±1.2) kg. Anatomical types included 37 cases of pre-ductal CoA, 44 cases of peri-ducutal CoA, and 5 cases of post-ductal CoA. And this group also included 73 infants complicating VSD, 59 infants complicating ASD, 2 infants complicating DORV, and 1 infant complicating TAPVC. \u0000 \u0000 \u0000Results \u0000All of the included patients underwent single-stage repair of CoA associated with intracardiac anomalies. Mean operative time was(279.0±56.4) min, mean cardiopulmonary bypass time was(162.3±51.0) min, and mean aorta cross-clamp time was(74.7±25.2) min. Mean length of ICU stay and ventilation time were(7.4±4.7) days and(101.1±75.4) hours, respectively. The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly [(42.3±17.7) mmHg vs.(22.1±9.4)mmHg, P<0.001], and 7 early deaths were observed after surgery. The mean follow-up time of 79 hospital survivors was(31.0±27.4) months, and no late death was found. Transcoarctation gradient of hospital survivors in the last time follow-up was(21.2±11.0)mmHg. Transcoarctation gradient of 29 cases was higher than 20 mmHg, however, only 4 cases with significant clinical symptom of lower limbs retardation were recommended for ballon angioplasty consultant. The cumulative recoarctation-free survival in 2-year follow-up was 69.2%. \u0000 \u0000 \u0000Conclusion \u0000To avoid early second-stage operations, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes of early to mid term follow-up were satisfactory. \u0000 \u0000 \u0000Key words: \u0000Congenital heart disease Coarctation of the aorta Surgery Infants","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"4 1","pages":"526-529"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87382046","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.011
Fei Li, M. Jia, X. Hou
Objective To research the influencing factors of postoperative atrial fibrillation(AF) in patients underwent coronary artery bypass grafting(CABG), and to explore the relationship between postoperative AF with complications and recovery. Methods From January 2017 to February 2018, 2 218 patients in Beijing Anzhen Hospital affiliated to Capital Medical University underwent simple CABG and returned to the ICU. After excluding preoperative AF and pacemaker implanted patients, a total of 1 952 patients were included in the research. According to whether there was postoperative AF, patients were divided into non-AF group [1 544 cases, male 1 017, female 527, averaged age(63.20±9.47)years old]and new-onset AF group [408 cases, male 280, female 128, averaged age(69.32±8.93) years old]. The gender, age, related medical history, cardiac function and other factors were recorded. And the postoperative laboratory test indicators, tracheal reintubation rate, tracheotomy rate, mortality, IABP and ECMO use rate, intensive care unit and hospital time were compared. Results Compared with the non-AF group, the rates of tracheal reintubation(P=0.007), tracheotomy(P=0.039), and hospital mortality(P=0.039) were higher on the new-onset AF group, and the postoperative mechanical ventilation time(P=0.010), the ICU time(P=0.037) and the hospital time(P=0.045) were longer. Multivariate regression analysis showed: advanced age(P=0.028), postoperative cardiogenic shock(P=0.033), postoperative AKI(P=0.041), postoperative CRP elevation(P=0.030), postoperative TNI elevation(P=0.028) and postoperative LAC elevation(P=0.044) were independent risk factors for postoperative new-onset AF in CABG patients. Conclusion Patients with new-onset AF after CABG have higher complication and mortality rate. It is necessary to prevent the occurrence of AF and improve the heart and vital organ function in time to reduce the mortality. Key words: Atrial fibrillation Coronary artery bypass grafting
{"title":"The retrospective research of postoperative atrial fibrillation in patients underwent coronary artery bypass grafting","authors":"Fei Li, M. Jia, X. Hou","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.011","url":null,"abstract":"Objective \u0000To research the influencing factors of postoperative atrial fibrillation(AF) in patients underwent coronary artery bypass grafting(CABG), and to explore the relationship between postoperative AF with complications and recovery. \u0000 \u0000 \u0000Methods \u0000From January 2017 to February 2018, 2 218 patients in Beijing Anzhen Hospital affiliated to Capital Medical University underwent simple CABG and returned to the ICU. After excluding preoperative AF and pacemaker implanted patients, a total of 1 952 patients were included in the research. According to whether there was postoperative AF, patients were divided into non-AF group [1 544 cases, male 1 017, female 527, averaged age(63.20±9.47)years old]and new-onset AF group [408 cases, male 280, female 128, averaged age(69.32±8.93) years old]. The gender, age, related medical history, cardiac function and other factors were recorded. And the postoperative laboratory test indicators, tracheal reintubation rate, tracheotomy rate, mortality, IABP and ECMO use rate, intensive care unit and hospital time were compared. \u0000 \u0000 \u0000Results \u0000Compared with the non-AF group, the rates of tracheal reintubation(P=0.007), tracheotomy(P=0.039), and hospital mortality(P=0.039) were higher on the new-onset AF group, and the postoperative mechanical ventilation time(P=0.010), the ICU time(P=0.037) and the hospital time(P=0.045) were longer. Multivariate regression analysis showed: advanced age(P=0.028), postoperative cardiogenic shock(P=0.033), postoperative AKI(P=0.041), postoperative CRP elevation(P=0.030), postoperative TNI elevation(P=0.028) and postoperative LAC elevation(P=0.044) were independent risk factors for postoperative new-onset AF in CABG patients. \u0000 \u0000 \u0000Conclusion \u0000Patients with new-onset AF after CABG have higher complication and mortality rate. It is necessary to prevent the occurrence of AF and improve the heart and vital organ function in time to reduce the mortality. \u0000 \u0000 \u0000Key words: \u0000Atrial fibrillation Coronary artery bypass grafting","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"42 1","pages":"551-555"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76319476","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.001
Qiang Zhao
{"title":"Long-term outcome of bilateral internal thoracic coronary artery grafting: commentary on 10-year outcome of the arterial revascularization trial","authors":"Qiang Zhao","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.001","url":null,"abstract":"","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"220 1","pages":"513-514"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75730635","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.002
Wu-hua Liu, Haitao Ma, Haitao Huang
Objective To investigate the effect of different thoracicdrainage methods afte single holethoracoscopicsurgery for lung cancer. Methods 200 patents with lung cancer undergoing single holethoracoscopicsurgery were divided into two groups : group A and group B in the first affliliated Hospital of Suzhou University from April 2014 to December 2016. Group A: 100 patients with 30#single thoracic drainage tube after operation. Groupe B: 100 patients with 30#thoracic drainage tube plus a negative pressure drainage tube after operation. The amount of thoracic drainage tube , drainage time , postoperative chest puncture, postoperative pain, hospital stay and total costs of hospitalization were observed in both groups. Results There was no difference in age, sex, pathological type and pulmonary lobectomy between the two groups. Total thoracic drainage[(1 007.4±512.95)ml vs.(982.35±359.93)ml]and totaltube time[(5.71±2.61)days vs.(5.43±1.91) days] had no significant difference between the two groups. There was a significant difference in the length of 30#thoracic drainage tube [(5.71±2.61)days vs.(2.9±0.61)days]between the two groups. The difference of hospitalization time[(12.05±2.93)days vs.(13.45±4.15)days]and hospitalization expenses[(63 376.47±1 615.82)yuan vs.(64 449.82±3 650.04)yuan]was statistically significant. The rate of rethoracotomy in gruop A was 7%, the rate of rethoracotomy in group B was 0, the comparison between the two groups was statistically significant. VAS pain scores were compared on the first day and the second day, there was no significant difference on the third day after operation. On the fifth day after operation, the difference was statistically significant. Conclusion Adding a negative pressure drainage tube on the basis of using a single thoracoscopic drainage tube for radical resection of lung cancer after single hole thoracoscopic surgery will not increase postoperative pain of patients, significantly shorten postoperative hospitalization time, effectively control postoperativerethoracopunchure rate, thus effectively reduce postoperative hospitalization costs of patients. Key words: Single hole Thoracoscopic Radical resection of lung cancer Thoracic drainage
{"title":"Analysis of the effect of different chest drainage after uniportal video-assisted thoracoscopic radical operation for lung cancer","authors":"Wu-hua Liu, Haitao Ma, Haitao Huang","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.002","url":null,"abstract":"Objective \u0000To investigate the effect of different thoracicdrainage methods afte single holethoracoscopicsurgery for lung cancer. \u0000 \u0000 \u0000Methods \u0000200 patents with lung cancer undergoing single holethoracoscopicsurgery were divided into two groups : group A and group B in the first affliliated Hospital of Suzhou University from April 2014 to December 2016. Group A: 100 patients with 30#single thoracic drainage tube after operation. Groupe B: 100 patients with 30#thoracic drainage tube plus a negative pressure drainage tube after operation. The amount of thoracic drainage tube , drainage time , postoperative chest puncture, postoperative pain, hospital stay and total costs of hospitalization were observed in both groups. \u0000 \u0000 \u0000Results \u0000There was no difference in age, sex, pathological type and pulmonary lobectomy between the two groups. Total thoracic drainage[(1 007.4±512.95)ml vs.(982.35±359.93)ml]and totaltube time[(5.71±2.61)days vs.(5.43±1.91) days] had no significant difference between the two groups. There was a significant difference in the length of 30#thoracic drainage tube [(5.71±2.61)days vs.(2.9±0.61)days]between the two groups. The difference of hospitalization time[(12.05±2.93)days vs.(13.45±4.15)days]and hospitalization expenses[(63 376.47±1 615.82)yuan vs.(64 449.82±3 650.04)yuan]was statistically significant. The rate of rethoracotomy in gruop A was 7%, the rate of rethoracotomy in group B was 0, the comparison between the two groups was statistically significant. VAS pain scores were compared on the first day and the second day, there was no significant difference on the third day after operation. On the fifth day after operation, the difference was statistically significant. \u0000 \u0000 \u0000Conclusion \u0000Adding a negative pressure drainage tube on the basis of using a single thoracoscopic drainage tube for radical resection of lung cancer after single hole thoracoscopic surgery will not increase postoperative pain of patients, significantly shorten postoperative hospitalization time, effectively control postoperativerethoracopunchure rate, thus effectively reduce postoperative hospitalization costs of patients. \u0000 \u0000 \u0000Key words: \u0000Single hole Thoracoscopic Radical resection of lung cancer Thoracic drainage","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"48 1","pages":"515-519"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80924949","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.004
Weidan Chen, Li Ma, Shengchun Yang, M. Zou, Yuansheng Xia, Wenlei Li, Ye Lu, Mingjie Zhang, Xinxin Chen
Objective To summarize the surgical results and experience of patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets. Methods From April 2013 to June 2017, 10 patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets underwent biventricular repair at Guangzhou Women and Children Medical Center. Seven were male, and 3 were female. The age and body weight at surgery was 2 months to 13 years and 3.7-23.6 kg. Repair was performed with modified one-patch technique in 3 patients, modified two-patch technique in 6 patients, two-patch technique in 1 patient. Results There was no hospital mortality. The ICU stay and hospital stay after operation were 2~5 days and 7~10 days. The follow-up duration was 16 to 65 months. All patients were alive and free from left ventricular outlet obstruction. The left atrioventricular valve function were normal in 2 patients, mild regurgitation in 6 patients, moderate regurgitation in 1 patient and severe regurgitation in 1 patient. Conclusion The outcomes of biventricular repair for patients with complete atrioventricular septal defect associated with Tetralogy of Fallot or double right ventricular outlets were satisfied, and long-term follow-up was demanded. Key words: Atrioventricular septal defect Tetralogy of Fallot Double right ventricular outlets
{"title":"Biventricular repair of complete artioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets","authors":"Weidan Chen, Li Ma, Shengchun Yang, M. Zou, Yuansheng Xia, Wenlei Li, Ye Lu, Mingjie Zhang, Xinxin Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.004","url":null,"abstract":"Objective \u0000To summarize the surgical results and experience of patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets. \u0000 \u0000 \u0000Methods \u0000From April 2013 to June 2017, 10 patients with complete atrioventricular septal defect associated with tetralogy of Fallot or double right ventricular outlets underwent biventricular repair at Guangzhou Women and Children Medical Center. Seven were male, and 3 were female. The age and body weight at surgery was 2 months to 13 years and 3.7-23.6 kg. Repair was performed with modified one-patch technique in 3 patients, modified two-patch technique in 6 patients, two-patch technique in 1 patient. \u0000 \u0000 \u0000Results \u0000There was no hospital mortality. The ICU stay and hospital stay after operation were 2~5 days and 7~10 days. The follow-up duration was 16 to 65 months. All patients were alive and free from left ventricular outlet obstruction. The left atrioventricular valve function were normal in 2 patients, mild regurgitation in 6 patients, moderate regurgitation in 1 patient and severe regurgitation in 1 patient. \u0000 \u0000 \u0000Conclusion \u0000The outcomes of biventricular repair for patients with complete atrioventricular septal defect associated with Tetralogy of Fallot or double right ventricular outlets were satisfied, and long-term follow-up was demanded. \u0000 \u0000 \u0000Key words: \u0000Atrioventricular septal defect Tetralogy of Fallot Double right ventricular outlets","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"36 1","pages":"523-525"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89057185","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.007
Lu Qitong, Liu Zhi-yong, He Wei, Ma Teng
Objective To summarize the clinical experience of artificial vascular sleeve-like inverted suture in proximal part of ascending aorta, and to explore the effectiveness of the method. Methods A retrospective study was performed. From August 2017 to April 2018, 10 patients with Stanford type A aortic dissection with surgical indications for ascending aortic replacement were treated with artificial vascular sleeve-like inverted suture for proximal part of ascending aorta, 9 cases of emergency operation, 8 cases of males and 2 females, aged 43-69 years, mean(51±6) years old. The specific method for operation is to invert the artificial blood vessel 2 cm outward and then insert it into the ascending aorta, suture the inverted part of the artificial blood vessel and the ascending aorta continuously. If there is obvious bleeding, stitch strips made of artificial blood vessel or pericardium with theanastomosis ring. The drainage in 24 hours after operation and early postoperative outcome were observed. Results There was no intraoperative death in the whole group, and there was no second thoracotomy for hemostasis. The drainage volume was 150-880 ml, average(260±55) ml in 24 hours after surgery. One patient developed gastrointestinal hemorrhage after operation, and healed after two times of hemostasis by bedside gastroscopy. Two patients had transient neurological dysfunction(TND). All of the 10 patients were cured and discharged after treatment. All patients were followed up for 1-6 months. All patients underwent transthoracic echocardiography. Eight of them underwent CT angiography, no new aortic regurgitation, and no obvious sinus widening. Conclusion The artificial blood vessel sleeve-like inverted suture is a simple and reliable operation in reinforcement for proximal part of ascending aorta. The anastomosis circle and the suture pinprick are not directly in contact with the blood flow, reducing the chance of bleeding. Even if there is tinybleeding, it will be easy to find and repair. In conclusion, this method is convenient and effective, and it is worthy of clinical promotion. Key words: Aortic dissection Suture Bleed
{"title":"Applications of artificial blood vessel sleeve-like inverted suture reinforcement in proximal part of ascending aorta","authors":"Lu Qitong, Liu Zhi-yong, He Wei, Ma Teng","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.007","url":null,"abstract":"Objective \u0000To summarize the clinical experience of artificial vascular sleeve-like inverted suture in proximal part of ascending aorta, and to explore the effectiveness of the method. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed. From August 2017 to April 2018, 10 patients with Stanford type A aortic dissection with surgical indications for ascending aortic replacement were treated with artificial vascular sleeve-like inverted suture for proximal part of ascending aorta, 9 cases of emergency operation, 8 cases of males and 2 females, aged 43-69 years, mean(51±6) years old. The specific method for operation is to invert the artificial blood vessel 2 cm outward and then insert it into the ascending aorta, suture the inverted part of the artificial blood vessel and the ascending aorta continuously. If there is obvious bleeding, stitch strips made of artificial blood vessel or pericardium with theanastomosis ring. The drainage in 24 hours after operation and early postoperative outcome were observed. \u0000 \u0000 \u0000Results \u0000There was no intraoperative death in the whole group, and there was no second thoracotomy for hemostasis. The drainage volume was 150-880 ml, average(260±55) ml in 24 hours after surgery. One patient developed gastrointestinal hemorrhage after operation, and healed after two times of hemostasis by bedside gastroscopy. Two patients had transient neurological dysfunction(TND). All of the 10 patients were cured and discharged after treatment. All patients were followed up for 1-6 months. All patients underwent transthoracic echocardiography. Eight of them underwent CT angiography, no new aortic regurgitation, and no obvious sinus widening. \u0000 \u0000 \u0000Conclusion \u0000The artificial blood vessel sleeve-like inverted suture is a simple and reliable operation in reinforcement for proximal part of ascending aorta. The anastomosis circle and the suture pinprick are not directly in contact with the blood flow, reducing the chance of bleeding. Even if there is tinybleeding, it will be easy to find and repair. In conclusion, this method is convenient and effective, and it is worthy of clinical promotion. \u0000 \u0000 \u0000Key words: \u0000Aortic dissection Suture Bleed","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"2007 1","pages":"534-536"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82492861","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.003
Z. Wan, Wei Huang, G. Jiang, L. Hou
Objective To investigate the clinical features of ciliated muconodular papillary tumor(CMPT) of the lung. Methods We retrospectively reviewed 11 cases with final pathology being diagnosed as CMPT in our department from April 2017 to April 2018. There were 8 males and 3 females with a mean age of(63.7±5.6) years. The clinical data, histopathological features, treatment, and prognosis were reviewed. All patients received CT scan before operation. Results The radiological features of CMPT include: located peripherally and most in right lower lobe; most CMPT lesions are GGO, some with air spaces in center and few being solid. All patients underwent video-assisted thoracic surgery(VATS) successfully, and there were no severe perioperative complications. The mean operating time was(78.0±28.2) min. The mean blood loss was(37.3±14.9) ml. The mean postoperative hospital stays were(3.45±0.93) days. Pathology examination of all patients were CMPT. Follow-up time ranged from 6 to 18 months and no recurrence was found. Conclusion CMPT is rare tumor, without specific clinical manifestation, but sometimes misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma. VATS is feasible and safe for CMPT, and the prognosis is good. Key words: Pulmonary neoplasms Ciliated muconodular papillary tumor Video-assisted thoracic surgery Prognosis
{"title":"Surgical treatment of ciliated muconodular papillary tumor of the lung: a report of 11 cases","authors":"Z. Wan, Wei Huang, G. Jiang, L. Hou","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.003","url":null,"abstract":"Objective \u0000To investigate the clinical features of ciliated muconodular papillary tumor(CMPT) of the lung. \u0000 \u0000 \u0000Methods \u0000We retrospectively reviewed 11 cases with final pathology being diagnosed as CMPT in our department from April 2017 to April 2018. There were 8 males and 3 females with a mean age of(63.7±5.6) years. The clinical data, histopathological features, treatment, and prognosis were reviewed. All patients received CT scan before operation. \u0000 \u0000 \u0000Results \u0000The radiological features of CMPT include: located peripherally and most in right lower lobe; most CMPT lesions are GGO, some with air spaces in center and few being solid. All patients underwent video-assisted thoracic surgery(VATS) successfully, and there were no severe perioperative complications. The mean operating time was(78.0±28.2) min. The mean blood loss was(37.3±14.9) ml. The mean postoperative hospital stays were(3.45±0.93) days. Pathology examination of all patients were CMPT. Follow-up time ranged from 6 to 18 months and no recurrence was found. \u0000 \u0000 \u0000Conclusion \u0000CMPT is rare tumor, without specific clinical manifestation, but sometimes misdiagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma. VATS is feasible and safe for CMPT, and the prognosis is good. \u0000 \u0000 \u0000Key words: \u0000Pulmonary neoplasms Ciliated muconodular papillary tumor Video-assisted thoracic surgery Prognosis","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"42 1","pages":"520-522"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79402054","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}
{"title":"Application of 3D visualization for preoperative planning during procedures on a surgical treatment of Castleman disease","authors":"Shaohui Song, Hao Wu, Jian-quan Yang","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.014","url":null,"abstract":"27岁男性患者，发现纵隔肿物10余年，感觉活动后气促乏力3天。肿物位于上纵隔近胸廓上口处，周围结构复杂，血供丰富，普通二维图像虽能提供直观的解剖关系，但因邻近组织及肿块自身遮挡，不利于术者细致了解整体空间结构和周围解剖情况。我们使用三维成像技术联合体渲染技术，对肿块或遮挡组织进行透明度调节处理，清楚辨别邻近组织间的三维空间构成情况，为手术提供重要解剖参考。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"24 1","pages":"564-565"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78601317","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.008
Yanting Hou, Qianzhen Li, Xiaochai Lyu, Jianzhi Du, Liang-wan Chen
Objective To summarize the clinical experience of cardiopulmonary bypass(CPB) in acute type A aortic dissection received aortic arch reconstruction on age over 70 years patients. Methods From April 2013 to December 2017, 35 elderly patients aged over 70 who were involved the aortic arch, brachiocephalic trunk, left common carotid artery and left subclavian artery and severe arch lesions, large false lumen and large rupture risk of acute A aortic dissection were reconstructed by triple-branched stent graft in emergency extracorporeal circulation. During the period of cardiopulmonary bypass, selective cerebral perfusion and discontinuous arrest under moderate hypothermia(25 degrees C) were used to reduce the time of cerebral ischemia and hypoxia, and to strengthen the management of the protection of important organs. Results Cardiopulmonary bypass time was(144.85±32.98)minutes, and aortic cross clap time was(51.82±17.59)minutes, and selective cerebral perfusion time was(12.17±4.70)minutes, discontinuous arrest time was(4.50±3.54) minutes, the lower body arrest time was(16.6±7.49)minutes. All patients were smoothly weaned from cardiopulmonary bypass.35 patients resuscitated within 48 hours, of which 3 patients had transient mental disorders in the early stage and recovered before hospital discharge; 2 patients had cerebral infarction. Hospital mortality in this group was 17.1%(6/35). Conclusion Advanced age is not a contraindication to the reconstruction of the arch of the aortic dissection. Reasonable management of cardiopulmonary bypass can provide an important guarantee for the reconstruction of the elderly patients with acute type A aortic dissection. Key words: Elderly patients Acute type A aortic dissection Cardiopulmonary bypass
{"title":"Management of cardiopulmonary bypass in elderly patients with acute type A aortic dissection of aortic arch reconstruction","authors":"Yanting Hou, Qianzhen Li, Xiaochai Lyu, Jianzhi Du, Liang-wan Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.008","url":null,"abstract":"Objective \u0000To summarize the clinical experience of cardiopulmonary bypass(CPB) in acute type A aortic dissection received aortic arch reconstruction on age over 70 years patients. \u0000 \u0000 \u0000Methods \u0000From April 2013 to December 2017, 35 elderly patients aged over 70 who were involved the aortic arch, brachiocephalic trunk, left common carotid artery and left subclavian artery and severe arch lesions, large false lumen and large rupture risk of acute A aortic dissection were reconstructed by triple-branched stent graft in emergency extracorporeal circulation. During the period of cardiopulmonary bypass, selective cerebral perfusion and discontinuous arrest under moderate hypothermia(25 degrees C) were used to reduce the time of cerebral ischemia and hypoxia, and to strengthen the management of the protection of important organs. \u0000 \u0000 \u0000Results \u0000Cardiopulmonary bypass time was(144.85±32.98)minutes, and aortic cross clap time was(51.82±17.59)minutes, and selective cerebral perfusion time was(12.17±4.70)minutes, discontinuous arrest time was(4.50±3.54) minutes, the lower body arrest time was(16.6±7.49)minutes. All patients were smoothly weaned from cardiopulmonary bypass.35 patients resuscitated within 48 hours, of which 3 patients had transient mental disorders in the early stage and recovered before hospital discharge; 2 patients had cerebral infarction. Hospital mortality in this group was 17.1%(6/35). \u0000 \u0000 \u0000Conclusion \u0000Advanced age is not a contraindication to the reconstruction of the arch of the aortic dissection. Reasonable management of cardiopulmonary bypass can provide an important guarantee for the reconstruction of the elderly patients with acute type A aortic dissection. \u0000 \u0000 \u0000Key words: \u0000Elderly patients Acute type A aortic dissection Cardiopulmonary bypass","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"26 1","pages":"537-540"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89584594","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 : 2019-09-25DOI: 10.3760/CMA.J.ISSN.1001-4497.2019.09.012
Xiaoyu Liu, Chenglong Li, N. Liu, X. Hou
Objective Establish the post cardiovascular surgery SOFA score(pcvsSOFA)based on the Sequential Organ Failure Assessment(SOFA)score to evaluate the severity and prognosis of patients after cardiovascular surgery. Methods 3 872 consecutive patients who underwent cardiovascular surgery and stayed in ICU more than 24 hours between July 2015 and December 2017 were retrospectively analyzed to establish a derivation cohort. Univariable and multivariable logistic regression were used to identify the predictors in the pcvsSOFA. And the validity of the new model was evaluated in the derivation cohort and validation cohort. Results Respiratory system score, coagulation system score, nervous system score and renal system score on the first day of ICU, Emergency surgery and re-surgery were risk factors and established the pcvsSOFA. The total score of pcvsSOFA was 20 point and was divided into four classes, namely class Ⅰ(pcvsSOFA-score: 1-5), class Ⅱ(pcvsSOFA-score: 6-10), class Ⅲ(pcvsSOFA-score: 11-15) and class Ⅳ(pcvsSOFA-score: 16-20)with their corresponding predicted mortality 0.9%(n=2 317), 5.7%(n=1 367), 26.8%(n=184), and 64.2%(n=4) in the derivation cohort. The area under the receiver operating characteristics curve(AUC)was 0.864(95%CI: 0.837-0.892), and the integrated discriminant improvement(IDI) was 0.035.In the validation cohort, AUC(pcvsSOFA)= 0.832(95%CI: 0.735-0.928), IDI=0.211. The AUC of SOFA, APACHE Ⅱ and SAPS Ⅱ was 0.771, 0.793 and 0.721 respectively. Conclusion Compared with the SOFA score, pcvsSOFA could be a better tool to assess the prognosis of critical patients in the early postoperative stage. Key words: SOFA score Cardiovascular surgery Outcome
{"title":"The application of post cardiovascular surgery SOFA score in hospital mortality in severe patients","authors":"Xiaoyu Liu, Chenglong Li, N. Liu, X. Hou","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.09.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.09.012","url":null,"abstract":"Objective \u0000Establish the post cardiovascular surgery SOFA score(pcvsSOFA)based on the Sequential Organ Failure Assessment(SOFA)score to evaluate the severity and prognosis of patients after cardiovascular surgery. \u0000 \u0000 \u0000Methods \u00003 872 consecutive patients who underwent cardiovascular surgery and stayed in ICU more than 24 hours between July 2015 and December 2017 were retrospectively analyzed to establish a derivation cohort. Univariable and multivariable logistic regression were used to identify the predictors in the pcvsSOFA. And the validity of the new model was evaluated in the derivation cohort and validation cohort. \u0000 \u0000 \u0000Results \u0000Respiratory system score, coagulation system score, nervous system score and renal system score on the first day of ICU, Emergency surgery and re-surgery were risk factors and established the pcvsSOFA. The total score of pcvsSOFA was 20 point and was divided into four classes, namely class Ⅰ(pcvsSOFA-score: 1-5), class Ⅱ(pcvsSOFA-score: 6-10), class Ⅲ(pcvsSOFA-score: 11-15) and class Ⅳ(pcvsSOFA-score: 16-20)with their corresponding predicted mortality 0.9%(n=2 317), 5.7%(n=1 367), 26.8%(n=184), and 64.2%(n=4) in the derivation cohort. The area under the receiver operating characteristics curve(AUC)was 0.864(95%CI: 0.837-0.892), and the integrated discriminant improvement(IDI) was 0.035.In the validation cohort, AUC(pcvsSOFA)= 0.832(95%CI: 0.735-0.928), IDI=0.211. The AUC of SOFA, APACHE Ⅱ and SAPS Ⅱ was 0.771, 0.793 and 0.721 respectively. \u0000 \u0000 \u0000Conclusion \u0000Compared with the SOFA score, pcvsSOFA could be a better tool to assess the prognosis of critical patients in the early postoperative stage. \u0000 \u0000 \u0000Key words: \u0000SOFA score Cardiovascular surgery Outcome","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"76 1","pages":"556-560"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83761236","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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