The Heart Surgery Forum[JOURNAL]
Sun
200 papers
Exploration on the Value of Circulation Quality Control Intervention Mode in Percutaneous Coronary Intervention in Patients with Coronary Heart Disease and Chronic Heart Failure.
Yang X, Ren S, Liu Y … +4 more , Wu X, Hao X, Bai X, Li R
Heart Surg Forum · 2023 Dec · PMID 38178330 · Publisher ↗
BACKGROUND: Patients with coronary heart disease (CHD) often have other diseases due to organ dysfunction, among which chronic heart failure (CHF) is the most common. Percutaneous coronary intervention (PCI) is the mains...
BACKGROUND: Patients with coronary heart disease (CHD) often have other diseases due to organ dysfunction, among which chronic heart failure (CHF) is the most common. Percutaneous coronary intervention (PCI) is the mainstream method for the treatment of such diseases. Because most of the patients are the elderly and the functions of various organs are declining, it is necessary to implement scientific and efficient management methods. OBJECTIVE: To explore the application value of circulation quality control intervention (CQCI) mode in PCI of patients with CHD and CHF. Time: From June 2021 to June 2023. METHODS: The clinical data of 197 CHD patients with CHF were retrospectively analyzed, and 14 patients who did not meet the inclusion criteria were excluded. According to different perioperative management methods, the remaining cases were divided into the reference group (RG, receiving routine clinical management) and observation group (OG, receiving routine clinical management and CQCI). The cardiac function indexes and emotional state before and after management were compared between the two groups, and the quality of life in two groups was compared. RESULTS: In this study, 100 patients were included in the RG and 83 patients were included in the OG finally. Compared with the RG, the OG had lower levels of left ventricular end systolic diameter and left ventricular end-diastolic diameter after management (p < 0.05), while the OG had significantly higher left ventricular ejection fraction level (p < 0.001). The OG had overtly higher clinical satisfaction than the RG (p < 0.05). After management, the Hospital Anxiety and Depression Scale score in the OG were distinctly lower than those in the RG (p < 0.001). After management, the OG had significantly higher scores of physiological field, psychological field, social relationship and environmental field than the RG (p < 0.001). CONCLUSION: The application of CQCI mode in the perioperative period of PCI has certain benefits for improving the cardiac function of patients. At the same time, this program can also improve the quality of life of patients to a certain extent, which is helpful to accelerate postoperative rehabilitation.
Pulsed Field Ablation for the Treatment of Atrial Fibrillation: A Review and a Look into its Future.
Guttipatti P, Saadallah N, Wan EY
Heart Surg Forum · 2024 · PMID 40475975 · Full text
Pulsed field ablation (PFA) is a novel technology to treat atrial fibrillation (AF) utilizing electric fields to induce nonthermal irreversible electroporation of electrically active cardiac tissue to induce cardiac cell...
Pulsed field ablation (PFA) is a novel technology to treat atrial fibrillation (AF) utilizing electric fields to induce nonthermal irreversible electroporation of electrically active cardiac tissue to induce cardiac cell death. PFA offers improved safety benefits compared to traditional radiofrequency ablation (RFA) and cryoablation by specifically ablating only cardiac tissue. However, there are avenues for further optimization including neurological risk associated with microbubble formation and left atrial function post ablation. Various PFA devices with different electric pulse waveforms have been studied and tested in human trials, with the majority utilizing microsecond duration pulses. Shorter nanosecond duration pulses, or nanosecond PFA, is beginning to be studied for AF ablation. In this review we will delve into current waveforms used for PFA, areas for improvement, mechanisms behind nanosecond PFA, and its clinical impact for cardiac ablation.
The Efficacy of Erector Spinae Plane Block for Thoracoscopic Surgery: A Meta-Analysis of Randomized Controlled Trials.
Liu L, Zhao Y, Yongpeng He … +3 more , Peng W, He H, Liang L
Heart Surg Forum · 2023 Oct · PMID 37920095 · Publisher ↗
BACKGROUND: The efficacy of erector spinae plane block for thoracoscopic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the impact of erector spinae plane block on thoracosco...
BACKGROUND: The efficacy of erector spinae plane block for thoracoscopic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the impact of erector spinae plane block on thoracoscopic surgery. METHODS: We searched the PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through February 2022 for randomized controlled trials (RCTs), assessing the effect of erector spinae plane block on thoracoscopic surgery. This meta-analysis was performed using the random-effect model. RESULTS: Seven RCTs, involving 439 patients, are included in the meta-analysis. Overall, compared with the control group for thoracoscopic surgery, erector spinae plane block (ESPB) results in significantly reduced pain scores at 1 h (standard mean difference (SMD) = -4.26; 95% confidence interval (CI) = -7.63 to -0.88; p = 0.01), 4 h (SMD = -4.08; 95% CI = -4.56 to -3.60; p < 0.00001), 8 h (SMD = -4.13; 95% CI = -4.62 to -3.65; p < 0.00001), and postoperative anesthesia consumption (SMD = -3.04; 95% CI = -4.58 to -1.50; p = 0.0001) and can decrease the incidence of nausea and vomiting (odd ratio (OR) = 0.18; 95% CI = 0.08 to 0.39; p < 0.001). CONCLUSIONS: ESPB can substantially enhance pain relief for thoracoscopic surgery.
Long-Term Results and Risk Factors of Treatment for Post-Infarction Ventricular Septal Rupture: A Single-Center Experience.
Zhao K, Li B, Guo X … +5 more , Sun B, Wang Y, Tao D, Wang Q, Wang H
Heart Surg Forum · 2023 Oct · PMID 37920094 · Publisher ↗
BACKGROUND: Ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare but lethal complication. We analyzed the long-term results and risk factors for survival in the treatment of VSR. METHODS: From...
BACKGROUND: Ventricular septal rupture (VSR) following myocardial infarction (MI) is a rare but lethal complication. We analyzed the long-term results and risk factors for survival in the treatment of VSR. METHODS: From January 2012 to December 2021, 115 consecutive patients with post-MI VSR were admitted to our hospital. Depending on different treatment methods patients were divided into following three groups: medical, transcatheter intervention, and surgical repair. During the study, relevant clinical data, operation-related conditions, and follow-up data were analyzed. The Kaplan-Meier method and log-rank test were used to determine the cumulative incidence of mortality. The independent risk factors for patient mortality were evaluated by multivariate logistic regression. RESULTS: The mean follow-up time was 43.4 ± 34.7 months. The overall in-hospital, 30-day, and long-term mortality rates were 24.3%, 38.3%, and 51.3%, respectively. In the medical group, the in-hospital and 30-day mortality rates were 46.7 % (21/45) and 82.2 % (37/45), respectively, with only three patients alive at follow-up. In the transcatheter intervention group, 30-day and long-term mortality rates were 12% and 28%, respectively. In the surgical repair group, 30-day and long-term mortality rates were 8.9% and 22.2%, respectively. Compared with the surgery-group patients, patients with transcatheter intervention had a longer time from VSR to intervention. Logistic regression analysis revealed that age, previous infarction, Killip class, serum creatinine, Troponin T, N-terminal pro-B-type natriuretic peptide, and medical strategy were risk factors for all-cause mortality. CONCLUSIONS: The 30-day and long-term outcomes of patients treated with surgical repair and transcatheter intervention were significantly better than medically treated patients.
Prediction of Acute Kidney Injury after Extracorporeal Cardiac Surgery (CSA-AKI) by Machine Learning Algorithms.
Tong Y, Niu X, Liu F
Heart Surg Forum · 2023 Oct · PMID 37920093 · Publisher ↗
BACKGROUND: Acute renal failure after extracorporeal cardiac surgery under general anesthesia is high and unpredictable, but machine learning algorithms could change this. A feasible approach is to use machine learning m...
BACKGROUND: Acute renal failure after extracorporeal cardiac surgery under general anesthesia is high and unpredictable, but machine learning algorithms could change this. A feasible approach is to use machine learning models to construct models to predict acute kidney injury after extracorporeal cardiac surgery (CSA-AKI) and screen for the best predictive model. METHOD: From January 2014 to December 2021, 2187 patients undergoing extracorporeal cardiac surgery at the third hospital of Hebei Medical University and the first medical centre of Chinese PLA General Hospital were collected in this study. After excluding 923 patients who did not meet the inclusion criteria, a dataset of 1264 patients with 125 clinical indexes was constructed. After screening the feature variables using Least absolute shrinkage (LASSO) regression, the dataset was randomly divided into a training set (70%), test set (30%), and six machine learning algorithms, including extreme gradient boosting (XGBoost), logistic regression (LRC), light gradient boosting machine (LGBM), random forest classifier (RFC), adaptive boosting (AdaBoost), and K-nearest neighbor (KNN), were used in training set for predicting the CSA-AKI. The machine learning model with the best predictive performance was selected to complete external validation of the test set. The SHapley Additive exPlanations (SHAP) algorithm was used to interpret the model. RESULTS: Of all 1264 patients, 372 (29.43%) patients presented with CSA-AKI. The LASSO regression eliminated 22 feature variables out of 125 before model development. Among the six prediction models, the RFC prediction model has the best prediction performance, with an Area Under Curve (AUC) value of 0.778 (95% CI: 0.726-0.830) in the test set and the best net benefit compared to the other tools. SHAP explained the impact of different feature variables on the predicted outcome, where the three most influential feature variables were creatinine clearance (CRC), intraoperative urine output (mL/kg/h) and age. CONCLUSION: We developed an RFC prediction model to predict the CSA-AKI, which has good predictive performance and can explain the factors affecting the prediction results of cases by integrating the SHAP method.
Effects of Moracizine Combined with Metoprolol on Hemodynamic Indices of the Left Atrium and Quality of Life in Patients with Atrial Fibrillation.
Han G, Fu T, Zhang Y
Heart Surg Forum · 2023 Oct · PMID 37920092 · Publisher ↗
BACKGROUND: Drugs are the first choice of treatment for atrial fibrillation (AF), but there is currently a lack of efficient drug treatment options. The aim of this study was to investigate a combination drug treatment p...
BACKGROUND: Drugs are the first choice of treatment for atrial fibrillation (AF), but there is currently a lack of efficient drug treatment options. The aim of this study was to investigate a combination drug treatment plan which may serve as a reference for the treatment of AF. METHODS: A total of 316 AF patients admitted to Jiaozhou Central Hospital in Qingdao from October 2020 to October 2022 were selected for this retrospective study. They were divided into a control group (CG, metoprolol, n = 156) and an observation group (OG, moracizine combined with metoprolol, n = 160) based on the treatment they received. The CG and OG groups were compared for clinical efficacy, occurrence of AF, cardiac output (CO), cardiac indexes (CI), stroke volume (SV), stroke indexes (SI) and improvement in QOL. RESULTS: The OG had a better effective rate of treatment, higher levels of CO, CI, SV and SI, and higher QOL scores compared to the CG, as well as a lower AF recurrence rate and AF burden (all p < 0.05). CONCLUSION: Moracizine combined with metoprolol is an effective treatment for AF patients. This drug combination was found to reduce the AF recurrence rate and burden in AF patients, and to improve their hemodynamic indices and QOL.
Serum Levels of Hcy, sST2 and CA-125 in CHF Patients and Their Correlation with Cardiac Function Classification.
Ma W, Zhang P, Hu H
Heart Surg Forum · 2023 Sep · PMID 37920091 · Publisher ↗
BACKGROUND: The relationships between serum levels of homocysteine (Hcy), soluble stromelysin 2 (sST2), and tumor-associated cancer antigen 125 (CA-125) and heart failure requires further investigation. The aim of the pr...
BACKGROUND: The relationships between serum levels of homocysteine (Hcy), soluble stromelysin 2 (sST2), and tumor-associated cancer antigen 125 (CA-125) and heart failure requires further investigation. The aim of the present study was to evaluate the levels of Hcy, sST2 and CA-125 in patients with congestive heart failure and to correlate these with cardiac function, thereby providing a reference for the clinical diagnosis and treatment of heart failure. METHODS: Seventy patients with chronic heart failure (CHF) diagnosed between August 2020 and July 2022 were classified into heart failure groups II (n = 25), III (n = 23) and IV (n = 22). Seventy individuals with normal physical examination results were selected as the healthy group. Serum Hcy, sST2 and CA-125 levels for all participants were evaluated and correlated with each other and with cardiac function classification. The diagnostic value of individual Hcy, sST2, CA-125 levels for CHF was evaluated, as well as a combination of these factors. RESULTS: Hcy, sST2, and CA-125 levels were lower in the healthy group than in the heart failure group. Moreover, a progressive increase in Hcy, sST2, and CA-125 levels were observed in heart failure groups II, III, and IV. Individual Hcy, sST2 and CA-125 levels, as well as a combination of these factors, were significantly correlated with cardiac function classification (p < 0.05). Hcy, sST2 and CA-125 levels each showed diagnostic value for CHF, with the three combined having the best diagnostic value. CONCLUSIONS: Abnormally high levels of Hcy, sST2 and CA-125 occur in CHF patients and are positively correlated with cardiac function classification. Individual levels of these factors, and particularly a combination of the three, show good sensitivity and specificity for CHF diagnosis that could be widely used in clinical practice.
Preoperative Nutritional Status of Infants with Non-Restricted Ventricular Septal Defect and Its Influence on Postoperative Recovery.
Huang QB, Shi BX, Zhou SH … +2 more , Li SL, Lin YJ
Heart Surg Forum · 2023 Oct · PMID 37920090 · Publisher ↗
PURPOSE: This study described the preoperative nutritional status of infants with nonrestricted ventricular septal defects (VSDs) and evaluated its effect on postoperative recovery. METHODS: We retrospectively collected...
PURPOSE: This study described the preoperative nutritional status of infants with nonrestricted ventricular septal defects (VSDs) and evaluated its effect on postoperative recovery. METHODS: We retrospectively collected data from infants with nonrestricted VSD who received surgical treatment in our hospital from January 2020 to December 2021 and analyzed their preoperative nutritional status and postoperative recovery. RESULTS: Fifty (53.8%) patients were underweight (weight for age Z score (WAZ) ≤-1), and 31 (33.3%) patients were malnourished (WAZ ≤-2). The mechanical ventilation time, duration of intensive care unit stay and hospital stay time after surgery of patients with WAZ ≤-2 were significantly longer than those of patients with WAZ >-2 (p < 0.05). The results of linear correlation analysis showed that age, WAZ and prealbumin were negatively correlated with mechanical ventilation time, duration of intensive care unit stay and hospital stay time after surgery, respectively. Multiple linear regression analysis showed that mechanical ventilation time = 7.080 - 0.668 WAZ - 0.013 prealbumin - 0.618 age (R2: 0.729, F: 79.773, p: 0.001); duration of intensive care unit admission = 11.775 - 1.385 WAZ - 0.018 prealbumin - 0.102 age (R2: 0.714, F: 74.072, p: 0.001); and hospital stay time = 17.663 - 1.673 WAZ - 0.017 prealbumin - 1.07 age (R2: 0.711, F: 72.842, p: 0.001). CONCLUSION: The incidence of malnutrition in infants with nonrestricted VSD was very high, and malnutrition had a significant adverse effect on postoperative recovery. Malnutrition significantly prolonged mechanical ventilation time, duration of intensive care unit stay and hospital stay after surgery.
Does False Lumen Thrombosis Lead to Better Outcomes in Patients with Aortic Dissection: A Meta-Analysis and Systematic Review.
Zhang S, Sun W, Liu S … +3 more , Song B, Xie L, Liu R
Heart Surg Forum · 2023 Oct · PMID 37920089 · Publisher ↗
OBJECTIVES: For a long time, the association of the false lumen status and the outcomes of patients suffering from aortic dissection has been unclear, so this review article aims to study whether the unobstructed of the...
OBJECTIVES: For a long time, the association of the false lumen status and the outcomes of patients suffering from aortic dissection has been unclear, so this review article aims to study whether the unobstructed of the false lumen is related to the outcome of patients suffering from aortic dissection. METHODS: We performed this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes Protocols (PRISMA) statement 2009 and registered with PROSPERO (CRD42022381869). We searched PubMed, the Cochrane library, Web of Science and Embase to collect potential studies. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The main outcome is long-term survival. Data included in the study were summarized using the risk ratio or mean difference and 95% confidence interval. RESULTS: There were 16 trials, 2829 patients in total, with a mean age of 62.1 years. Compared with completely thrombosed false lumen, patent group has better long-term survival (risk ratio (RR), 0.88; 95% CI, 0.79 to 0.97; p = 0.01; I2 = 58%) and smaller yearly aortic growth rate (mean difference (MD), 1.03; 95% CI, 0.23 to 1.82; p = 0.01; I2 = 98%). In addition, patients with a patent false lumen had a lower risk of aortic event (RR, 0.81; 95% CI, 0.68 to 0.97; p = 0.02; I2 = 37%), but higher risk of aortic rupture (RR, 7.02; 95% CI, 2.55 to 19.3; p = 0.0002; I2 = 0) and hospital death (RR, 2.72; 95% CI, 1.45 to 5.08; p = 0.002; I2 = 0). CONCLUSION: Completely thrombosed of the false lumen is more beneficial to the long-term survival of patients with aortic dissection. And the risk of aortic rupture and hospital death in patients with patent false lumen is 7 times and 3 times that of patients with complete thrombosed false lumen. It is expected to provide individualized medical care for different types of patients according to different false lumen status to minimize death and related complications.
Exploring the Common Gene Signatures Between Myocardial Infarction-Reperfusion Injury and the Gut Microbiome Using Bioinformatics.
Jiang X, Li C, Xia X … +3 more , Tong J, Cheng J, Li X
Heart Surg Forum · 2023 Oct · PMID 37920088 · Publisher ↗
BACKGROUND: This bioinformatics report attempts to explore the cross-talk genes, transcription factors (TFs), and pathways related to myocardial ischemia-reperfusion injury (MIRI) as well as the gut microbiome. METHOD: T...
BACKGROUND: This bioinformatics report attempts to explore the cross-talk genes, transcription factors (TFs), and pathways related to myocardial ischemia-reperfusion injury (MIRI) as well as the gut microbiome. METHOD: The datasets GSE61592 (three MIRI and three sham samples) and GSE160516 (twelve MIRI and four sham samples) were selected in the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) identification (p < 0.05 and |log FC (fold change)| ≥1) together with functional annotation (p < 0.05) was implemented. The Cytoscape platform established the protein-protein interaction (PPI) network. Genes associated with gut microbiome disorder were extracted based on the DisGeNET database, and those associated with MIRI were overlapped. The Recursive Feature Elimination (RFE) algorithm was adopted for selecting features, and cross-talk genes were predicted by the Support Vector Machine (SVM) models. A network encompassing cross-talk genes along with the TFs was thereby established. RESULT: The MIRI datasets comprised 138 shared DEGs, with 101 showing up-regulation whereas 37 showing down-regulation. Notably, the PPI interwork for MIRI contained 2517 edges along with 1818 nodes. By using RFE and SVM methods, six feature genes with the highest prediction were identified: B2m, VCAM-1, PDIA4, Ptgds, Mlxipl, and ACADS. Among these genes, B2m and PDIA4 were most highly expressed in MIRI and the gut microbiome disorder. CONCLUSION: B2m and PDIA4 were identified to be significantly correlated with candidate cross-talk genes of MIRI with gut microbiome disorder, implying a similarity between MIRI and Gut microbiome disorder (GMD). These genes can serve as an experimental research basis for future studies.
Modified Transannular Patching Palliation versus Modified Blalock-Taussig-Thomas Shunt in Infants with Severe Tetralogy of Fallot with Diminutive Pulmonary Arteries.
Han Y, Guo Y, Duan L … +4 more , Li T, Zhu H, Sun G, Gu C
Heart Surg Forum · 2023 Oct · PMID 37920087 · Publisher ↗
OBJECTIVE: The purpose of this study was to compare pulmonary arterial (PA) growth and morbidity, mortality, reintervention and complete repair rates after modified transannular patching palliation (mTAP) versus modified...
OBJECTIVE: The purpose of this study was to compare pulmonary arterial (PA) growth and morbidity, mortality, reintervention and complete repair rates after modified transannular patching palliation (mTAP) versus modified Blalock-Taussig-Thomas shunt (mBTS) for palliation in infants with severe tetralogy of Fallot (TOF) with diminutive pulmonary arteries. METHODS: This was a retrospective case review study of 107 patients (64 males) with severe TOF who underwent staged repair with either mTAP (n = 55) or mBTS (n = 52) over an 8-year period. Procedure-related PA growth and morbidity, mortality, reintervention and complete repair rates were compared. RESULTS: Two deaths occurred in the mBTS group due to sudden cardiac arrest, and five patients needed reintervention after the mBTS procedure because of shunt thrombosis or stenosis. Postoperative complications of mBTS included sudden cardiac arrest, shunt thrombosis/stenosis, vocal cord palsy and diaphragmatic palsy. Unlike in the mBTS group, no death, severe complications or reintervention occurred in the mTAP group. Oxygen saturations post mTAP and mBTS were significantly higher, which improved from 67.73 ± 4.36% to 94.33 ± 2.19% in the mTAP group and from 68.24 ± 3.87% to 86.87 ± 3.38% in the mBTS group. The increase in oxygen saturation and pulmonary artery growth (from pre- to post palliation) was significantly better with mTAP than with mBTS palliation (p < 0.01). All 55 patients showed complete repair after mTAP, and the time from palliation to complete repair was significantly shorter in the mTAP group. CONCLUSIONS: In a severe form of TOF with the hypoplastic PA tree, mTAP seems to be a better strategy that is safe and better facilitates satisfactory pulmonary arterial growth until complete repair than the mBTS procedure.
Application Effects of NNN-link Care Model in Patients with Coronary Heart Disease.
Duan W, Ren B
Heart Surg Forum · 2023 Oct · PMID 37920086 · Publisher ↗
OBJECTIVE: To investigate the effect of a NNN-linked care model applied in elderly patients with coronary heart disease. METHODS: A total of 120 elderly patients with coronary heart disease admitted to the hospital from...
OBJECTIVE: To investigate the effect of a NNN-linked care model applied in elderly patients with coronary heart disease. METHODS: A total of 120 elderly patients with coronary heart disease admitted to the hospital from January, 2023 to May, 2023 were randomly divided into two groups of 60 cases respectively. The control group received routine intervention, and the observation group received the NNN-linked care model. Changes in cardiac function, the ability for self-care, and quality of life were recorded between the groups before and after the intervention. RESULTS: Indices of cardiac function in the observation group were higher than those of the control group after 3 weeks (p < 0.05). Compared with the control group, the total score for the ability for self-care and the scores of each dimension of the observation group were higher after 3 weeks of intervention (p < 0.05). The scores of quality of life of the observation group were higher in comparison with the control group after 3 weeks of intervention (p < 0.05). CONCLUSION: The application of the NNN-linked care model to elderly patients with coronary heart disease can improve the ability for self-care, increase cardiac function and improve the quality of life.
Application Effect of Multi-Dimension Nursing Combined with GRACE Scoring System in Patients with Atrial Fibrillation after Green Precision Catheter Radiofrequency Ablation.
Duan W, Baojun Ren
Heart Surg Forum · 2023 Oct · PMID 37920085 · Publisher ↗
OBJECTIVE: To explore the application effect of multi-dimensional nursing combined with the Global Registry of Acute Events (GRACE) scoring system in the nursing of patients with atrial fibrillation after radiofrequency...
OBJECTIVE: To explore the application effect of multi-dimensional nursing combined with the Global Registry of Acute Events (GRACE) scoring system in the nursing of patients with atrial fibrillation after radiofrequency ablation with green precision catheter radiofrequency ablation. METHODS: A total of 274 patients diagnosed with atrial fibrillation undergoing green precision catheter radiofrequency ablation were collected from the Department of Cardiology at our hospital in a retrospective study. After the inclusion, exclusion, diagnostic criteria and physical examination, all the subjects underwent green precision catheter radiofrequency ablation. According to various nursing methods that were adopted, they were divided into two groups with 7-14 days of nursing intervention by digital randomization: the study group (multi-dimensional nursing combined with GRACE scoring system evaluation, n = 136 cases) and the control group (postoperative routine nursing, n = 138 cases). The MOS item short from health survey (SF-36) score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, complication rates and the nursing quality of the two groups were observed. RESULTS: After multi-dimensional nursing combined with the GRACE in-hospital scoring system for stratified nursing in the study group, SF-36 scores in both groups increased after conventional nursing in the control group, but there was a statistical difference between the study group and the control group (p < 0.05). HAMA score and HAMD score decreased, and there were statistical differences between the study group and the control group (p < 0.05). The comparison between the study group and the control group showed that "Cardiac tamponade", "Atrioventricular block", "Peripheral vascular injury" and the total incidence of complications were statistically different (p < 0.05). The basic satisfaction, number of satisfaction and total satisfaction rate of the study group were higher than those of the control group, and the difference was statistically significant (p < 0.05). CONCLUSIONS: Multi-dimensional nursing combined with the GRACE scoring system in the nursing care of patients with atrial fibrillation after radiofrequency ablation with the green precision catheter, improves the quality of life, alleviates negative emotions, reduces the incidence of complications, and results in better quality of nursing care.
Bilateral Pectoralis Major Muscle Flaps in Treating Deep Sternal Wound Infection following CABG in Diabetic Patients: Two Case Reports.
Liu Z, Hu Y, Cheng X … +3 more , Wu N, Yang T, Wang X
Heart Surg Forum · 2023 Sep · PMID 37920084 · Publisher ↗
Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac operations, especially after coronary artery bypass grafting (CABG) in diabetic patients. Bilateral pectoralis major muscle flaps have...
Deep sternal wound infection (DSWI) is a life-threatening complication after cardiac operations, especially after coronary artery bypass grafting (CABG) in diabetic patients. Bilateral pectoralis major muscle flaps have been performed to treat DSWI. Two diabetic patients suffering from DSWI after CABG were treated by bilateral pectoralis major muscle flaps in our hospital. Both patients were discharged with full recovery. Satisfactory results can be obtained with bilateral pectoralis major muscle flaps following tissue debridement and drainage. This procedure should be performed when DSWI occurs in diabetic patients after CABG.
Research and Prediction of Factors Related to High Degree Atrioventricular Block after TAVI Surgery Based on Logistic Regression Model.
Hu P, Lin N, Wu Z
Heart Surg Forum · 2023 Oct · PMID 37920083 · Publisher ↗
OBJECTIVE: Based on the logistic regression model, analyze the risk factors for high degree atrioventricular block after transcatheter aortic valve replacement (TAVI) surgery and further analyze its predictive value. MET...
OBJECTIVE: Based on the logistic regression model, analyze the risk factors for high degree atrioventricular block after transcatheter aortic valve replacement (TAVI) surgery and further analyze its predictive value. METHODS: 402 patients who underwent TAVI surgery at Henan Thoracic Hospital for "aortic stenosis" between January 2020 and January 2023 were selected as the study subjects. The study subjects were divided into A group (N = 89) and B group (N = 313) based on whether high degree atrioventricular block occurred after surgery. The age, biochemistry and other general data of patients were systematically collected through inpatient cases, and the preoperative Right bundle branch block, I degree atrioventricular block, QRS duration, and indoor block were collected through our hospital's electrocardiogram (ECG) system, Calcification integral of Aortic valve was calculated by computed tomography (CT) results. Logistic regression analysis was performed on the clinical data, and the predictive value of related factors was further analyzed through the Receiver operating characteristic. RESULTS: The preoperative QRS wave duration in the A group (165.06 ± 61.25) was significantly higher than that in the B group (108.30 ± 16.30), and the difference was statistically significant (p < 0.05). Compared with the B group, the incidence of Right bundle branch block in the A group was significantly higher before operation. The calcification score of Aortic valve in the A group (97.58 ± 61.25) was significantly higher than that in the B group (43.59 ± 7.56), with a statistically significant difference (p < 0.05). Further multivariate logistic regression analysis showed that the duration of QRS wave before operation and Aortic valve calcification score were independent risk factors for high atrioventricular block after TAVI (p < 0.05). Through Receiver operating characteristic analysis, it was found that preoperative QRS wave duration and Aortic valve calcification score had a high predictive value for the occurrence of high atrioventricular block after TAVI. The optimal cutoff value of QRS wave duration for predicting high atrioventricular block was 152, area under curve (AUC): 0.780 (95% CI: 0.718-0.841, p < 0.001). The optimal cutoff value for predicting high degree atrioventricular block with aortic calcification score is 61.5, AUC: 0.997 (95% CI: 0.992-1.000, p < 0.001). CONCLUSIONS: Preoperative QRS wave duration and Aortic valve calcification score are independent risk factors for high degree atrioventricular block after TAVI, and they have high predictive value. In clinical work, risk factors should be found early and responded in time.
A Review of Advances in the Surgical Treatment of Coronary Heart Disease and Lung Cancer.
Hong Y, Wei S, Tang M … +1 more , Liu W
Heart Surg Forum · 2023 Oct · PMID 37920082 · Publisher ↗
Lung cancer is currently the most prevalent and fatal malignant tumor in China. Additionally, the incidence of coronary heart disease is steadily increasing. Both diseases exhibit a higher risk of mortality with age, par...
Lung cancer is currently the most prevalent and fatal malignant tumor in China. Additionally, the incidence of coronary heart disease is steadily increasing. Both diseases exhibit a higher risk of mortality with age, particularly among elderly patients. Moreover, these diseases are interconnected and share common risk factors. However, the treatment options for patients suffering from both lung cancer and coronary heart disease lack clarity and standardized criteria. This article critically examines the literature on surgical interventions for patients with lung cancer complicated by coronary artery disease during the period from January 2021 to December 2022. It summarizes the safety and effectiveness of these interventions and highlights the various surgical options available for different patient profiles.
Efficacy and Safety of Distal Radial Artery Approach for Coronary Angiography: A Retrospective Study.
Chen J, Li W, Huang L … +1 more , Zhou L
Heart Surg Forum · 2023 Oct · PMID 37920081 · Publisher ↗
BACKGROUND: The distal radial artery approach has been employed as a potential alternative technique for coronary angiography. Nevertheless, its clinical implementation is significantly constrained by the narrow diameter...
BACKGROUND: The distal radial artery approach has been employed as a potential alternative technique for coronary angiography. Nevertheless, its clinical implementation is significantly constrained by the narrow diameter of the radial artery. A comprehensive investigation of the efficacy and safety of the distal radial artery approach for coronary angiography is lacking. The objective of this study is to investigate the impact of the distal radial artery approach for coronary angiography and transradial artery access for interventional diagnosis and treatment. In addition, the effectiveness and safety of the distal radial artery approach for coronary artery angiography will be analyzed, for the wider adoption of this technique in clinical practice. METHODS: A total of 68 patients with coronary heart disease (CHD) who underwent coronary catheterization via the left distal radial artery approach from December 2020 to December 2022 using the Distal radial artery approach (TRA) comprised the case-control study group. Seventy-three CHD patients who underwent routine left Transradial Artery Access coronary catheterization were selected as the Regular TRA group during the same period. Clinical data including age, body mass index (BMI), gender, CHD risk factors, routine drug treatment, ultrasonic-related indicators and operation-related indicators were collected from electronic medical records and the catheterization database from the two groups of patients. RESULTS: The diameter and Endothelium-dependent vasodilation (noe FMD) of puncture vessels in the Distal TRA group were significantly lower than those in the Regular radial artery approach (TRA) group (p-value < 0.05). After a period of 48 hours following the catheterization, the puncture vessel diameter and flow-mediated dilation (FMD) of the Distal TRA group were significantly lower compared to those of the Regular TRA group (p-value < 0.05). The effectiveness of transradial artery access was then compared between the two groups. It was determined that the Distal TRA group exhibited significantly higher values in terms of the Visual Analog Scale (VAS) score, puncture time, and heparin usage, in comparison to the Regular TRA group (p-value < 0.05). The occurrence rates of local hematoma, mediastinal hematoma, retroperitoneal hematoma, pseudoaneurysm, arteriovenous fistula, vagal reflex, vasospasm, blood transfusion, and other complications among patients in the Distal TRA group were comparable to those in the Regular TRA group (p-value > 0.05). The incidence of puncture and X-ray radiation in the Distal TRA group was found to be marginally higher compared to the Regular TRA group. This study suggests that the safety profile of patients undergoing coronary artery catheterization via the distal radial artery is relatively higher than those undergoing the procedure via the transradial artery, although the difference was not statistically significant (p-value > 0.05). CONCLUSIONS: The Distal radial artery approach can be used for conducting comprehensive coronary interventional diagnosis and treatment procedures, offering benefits such as reduced postoperative compression time, better hemostasis through the distal radial artery approach, and enhanced patient comfort. This approach demonstrates favorable efficacy and safety, making it a suitable routine puncture method for clinical treatment.
Expression of m6A Regulator Genes can Facilitate the Diagnosis of Chronic Heart Failure.
Zhou F, Yu Y, Li Y … +6 more , Chen J, Wen S, Liu N, Li X, Bai R, Yan W
Heart Surg Forum · 2023 Oct · PMID 37920080 · Publisher ↗
BACKGROUND: RNA N6-methyladenosine (m6A) is the most common type of modification in eukaryotic mRNA. The relationship between m6A modification and disease has been studied extensively, but there have been few studies on...
BACKGROUND: RNA N6-methyladenosine (m6A) is the most common type of modification in eukaryotic mRNA. The relationship between m6A modification and disease has been studied extensively, but there have been few studies on chronic heart failure (CHF). This study investigated a possible role for m6A in the diagnosis of CHF. METHODS: Seven candidate m6A regulators (writers: WTAP and ZC3H13; readers: YTHDF3, FMR1, IGFBP1, and ELAVL1; eraser: FTO) were identified using a random forest (RF) model and the GSE5406 dataset from the Gene Expression Omnibus database. A nomogram model was developed to predict the risk of CHF, while consensus clustering methodology assigned CHF samples into two m6A patterns (cluster A and cluster B) according to the 7 candidate m6A regulators. Principal component analysis was used to calculate an m6A score for each sample and to quantify m6A patterns. RESULTS: Decision curve analysis and the nomogram model were used to obtain predictions that may be of clinical use. Patients in cluster B had higher m6A scores than patients in cluster A. Cluster B patients also had higher expression levels (ELs) of IL-4, IL-5, IL-10 and IL-13 than patients in cluster A, whereas cluster A patients had a higher EL for IL-33. The m6A cluster B pattern likely represents the ischemic heart failure (HF) disease group. CONCLUSION: m6A regulators are important in the pathogenesis of CHF associated with ischemic and idiopathic dilated cardiomyopathy, and may prove useful for the diagnosis and treatment of CHF.
A Rare Case of an Adult Pregnant Patient with the Left Coronary Artery Originating from the Pulmonary Artery: Successful Management and Healthy Maternal-Fetal Outcome.
Wang H, Liang Z, Zhang G … +2 more , Fang H, Li D
Heart Surg Forum · 2023 Sep · PMID 37920079 · Publisher ↗
An anomalous left coronary artery originating from the pulmonary artery (ALCAPA) refers to the abnormal origin of the left coronary artery either from the main pulmonary artery, pulmonary artery sinus, or the left and ri...
An anomalous left coronary artery originating from the pulmonary artery (ALCAPA) refers to the abnormal origin of the left coronary artery either from the main pulmonary artery, pulmonary artery sinus, or the left and right pulmonary arteries, with the main pulmonary artery or pulmonary artery sinus being the most common sites. If not diagnosed and treated promptly, this condition can result in death within the first year of life in 90% of patients. Asymptomatic children can survive into adulthood, but they are at a high risk of sudden death. In this article, we report a case of a 24-year-old pregnant woman who was diagnosed with ALCAPA during prenatal examination. The pregnancy was successfully maintained until 36 weeks, after which a cesarean section was performed. The patient was then admitted to the cardiac surgery department to improve cardiac function, and six weeks later, a successful left coronary artery transplantation was performed. The patient was discharged and followed up for three months, during which her condition remained stable.
Meta-Analysis of the Efficacy of Levosimendan in the Treatment of Severe Sepsis Complicated with Septic Cardiomyopathy.
Guan Q, Zhang C, Li B … +4 more , Huang D, Li A, Qin J, Zhang X
Heart Surg Forum · 2023 Oct · PMID 37920078 · Publisher ↗
INTRODUCTION: Sepsis is a medical condition characterized by acute organ dysfunction and uncontrolled inflammation. Organ dysfunction in sepsis is the primary cause of mortality in patients with myocardial dysfunction. L...
INTRODUCTION: Sepsis is a medical condition characterized by acute organ dysfunction and uncontrolled inflammation. Organ dysfunction in sepsis is the primary cause of mortality in patients with myocardial dysfunction. Levosimendan is a vasodilating and inotropic agent used in patients with acute heart failure and has resulted in decreased morbidity and mortality in these patients. Our main objective is to examine levosimendan's efficacy in treating severe sepsis complicated with septic cardiomyopathy. METHODS: We systematically searched five databases, PubMed, Web of Science, Embase, Cochrane Library and BioMed Central, for articles and publications from their inception to 2023. Our study adopted the PICOS approach in identifying suitable publications during the systematic search. Inclusion criteria included randomized, controlled trials utilizing levosimendan in adult patients diagnosed with septic shock or severe sepsis. We excluded non-English publications and non-randomized controlled trials. The Newcastle-Ottawa scale (NOS) scale was used to assess the methodological quality, while the risk of bias was assessed through the Cochrane Risk of bias tool. All statistical analyses were performed using RevMan version 5.4. RESULTS: Eight studies met the eligibility criteria and were included in the analysis. There was a statistically significant positive effect on cardiac input in patients treated with levosimendan compared to those treated with dobutamine (p < 0.001). Similarly, there were positive effects on left ventricular ejection fraction (LVEF) (p < 0.001) and left ventricular stroke work index (LVSWI) (p < 0.001). We observed a significant reduction in mortality (p < 0.01) and serum levels of lactic acid (p < 0.01). DISCUSSION: Levosimendan is a calcium sensitizer associated with an influx of calcium ions and activation of ATP-dependent potassium channels that increases myocardial contractility contractions, enhances vasodilation and improves oxygen supply to the cells and tissues. CONCLUSION: Levosimendan is highly efficacious and safe in the management of sepsis and sepsis-induced cardiomyopathy.
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