The Heart Surgery Forum[JOURNAL]
Sun
200 papers
Monocyte to Lymphocyte Ratio, A Novel Predictor of Acute Kidney Injury After Cardiac Valve Surgery.
Wang Z, Li J, Song H … +2 more , Wei D, Zhao X
Heart Surg Forum · 2022 Dec · PMID 36602501 · Publisher ↗
BACKGROUND: Although inflammation contributes to the development of acute kidney injury (AKI), the role of monocyte to lymphocyte ratio (MLR) in predicting the risk of postoperative AKI in patients underwent cardiac surg...
BACKGROUND: Although inflammation contributes to the development of acute kidney injury (AKI), the role of monocyte to lymphocyte ratio (MLR) in predicting the risk of postoperative AKI in patients underwent cardiac surgery is not completely clear yet. This study aimed to investigate whether elevated MLR predicts postoperative AKI. MATERIALS AND METHODS: In this retrospective study, a total of 331 adult patients who underwent heart valve replacement were included. These patients are not distinguished between single valve replacement or double valve replacement. AKI was diagnosed, according to the KDIGO classification criteria. The associations between monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and the occurrence of AKI were investigated. RESULTS: Postoperative AKI was detected in 37 (11.2%) patients. In the early period after surgery, the patients who developed AKI had a significant higher preoperative MLR than those who did not (0.38(0.33-0.44) vs. 0.26(0.20-0.34), = 0.02). The receiver operating characteristics (ROC) curve showed that the area under the curve (AUC) of the MLR for predicting AKI was 0.772 (P = 0.01), and the cut-off value was 0.47. Multivariate logistic regression analysis suggested that the higher preoperative MLR (≥0.47) was independent predictor of AKI (OR: 2.951, 95% CI: 1.412-6.167, P = 0.004). According to the cut-off value group verification, patients in the higher preoperative MLR group are more likely to have low cardiac output syndrome (LCOS), renal replacement therapy, and hospital death after surgery. CONCLUSION: These results showed that MLR could be used as a cost-effective predictor of postoperative AKI in patients who undergo heart valve replacement surgery.
Random Forest-Based Prediction of Acute Respiratory Distress Syndrome in Patients Undergoing Cardiac Surgery.
Wang W, Li L, Gu H … +3 more , Chen Y, Zhen Y, Dong Z
Heart Surg Forum · 2022 Dec · PMID 36602500 · Publisher ↗
BACKGROUND: To develop a machine learning-based model for predicting the risk of acute respiratory distress syndrome (ARDS) after cardiac surgery. METHODS: Data were collected from 1011 patients, who underwent cardiac su...
BACKGROUND: To develop a machine learning-based model for predicting the risk of acute respiratory distress syndrome (ARDS) after cardiac surgery. METHODS: Data were collected from 1011 patients, who underwent cardiac surgery between February 2018 and September 2019. We developed a predictive model on ARDS by using the random forest algorithm of machine learning. The discrimination of the model was then shown by the area under the curve (AUC) of the receiver operating characteristic curve. Internal validation was performed by using a 5-fold cross-validation technique, so as to evaluate and optimize the predictive model. Model visualization was performed to reveal the most influential features during the model output. RESULTS: Of the 1011 patients included in the study, 53 (5.24%) suffered ARDS episodes during the first postoperative week. This random forest distinguished ARDS patients from non-ARDS patients with an AUC of 0.932 (95% CI=0.896-0.968) in the training set and 0.864 (95% CI=0.718-0.997) in the final test set. The top 10 variables in the random forest were cardiopulmonary bypass time, transfusion red blood cell, age, EuroSCORE II score, albumin, hemoglobin, operation time, serum creatinine, diabetes, and type of surgery. CONCLUSION: Our findings suggest that machine learning algorithm is highly effective in predicting ARDS in patients undergoing cardiac surgery. The successful application of the generated random forest may guide clinical decision-making and aid in improving the long-term prognosis of patients.
The White Coat Ceremony: Welcome to the Medical Profession.
Ely S, Tribble C
Heart Surg Forum · 2022 Dec · PMID 36602499 · Publisher ↗
We have written about a number of the transitions, or 'lurches,' that most of us in medicine encounter as we move through the various stages of education and training in our profession. Some of our prior musings have add...
We have written about a number of the transitions, or 'lurches,' that most of us in medicine encounter as we move through the various stages of education and training in our profession. Some of our prior musings have addressed the transition into a Surgery Clerkship or a Surgery externship in the third or fourth years of medical school, respectively, as well as transitions into internship, the senior years of a Surgery residency, and a new job after completing Thoracic Surgery training. [Tribble: 2019, 2021, 2018, 2021, 2022].
Helping Applicants Write Their Way into a Surgical Residency.
Tribble C
Heart Surg Forum · 2022 Nov · PMID 36602402 · Publisher ↗
So, you've got students clamoring for help writing their personal statements for Surgery Residency applications? Writing a personal statement for an application to a residency program is often one of the most daunting as...
So, you've got students clamoring for help writing their personal statements for Surgery Residency applications? Writing a personal statement for an application to a residency program is often one of the most daunting aspects of the application process. In fact, it is probably the most daunting part of that process. However, there is a surprising paucity of information about how best to approach writing these residency application essays, in stark contrast to the plentiful advice available for other types of applications, such as those required for college or medical school admission.
Unplanned Return to Cardiac Intensive Care Unit of Children After Congenital Heart Surgery: Incidence, Outcomes, and Risk Factors.
Lin ZW, Lin WH, Lin SH … +2 more , Chen Q, Cao H
Heart Surg Forum · 2022 Nov · PMID 36602401 · Publisher ↗
OBJECTIVE: Factors leading to an unplanned return to the cardiac intensive care unit (CICU) in children after congenital heart disease and their impact on mortality have not been well characterized. We sought to determin...
OBJECTIVE: Factors leading to an unplanned return to the cardiac intensive care unit (CICU) in children after congenital heart disease and their impact on mortality have not been well characterized. We sought to determine the incidence and outcomes of unplanned return to the CICU. A secondary objective was to identify risk factors. METHODS: Retrospective analysis of the registration data collected by our unit. The study subjects included postoperative patients with congenital heart disease who survived to initial transfer out of the CICU. Patients who unexpectedly returned to the CICU due to an acute change in clinical status were defined as unplanned returns. Demographic, preoperative, intraoperative, and postoperative variables were assessed. Univariate comparisons were performed between the return group and non-return group, and multivariate regression analysis was performed to identify potential risk factors for unplanned return to the CICU. RESULTS: Of the 531 children who met the inclusion criteria, 29 were unplanned returns to the CICU. Respiratory symptoms (41.4%) and cardiac symptoms (44.8%) were the most common reasons for returning to the CICU. Patients with unplanned returns had a higher mortality rate (13.8% vs. 0.56%, P < 0.01). In multivariate analysis, unplanned CICU admission was associated with chromosomal abnormalities (P < 0.01), longer ventilator duration (P < 0.01), and more prolonged cardiopulmonary bypass (P < 0.01) was associated with a return to independence. CONCLUSIONS: Unplanned return to the CICU during the same hospital stay was uncommon but associated with higher mortality. Chromosomal abnormalities, longer ventilator use duration, and prolonged CPB were significant risk factors for the entire cohort. We hope to minimize the impact of unplanned return after congenital heart disease surgery by changing the process of transferring these high-risk postoperative patients out of the CICU and early postoperative care.
Incomplete Pericardial Dissection, Fluid Overload, Delayed Diagnosis And Treatment, And Tuberculosis Pericarditis Are Associated With Low Cardiac Output Syndrome Following Pericardiectomy.
Huang JB, Wen ZK, Yang JR … +5 more , Li JJ, Li M, Lu CC, Liang DY, Wei CX
Heart Surg Forum · 2022 Nov · PMID 36602399 · Publisher ↗
BACKGROUND: We aimed to investigate risk factors of LCOS following pericardiectomy. METHODS: This was a retrospective study of patients undergoing pericardiectomy at three hospitals between January 1994 and May 2021. RES...
BACKGROUND: We aimed to investigate risk factors of LCOS following pericardiectomy. METHODS: This was a retrospective study of patients undergoing pericardiectomy at three hospitals between January 1994 and May 2021. RESULTS: A total of 826 patients were divided into two groups: group with LCOS (N = 126) and group without LCOS (N = 700). The incidence of postoperative LCOS was 15.3%. There were 66 operative deaths (8.0%). Univariable and multivariable analyses showed that factors are associated with LCOS, including postoperative LVEDD (P < 0.001), preoperative LVEDD (P < 0.001), time between symptoms and surgery (P < 0.001), thickness of pericardium (P < 0.001), intubation time (P = 0.002), hospitalized time postoperative (P < 0.001), preoperative central venous pressure (P = 0.016), postoperative central venous pressure (P = 0.034), D0 fluid balance (P = 0.019), D2 fluid balance (P = 0.017), postoperative chest drainage (P < 0.001), surgical duration (P < 0.001), bleeding during operation (P = 0.001), serum creatinine 24h after surgery (P < 0.001), serum creatinine 48h after surgery (P = 0.017), fresh-frozen plasma (P = 0.005), packed red cells (P = 0.006), and tuberculosis pericarditis (P = 0.026). CONCLUSION: In our study, incomplete pericardial dissection, fluid overload, delayed diagnosis and treatment, and tuberculosis pericarditis are associated with LCOS following pericardiectomy.
Predictive Efficacy of the Index of Microcirculatory Resistance for Acute Allograft Rejection and Cardiac Events After Heart Transplantation: A Systematic Review and Meta-Analysis.
Lu Z, Song G, Bai X
Heart Surg Forum · 2022 Nov · PMID 36602397 · Publisher ↗
BACKGROUND: In patients treated by heart transplantation, the index of microcirculatory resistance (IMR) has been found to have predictive potential for subsequent acute allograft rejection (AAR) and long-time cardiac ev...
BACKGROUND: In patients treated by heart transplantation, the index of microcirculatory resistance (IMR) has been found to have predictive potential for subsequent acute allograft rejection (AAR) and long-time cardiac events. When consulting related literature, the studies mostly were single-center with small sample sizes. The question of whether IMR can be utilized as a predictive biomarker is becoming increasingly contentious. To confirm the predictive efficacy of IMR, researchers did a systematic review and meta-analysis. METHOD: From inception to April 2022, PubMed, EMBASE, Cochrane Library, Web of Science, Ovid, ProQuest, and Scopus systematically were searched. The results were presented as pooled ratio rate (RR) with 95% confidence intervals (CI). Assessment of the quality, heterogeneity analyses, and publication bias analysis also were performed. RESULTS: A total of 616 patients were studied in five trials. There were significant differences in subsequent AAR (RR = 4.08; 95% CI: 2.69~6.17; P = 0.000) or long-time cardiac events (RR=2.14; 95% CI: 1.44~3.19; P = 0.000) between IMR-high and IMR-low patients in the forest plots. Patients treated with heart transplantation in the high IMR group had better predictive efficacy than the low IMR group. CONCLUSIONS: High IMR could predict the events of subsequent AAR and cardiac events after heart transplantation. This will help reduce the occurrence of adverse events and personalize treatment for patients.
Analysis of Influencing Factors of Surgical Options for Coronary Atherosclerotic Heart Disease Complicated with Moderate Ischemic Mitral Regurgitation.
Lu Z, Bai X, Song G
Heart Surg Forum · 2022 Nov · PMID 36602396 · Publisher ↗
BACKGROUND: There are several controversies regarding the surgical approach for patients with coronary atherosclerotic heart disease (CAHD) complicated with moderate ischemic mitral regurgitation (IMR). METHODS: A retros...
BACKGROUND: There are several controversies regarding the surgical approach for patients with coronary atherosclerotic heart disease (CAHD) complicated with moderate ischemic mitral regurgitation (IMR). METHODS: A retrospective study was performed among 115 patients divided into two groups. Clinical and echocardiographic parameters, including perioperative indexes and follow ups, degree of stenosis in the coronary arteries, and cardiac function index, were analyzed. Patients who died in the hospital due to complications during the perioperative period were defined as the deterioration group (deterioration of coronary artery bypass grafting, CABG vs. deterioration of coronary artery bypass grafting combined with mitral valve surgery, CABG+MVS: N = 7, 58.3% vs. N = 5, 41.7%), whereas the remaining patients were defined as the rehabilitation group (rehabilitation of CABG vs. rehabilitation of CABG+MVS: N = 52, 50.5% vs. N = 51, 49.5%). Data were compared between the rehabilitation of the CABG and CABG+MVS groups to explore the predictors for surgical method selection. RESULTS: Postoperative patients who died during hospitalization were excluded (N = 12). At 1-year follow up, there were 52 patients in the CABG rehabilitation group and 51 in the CABG+MVS rehabilitation group. During the follow-up period, 10 patients died (rehabilitation of CABG vs. rehabilitation of CABG+MVS: N = 7, 13.7% vs. N = 3, 5.8%). Nevertheless, the difference was not statistically significant. The logistic regression analysis identified four independent factors when choosing the surgical modality: prior-myocardial infarction (prior-MI), preoperative atrial fibrillation (pre-AF), and the stenotic degree of the left circumflex (LCX) and left main (LM) arteries. CONCLUSIONS: Prior-MI, pre-AF, and the degree of stenosis in LCX and LM could influence the choice of surgical method. This study provided new insights into the treatment of CAHD with moderate IMR.
Right Sinus of Valsalva Aneurysm and Dissection into the Interventricular Septum: A Case Report.
Ma N, Mou X, Yuan H … +2 more , Lai Y, Jiang B
Heart Surg Forum · 2022 Nov · PMID 36602392 · Publisher ↗
Sinus of Valsalva aneurysm (SVA) is considered to be an uncommon cardiac anomaly, carrying a very high rate of mortality. After treatment, the prognosis is excellent. Thus, it is important to make a timely diagnosis and...
Sinus of Valsalva aneurysm (SVA) is considered to be an uncommon cardiac anomaly, carrying a very high rate of mortality. After treatment, the prognosis is excellent. Thus, it is important to make a timely diagnosis and clarify the anatomical details of the SVA. Here, we report a right SVA with dissection into the interventricular septum, with bulging and incomplete rupture into the left outflow tract. The SVA was evaluated using echocardiography (transoesophageal, transthoracic, and three-dimensional echocardiography) and cardiac computed tomography (CT), especially three-dimensional reconstruction, to help us plan the surgical approach. After surgery, the patient's recovery was favorable.
Surgical Resection of Primary Cardiac Cavernous Hemangioma: A Case Report.
Wen Y, Ren S, Yan Q … +1 more , Ma G
Heart Surg Forum · 2022 Nov · PMID 36602391 · Publisher ↗
Cardiac tumors are rare. They were found in only 0.001%-0.300% of cases in a relatively recently reported autopsy series. Among cardiac tumors, primary hemangioma accounted for approximately 2.8% of all primary resected...
Cardiac tumors are rare. They were found in only 0.001%-0.300% of cases in a relatively recently reported autopsy series. Among cardiac tumors, primary hemangioma accounted for approximately 2.8% of all primary resected tumors, indicating this is a particularly rare benign neoplasm. We present a patient with a 5×3×2 cm cavernous hemangioma, arising from the right atrial roof and occupying the atrial septum and inseparable from the aortic root. We successfully accomplished a complete surgical resection of a cardiac cavernous hemangioma and reconstructed the cardiac atrium by a bovine pericardial patch.
A Partial Clamp During Off-Pump Coronary Artery Bypass Grafting Can be Safely Used When Utilizing the Calcium Score with Computed Tomography For Evaluating The Ascending Aorta.
Yoshihiro G, Takagi S, Yanagisawa J … +1 more , Nakasu A
Heart Surg Forum · 2022 Nov · PMID 36602388 · Publisher ↗
BACKGROUND: No previous study has shown that the volume of calcium score is useful for evaluating the aorta when performing a partial clamp (PC). The purpose of this study was to examine the effect of different clamping...
BACKGROUND: No previous study has shown that the volume of calcium score is useful for evaluating the aorta when performing a partial clamp (PC). The purpose of this study was to examine the effect of different clamping strategies during off-pump coronary artery bypass grafting (OPCAB), in terms of the incidence of postoperative stroke using the calcium score of the ascending aorta. METHODS: We retrospectively reviewed 339 patients, who underwent isolated OPCAB between August 2013 and March 2021. There were two groups of patients, depending on the procedure. A PC was used for proximal anastomoses in 130 (38.3%) patients. A clampless proximal facilitating anastomotic device (CFD) was used in 107 (31.5%) patients. We prescribed preoperative CT for all patients, and the Agatston score was used. RESULTS: The calcium score significantly was higher in the CFD group than in the PC group (29.7 ± 66.5 vs. 1819.8 ± 2391.5, < 0.001). The number of distal anastomoses and operative time were not significantly different between the two groups. There was no mortality and three strokes occurred at the 30-day follow up. Two strokes occurred in the PC group (1.5%) and one in the CFD group (0.9%), which was not significantly different (P = 0.98). CONCLUSION: A PC does not increase postoperative stroke incidence compared with a CFD, when utilizing calcium score evaluation in OPCAB.
The Efficacy of Nitrite Therapy for the Treatment of Heart Failure: A Meta-Analysis of Randomized Controlled Trials.
Zhou Q, Zhang Q, Xu H
Heart Surg Forum · 2022 Oct · PMID 36317919 · Publisher ↗
INTRODUCTION: The efficacy of nitrite therapy for the treatment of heart failure remains controversial. We conducted a systematic review and meta-analysis to explore the impact of nitrite therapy on heart failure. METHOD...
INTRODUCTION: The efficacy of nitrite therapy for the treatment of heart failure remains controversial. We conducted a systematic review and meta-analysis to explore the impact of nitrite therapy on heart failure. METHODS: We searched the PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through November 2019 for randomized controlled trials (RCTs) assessing the effect of nitrite therapy on heart failure. This meta-analysis was performed using the random-effect model. RESULTS: Three RCTs are included in the meta-analysis. Overall, compared with the control group for heart failure, nitrite therapy is associated with significantly reduced PCWP (Std. MD=-1.22; 95% CI=-1.81 to -0.63; P < 0.0001) and improved PAC (Std. MD=0.71; 95% CI=0.16 to 1.27; P = 0.01), but reveals no substantial influence on peak VO2 (Std. MD=-0.19; 95% CI=-0.49 to 0.11; P = 0.21), systolic BP (Std. MD=-3.98; 95% CI=-8.24 to 0.28; P = 0.07), mean BP (Std. MD=-1.53; 95% CI=-3.37 to 0.31; P = 0.10), or heart rate (Std. MD=0.40; 95% CI=-0.14 to 0.94; P = 0.15). CONCLUSIONS: Nitrite therapy may show some benefits to heart failure.
Is Surgery the Only Fate of the Patient with Leriche Syndrome? Our Endovascular Therapy Results Early Follow-Up Outcomes.
Beyaz MO, Urfalı S, Kaya S … +2 more , Oruç D, Fansa İ
Heart Surg Forum · 2022 Oct · PMID 36317918 · Publisher ↗
AIM: In this research, we aimed to present early follow-up results of the endovascular treatment in patients with Leriche syndrome at our single center. METHODS AND MATERIALS: Between October 2020 and January 2022, 14 pa...
AIM: In this research, we aimed to present early follow-up results of the endovascular treatment in patients with Leriche syndrome at our single center. METHODS AND MATERIALS: Between October 2020 and January 2022, 14 patients with Leriche syndrome (12 men, two women) who underwent endovascular treatment at our center retrospectively were evaluated. Before the treatment, the ankle-brachial index (ABI) was found 0.50 ± 0.11 on the right leg and 0.45 ± 0.09 on the left leg. RESULTS: All of the patients with Leriche syndrome applied to our clinic for the first time. In five patients, the fully occluded lesion length was over 3 cm (ranging between 3.5-7.2 cm), hence they were treated with aortic and bilateral iliac bare metallic stents. Although in one patient, the aortic occluding lesion was below 3 cm; it was treated with a bare aortic and bilateral bare iliac stent application because the lesion in the aorta was too calcific. In eight patients, the lesion length was less than 3 cm, bilateral iliac metal bare stents were applied in a kissing stent way. CONCLUSION: Endovascular therapy for chronic aorto-iliac occlusive disease has an early high technical success with primary and secondary patency rates. Especially in patients with high risk factors, it may be considered as a good alternative to conventional surgery.
Early Clinical Outcomes of Thoracoscopic Mitral Valvuloplasty: The First 90 Cases.
Lin XF, Xu Z, Zheng ZH … +2 more , Wang T, Dai XF
Heart Surg Forum · 2022 Sep · PMID 36317917 · Publisher ↗
BACKGROUND: We reported 90 cases of thoracoscopic mitral valvuloplasty in its early stages and sought to analyze early clinical outcomes. METHODS: Ninety consecutive patients, who underwent thoracoscopic mitral valvulopl...
BACKGROUND: We reported 90 cases of thoracoscopic mitral valvuloplasty in its early stages and sought to analyze early clinical outcomes. METHODS: Ninety consecutive patients, who underwent thoracoscopic mitral valvuloplasty at our institute between April 2020 and December 2021, were assessed for outcomes. Clinical data, including baseline characteristics, operative data, postoperative data, and early follow-up results, were collected. The early clinical outcomes were used to assess the reliability and efficiency of this technique. RESULTS: No in-hospital death occurred. One patient underwent a median sternotomy for bleeding. Intraoperative transesophageal echocardiography revealed no mitral regurgitation in 82 patients and mitral regurgitation of 0-2 cm2 in six. The remaining two patients with mitral regurgitation >2 cm2 experienced serious systolic anterior motion but underwent successful re-valvuloplasty during a second pump-up. the mean cardiopulmonary bypass time was 177.1±54.8 min and aortic clamping time, 114.0±44.9 min. Each patient received a prosthetic ring (CG Future™), and 64 patients received artificial chordae with an average of 2.7±1.5 (ranging from 1 to 6) pairs. The mean follow up was 8.8±7.0 (range, 1-22 months), while two patients were lost to follow up. Recurrent severe mitral regurgitation was observed in one patient three months after the operation, and mitral valve replacement was performed via median sternotomy. During follow up, one patient died of upper respiratory tract infection, and one suffered from low cardiac output. CONCLUSIONS: Thoracoscopic mitral valvuloplasty is safe and effective and, once surgeons overcome the learning curve, can achieve excellent early clinical outcomes.
Summary of the Experiences and Results of Transesophageal Ultrasound-Guided Ventricular Septal Defect and Atrial Septal Defect Closure Operation.
Wang F, Wang W, Wu Q … +6 more , Cao Y, Huang H, Tao E, Fang Q, Tang L, Wan L
Heart Surg Forum · 2022 Sep · PMID 36317916 · Publisher ↗
BACKGROUND: Ventricular septal defect (VSD) and atrial septal defect (ASD) are congenital heart diseases. The techniques of transthoracic closure (TC) and percutaneous closure (PC) for the treatment of VSD and ASD have c...
BACKGROUND: Ventricular septal defect (VSD) and atrial septal defect (ASD) are congenital heart diseases. The techniques of transthoracic closure (TC) and percutaneous closure (PC) for the treatment of VSD and ASD have continuously improved and matured. This study aimed to retrospectively analyze the therapeutic effects of TC and PC on VSD and ASD patients. METHODS: We retrospectively reviewed 928 patients (552 VSD and 376 ASD) who had undergone TC or PC guided by transesophageal ultrasound at the Department of Cardiac Macrovascular Surgery of the First Affiliated Hospital of Nanchang University between August 2010 and August 2020. We collected and evaluated the clinical data of the patients, including age, gender, weight, inlet and outlet diameters of defect, and the operation results of TC and PC. Descriptive statistics were used to analyze means and standard deviations (SD), and the Chi-square test was used to evaluate the difference between groups. RESULTS: Among the 928 patients who were treated with the closure operation, there were no casualties, with 907 patients (97.7%) showing successful closure. Among the 552 VSD patients who were treated with TC, 540 showed successful close, while 12 cases required extracorporeal circulation after the failure of TC. Among the 376 patients with ASD, 256 patients were treated with TC, of which 251 were successful, and five were failures, including three shedding cases. In addition, among the 120 patients who were treated with PC, 116 were successful, and four were failures, including two shedding cases. Postoperative follow up for patients with successful closure operations demonstrated that the complications of aortic and tricuspid regurgitation, hydro-pericardium, III° atrioventricular block, shedding of closure umbrella, hemolysis, and thrombosis had not occurred. CONCLUSION: Closure operation of VSD and ASD by esophageal ultrasound has the advantages of lower trauma and blood loss, shorter hospital stay, simple operation, fewer postoperative complications, and significant therapeutic efficacy.
Embolization of Aortopulmonary Collateral Artery Cooperate with Valved Conduit Attached to the Right Ventricular Outflow Tract for Patient After Tetralogy of Fallot Repair: A One-Stop Procedure.
Wu Q, Chen X, Li J … +2 more , Chen L, Yan L
Heart Surg Forum · 2022 Oct · PMID 36317915 · Publisher ↗
We describe a one-stop procedure for aortopulmonary collateral artery (APCA) and postoperative complications of Tetralogy of Fallot (TOF). Postoperative complications of TOF include right ventricular outflow tract stenos...
We describe a one-stop procedure for aortopulmonary collateral artery (APCA) and postoperative complications of Tetralogy of Fallot (TOF). Postoperative complications of TOF include right ventricular outflow tract stenosis, pulmonary valvular annular stenosis, pulmonary regurgitation, and aortopulmonary artery stenosis. The one-stop procedure was defined as after APCA embolization. The heart continued to function under cardiopulmonary bypass during median sternotomy to reconstruct the right ventricular outflow tract with a valved conduit and replace the aortopulmonary artery. A biological valved was sewed within the valved conduit in an artificial blood vessel in vitro and subsequently was used in the procedure and achieved significant results.
Application of High-Frequency Oscillation Ventilation Combined With Volume Guarantee in Preterm Infants With Acute Hypoxic Respiratory Failure After Patent Ductus Arteriosus Ligation.
Lin HZ, Lin WH, Lin SH … +2 more , Xiu WL, Zheng YR
Heart Surg Forum · 2022 Sep · PMID 36317914 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with volume guarantee (HFOV-VG) in preterm infants with acute hypoxemic respiratory failure (AHRF) after...
OBJECTIVE: This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with volume guarantee (HFOV-VG) in preterm infants with acute hypoxemic respiratory failure (AHRF) after patent ductus arteriosus ligation. METHODS: We retrospectively analyzed the clinical data of 41 preterm infants, who were ventilated for AHRF after patent ductus arteriosus ligation between January 2020 and January 2022. HFOV alone was used in 20 of the 41 infants, whereas HFOV-VG was used in the other 21 infants. RESULTS: There was no statistically significant difference in the demographic information and baseline characteristics of preterm infants included in the study. The average frequency tidal volume (VThf) of the HFOV-VG group was lower than that of the HFOV group (2.6 ± 0.6 mL versus 1.9 ± 0.3 mL, P < .001). In addition, the incidence of hypocapnia and hypercapnia in infants supported with HFOV-VG was significantly lower (15 versus 8, P < .001; 12 versus 5, P < .001). Furthermore, the duration of invasive ventilation in the HFOV-VG group also was lower than in the HFOV group (3.7 ± 1.2 days versus 2.1 ± 1.0 days, P < .01). CONCLUSION: Compared with HFOV alone, HFOV-VG decreases VThf levels and reduces the incidence of hypercapnia and hypocapnia in preterm infants with acute hypoxic respiratory failure after patent ductus arteriosus ligation.
A Case of Stanford Type A Acute Aortic Dissection With Preoperative Extensive Cerebral Infarction Successfully Treated Surgically.
Hiraga S, Hirose T, Fukuba R … +5 more , Takemura J, Tonomura R, Tamada S, Mitani K, Yokoyama S
Heart Surg Forum · 2022 Sep · PMID 36317913 · Publisher ↗
Patients with organ malperfusion from acute aortic dissection (AAD) have poor outcomes, and the surgical indications for patients with AAD complicated by extensive cerebral infarction have not been established. Here, we...
Patients with organ malperfusion from acute aortic dissection (AAD) have poor outcomes, and the surgical indications for patients with AAD complicated by extensive cerebral infarction have not been established. Here, we report a successfully treated surgical case of a patient with cerebral infarction and Stanford type A, AAD. A 77-year-old man was admitted to the hospital with a chief complaint of left paresis. After confirming that there was no cerebral hemorrhage with a head computed tomography and an incision in the right neck, and the right internal carotid artery was ligated and closed, emergency surgery was performed with a 24 mm Triplex® raft. The ascending aorta was replaced, and a bypass was performed with a prosthetic graft from the right axillary artery. No cerebral hemorrhage or neurological issues were observed postoperatively, which indicates the possibility of surgical intervention as a treatment strategy for this disease.
Mesenteric Ischemia After Cardiac Surgery in Dialysis Patients: An Overlooked Risk Factor.
Takeyoshi D, Shirasaka T, Shibagaki K … +4 more , Okubo R, Kunioka S, Kikuchi Y, Kamiya H
Heart Surg Forum · 2022 Oct · PMID 36317912 · Publisher ↗
BACKGROUND: No study has examined the association of the calcification of abdominal artery orifices with nonocclusive mesenteric ischemia (NOMI) in dialysis patients undergoing cardiac surgery. Thus, this study aimed to...
BACKGROUND: No study has examined the association of the calcification of abdominal artery orifices with nonocclusive mesenteric ischemia (NOMI) in dialysis patients undergoing cardiac surgery. Thus, this study aimed to determine whether calcification of abdominal blood vessel orifices in hemodialysis patients may be a risk factor for NOMI and examine the long-term survival of dialysis patients after undergoing cardiac surgery. METHODS: From April 2014 to September 2020, 100 dialysis patients underwent cardiac surgery at our hospital. The calcification of the celiac artery (CA) and superior mesenteric artery (SMA) was evaluated by computed tomography, and the degree of orifice stenosis was graded as follows: patent, 0; partial occlusion, 1; and complete occlusion, 2. RESULTS: Eight patients experienced NOMI, and all of them died. SMA calcification scores were not significantly different between the NOMI and non-NOMI groups (1.38±0.52 vs. 1.13±0.69; P = 0.247). However, the average CA orifice calcification score was significantly greater in the NOMI group than in the non-NOMI group (1.63±0.52 vs. 1.15±0.65; P = 0.039), and the SMA+CA orifice calcification scores were significantly different between the groups (3.00±0.76 vs. [non-NOMI] 2.25±1.18; P = 0.028). In all patients, the 30-day and in-hospital mortality rates were 13% and 18%, respectively. All patients were completely followed up with a mean follow-up period of 604±585 days. Kaplan-Meier survival curves showed that patients with SMA and CA calcification tended to have a shorter overall survival than patients without calcification; however, no significant difference was noted. CONCLUSIONS: The calcification of CA and/or SMA orifices was associated with postoperative NOMI and poor long-term survival among dialysis patients undergoing cardiac surgery.
Systemic Immune-Inflammation Index: A Novel Predictor for Risk of Postoperative Atrial Fibrillation in Patients Undergoing Isolated Coronary Artery Bypass Grafting.
Uğuz B, Topal D, Badem S … +2 more , Kahraman N, Uğuz İ
Heart Surg Forum · 2022 Sep · PMID 36317911 · Publisher ↗
OBJECTIVE: To investigate the utility of systemic immune-inflammation index (SII) and inflammatory panel in predicting the risk of postoperative atrial fibrillation (PoAF) among patients undergoing elective isolated coro...
OBJECTIVE: To investigate the utility of systemic immune-inflammation index (SII) and inflammatory panel in predicting the risk of postoperative atrial fibrillation (PoAF) among patients undergoing elective isolated coronary artery bypass grafting (CABG). METHODS: A total of 116 patients (mean age: 61.9 ± 9.8 years, 78.4% were males) undergoing isolated CABG were included in this retrospective study. Patients were divided into two groups, including those who developed PoAF (N = 26) and those without PoAF (N = 90). Inflammatory panel was evaluated in both groups. RESULTS: Patients with PoAF had significantly higher values for P-wave dispersion (PWD; 53.9 ± 5.9 versus 40.2 ± 5.1, P < .001), HATCH score (2.4 ± 1.3 versus 1 ± 1.1, P < .001), and left atrial dimension (4.0 ± 0.3 versus 3.8 ± 0.2 cm, P = .003). In the multivariate analysis with inclusion of PWD, HATCH score and SII, only SII (OR 1.007, 95% CI 1.002 to 1.012, P = .003) and PWD (OR 1.86, 95% CI 1.225 to 2.757, P = .002) were shown to be independent predictors of increased risk for PoAF. CONCLUSION: Preoperative SII seems to be a non-invasive readily available marker that significantly predicts the risk of PoAF in patients undergoing isolated CABG.
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