Weipeng Shao, Jingjing Huang, J. Zhang, Shanwu Ma, Hongxiang Feng, Hongliang Sun, Yanhong Ren, Xiaowei Wang, Zhen-rong Zhang, Deruo Liu
{"title":"Impact of interstitial lung disease on postoperative morbidity and 60 day mortality after pulmonary resection for lung cancer","authors":"Weipeng Shao, Jingjing Huang, J. Zhang, Shanwu Ma, Hongxiang Feng, Hongliang Sun, Yanhong Ren, Xiaowei Wang, Zhen-rong Zhang, Deruo Liu","doi":"10.3760/CMA.J.CN112434-20190818-00273","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190818-00273","url":null,"abstract":"Objective \u0000To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients. \u0000 \u0000 \u0000Methods \u0000We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed. \u0000 \u0000 \u0000Results \u0000There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex(P=0.023), ILD(P=0.001), COPD(P=0.027) were independent risk factors for postoperative morbidity. ILD(P=0.023) and postoperative morbidity(P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. \u0000 \u0000 \u0000Conclusion \u0000Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients. \u0000 \u0000 \u0000Key words: \u0000ILD; Pulmonary resection; AE-ILD; Morbidity; 60-day mortality","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"48 1","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhou Zhao, Li-xue Zhang, Guo-dong Zhang, Xiangui Zhang, Xuan Wang, Junxue Gao, G. Fan, B. Lian, Jing Liu, Gang Liu, Shenglong Chen, Yu Chen
{"title":"Perioperative study of blood flow of in-situ BIMA in coronary artery bypass grafting","authors":"Zhou Zhao, Li-xue Zhang, Guo-dong Zhang, Xiangui Zhang, Xuan Wang, Junxue Gao, G. Fan, B. Lian, Jing Liu, Gang Liu, Shenglong Chen, Yu Chen","doi":"10.3760/CMA.J.CN112434-20190723-00246","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190723-00246","url":null,"abstract":"Objective \u0000To observate the changing trend of flow of in-situ bilateral internal mammary artery as grafts during perioperative period in patients undergoing coronary artery bypass grafting(CABG), and to compare the parameters of flow between LIMA and RIMA. \u0000 \u0000 \u0000Methods \u0000A total of 57 patients , 50 males and 7 femails, mean aged(57.8±10.1) years, underwent bilateral IMA CABG in our hospital from August 2016 to January 2019. Transthoracic ultrasound of IMA examination was performed before CABG. The blood flow, the PI(pulsation index) and other parameters were measured and recorded by intraoperative TTFM. \u0000 \u0000 \u0000Results \u0000There was no significant difference of the average diameter and PI between LIMA and RIMA, but the preoperative flow of RIMA is higher(P=0.026) in our study. There was no significant difference of the average flow and PI between LIMA and RIMA recorded by TTFM(P>0.05), but the higher diastolic flow(DF) in LIMA grafts(P=0.022) compared with RIMA grafts may be associated with the different target sites(P<0.05). Compared with the preoperative flow and PI of IMA, the intraoperative flow and PI of both LIMA and RIMA grafts were better(P<0.001). \u0000 \u0000 \u0000Conclusion \u0000Compared with the preoperative flow of IMA, both flow of LIMA and RIMA are better. In spite of the targets exist difference , there are no significant difference of the average flow and PI between LIMA graft and RIMA graft recorded by TTFM. \u0000 \u0000 \u0000Key words: \u0000Internal mammary artery; Coronary artery bypass grafting; Transit-time flowmeter; Transthoracic arterial ultrasound","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"16 1","pages":"175-179"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81689604","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}
Dalei Guo, Yan Liu, P. Su, Xitao Zhang, Junbo Yan, Song Gu, Jie Gao, Y. Gou, Yue Xin, Qianwei Wang
{"title":"Dialectical analysis of heparin residue in perioperative period of off-pump coronary artery bypass grafting","authors":"Dalei Guo, Yan Liu, P. Su, Xitao Zhang, Junbo Yan, Song Gu, Jie Gao, Y. Gou, Yue Xin, Qianwei Wang","doi":"10.3760/CMA.J.CN112434-20190521-00167","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112434-20190521-00167","url":null,"abstract":"Objective \u0000To investigate the best neutralization ratio of protamine and heparin during off-pump coronary artery bypass grafting(OPCABG) by analyzing the advantages and disadvantages of heparin residue after OPCABG. \u0000 \u0000 \u0000Methods \u0000From July 2018 to January 2019, 112 patients undergoing elective OPCABG were included in this study. The patients’ whole blood was drawn at 2 time points, including before entering operating room and entering intensive care unit, to receive thrombelastography(TEG) and heparinase-modified thromboelastography(hmTEG) . Conventional coagulation indexes such as activated coagulation time(ACT) were also detected. All the patients were divided into 3 groups, the non-heparin residue group(30 cases), heparin residue group 1(42 cases) and heparin residue group 2(40 cases) according to the laboratory results of TEG, hmTEG and ACT. We observed the dosage of each group of protamine and heparin, as well as the ratio of heparin and protamine. The changes of R time in TEG and ACT between 3 groups were analyzed and compared. Postoperative chest tube drainage at postoperative 12 h and 48 h, cTnI peak value, incidence of perioperative myocardial infarction(MI), incidence of reoperation and poor wound healing, amount of blood loss and transfusion, and acute renal injury were compared between the 3 groups. \u0000 \u0000 \u0000Results \u0000No significant trio-group differences existed in basic clinical characteristics(all P>0.05). Postoperative R(CKH)time was similar in the 3 groups(P>0.05). Comparing with heparin residue group 1 and heparin residue group 2, the ACT after protamine neutralizing heparin and postoperative R time were decreased, the dosage of protamine, ratio of heparin and protamine, cTnI peak value were increased in the non-heparin residue group(P 0.05). The perioperative myocardial infarction, incidence of reoperation and poor wound healing, postoperative acute renal injury and time of in ICU stay showed no significant differences between the 3 groups(P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Moderate heparin residue after OPCAB suggests that it has myocardial protective effect, and does not significantly increase the risk of bleeding. A large number of heparin residues can affect the coagulation function and lead to bleeding tendency, increase the amount of blood loss and transfusion. It is reasonable to make ACT after protamine neutralize heparin higher than the level of ACT before operation, and not higher than 20% of the level before operation. \u0000 \u0000 \u0000Key words: \u0000Heparin; Protamine; Coronary artery bypass grafting, off-pump; Thromboelastograph","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"50 1","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88185288","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}
Suwei Chen, Yongliang Zhong, Chengnan Li, Y. Ge, Z. Qiao, R. Qi, Haiou Hu, Junming Zhu, Li-Zhong Sun
{"title":"Surgical treatment strategy for traumatic aortic injury","authors":"Suwei Chen, Yongliang Zhong, Chengnan Li, Y. Ge, Z. Qiao, R. Qi, Haiou Hu, Junming Zhu, Li-Zhong Sun","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.003","url":null,"abstract":"Objective \u0000To summarize the surgical treatment strategy for aortic injury caused by trauma. \u0000 \u0000 \u0000Methods \u0000From January 2009 to January 2018, 34 patients with TAI were treated in Beijing Anzhen Hospital. 10 had hypertension. 23 cases were males. There were 31 cases caused by traffic accidents, 2 cases were fall injuries, and 1 case was bruise. 9 cases were thoracic aortic pseudoaneurysm, 6 cases were thoracic aorta, and 19 cases were aortic dissection. 29 patients underwent TEVAR and 5 patients underwent OR (2 patients with type A aortic dissection undergoing Bentall + Sun's procedure, 1 patient with type B aortic dissection and 2 patients with thoracic aortic pseudoaneurysm undergoing stented elephant trunk procedure). \u0000 \u0000 \u0000Results \u0000The follow-up time was (45.09±23.10) months. The mean age of patients undergoing OR or TEVAR was (44.80±20.57) years old, (45.93±11.01) years old; the mean operation time was(403.20±30.30) minutes, (105.72±27.76) minutes; the mean hospitalization (19.00±6.04), (5.76±3.08) days. There were no deaths in the two groups. 2 patients uundergoing TEVAR had left upper limb numbness. \u0000 \u0000 \u0000Conclusion \u0000The treatment of patients with TAI should be based on the general condition, the classification of injury, the involving regions and anatomical features to choose different treatments. In addition, the long-term prognosis of patients remains to be determined. \u0000 \u0000 \u0000Key words: \u0000Aortic disease; Trauma; Stented elephant trunk procedure; Thoracic aortic endovascular repair","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"9 1","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75635769","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":"Clinical characteristics and safety of valvular surgery in elderly patients aged over 75 years","authors":"Bing Liu, Shengli Jiang, Lin Zhang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.002","url":null,"abstract":"Objective \u0000To study the clinical characteristics and surgical conditions of valve surgery in elderly patients over 75 years old. \u0000 \u0000 \u0000Methods \u0000Datas of patients over 75 years old with valve surgery in our hospital from January 2014 to January 2019 were retrospectively analyzed. 73 cases were analyzed, accounting for 5.3%(73/1 372) of the cardiac valve operations performed during the same period.There were 46 males and 27 females, with an average age of 77.35 years(75-88 years). The main diagnoses were MR 28 cases(38.3%), MS 8 cases(11.0%), AR 7 cases(9.6%), AS+ AR 7 cases(9.6%) and AS 6 cases (8.2%). There were 28 cases(38.4%) of MVR+ TVP, 20 cases(27.4%) of AVR, and 11 cases(15.1%) of MVR.Pacemakers were installed in 2 patients(2.7%) and coronary artery bypass grafting was performed in 14 patients(19.2%). \u0000 \u0000 \u0000Results \u0000There were statistically significant differences in left atrial end-diastolic diameter(LA), left ventricular end-diastolic diameter(LV), right atrial end-diastolic diameter(RA) and ejection fraction(EF) before and after surgery(P 0.05) in surgical interception time, extracorporeal circulation time, postoperative ventilator time, ICU time, surgical complications, postoperative liver and kidney functioninsufficiencyand mortality, as compared with 150 cases of valve surgery under 60 years old(P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Mitral regurgitation is the most common valvular disease in senile patients over 75 years old, the cardiac structure is improved significantly after surgery, and the risk of surgery is the same as that in normal age groups. Therefore, valvular surgery issafe in elderly patients over 75 years old. \u0000 \u0000 \u0000Key words: \u0000Senile valve; Clinical characteristics; Surgery; Safety","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"15 1","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73565962","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}
Qi-Fu Guo, Min Zheng, Ye Xu, Wenliang Qian, Chen Zhu, Ning Wang, Wen Zhao, Jing Yang
{"title":"Discovery of tracheal diverticulum using HRCT scan in patients with chronic cough: four cases report and literature review","authors":"Qi-Fu Guo, Min Zheng, Ye Xu, Wenliang Qian, Chen Zhu, Ning Wang, Wen Zhao, Jing Yang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.009","url":null,"abstract":"对2018年8月至2019年3月上海交通大学医学院附属同仁医院诊治的4例气管憩室导致慢性咳嗽患者的临床和病理资料进行分析,胸部高分辨HRCT检查显示,胸廓入口处气管旁右侧后壁的类圆形或不规则囊状或柱状气体影,连续横断薄层扫描或多平面重建等后处理技术发现气囊与气管之间无或有一较细的管道相连,气管镜检查均未见明显异常通道,术后病理报告示气管憩室。经颈部沿皮纹横弧形切口顺利切除气管憩室,术后慢性咳嗽症状消退,随访2~8个月,疗效满意。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"55 1","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74813294","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 ballon atrial septostomy for left heart venting during extracorporeal membrane oxygenation","authors":"Dingyang Li, Gangcheng Zhang, Q. Shen, Yan Liu, Naiwen Cao, Yueting Zhou","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.005","url":null,"abstract":"Objective \u0000To discuss whether balloon atrial septostomy(BAS) can provide safe and effective left ventricular venting for venoarterial extracorporeal membrane oxygenation(V-A ECMO). \u0000 \u0000 \u0000Methods \u0000From March 2017 to January 2019, 9 patients received BAS for left ventricular venting during V-A ECMO treatment in our hospital, including 5 males and 4 females, aged 12-72 years. There were 3 cases of severe myocarditis, 4 cases of low cardiac output after cardiac surgery, and 2 cases of acute myocardial infarction. Basic data, procedure data, outcome and follow-up were recorded. \u0000 \u0000 \u0000Results \u0000BAS were successfully performed in 9 patients. Procedure time on average was 42.2 min. Anterior mediastinal hematoma occurred in 1 case. There were no other procedure-related complications in the rest cases. No pulmonary edema or thrombosis occurred in all 9 cases during ECMO. No closure procedure was performed. \u0000 \u0000 \u0000Conclusion \u0000BAS is a safe and effective method for left ventricular venting. The procedure is conductive to the recovery of patients with severe left heart failure. \u0000 \u0000 \u0000Key words: \u0000Atrial septostomy; Transseptal puncture; Extracorporeal membrane oxygenation; Left ventricular venting","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"99 41 1","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85744252","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":"Risk factors and prevention strategies of spinal cord ischemic injury after thoracoabdominal aortic aneurysm repair","authors":"Yusong Wang, Guanglang Zhu, Ziyang Sun, Lei Zhang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.02.012","url":null,"abstract":"Thoracic and abdominal aortic aneurysm repair has always been a challenging procedure in cardiovascular surgery due to its high mortality and complication rate. At present, there are traditional open surgery, hybrid surgery and intracavitary repair for thoracic and abdominal aortic aneurysms. The main postoperative complication of spinal cord ischemia injury is paraplegia, which seriously affects the long-term survival rate and quality of life of patients. This paper summarized and considered the pathogenesis, risk factors and prevention measures of spinal cord ischemia injury after thoracic and abdominal aortic aneurysm repair.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":"15 1","pages":"118-124"},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75272598","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}