Chinese Journal of Thoracic and Cardiovaescular Surgery最新文献_第4页

Surgical treatment of deep sternotomy infection caused by residual pacing lead: 78 cases analysis 起搏导联残留致胸深切口感染78例手术治疗分析

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.003

Zhentian Cui, Yongshun Gao

{"title":"Surgical treatment of deep sternotomy infection caused by residual pacing lead: 78 cases analysis","authors":"Zhentian Cui, Yongshun Gao","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.003","url":null,"abstract":"Objective \u0000To analysis and summarize the experience of surgical treatment of deep sternal infection caused by residual epicardial pacing. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis of 78 patients with deep incision infection due to residual epicardial pacing lead after heart disease were selected from the Seventh Medical Center of PLA General Hospital from May 2014 to December 2018. Including 47 males and 31 females, aged 3-72 years old. 38 patients with heart valve surgery(including 18 cases with aortic valvuloplasty, 9 cases with aortic valve replacement, 11 cases with double valve replacement), 14 cases with coronary artery bypass grafting, 26 cases with congenital heart disease surgery(10 cases with atrial septal defect repairment, 11 cases with ventricular septal defect repairment, 5 cases with complex malformation surgery). All patients were infected with sternal incision due to incomplete extraction of the cardiac pacing lead, and treated with the muscle flap turnover operation. The treatment time was 1-5 years after the cardiac surgery in 32 cases, and 46 cases in 1 year. \u0000 \u0000 \u0000Results \u0000There was no death in the study. 70 cases were cured in stageⅠ, 5 cases in stageⅡ, and 3 cases were cured after re-operation. 71 cases were followed up for 1 year, there was no recurrence of wound infection. \u0000 \u0000 \u0000Conclusion \u0000The operation of pectoralis major muscle flap turnover has opened up a new approach for the treatment of thoracic incision infection caused by residual epicardial pacing lead after cardiac surgery, and it is worth popularizing in clinical practice. \u0000 \u0000 \u0000Key words: \u0000Cardiac surgical procedure; Deep sternal infection; Pectoralis major muscle flap inversion plasty","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87523828","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}

引用次数: 0

Application of valve-in-valve in transcatheter mitral valve replacement 瓣中瓣在经导管二尖瓣置换术中的应用

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.011

Z. Xiaohua, Chen Huang, Gongcheng Huang, Ma Guofeng, Fan Feng, Yue Wang, Jing Xu

引用次数: 0

The research of selective unifocalization in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals and recognition of major aortopulmonary collaterals from the perspective of histopathology 肺动脉闭锁合并室间隔缺损伴肺动脉主支的选择性统一定位研究及组织病理学角度对肺动脉主支的识别

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.001

Ji Xianchao, Bo Peng, Li Li, Ju Zhao, Shoujun Li, Fuxia Yan, Jinping Liu, Xu Wang, Jun Yan, Qiang Wang

{"title":"The research of selective unifocalization in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals and recognition of major aortopulmonary collaterals from the perspective of histopathology","authors":"Ji Xianchao, Bo Peng, Li Li, Ju Zhao, Shoujun Li, Fuxia Yan, Jinping Liu, Xu Wang, Jun Yan, Qiang Wang","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.001","url":null,"abstract":"Objective \u0000To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs). \u0000 \u0000 \u0000Methods \u0000The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs. \u0000 \u0000 \u0000Results \u00006 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology. \u0000 \u0000 \u0000Conclusion \u0000There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs. \u0000 \u0000 \u0000Key words: \u0000Pulmonary atresia; Major aortopulmonary collaterals; Selective unifocalization; Histopathology; Elastic arteries","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87410799","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}

引用次数: 0

Risk factors of failed observational treatment of traumatic hemothorax 外伤性血胸观察治疗失败的危险因素

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.006

Shaowei Xin, Tao Wang, Xiangbing Xin, Yongchao Han

{"title":"Risk factors of failed observational treatment of traumatic hemothorax","authors":"Shaowei Xin, Tao Wang, Xiangbing Xin, Yongchao Han","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.006","url":null,"abstract":"Objective \u0000To identify the risk factors of failed observational treatment of traumatic hemothorax. \u0000 \u0000 \u0000Methods \u0000Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis. \u0000 \u0000 \u0000Results \u0000The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group(P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures(OR=5.535, 95%CI: 1.065-28.754, P=0.042)and pneumothorax(OR=9.529, 95%CI: 1.988-45.580, P=0.005). \u0000 \u0000 \u0000Conclusion \u0000Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax. \u0000 \u0000 \u0000Key words: \u0000Hemothorax; Thoracic trauma; Rib fracture","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82624087","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}

引用次数: 0

The main techniques of pulmonary segmentectomy and its effect on pulmonary function 肺段切除术的主要技术及其对肺功能的影响

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.013

Hai Tang, H. Su, Chang Chen

引用次数: 0

Early in-hospital management strategy for patients with blast injury of the lungs 肺爆炸伤患者的早期院内处理策略

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.014

Yunfeng Yi

引用次数: 0

Mitral repair or bioprosthetic replacement for rheumatic valve drseascs in elderly patients 二尖瓣修复或生物假体置换治疗老年风湿性瓣膜病

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.004

Baiyu Tian, Jie Han, Yan Li, Yuqing Jiao, Xu Meng

{"title":"Mitral repair or bioprosthetic replacement for rheumatic valve drseascs in elderly patients","authors":"Baiyu Tian, Jie Han, Yan Li, Yuqing Jiao, Xu Meng","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.004","url":null,"abstract":"Objective \u0000Mitral valve replacement is more frequently performed in elder patients with rheumatic valve diseases. Mitral valve repair may be feasible in young patients with suitable anatomy in rheumatic mitral valve disease, but still controversial in elder patients. Our study was to compare mitral repair to bioprosthetic replacement in patients aged 60 years or older. \u0000 \u0000 \u0000Methods \u0000Eighty two patients(age ≥60 years) underwent mitral valve surgery(mitral repair or bioprosthetic replacement)in our single institution from January 2014 to January 2016 were reviewed, including 25 cases of repair(MVP) and 57 cases of bioprosthetic replacement(MVR). 5 years follow-up oganalysis. \u0000 \u0000 \u0000Results \u0000Mean age in MVP and MVR was 64.43 years and 67.28 years, respectively. There were no statistically differences in extracorporeal circulation time(P=0.99) and aorta blocking time(P=0.88); the operative mortality rate in MVR was 5.3% while none in MVP(P=0.24). During follow-up 6 deaths happened in MVR, 4 of them died from MACE while the other 2 died from other causes. There was no death in MVP(P=0.17). No redo or other complications were found during follow-up. \u0000 \u0000 \u0000Conclusion \u0000In patients aged 60 years or older with rheumatic mitral valve disease, mitral repair is associated with a same perioperative and mid-term result compared with bioprosthetic replacement. Rheumatic mitral valves could be repaired in elderly patients. \u0000 \u0000 \u0000Key words: \u0000Mitral valve insafficiency; Mitral valve repair; Bioprosthesis; Elderly","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83192724","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}

引用次数: 0

The study of hemodynamic mechanism of a novel endovascular stent on complicated abdominal aortic aneurysms 新型血管内支架治疗复杂腹主动脉瘤的血流动力学机制研究

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.007

Baotong Li, Yuechao Zhao, Hansong Sun, Shanglin Chen

{"title":"The study of hemodynamic mechanism of a novel endovascular stent on complicated abdominal aortic aneurysms","authors":"Baotong Li, Yuechao Zhao, Hansong Sun, Shanglin Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.007","url":null,"abstract":"Objective To detect the hemodynamic mechanism of the novel endovascular stent on complicated abdominal aortic aneurysms by Computational Fluid Dynamics(CFD) firstly, and then compare the effect of the novel endovascular stent and the streamliner multilayer flow modulator(SMFM) stent. Methods All medical images were obtained by computed tomography. A semiautomatic segmentation protocol within Mimics(v17.0; Materialise, Leuven, Belgium) was used to extract the threedimensional aortic aneurysms. The stents was generated numerically and fitted along the aortic aneurysms. The lumen volume represented the fluid domain that was discretised in smaller volumes, which defined a mesh within the ICEM software(Ansys ICEM CFD v15.0). Hemodynamic analysis was performed with software Fluent 16.0. Results Both kinds of stents can change the pattern of flow distribution. Compared with SMFM, the novel endovascular stent can significantly reduce the flow velocity in aneurysms, the shear force and the pressure on the aneurysms wall.What’s more, the flow velocity of the branch artery was accelerated by the novel endovascular stent. Conclusion The novel endovascular stent can significantly reduce the flow velocity in aneurysms, the shear force and the pressure on the aneurysms wall, and acceleratethe the flow velocity of the branch artery. Key words: Aortic aneurysms; Computational fluid dynamics; Streamliner multilayer flow modulator; Novel endovascular stent","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88688609","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}

引用次数: 0

Short-term clinical outcome of mechanical aortic valve pannus removal 机械主动脉瓣切除的近期临床效果

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.008

Shixiong Wei, Shengli Jiang, Lin Zhang, Z. Gong, Tong Ren, Huimin Cui, Liang-gang Li

{"title":"Short-term clinical outcome of mechanical aortic valve pannus removal","authors":"Shixiong Wei, Shengli Jiang, Lin Zhang, Z. Gong, Tong Ren, Huimin Cui, Liang-gang Li","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.008","url":null,"abstract":"比较单纯血管翳清除术与传统二次瓣膜置换手术在治疗主动脉机械瓣血管翳形成患者的短期临床疗效差异。2015年3月至2019年10月，共26例患者(女性18例)因主动脉机械瓣置换术后血管翳形成导致瓣膜失功，根据术式不同将患者分为血管翳清除组(接受单纯血管翳清除术)与瓣膜置换组(接受传统二次瓣膜置换手术)。本研究着重比较两组患者术前一般情况，观察两组患者围手术期实验室指标、超声心动图特征，并对其进行随访，以评估两种手术方式在治疗人工瓣膜血管翳上的疗效差异。两组患者术前一般资料差异无统计学意义，全部患者接受择期手术治疗，同期行二尖瓣置换手术8例，三尖瓣修补术15例(置换3例，成形12例)，主动脉根部手术2例，术后无早期不良事件发生。血管翳清除组患者术中体外循环时间(128.7 min对179.7 min，P<0.05)及升主动脉断时间(74.2 min对132.7 min，P<0.05)均显著少于瓣膜置换组患者，术后炎症反应更低，两组患者在其他实验室检查及超声心动图指标方面差异无统计学意义。与传统二次瓣膜置换手术患者相比，单纯血管翳清除术式能够明显减少体外循环时间、大幅降低转机过程带来的全身炎症反应、降低患者住院时间。术后短期内无明显不良影响，是一种值得推广的创新型手术方式，其远期疗效尚待进一步随访调查。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90116591","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}

引用次数: 0

Experience of preoperative 3D-CTBA reconstruction guiding superior vena cava 术前3D-CTBA重建引导上腔静脉的体会

Chinese Journal of Thoracic and Cardiovaescular Surgery Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1001-4497.2020.01.009

Zhenyang Zhang, Tianci Chai, Jiangbo Lin, Mingqiang Kang, Wenhua Chen, H. Qiu, Zhiqiang Zou, Jiafu Zhu, Lei Gao, Chuangcai Yang

引用次数: 0