Chinese Journal of Thoracic and Cardiovaescular Surgery最新文献

{"title":"Congenital hiatal hernia associated with gastric gangrene in a child","authors":"Yuhao Wu, Yunni Ran, Jiangtao Dai, Gang Wang, Hongbo Li, Yonggang Li, Chun Wu","doi":"10.3760/CMA.J.ISSN.1001-4497.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2020.01.012","url":null,"abstract":"食管裂孔疝嵌顿并胃坏疽十分罕见。本文回顾1例9岁6个月女性患儿先天性食管裂孔疝嵌顿并胃坏疽的发病、诊断及治疗过程，总结该病的临床表现和诊治要点。患儿患先天性食管裂孔疝嵌顿，病情危重，胸部CT及上消化道造影可明确诊断，行胃大部切除及食管裂孔疝修补后出现食管远端出血及食管－胃连接处狭窄，早期手术解除嵌顿是降低术后并发症及病死率的关键。","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":"74946932","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":"Bilateral sequential pulmonary transplantation with closure of ventricular septal defect in a patient with Eisenmenger syndrome","authors":"Jun Pan, Zhenjun Xu, Cheng Chen, Jianqiu Xiong, Jingyu Chen, Dongjin Wang","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.012","url":null,"abstract":"艾森曼格综合征被视为先天性室间隔缺损修补的禁忌证，该类患者的外科治疗策略包括心肺联合移植或双肺移植同期矫治心脏畸形。1例27岁女性患者，剖宫产术后2周因先天性心脏病、室间隔缺损，艾森曼格综合征行双肺移植同期行室间隔缺损修补术成功。患者术后46天康复出院，治疗效果良好。提示双肺移植同期行室间隔缺损修补治疗室间隔缺损继发艾森曼格综合征患者有效。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77149452","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":"The factors associated with postoperative in-hospital adverse events in patients with aortic valve prolapse","authors":"Y. Ruan, Xiaowei Liu, Xin Wang, Jiancheng Han, Haibo Zhang, Xu Meng, Yihua He","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.009","url":null,"abstract":"回顾性分析2009年1月1日至2017年12月31日期间在我院因主动脉瓣脱垂(AVP)和严重主动脉瓣关闭不全(AI)接受主动脉瓣置换术(AVR)患者135例。收集研究对象的基线临床特征，超声心动图参数以及手术参数。所有患者术后住院期间随访，评估与院内不良事件相关的危险因素，包括死亡、心功能恶化、术后发生完全性房室传导阻滞和再次手术。住院期间共发生25例不良事件，其中5例死亡，17例心功能恶化，2例完全性房室传导阻滞置入永久性起搏器，3例进行再次手术。多因素logistic回归模型显示女性(OR＝7.89，95%CI：1.92～32.50，P＝0.004)，心功能(NYHA分级) Ⅲ～Ⅳ级(OR＝3.72，95%CI：1.12～12.37，P＝0.033)和基线左心室舒张期末内径(LVEDD)(OR＝1.08，95%CI：1.02～1.15，P＝0.010)，或LVEDD≥67 mm(OR＝5.50，95%CI：1.43～21.14，P＝0.013)或体表面积校正的LVEDD(OR＝1.11，95%CI：1.02～1.20，P＝0.016)与院内不良事件独立相关。心功能(NYHA分级) Ⅲ～Ⅳ级，基线LVEDD或体表面积校正的LVEDD预测AVP患者进行外科瓣膜置换手术后院内不良事件发生的风险，但因样本量受限及混杂因素不能完全考虑到，结果推广需慎重。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86361095","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 technique of the magnetic sphincter augmentation for treating gastroesophageal reflux disease","authors":"Yifeng Sun, Yu Yang, H. Gu, Yi He, Xiao-bin Zhang, Haoyao Jiang, Yang Yang, R. Hua, Xufeng Guo, B. Ye, T. Mao, Zhigang Li","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.011","url":null,"abstract":"探讨应用宁波胜杰康生物科技有限公司生产的磁括约肌增强器置入食管下端手术操作的临床技术要点。2018年8月至2018年11月共6例患者经严格筛选入组，患者平卧位，通过腹腔镜的方式游离胃－食管交接区左、右侧缘与食管裂孔左、右侧缘，显露左侧胃食管交接区。食管后壁迷走神经前套带将食管提起，游离食管后壁组织，观察裂孔发育情况；如裂孔较大，予以不可吸收线修补，测量器由副操作孔导入测量食管周径，根据测量数值决定磁力环大小。磁力环由主操作孔送入，食管后壁迷走神经前方、迷走神经肝支上方经食管后壁包绕食管，磁力环在食管前方自行锁紧。手术顺利，无术后并发症，中位手术时间61.5 min(58～101)min，术后第1天造影，无造影剂外泄，磁力环开闭良好，予以半流质饮食。患者中位总住院4.5天(3～7)天。术后住院时间最长4天，最短2天，中位时间3天，出院前均未发现不良事件。术后1年6例均完成GERD-HRQL评分，食管功能测试完成4例，24 h酸暴露时间、Demeester评分，结果显示GERD-HRQL，24 h酸暴露时间、Demeester评分均较术前显著下降。1例患者述仍时有反酸，间断服用PPI药物，其余5例患者停服PPI药物。磁力环装置可通过腔镜方便置入，术中关键点在于保留迷走神经肝支、食管裂孔的显露、迷走神经后干显露、磁力环选择。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84699805","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":"Combined epicardial and transapical endocardial radiofrequency ablation for ventricular tachycardia with ventricular aneurysm in a porcine model","authors":"Bo Li, Changcheng Liu, Liangshan Wang, Haiming Li, Longsheng Dai, C. Gu","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.008","url":null,"abstract":"Objective \u0000To evaluate the feasibility and validity of combined directly epicardial and transapical endocardial substrate ablation guided by Carto mapping for ventricular tachycardia(VT) with left ventricular aneurysm(LVA) intra-operation in a swine model. \u0000 \u0000 \u0000Methods \u0000Twenty-four swine models with sustained VT and LVA were randomly divided into study group(radiofrequency ablation, RFCA, from epicardium via direct-view and endocardium via transapical access, 12 cases) and control group(endocardial RFCA via retrograde transaortic access, 12 cases). Substrate mapping for captured abnormal potentials via endocardium and epicardium was used to precisely locate the low-voltage areas. After ablation in two groups, VT was induced again to compare the effectiveness of different RFCA strategies. \u0000 \u0000 \u0000Results \u0000Three dimensional electro-anatomic mapping was implemented successfully in two groups under open chest. And VT substrates were largely located in the border zone of LVA. All objects in the study group underwent endocardial ablation via transapical access smoothly without operative failure. When VT inducing again, 2 cases of study group was with inducible VT, however, VT recurrence in control group was 5 cases, P=0.04. \u0000 \u0000 \u0000Conclusion \u0000Combined direct epicardial and transapical endocardial substrate mapping and ablation appeared to be feasible and effective for treating VT with LVA under thoracotomy. \u0000 \u0000 \u0000Key words: \u0000Tachycardia, ventricular; Ventricular aneurysm; Radiofrequency ablation; Animal model","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240166","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":"Aorta-anonymous venous fistula due to pacing electrode lead: one case report","authors":"Xiaocheng Gu, Shaoqin Li, Z. Jia","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.013","url":null,"abstract":"62岁女患者，置入起搏器14年，诊断为起搏电极导线所致主动脉－无名静脉瘘，外科手术修补。术后心力衰竭症状消失，患者恢复良好。本例提示，有起搏器置入史患者，起搏电极导线可导致主动脉－无名静脉瘘，引起心功能衰竭。","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85613260","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":"Biventricular surgical repair of Swiss-cheese ventricular septal defects with two-patch and right ventricle apex excluding technique in 9 infants: surgical experiences and clinical results","authors":"Qin Wu, Lei Shi, Yong Di, Yueyi Ren, Kuiliang Wang, Rui Chen","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.004","url":null,"abstract":"Objective \u0000To reviewe our clinical experience on biventricular surgical repair of Swiss-cheese ventricular septal defects with two-patch and right ventricle apex excluding technique in 9 infants. \u0000 \u0000 \u0000Methods \u0000From March 2014 to March 2019, a series of 9 patients(M/F=2/7) with Swiss-cheese ventricular septal defects were admitted in our center to receive surgical treatment, with a median age of 4.8(2-12) months and a median body weight of 4.5(3.7-6.8) kg. All the 9 cases were symptomatic with shortness of breath and sweating. All the patients received echocardiography, ECG and chest X-ray. 3 patients with other intracardiac anomalies received CT angiography and 1 with severe pulmonary hypertension had transcatheter angiography. 4 cases of 9 had antenatal echocardiography but with no positive findings. The median cardiothoracic ratio was 0.63(0.58-0.72). 8 cases underwent one-stage surgical repair with the two-patch and right ventricle apex excluding technique and 1 case received a second-stage surgical repair with the same technique following a previous pulmonary artery banding procedure. The surgical repair was carried out with cardiopulmonary bypass under moderate hypothermia and using HTK cardioplagia to stop the heart in all the 9 cases. 2 fresh autologous pericardium patchs were used to closure defects of the outflow tract area and the apex trabecular defects respectively by excluding the apex of the right ventricle from the right ventricular inflow. Other intracardiac anomalies were corrected simultaneously. Patients were strictly followed up with a stanard protocol. \u0000 \u0000 \u0000Results \u0000All the operations were successful. Median cardiopulmonary bypass time and aortic clamping time were 96(68-167)min and 68(43-122)min respectively. Delayed chest closure were done in 2 cases within 48-72 hours postoperatively. The time of mechincal ventilation and ICU stay were 131.3(32-328)hours and 8.7(5-31)days respectively. All the patients were discarged in 11.5(9-42)days after operation. There was no mortality and major complication except for 1 case of low cardiac output syndrome, 2 cases of ventilator associated pnumonia and 2 cases of residual shunt(less than 2 mm). All the patients were followed up for 3.2 years(1 month-9 years). There was no death and major complication. The latest echocardiography results showed that the left and right heart function was normal in all the cases. \u0000 \u0000 \u0000Conclusion \u0000Biventricular surgical repair of Swiss-cheese ventricular septal defects with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants can be relatively easy with favorable early and mid-term results. Long term results need to be evaluated with more cases. \u0000 \u0000 \u0000Key words: \u0000Ventricular septal defects; Surgical repair","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80153392","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":"Conventional and sutureless techniques for surgical repair of supracardiac total anomalous pulmonary venous connection","authors":"Furong Liu, J. Zhuang, Jimei Chen, S. Wen, Gang Xu, J. Cen","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.003","url":null,"abstract":"Objective \u0000To review our experiences with conventional and sutureless techniques in patients with supracardiac total anomalous pulmonary venous connection. \u0000 \u0000 \u0000Methods \u0000From January 2004 to January 2016, 150 patients with suparacardiac total anomalous pulmonary venous connection underwent conventional or sutureless techniques. Kaplan-Meier curve was used to demonstrate the survival estimates. Cox proportional hazard model was used to identify risk factors for death and postoperative pulmonary venous obstruction(PVO). \u0000 \u0000 \u0000Results \u0000There were 9 in-hospital deaths and 2 late deaths. The survival rates at 30 days, 1 year, and 12 years were 94.0%, 93.3%, and 92.7%, respectively. Follow-up was completed in 95.7% of the survivors. Median follow-up was 47 months(range: 0-136 months). Twenty-one patients required reoperation for pulmonary venous obstruction. The survival rates in neonate group is significantly lower than that in infants and children group(P=0.026). For those who were diagnosed with preoperative PVO, the survival rates(conventional group 92.3% VS sutureless group 93.9%, P=0.741) and incidence of freedom from reoperation(conventional group 55.6% VS sutureless group 90.9%, P=0.166) in both the conventional and sutureless group were similar. Multivariable analysis showed that preoperative pulmonary venous obstruction(P=0.015) and longer duration of ventilation(P=0.011) were incremental risk factors for death. Aortic cross-clamp time(P=0.038) was associated with postoperative pulmonary venous obstruction. \u0000 \u0000 \u0000Conclusion \u0000Both the conventional and sutureless techniques in surgical repair for supracardiac total anomalous pulmonary venous connection can achieve satisfactory outcomes. \u0000 \u0000 \u0000Key words: \u0000Total anomalous pulmonary venous connection; Surgical outcomes; Pulmonary venous obstruction; Sutureless technique","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78631553","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 modified David technique to aortic sinus repair in acute type A aortic dissection","authors":"Long Wu, K. Zhang, Xiaofan Huang, Xianqing Feng, Yu Song, Baoqing Liu, Xionggang Jiang, N. Dong","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.005","url":null,"abstract":"Objective \u0000To summarize the effect of modified David technique on acute type A aortic dissection sinus formation. \u0000 \u0000 \u0000Methods \u0000From March 2018 to September 2018, modified David technique was applied to aortic sinus remodeling in acute A-type aortic dissection in 19 patients, 13 males and 6 females. The age was 45-67(50.42±15.37) years old and the weight was 45-112(60.32±25.18) kg. Single sinus(noncoronary sinus) was repaired in 15 cases, double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 2 cases, left sinus Florid sleeve technical treatment plus double sinus formation(noncoronary sinus+ right coronary sinus+ coronary artery transplantation) in 1 case, Single sinus(noncoronary sinus) repaired and aortic vavle replacement in 1 case. Frozen elephant trunk and total arch replacement in 13 cases, hemiarch replacement in 3 cases. \u0000 \u0000 \u0000Results \u0000There were no deaths in this group. The cardiopulmonary bypass time was 176-245(193.27±32.46) minutes, the aortic cross clamp time was 105-187(122.36±18.57)minutes, and the operation time was 6.5-11.0(7.63±1.31) hours. The mechanical ventilation time was 18-122(48.27±34.73)hours, the intensive care unit stay time was 2-10(5.35±2.62) days, and the postoperative hospital stay was 7-22(12.63±3.25)days. There was no delayed sternal closure during operation, and there was no secondary thoracotomy after operation. One patient developed a transient advanced atrioventricular block. Transient neurological dysfunction was observed in 5 patients. All patients were followed up for more than half a year. The color Doppler echocardiography and computed tomography angiograph(CTA)showed no aortic regurgitation or residual dissection. \u0000 \u0000 \u0000Conclusion \u0000The application of modified David technique in the remodeling of aortic root sinus in acute type A aortic dissection is an effective technique with relatively simple process, which is worth promoting. \u0000 \u0000 \u0000Key words: \u0000Aortic dissection; David procedure; Aotic sinus repair","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74925984","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":"Current status of surgical diagnosis and treatment of pulmonary malignant ground glass nodules","authors":"Liang Cheng, Zhong Jiang, Wei Gao, Yongsheng Zhao, M. Fu","doi":"10.3760/CMA.J.ISSN.1001-4497.2019.12.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-4497.2019.12.014","url":null,"abstract":"In recent years, with the development of imaging technology, more and more ground-glass Nodule (GGN) in the lungs have been discovered. After GGN is detected, it should be further judged whether it is benign or malignant by combining with existing inspection methods. Common diagnostic and examination methods include PET/CT, fiberoptic bronchoscopy, CT-guided puncture biopsy and High Resolution CT (HRCT), each of them with its own advantages and disadvantages. For GGN with high malignant risk, minimally invasive surgical intervention is needed to prevent the progress of the disease. The hot issues of surgical treatment include the selection of minimally invasive surgical methods, the precise positioning of GGN in the lung, the accuracy and limitations of intraoperative freezing examination, lymph node dissection of GGN, and postoperative follow-up of malignant GGN diagnosed as cancer. Under the premise that surgical diagnosis and treatment play an increasingly important role in the management of GGN, this paper will review the existing GGN related studies and make a summary of the surgical diagnosis and treatment of malignant GGN.","PeriodicalId":10181,"journal":{"name":"Chinese Journal of Thoracic and Cardiovaescular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82676233","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}