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Wang LF, Li Y, Jin M, Li HB, Zhang N, Gong M, Zhang HJ, Liu YY, Lai YQ. FL% is associated with the severity of acute DeBakey type I aortic dissection in patients undergoing frozen elephant trunk and total arch replacement. Front Surg 2024; 11:1329771. [PMID: 38655210 PMCID: PMC11035816 DOI: 10.3389/fsurg.2024.1329771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Objectives The diameter, area, and volume of the true lumen and false lumen (FL) have been measured in previous studies to evaluate the extent of DeBakey type I aortic dissection. However, these indicators have limitations because of the irregular shapes of the true and false lumens and the constant oscillation of intimal flap during systole and diastole. The ratio of arch lengths seems to be a more reliable indicator. FL% was defined as the ratio of the arch length of FL to the circumference of the aorta at the different levels of the aorta. The purpose of this article was to investigate whether FL% is a predictor of the severity of acute DeBakey type I aortic dissection in patients undergoing frozen elephant trunk (FET) and total arch replacement. Methods In this retrospective observational study, we analyzed a total of 344 patients with acute DeBakey type I aortic dissection that underwent FET and total arch replacement at our center from October 2015 to October 2019. The patients were divided into two groups by cluster analysis according to the perioperative course. Binary logistic regression analyses were performed to determine whether FL% could predict the severity of acute DeBakey type I aortic dissection. The area under the receiver operating characteristic curve (AUROC) was used to assess the power of the multivariate logistic regression model for the severity of acute DeBakey type I aortic dissection. Results The patients in the ultra-high-risk group (109 patients) had significantly more severe clinical comorbidities and complications than the patients in the high-risk group (235 patients). The ascending aortic FL% [odds ratio (OR), 11.929 (95% CI: 1.421-100.11); P = 0.022], location of initial tear [OR, 0.68 (95% CI: 0.47-0.98); P = 0.041], the degree of left iliac artery involvement [OR, 1.95 (95% CI: 1.15-3.30); P = 0.013], and the degree of right coronary artery involvement [OR, 1.46 (95% CI: 1.01-2.12); P = 0.045] on preoperative computed tomography angiography were associated with the severity of acute DeBakey type I aortic dissection. The AUROC value of this multivariate logistic regression analysis was 0.940 (95% CI: 0.914-0.967; P < 0.001). The AUROC value of ascending aortic FL% was 0.841 (95% CI: 0.798-0.884; P < 0.001) for the severity of acute DeBakey type I aortic dissection in patients undergoing FET and total arch replacement. Conclusions Ascending aortic FL% was validated as an essential radiologic index for assessing the severity of acute DeBakey type I aortic dissection in patients undergoing FET and total arch replacement. Higher values of ascending aortic FL% were more severe.
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Affiliation(s)
- Long-Fei Wang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yu Li
- Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Mu Jin
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hai-Bin Li
- Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ming Gong
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hong-Jia Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yu-Yong Liu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yong-Qiang Lai
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Liu JJ, Liang L, Kong QY, Ma XL, Chi LQ, Lai YQ. A study on the perioperative effects of obesity on minimally invasive coronary artery bypass grafting and its surgical techniques. Interdiscip Cardiovasc Thorac Surg 2023:ivad092. [PMID: 37364009 DOI: 10.1093/icvts/ivad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To discuss the perioperative effects of obesity on minimally invasive coronary artery bypass grafting (CABG) and its surgical techniques. METHODS A total of 582 patients with multivessel lesion who underwent off-pump CABG by our medical group of Beijing Anzhen Hospital between January 2017 and January 2021 were divided into the minimally invasive cardiac surgery (MICS) group and the conventional group (median sternotomy) according to the surgical method used. The body mass index of the patients was calculated, based on which both groups were divided into obese (≥28 kg/m2) and non-obese subgroups (<28 kg/m2). Firstly, the perioperative data of the obese subgroups of both MICS and conventional groups were compared. Secondly, the obese and non-obese subgroups were compared in MICS group. RESULTS Despite a higher proportion of diabetes in the MICS group, there was no significant difference in preoperative baseline nor in the incidence of major complications within 30 days after surgery between obese subgroups of the MICS and conventional groups. The MICS group had a significantly lower rate of poor wound healing, along with a higher predischarge Barthel Index. Also, preoperative baseline between the obese and non-obese subgroups of the MICS group exhibited no statistically differences. The obese subgroup had longer postoperative ventilator assistance, while other intraoperative data and postoperative observation indexes exhibited no significant differences. CONCLUSIONS MICS CABG method is safe and feasible for obese patients with multivessel lesion. Minimally invasive surgery is beneficial to wound healing in obese patients. However, it requires a thorough preoperative evaluation and adequate surgical experience and skills.
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Affiliation(s)
- Jia-Ji Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Lin Liang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Qing-Yu Kong
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Xiao-Long Ma
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Li-Qun Chi
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
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Lu Y, Cao J, Zhu EJ, Gao MX, Mou TT, Zhang Y, Xie XF, Tian Y, Yun MK, Meng JJ, Yang XB, Lai YQ, Dong R, Zhang XL. [Predictive value of the proportion of hibernating myocardium in total perfusion defect on reverse remodeling in patients with HFrEF underwent coronary artery bypass graft]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:384-392. [PMID: 37057325 DOI: 10.3760/cma.j.cn112148-20221121-00912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objective: To evaluate the predictive value of the proportion of hibernating myocardium (HM) in total perfusion defect (TPD) on reverse left ventricle remodeling (RR) after coronary artery bypass graft (CABG) in patients with heart failure with reduced ejection fraction (HFrEF) by 99mTc-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) combined with 18F-flurodeoxyglucose (FDG) gated myocardial imaging positron emission computed tomography (PET). Methods: Inpatients diagnosed with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2016 to January 2022 were prospectively recruited. MPI combined with 18F-FDG gated PET was performed before surgery for viability assessment and the patients received follow-up MPI and 18F-FDG gated PET at different stages (3-12 months) after surgery. Δ indicated changes (post-pre). Left ventricular end-systolic volume (ESV) reduced at least 10% was defined as RR, patients were divided into reverse remodeling (RR+) group and the non-reverse group (RR-). Binary logistic regression analysis was used to identify predictors of RR. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated to assess the cut-off value for predicting RR. Additionally, we retrospectively enrolled inpatients with HFrEF at the Cardiac Surgery Center, Anzhen Hospital of Capital Medical University from January 2021 to January 2022 as the validation group, who underwent MPI and 18F-FDG gated PET before surgery. Echocardiography was performed before CABG and after CABG (3-12 months). In the validation group, the reliability of obtaining the cut-off value for the ROC curve was verified. Results: A total of 28 patients with HFrEF (26 males; age (56.9±8.7) years) were included in the prospective cohort. HM/TPD was significantly higher in the RR+ group than in the RR- group ((51.8%±17.9%) vs. (35.7%±13.9%), P=0.016). Binary logistic regression analysis revealed that HM/TPD was an independent predictor of RR (Odds ratio=1.073, 95% Confidence interval: 1.005-1.145, P=0.035). ROC curve analysis revealed that HM/TPD=38.3% yielded the highest sensitivity, specificity, and accuracy (all 75%) for predicting RR and the AUC was 0.786 (P=0.011). Meanwhile, a total of 100 patients with HFrEF (90 males; age (59.7±9.6) years) were included in the validation group. In the validation group, HM/TPD=38.3% predicted RR in HFrEF patients after CABG with the highest sensitivity, specificity and accuracy (82%, 60% and 73% respectively). Compared with the HFrEF patients in the HM/TPD<38.3% group (n=36), RR and cardiac function improved more significantly in the HM/TPD≥38.3% group (n=64) (all P<0.05). Conclusions: Preoperative HM/TPD ratio is an independent factor for predicting RR in patients with HFrEF after CABG, and HM/TPD≥38.3% can accurately predict RR and the improvement of cardiac function after CABG.
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Affiliation(s)
- Y Lu
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - J Cao
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - E J Zhu
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M X Gao
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - T T Mou
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y Zhang
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X F Xie
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y Tian
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M K Yun
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - J J Meng
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X B Yang
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y Q Lai
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - R Dong
- Heart Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X L Zhang
- Department of Nuclear Medicine, Laboratory for Molecular Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Li G, Shao Y, Guo HC, Zhi Y, Qiao B, Ma K, Lai YQ, Du J, Li Y. MicroRNA-27b-3p downregulates FGF1 and aggravates pathological cardiac remodelling. Cardiovasc Res 2021; 118:2139-2151. [PMID: 34358309 PMCID: PMC9302889 DOI: 10.1093/cvr/cvab248] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Indexed: 12/13/2022] Open
Abstract
AIMS The heart undergoes pathological remodelling under increased stress and neuronal imbalance. MicroRNAs (miRNAs) are involved in post-transcriptional regulation of genes in cardiac physiology and pathology. However, the mechanisms underlying miRNA-mediated regulation of pathological cardiac remodelling remain to be studied. This study aimed to explore the function of endogenous microRNA-27b-3p (miR-27b-3p) in pathological cardiac remodelling. METHODS AND RESULTS miR-27b-3p expression was elevated in the heart of a transverse aortic constriction (TAC)-induced cardiac hypertrophy mouse model. MiR-27b-knockout mice showed significantly attenuated cardiac hypertrophy, fibrosis, and inflammation induced by two independent pathological cardiac hypertrophy models, TAC and Angiotensin II (Ang II) perfusion. Transcriptome sequencing analysis revealed that miR-27b deletion significantly downregulated TAC-induced cardiac hypertrophy, fibrosis, and inflammatory genes. We identified fibroblast growth factor 1 (FGF1) as a miR-27b-3p target gene in the heart and was upregulated in miR-27b-null mice. We found that both recombinant FGF1 (rFGF1) and inhibition of miR-27b-3p enhanced mitochondrial oxidative phosphorylation (OXPHOS) and inhibited cardiomyocyte hypertrophy. Importantly, rFGF1 administration inhibited cardiac hypertrophy and fibrosis in TAC or Ang II-induced models, and enhanced OXPHOS by activating PGC1α/β. CONCLUSIONS Our study demonstrated that miR-27b-3p induces pathological cardiac remodelling and suggests that inhibition of endogenous miR-27b-3p or administration of FGF1 might have the potential to suppress cardiac remodelling in a clinical setting. TRANSLATIONAL PERSPECTIVE MicroRNAs (miRNAs) are involved in post-transcriptional regulation of genes in cardiac physiology and pathology. However, the mechanisms underlying miRNA-mediated regulation of pathological cardiac remodelling remain to be studied. We show for the first time that miR-27b deletion attenuates cardiac hypertrophy, fibrosis, and inflammation and that rFGF1 administration inhibits cardiac hypertrophy and fibrosis in TAC- or Ang II-induced models, and enhances OXPHOS by activating PGC1α/β. Our findings suggest that miR-27b-3p and FGF1 may be potential therapeutic targets to treat conditions characterised by pathological cardiac remodelling.
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Affiliation(s)
- Guoqi Li
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Yihui Shao
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Hong-Chang Guo
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Ying Zhi
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Bokang Qiao
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Ke Ma
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Yong-Qiang Lai
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Jie Du
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
| | - Yulin Li
- Beijing Anzhen Hospital, Capital Medical University; The Key Laboratory of Remodelling-Related Cardiovascular Diseases, Ministry of Education; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, 100029, China
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Lai YQ, Peng BG. [Efficacy of nasal cavity ventilation expansion surgery for OSAHS with multiplane obstruction]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 31:423-427. [PMID: 29871278 DOI: 10.13201/j.issn.1001-1781.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Indexed: 11/12/2022]
Abstract
Objective:To evaluate the improvement of nasal obstruction sympotom, AHI and LSaO²of OSAHS patients with multiplane obstruction after nasal cavity ventilation expansion techniques.Method:All the 41 OSAHS patients diagnosed by PSG were assessed with multiplane obstruction after examinations.Nasal cavity ventilation expansion techniques were performed. Each patient received the examinations of acoustic rhinometry and nasal resistance to assess the objective nasal ventilation, completed the nasal obstruction symptom evaluation(NOSE) scale to assess the subjective nasal obstructon. Postoperative datas were obtained at least 3 months later. Result:①The unilateral nasal volume 0-5 cm(UV5)were significantly changed(P<0.05), whereas the nasal resistance(NR)and NOSE were significantly decreased(P<0.05);②the AHI was significantly decreased,the LSaO2 was significantly increased(P<0.05). Conclusion:①The nasal cavity ventilation expansion techniques can improve the nasal ventilation of OSAHS patients with multiplane obstruction;②the postoperative AHI was significantly decreased whereas the chronic hypoxemia of patients was improve after surgery. Nasal cavity ventilation expansion surgery was effective and helpful for the later treatments for OSAHS patients with multiplane obstruction.
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Affiliation(s)
- Y Q Lai
- Departent of Otolaryngology,the Fourth Clinical Medical College of Peking University,Beijing Jishuitan Hospital,Beijing,100035,China
| | - B G Peng
- Departent of Otolaryngology,the Fourth Clinical Medical College of Peking University,Beijing Jishuitan Hospital,Beijing,100035,China
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Guo HC, Li JH, Jiang TY, Ren CW, Dai J, Zhou YJ, Lai YQ. Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy. Chin Med J (Engl) 2018; 131:527-531. [PMID: 29483385 PMCID: PMC5850667 DOI: 10.4103/0366-6999.226075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy (MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM). This study aimed to determine the clinical outcome of these two strategies. Methods From January 2011 to January 2015, 226 patients with HCM were treated, 68 by PTSMA and 158 by MMSM. Both ultrasonic cardiograms and heart functional class were recorded before, after operations and in the follow-up. Categorical variables were compared using Chi-square or Fisher's exact tests. Quantitative variables were compared using the paired samples t-test. Results Interventricular septal thickness was significantly reduced in both groups (21.27 ± 4.43 mm vs. 18.72 ± 4.13 mm for PTSMA, t = 3.469, P < 0.001, and 21.83 ± 5.03 mm vs. 16.57 ± 3.95 mm for MMSM, t = 10.349, P < 0.001, respectively). The left ventricular outflow tract (LVOT) pressure gradient (PG) significantly decreased after the operations in two groups (70.30 ± 44.79 mmHg vs. 39.78 ± 22.07 mmHg for PTSMA, t = 5.041, P < 0.001, and 74.58 ± 45.52 mmHg vs. 13.95 ± 9.94 mmHg for MMSM, t = 16.357, P < 0.001, respectively). Seven patients (10.29%) in the PTSMA group required a repeat operation in the follow-up. Eight (11.76%) patients were evaluated for New York Heart Association (NYHA) III/IV in the PTSMA group, which was significantly more than the five (3.16%) in the same NYHA classes for the MMSM group at follow-up. Less than 15% of patients in the PTSMA group and none of the patients in the MMSM group complained of chest pain during follow-up. Conclusions Both strategies can not only relieve LVOT PG but also improve heart function in patients with HCM. However, MMSM might provide a more reliable reduction in gradients compared to PTSMA.
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Affiliation(s)
- Hong-Chang Guo
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jin-Hua Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Teng-Yong Jiang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Chang-Wei Ren
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiang Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yu-Jie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Guo HW, Kong WS, Lai YQ, Kuang F, Zhuang JW, Shan ZG. [Clinical analysis of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery]. Zhonghua Yi Xue Za Zhi 2018. [PMID: 29534387 DOI: 10.3760/cma.j.issn.0376-2491.2018.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary. Results: One patient died of false aneurysm due to the sternal sinus tract infection, there were no peri-operative death for all the left 52 patients. Forty-five patients had primary healing and 7 patients had secondary healing. All the patients became total recovery within 3-12 weeks after operation and maintained well during the 5-18 months' follow-up. Conclusions: For the patients with chronic sternal osteomyelitis, operative therapy should be performed as soon as possible once the diagnosis is confirmed. Combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation is confirmed to be effective and secure.
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Affiliation(s)
- H W Guo
- Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361000, China
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Guo HC, Wang Y, Dai J, Ren CW, Li JH, Lai YQ. Application of 3D printing in the surgical planning of hypertrophic obstructive cardiomyopathy and physician-patient communication: a preliminary study. J Thorac Dis 2018; 10:867-873. [PMID: 29607159 DOI: 10.21037/jtd.2018.01.55] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background The aim of this study was to evaluate the effect of 3-dimensional (3D) printing in treatment of hypertrophic obstructive cardiomyopathy (HOCM) and its roles in doctor-patient communication. Methods 3D-printed models were constructed preoperatively and postoperatively in seven HOCM patients received surgical treatment. Based on multi-slice computed tomography (CT) images, regions of disorder were segmented using the Mimics 19.0 software (Materialise, Leuven, Belgium). After generating an STL-file (StereoLithography file) with patients' data, the 3D printer (Objet350 Connex3, Stratasys Ltd., USA) created a 3D model. The pre- and post-operative 3D-printed models were used to make the surgical plan preoperatively and evaluate the outcome postoperatively. Meanwhile, a questionnaire was designed for patients and their relatives to learn the effectiveness of the 3D-printed prototypes in the preoperative conversations. Results The heart anatomies were accurately printed with 3D technology. The 3D-printed prototypes were useful for preoperative evaluation, surgical planning, and practice. Preoperative and postoperative echocardiographic evaluation showed left ventricular outflow tract (LVOT) obstruction was adequately relieved (82.71±31.63 to 14.91±6.89 mmHg, P<0.001), the septal thickness was reduced from 21.57±4.65 to 17.42±5.88 mm (P<0.001), and the SAM disappeared completely after the operation. Patients highly appreciated the role of 3D model in preoperative conversations and the communication score was 9.11±0.38 points. Conclusions A 3D-printed model is a useful tool in individualized planning for myectomies and represent a useful tool for physician-patient communication.
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Affiliation(s)
- Hong-Chang Guo
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China
| | - Yang Wang
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China.,Department of Cardiac Surgery, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - Jiang Dai
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China
| | - Chang-Wei Ren
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China
| | - Jin-Hua Li
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China
| | - Yong-Qiang Lai
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100000, China
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Ruan YP, Liu XW, Zhang Y, Han JC, Lai YQ, Lü J, He YH. [Comparison of early clinical effects of ablation with surgery treatment in patients with hypertrophic cardiomyopathy]. Zhonghua Yi Xue Za Zhi 2017; 97:3553-3557. [PMID: 29275594 DOI: 10.3760/cma.j.issn.0376-2491.2017.45.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69). The baseline characteristics, disease status, other history of surgery and echocardiography parameters before and after septal reduction were collected, as well as the complication within 1 week after operation. Results: The mean age in surgery group was (46±14) years old, with 76 males (56.3%); mean age was (47±11) years old and with 51 males (73.9%) in PTMSA group. There was no significant difference in age, gender, the time of symptom and diagnosis, syncope, family history and atrial fibrillation between the two groups (all P>0.05). The proportion of mitral valve prolapse in the surgery group was higher than that in PTMSA group (75.8% vs 44.2%, P<0.05). Baseline left ventricular outflow tract (LVOT) gradient was comparable (82.7 mmHg in surgery group vs 77.7 mmHg in PTMSA group, P>0.05). The mean resting LVOT gradient after septal reduction therapy was lower (16.55 mmHg in surgery group, 26.68mmHg in PTMSA group) than that before operation, with lower gradient in surgery group (P<0.05). Compared with PTMSA group, the duration of hospitalization was longer in surgery group (P<0.05). There was similar rate of operation related complications in the two groups. Conclusions: Both septal reduction therapies can improve the LVOT obstruction, more significant in surgery group, but with longer hospital stay. The rate of operation related complication is similar in both groups.
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Affiliation(s)
- Y P Ruan
- Department of Ultrasound, Maternal-fetal Medicine Research Consultation Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Lai YQ, Peng BG. [Surgical treatment progress of OSAHS with multiplane obstruction]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:1530-1535. [PMID: 29798111 DOI: 10.13201/j.issn.1001-1781.2017.19.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Indexed: 11/12/2022]
Abstract
For OSAHS patients with multiplane obstruction,the surgery aimed to single-plane can not receive satisfactory results,while perioperative risks increased significantly. In this paper,in order to provide safe and effective diagnosis and treatment strategies,the assessment,the surgical treatments and effects of different obstructive planes are reviewed.
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11
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Guo HC, Ren CW, Dai J, Lai YQ. Surgical Treatment of Arrhythmogenic Right Ventricular Cardiomyopathy with Absent Pulmonary Valve. Chin Med J (Engl) 2017; 130:1383-1384. [PMID: 28524842 PMCID: PMC5455052 DOI: 10.4103/0366-6999.206344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Hong-Chang Guo
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Chang-Wei Ren
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiang Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Affiliation(s)
- Hong-Chang Guo
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Chang-Wei Ren
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiang Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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13
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Ren CW, Liu JJ, Li JH, Li JW, Dai J, Lai YQ. RNA‑seq profiling of mRNA associated with hypertrophic cardiomyopathy. Mol Med Rep 2016; 14:5573-5586. [PMID: 27840985 DOI: 10.3892/mmr.2016.5931] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 09/20/2016] [Indexed: 11/06/2022] Open
Abstract
The mechanisms of hypertrophic cardiomyopathy (HCM) pathogenesis can be investigated by determining the differences between healthy and disease states at the molecular level. In the present study, large‑scale transcriptome sequencing was performed to compare mRNA expression in patients with HCM and control groups using an Illumina sequencing platform. Compared with the genome background, 257 differentially expressed genes (DEGs) were identified in which 62 genes were downregulated and 195 genes were upregulated. Reverse transcription‑quantitative polymerase chain reaction was performed to validate the expression pattern of certain mRNAs. Gene ontology enrichment and KEGG analysis of mRNAs was conducted to identify the biological modules and pathological pathways associated with the DEGs. To the best of our knowledge, this is the first time study to investigate the differences in mRNA between patients with HCM and normal controls at the transcriptome level. The results of the study will contributed to the understanding of the important molecular mechanisms involved in HCM and aid the selection of key genes to investigate in the future.
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Affiliation(s)
- Chang-Wei Ren
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Jia-Ji Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Jin-Hua Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Jing-Wei Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Jiang Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
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Ren CW, Lai YQ, Yang S, Xu SD, Sun LZ. Four-branch Prosthetic Graft Used for Stanford Type A Aortic Dissection with Aberrant Right Subclavian Artery. Chin Med J (Engl) 2016; 128:1558. [PMID: 26021518 PMCID: PMC4733775 DOI: 10.4103/0366-6999.157701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | | | | | - Li-Zhong Sun
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Liu JJ, Ren CW, Wu WH, Lai YQ. One-stage Hybrid Procedure for Patients with Valvular Pulmonary Stenosis and Coronary Artery Disease. Chin Med J (Engl) 2016; 129:624-5. [PMID: 26905005 PMCID: PMC4804452 DOI: 10.4103/0366-6999.177005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | | | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Ren CW, Liu CL, Lai YQ, Sun LZ, Xu SD. "Collared Anastomosis" Technique Used in Arch Replacement Combined with Frozen Elephant Trunk Implantation Procedure for Giant Arch and Thoracic Aorta Dilatation. Chin Med J (Engl) 2015; 128:1982. [PMID: 26168843 PMCID: PMC4717943 DOI: 10.4103/0366-6999.160622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | | | | | - Shang-Dong Xu
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Jiang WJ, Cui YC, Li JH, Zhang XH, Ding HH, Lai YQ, Zhang HJ. Is autologous or heterologous pericardium better for valvuloplasty? A comparative study of calcification propensity. Tex Heart Inst J 2015; 42:202-8. [PMID: 26175630 DOI: 10.14503/thij-14-4296] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium. We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at 4 months in group C, and at 6 months in group D. Each collected sample was divided into 2 parts, one for calcium-content measurement by means of atomic-absorption spectroscopy, and one for morphologic and histopathologic examinations. When compared with the autologous pericardium, calcium levels in the heterologous pericardium were higher in groups B, C, and D (P <0.0001, P <0.0002, and P <0.0006, respectively). As embedding time increased, calcium levels in the heterologous pericardium increased faster than those in the autologous, especially in group D. Disorganized arrangements of collagenous fibers, marked calculus, and ossification were seen in the heterologous pericardium. Inflammatory cells-mainly lymphocytes and small numbers of macrophages-infiltrated the heterologous pericardium. The autologous pericardium showed a stronger ability to resist calcification. Our results indicate that autologous pericardium might be a relatively better choice for valvuloplasty.
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Affiliation(s)
| | | | | | | | - Shang-Dong Xu
- Department of Cardiovascular Surgery Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Wang P, Mao B, Luo W, Wei B, Jiang W, Liu D, Song L, Ji G, Yang Z, Lai YQ, Yuan Z. The alteration of Hippo/YAP signaling in the development of hypertrophic cardiomyopathy. Basic Res Cardiol 2014; 109:435. [DOI: 10.1007/s00395-014-0435-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 08/05/2014] [Accepted: 08/20/2014] [Indexed: 10/24/2022]
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20
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Ruan XL, Qiu JJ, Wu C, Huang T, Meng RB, Lai YQ. Magnetic single-walled carbon nanotubes–dispersive solid-phase extraction method combined with liquid chromatography–tandem mass spectrometry for the determination of paraquat in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 965:85-90. [DOI: 10.1016/j.jchromb.2014.06.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/04/2014] [Accepted: 06/13/2014] [Indexed: 11/16/2022]
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21
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Jiang WJ, Li JH, Dai J, Lai YQ. Cardiac hemangioma at the apex of the right ventricle: a case report and literature review. J Thorac Cardiovasc Surg 2013; 147:e18-21. [PMID: 24290718 DOI: 10.1016/j.jtcvs.2013.10.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 10/31/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Wen-Jian Jiang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jin-Hua Li
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jiang Dai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yong-Qiang Lai
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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22
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Hao XH, Huang FJ, Wang SY, Zhang C, Zhang ZG, Lai YQ. Off-pump coronary artery bypass grafting with device closure of atrial septal defect. Ann Thorac Surg 2010; 90:1727-9. [PMID: 20971311 DOI: 10.1016/j.athoracsur.2009.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 12/11/2009] [Accepted: 12/15/2009] [Indexed: 10/18/2022]
Abstract
Patients with coronary artery disease and atrial septal defect may have unique clinical characters. We describe an off-pump combined approach for intraoperative device closure of atrial septal defect during coronary artery bypass grafting.
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Affiliation(s)
- Xing-Hai Hao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Abstract
Intercostal artery aneurysms associated with coarctation of aorta (CoA) are rare and their natural histories are poorly understood. This report describes the surgical correction of this anomaly in an adult without performing extracorporeal circulation. The coarctated segment of aorta and intercostal artery aneurysm were resected, and the continuity of the descending aorta was reestablished with an interposed vascular graft.
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Affiliation(s)
- Zhi-Qiang Luo
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Liao XX, Liao CX, Huang YP, Qin AC, Yuan J, Lai YQ, Gong ZY. Intrahepatic levels of Fractalkine in healthy individuals and patients with hepatic fibrosis and cirrhosis. Shijie Huaren Xiaohua Zazhi 2009; 17:3456-3459. [DOI: 10.11569/wcjd.v17.i33.3456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the intrahepatic levels of chemokine Fractalkine in healthy individuals and patients with hepatic fibrosis and cirrhosis.
METHODS: Hepatic tissues were obtained in surgery from 9 normal persons, 10 patients with fibrotic liver, 11 patients with cirrhosis. The content of Fractalkine in hepatic tissue was assayed by ELISA.
RESULTS: The intrahepatic levels of Fractalkine in patients with hepatic fibrosis and cirrhosis were remarkably higher than that in healthy individuals (13.72 ± 5.59 ng/g and 14.70 ± 3.52 ng/g vs 4.84 ± 3.72 ng/g, respectively; both P < 0.05). No significant difference was noted in intrahepatic level of Fractalkine between patients with hepatic fibrosis and cirrhosis.
CONCLUSION: Intrahepatic level of Fractalkine increases with the aggravation of hepatic fibrosis and remains high in liver cirrhosis.
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26
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Ji B, Miao N, Lai YQ, Luo Y. Acid-base management and temperature control during hypothermic circulatory arrest. Ann Thorac Cardiovasc Surg 2009; 15:272-274. [PMID: 19763063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Accepted: 03/08/2009] [Indexed: 05/28/2023] Open
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Abstract
BACKGROUND Edge-to-edge mitral valve plasty technique has been widely used to treat bileaflet prolapse. This procedure anchors the correspondence leaflets to create a double-orifice mitral valve. The original mitral valve anatomy is changed, and the opening of mitral valve is restricted. Little is known whether this procedure affects the left ventricular diastolic function. METHODS Thirty patients with mitral regurgitation were included in this study. Fifteen with posterior leaflet prolapse received quadrangular resection (group 1), 15 with anterior or bileaflet prolapse underwent edge-to-edge procedure (group 2). Acute hemodynamics was monitored with a Swan-Ganz catheter (Edwards Lifesciences LLC, Irvine, CA, USA). Left ventricular diastolic function was also evaluated with echocardiography in 28 patients with sinus rhythm. The ratio of peak E velocity and A velocity (E/A), the ratio of early diastolic peak flow velocity to early diastolic mitral annular movement velocity (E/Em), and the ratio of early diastolic mitral annular velocity to late diastolic mitral annular velocity (Em/Am) were measured before operation and one week after operation. RESULTS Mitral valve area and mitral regurgitate grade decreased significantly after operation. There was no significant change in pulmonary artery wedge pressure between two groups and in each group before and after operation. Echocardiography evaluation showed there was no significant difference in E/A, E/Em, and Em/Am before and after operation between two groups and in each group. CONCLUSION Edge-to-edge mitral valve plasty procedure has no significant impairment on left ventricular diastolic function. A double-orifice mitral valve has similar hemodynamic behavior with a physiological valve.
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Affiliation(s)
- Yong-Qiang Lai
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing, China.
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Lai YQ, Li JH, Li JW, Xu SD, Luo Y, Zhang ZG. Concomitant irrigated monopolar radiofrequency ablation of atrial fibrillation in adults with congenital heart disease. Interact Cardiovasc Thorac Surg 2007; 7:80-2. [PMID: 18024493 DOI: 10.1510/icvts.2007.165225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Atrial fibrillation is the most frequent form of atrial arrhythmias in adults with congenital heart disease. Some serious complications are related with the presence of atrial fibrillation after surgery. Because of the complexity and the risk of bleeding, the Maze III procedure has been largely replaced by alternative energy sources. Our experience in using irrigated monopolar radiofrequency ablation to treat atrial fibrillation in adults with congenital heart disease is reported. Seven patients with congenital heart disease and atrial fibrillation underwent irrigated monopolar radiofrequency ablation. All patients were confirmed in permanent fibrillation preoperatively. Six were adult atrial septal defect patients and one was an adult patent ductus arteriosus patient. All patients survived the procedure and discharged in sinus rhythm. There were no complications related to radiofrequency ablation. The time of ablation ranged from 17 to 22 min (average 19.5 min). Follow-up ranged from 3 to 48 months. One patient with mitral valve replacement (MVR) died of cerebral hemorrhage 13 months after surgery. The last electrocardiogram showed that six patients were in sinus rhythm and one patient in junctional rhythm. Irrigated monopolar radiofrequency ablation is an easy, effective, safe and economic concomitant operation to eliminate atrial fibrillation in adult patients with congenital heart defect and atrial fibrillation.
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Affiliation(s)
- Yong-Qiang Lai
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, 36 Wuluju Chaoyang District, Beijing, 100029 China.
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Lai YQ, Zhou QW, Wei H, Zhang C, Zhang ZG. Intrapulmonary channel for one-stage correction of aortic arch obstruction. Asian Cardiovasc Thorac Ann 2006; 14:402-6. [PMID: 17005888 DOI: 10.1177/021849230601400511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are several methods of surgical repair of aortic coarctation or interruption; the optimal technique is still controversial. The purpose of this study was to assess a new surgical method: intrapulmonary channel for one-stage repair of aortic coarctation or interruption associated with intracardiac anomalies. Between 1993 and 1995, 4 patients with aortic coarctation or interruption and intracardiac anomalies received one-stage surgical correction. Their ages ranged from 5 to 26 years (mean, 16 years). The aortic arch lesions were preductal coarctation in 2, and type B interruption in 2. Coexisting anomalies consisted of patent ductus arteriosus in 4, ventricular septal defect in 3, and aortopulmonary window in 1. An intrapulmonary channel was constructed in all patients, and co-existing anomalies were corrected simultaneously. There was no hospital death or late mortality. A cerebral complication occurred in one patient because of air embolism. Mean follow-up was 9.5 years (range, 8.5-11.5 years). There was no evidence of recoarctation or late aneurysm formation. For selected patients with aortic coarctation or interruption and intracardiac anomalies, an intrapulmonary channel might be an option for one-stage correction.
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Affiliation(s)
- Yong-Qiang Lai
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, 36 Wuluju, Chaoyang District, Beijing 100 029, China.
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Lai YQ, Meng X, Bai T, Zhang C, Luo Y, Zhang ZG. Edge-to-Edge Tricuspid Valve Repair: An Adjuvant Technique for Residual Tricuspid Regurgitation. Ann Thorac Surg 2006; 81:2179-82. [PMID: 16731150 DOI: 10.1016/j.athoracsur.2006.01.046] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 01/09/2006] [Accepted: 01/10/2006] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tricuspid regurgitation is a very common valve disease. Significant morbidity and mortality is associated with tricuspid valve replacement and tricuspid valve plasty is still a preferred choice. Because of the abnormality of valve and subvalvular apparatus, tricuspid valve plasty is sometimes complicated and associated with suboptimal results. This report deals with our surgical experience in using edge-to-edge valve plasty technique in cases with severe residual tricuspid regurgitation. METHODS From April 2001 to November 2004, 15 patients with severe residual tricuspid regurgitation underwent edge-to-edge tricuspid valve plasty. The etiology of tricuspid regurgitation was secondary to rheumatic heart disease in 5 cases, secondary to congenital heart disease in 5 cases, to congenital tricuspid valve dysplasia in 1 case, and to posttraumatic and degenerative disease in 2 cases, respectively. After tricuspid valve repair was performed with traditional methods, severe tricuspid regurgitation was still present. Edge-to-edge tricuspid valve plasty was used in these patients. RESULTS There was 1 hospital death. No or trivial tricuspid regurgitation was found in 6 cases, and mild tricuspid regurgitation was present in 9 cases after operation. The follow-up ranged from 8 to 51 months (median, 25.3). Trivial to mild tricuspid regurgitation was present in 12 cases and mild to moderate tricuspid regurgitation in 2 cases. CONCLUSIONS Edge-to-edge tricuspid valve plasty is an effective adjuvant procedure for patients who have severe residual tricuspid regurgitation.
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Affiliation(s)
- Yong-Qiang Lai
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing, China.
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31
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Agnihotri AK, Desai SC, Lai YQ, Fitzsimons MG, Hilgenberg AD, Vlahakes GJ. Two distinct clinical presentations in adult unicuspid aortic valve. J Thorac Cardiovasc Surg 2006; 131:1169-70. [PMID: 16678607 DOI: 10.1016/j.jtcvs.2005.11.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Accepted: 11/02/2005] [Indexed: 10/24/2022]
Affiliation(s)
- Arvind K Agnihotri
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass 02114, USA.
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32
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Lai YQ, Luo Y, Zhang C, Zhang ZG. Utilization of double-orifice valve plasty in correction of atrioventricular septal defect. Ann Thorac Surg 2006; 81:1450-4. [PMID: 16564291 DOI: 10.1016/j.athoracsur.2005.10.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Revised: 10/20/2005] [Accepted: 10/31/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atrioventricular valve regurgitation represents the principal indication for reoperation after repair of atrioventricular septal defect. Deciding how to correct atrioventricular valve regurgitation is challenging in some cases because of the complexity of the anatomic features. This report deals with our surgical experience in using a double-orifice valve plasty technique in cases with atrioventricular septal defect. METHODS From August 2002 to August 2004, 8 patients underwent double-orifice valve plasty in surgical correction of atrioventricular septal defect. Anatomic types were partial (6 patients), intermediate (1 patient), and complete (1 patient). After the mitral cleft was closed, moderate to severe atrioventricular valve regurgitation was still present in these patients. Double-orifice valve plasty was used in the mitral valve in 7 patients and in the tricuspid valve in 1. RESULTS No hospital deaths or postoperative morbidity occurred. The follow-up ranged from 6 months to 30 months (median, 14.4 months). No or trivial atrioventricular valve regurgitation was found in 6 patients and mild atrioventricular valve regurgitation was present in 2. CONCLUSIONS Double-orifice valve plasty is an easy and effective additional procedure for children and for adult patients who have moderate or severe atrioventricular valve regurgitation after repair of atrioventricular septal defect.
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Affiliation(s)
- Yong-Qiang Lai
- Division of Cardiac Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing, China.
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