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Strategy and technique for surgical treatment of Ebstein’s anomaly

Chinese Medical Journal 2024年第10期137卷 1218-1224页

作者： Qingyu Wu Xiaoya Zhang Mingkui Zhang Hongyin Li Dongya Zhang Lianyi Wang Qingfeng Wu cardiac Center Division of Cardiac SurgeryThe First Hospital of Tsinghua UniversityBeijing 100016China

Background:Ebstein’s anomaly(EA)is a rare and complex congenital heart anomaly,and the effect of surgical treatment is not *** study aims to introduce our experience in management strategies,surgical techniques,and operative indications for patients with Ebstein’s ***:A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020.32 patients had previously received cardiac surgery in other *** clinical data including diagnosis,operative indications,techniques,pathological changes,and survival rates were collected and ***:Anatomical correction was performed in 203(78.7%)operations,1½ventricle repair in 38(14.7%)operations,tricuspid valve repair only in four operations(1.6%),tricuspid valve replacement in ten(3.9%),total cavopulmonary connection(TCPC)in two(0.8%),and Glenn operation in one operation(0.4%).Reoperation was performed in five patients(2.0%)during *** them,tricuspid valve replacement was performed in one patient,1½ventricle repair in two patients,and tricuspid valve annulus reinforcement in two *** patients died with an early mortality rate of 2.0%.Complete atrioventricular conduction block was complicated in one patient(0.4%).A total of 244 patients was followed up(four in the 253 patients lost)with a duration of 3.0-168.0(87.6±38.4)*** function of 244 patients improved significantly with mean New York Heart Association(NYHA)functional class recovery from 3.5 to *** mean grade of tricuspid valve regurgitation improved from 3.6 to *** late deaths(1.2%)*** survival rates at five and ten years after surgery were 98.6%and 98.2%,*** was performed in five patients(2.0%)during the follow-up ***:Based on our management strategies and operative principles and techniques,anatomical correction of EA is capable of achiev

关键词： Ebstein’s anomaly Anatomical repair Surgical treatment Long-term result

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Extracorporeal membrane oxygenation versus cardiopulmonary bypass during transcatheter aortic valve implantation: a meta-analysis of survival benefits

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World Journal of Emergency Medicine 2024年第4期15卷 306-310页

作者： Huiruo Liu Liangshan Wang Xing Hao Zhongtao Du Chenglong Li Hong Wang Xiaotong Hou centre for cardiac Intensive Care Beijing Institute of HeartLung and Blood Vessel DiseasesBeijing Anzhen HospitalCapital Medical UniversityBeijing 100029China

Since its approval by the Food and Drug Administration in 2011,transcatheter aortic valve implantation(TAVI)has rapidly evolved to become the preferred ultimate intervention for high-and intermediate-risk patients with severe symptomatic aortic stenosis.[1]This is due to its non-open-heart,minimally invasive and off-pump advantages.[1]Nevertheless,as a result of the frequent frailty and comorbidity profiles of patients undergoing TAVI,such as advanced cardiac dysfunction and extensive coronary artery disease,or technically difficult anatomy for the procedure itself,[2-4]it is common for these patients to experience critical circulatory collapse *** factors are linked to elevated mortality rates,necessitating suitable mechanical circulatory support(MCS)to reverse the disastrous situations.[5]

关键词： anatomy bypass elevated

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Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report

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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang Intensive Care Unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China Department of cardiac Surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely ***,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important *** the incidence of LVT during VA-ECMO is not high,the consequences of embolization are *** SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 *** excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for *** day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic *** ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral *** LVT with high mobility during VA-ECMO may cause embolism in important ***,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

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A case report of chylous ascites after cardiac surgery

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Emergency and Critical Care Medicine 2024年第1期4卷 42-45页

作者： Shuaishuai Yuan Pailing Xie Xiantao Liu Peijun Li The University of Hong Kong-Shenzhen Hospital Cardiovascular Medicine Center cardiac Intensive Care Unit ShenzhenGuangdongChina.

Background:Chylous ascites(CA),an emulsion rich in triglycerides,is a rare type of ascites,especially after cardiac ***,there are few reports of the occurrence of CA after mitral valve replacement,aortic valve replacement,tricuspid valvuloplasty,and coronary artery bypass *** presentation:We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence,aortic incompetence,tricuspid incompetence,and coronary atherosclerotic heart *** days after surgery,3000 mL of milky-yellow ascites appeared in the abdominal cavity,diagnosed as CA by laboratory *** ascites gradually disappeared after being drained,and the patients *** curative was objective,but the exact cause is not ***:Although CA is rare,it may occur during the surgical intervention in cardiac surgery.

关键词： cardiac intensive care unit cardiac valve replacement Case report Chylous ascites Coronary artery bypass graft Department of cardiac surgery

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First-in-man Experience of a New Transcatheter Edge-to-edge Repair System Neoblazar in Patients With Severe Tricuspid Regurgitation

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Cardiology Discovery 2024年第2期4卷 160-166页

作者： Xiang Chen Da Zhu Maolong Su Xu Chen Pianpian Yan Hongmei Wen Bin Wang Nianguo Dong Xiangbin Pan Yan Wang Department of Cardiology Xiamen Cardiovascular Hospital of Xiamen UniversityXiamenFujian 361004China Department of cardiac Surgery Fuwai Yunnan Cardiovascular HospitalKunmingYunnan 650102China Department of cardiac Surgery Wuhan Union HospitalTongji Medical CollegeHuazhong University of Science and Technology UniversityWuhanHubei 430022China

objective:Severe tricuspid regurgitation frequently leads to increased mortality and a poor *** edge-to-edge repair(TEER)for tricuspid valve regurgitation has been reported as a safe alternative to traditional open-heart *** study endeavors to assess the efficacy and safety of a newly designed Neoblazar TEER system in this high-risk ***:This investigation was structured as a prospective,single-arm,first-in-man trial in China(*** number:NCT05497141).From August 2022 to October 2022,patients with severe tricuspid regurgitation were enrolled from 3 centers(Xiamen Cardiovascular Hospital,Fuwai Yunnan Cardiovascular Hospital,and Wuhan Union Hospital).The primary endpoint was achieving a minimum 1-grade reduction in tricuspid regurgitation at the 6-month post-TEER intervention,in addition to the pertinent New York Heart Association *** echocardiographic evaluations were conducted at the following distinct intervals:baseline,discharge,1 month,and 6 months post-TEER ***:A total of 10 patients were enrolled in the *** after the TEER procedure with the Neoblazar system,massive tricuspid regurgitation(grade 5+)at baseline decreased to moderate-severe tricuspid regurgitation(grade 3+)in 2 patients and the optimal tricuspid regurgitation reduction(severe tricuspid regurgitation(grade 4+)to mild tricuspid regurgitation(grade 1+)were achieved in 6 *** 6 months of follow-up,tricuspid regurgitation reduction was found to be durable in all enrolled patients,among whom at least 1 grade of tricuspid regurgitation reduction was sustained,even without ***,the New York Heart Association class among these subjects significantly improved,with the percentage of patients categorized as class I-ll increasing from 0/10 at baseline to 5/10 after 1 month(P=0.015)and 8/10 after 6 months(P<0.001).Conclusion:Tricuspid TEER with the newly designed Neoblazar system a

关键词： Tricuspid valve insufficiency Transcatheter edge-to-edge repair Heart failure

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Isogeometric Analysis of Hyperelastic Material Characteristics for Calcified Aortic valve

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Computer Modeling in Engineering & Sciences 2024年第6期139卷 2773-2806页

作者： Long Chen Ting Li Liang Liu Wenshuo Wang Xiaoxiao Du Wei Wang School of Mechanical Engineering University of Shanghai for Science and TechnologyShanghai200093China Department of cardiac Surgery Zhongshan HospitalFudan UniversityShanghai200093China School of Mechanical Engineering and Automation Beihang UniversityBeijing100191China

This study explores the implementation of computed tomography(CT)reconstruction and simulation techniques for patient-specific valves,aiming to dissect the mechanical attributes of calcified valves within transcatheter heart valve replacement(TAVR)*** order to facilitate this exploration,it derives pertinent formulas for 3D multi-material isogeometric hyperelastic analysis based on Hounsfield unit(HU)values,thereby unlocking foundational capabilities for isogeometric analysis in calcified aortic valves.A series of uniaxial and biaxial tensile tests is executed to obtain an accurate constitutive model for calcified active *** mitigate discretization errors,methodologies for reconstructing volumetric parametric models,integrating both geometric and material attributes,are *** these analytical formulas,constitutive models,and precise analytical models to isogeometric analyses of calcified valves,the research ascertains their close alignment with experimental results through the close fit in displacement-stress curves,compellingly validating the accuracy and reliability of the *** study presents a step-by-step approach to analyzing themechanical characteristics of patient-specific valves obtained fromCT images,holding significant clinical implications and assisting in the selection of treatment strategies and surgical intervention approaches in TAVR procedures.

关键词： Calcified aortic valves tensile test constitutive relations CT reconstruction isogeometric hyperelastic analysis

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Transcatheter aortic valve replacement:A journey of two decades and beyond

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Chinese Medical Journal 2024年第9期137卷 1012-1015页

作者： Tianyuan Xiong Mao Chen Department of Cardiology West China HospitalSichuan UniversityChengduSichuan 610041China Laboratory of cardiac Structure and Function Institute of Cardiovascular DiseasesWest China HospitalSichuan UniversityChengduSichuan 610041China

The number of patients with calcic aortic stenosis(AS)is 9.4 million according to 2019 Global Disease Burden estimates,which will continue to increase as the population ages.[1]For the treatment of symptomatic severe AS,transcatheter aortic valve replacement(TAVR)has evolved to be a well-established option across all risk spectra,with a rapid growth of procedures *** rise of TAVR initiates the revolution of the management of valvular heart diseases,from patient surveillance,the staging of disease,the use of multimodality imaging,the concept of the Heart Team,new designs and iterations of devices to technical innovations and the discovery of unmet clinical *** a consequence of the global adoption of TAVR,geographical differences in the epidemiology of AS and patient characteristics have also been further identi*** examination of the changing patient population,current applications and breakthroughs,and remaining challenges are crucial for the future of this ***,we discuss the temporal utilization of TAVR,the accumulation of evidence and progress of devices,the selection of patients,and some ongoing topics concerning the improvement of TAVR.

关键词： epidemiology breakthrough beyond

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Unplanned J-valve implantation during open heart surgery for severe valvular annulus and ventricle calcification

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Journal of Geriatric Cardiology 2022年第12期19卷 1003-1006页

作者： Tian-Ge LUO Bo LI Jie HAN Hai-Bo ZHANG cardiac valve centre Department of Cardiac SurgeryBeijing Anzhen HospitalCapital Medical UniversityBeijing Institute of Heart Lung and Blood Vessel DiseaseBeijingChina Department of cardiac Surgery People’s Hospital of Liaoning ProvinceShenyangChina

Aortic annulus calcification(AC)and mitral AC are common in patients with cardiac valvular disease.[1]Procedures to resect or debride aortic AC and mitral AC may lead to cerebral emboli,heart failure,arrhythmia,coronary artery lesions,and even ventricular rupture.[2]Therefore,it is often a challenge for surgeons to choose an appropriate surgical strategy for patients with severe valvular AC.[3,4]A sutureless valve is a good choice,doing away with the need to take time to remove the AC,but many countries do not have this *** aortic valve implantation(TAVI)and transcatheter mitral valve replacement(TMVR)have developed rapidly during recent years.

关键词： mitral implantation calcification

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Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review

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World Journal of Cardiology 2024年第1期16卷 27-39页

作者： Christos Kourek Marios Kanellopoulos Vasiliki Raidou Michalis Antonopoulos Eleftherios Karatzanos Irini Patsaki Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Clinical Ergospirometry Exercise and Rehabilitation LaboratoryEvangelismos HospitalAthens 10676Greece Intensive Care Unit Onassis Cardiac Surgery CenterKallithea 17674Greece Department of Physiotherapy University of West AtticaAthens 12243Greece

BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher *** mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of *** electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these *** To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac *** We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac *** were assessed for methodological rigor and risk of bias via the *** primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and *** Ten studies were included in our systematic review,resulting in 703 *** half of them performed NMES and the other half were included in the control group,treated with usual *** studies investigated patients after cardiac surgery and 1 study before cardiac *** capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac *** studies

关键词： Neuromuscular electrical stimulation cardiac surgery coronary artery bypass grafting Heart valve replacement Peak VO2 Safety

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cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2014年第4期11卷 279-285页

作者： Renzo Zanettini Gemma Gatto Ileana Mori Maria Beatrice Pozzoni Stefano Pelenghi Luigi Martinelli Silvio Klugmann cardiac Rehabilitation centre Istituti Clinici di Perfezionamento Hospital via Bignami 1 20126 Milan Italy De Gasperis Cardiology and cardiac Surgery Department Niguarda Ca' Granda Hospital Piazza Ospedale Maggiore 3 20162 Milan Italy

跟随大动脉的阀门培植(TAVI ) 通常基于的 transcatheter 的耐心的结果的 BackgroundEvaluation 幸存和临床的改进。生活的质量上的研究被限制，并且从在过程以后的全面评价的数据是在 TAVI 经历了在里面医院和在分泌物以后以后，病人... 详细信息

跟随大动脉的阀门培植(TAVI ) 通常基于的 transcatheter 的耐心的结果的 BackgroundEvaluation 幸存和临床的改进。生活的质量上的研究被限制，并且从在过程以后的全面评价的数据是在 TAVI 经历了在里面医院和在分泌物以后以后，病人们为心脏的康复提交了的 *** 评估临床、功能、营养的地位的多维的评价，自治的度，认知缺陷，到康复的 *** 承认的消沉和质量，近似，病人的一半有严重功能的缺陷和依赖为在他们的医院停留期间，三分之一个个病人承受了重要临床的复杂并发症，二不得不被转移到培植中心。尽管有这，全面结果很好。所有留下的病人在分泌物是临床上稳定的，生活的功能的地位，自治和质量在大多数被改进。在 540 天的吝啬的后续期间(变化：192-738 天) ，五个病人从 noncardiac 原因死了，三为心脏的事件被就医，并且九为非心脏的原因。功能的地位和自治在病人的多数仍然保持令人满意，大多数继续到在 TAVI 经常是很脆弱的以后，为康复提交的实时 ***，与功能的缺陷，其它上的依赖和临床的复杂并发症的高风险的一个高等级。在一个康复计划期间，基于一个多维的评价和干预，大多数病人在功能的地位，生活的质量，和自治显示出重要改进，它在中间的后续期间在题目的多数仍然保持稳定。

关键词：主动脉康复心脏随访植入中期导管认知功能障碍

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