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Extensive complex thoracoabdominal aortic aneurysm salvaged by surgical graft providing landing zone for endovascular graft:A case report

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World Journal of Clinical Cases 2022年第15期10卷 5005-5011页

作者： Albert Youngwoo Jang Pyung Chun Oh Jin Mo Kang Chul Hyun Park Woong Chol Kang Department of cardiology Gachon University Gil Medical CenterIncheon 1198South Korea Department of Internal Medicine Gil Medical CenterGachon Cardiovascular Research InstituteGachon University College of MedicineIncheon 1198South Korea Division of Vascular Surgery Gachon University Gil Medical CenterIncheon 1198South Korea Department of Thoracic and Cardiovascular Surgery Gachon University Gil Medical CenterIncheon 1198South Korea Division of cardiology Gil Medical CenterGachon University of Medicine and ScienceIncheon 1198South Korea

BACKGROUND Surgical repair of complex abdominal aortic aneurysm is associated with a higher perioperative mortality and *** advent of endovascular aortic repair(EVAR)has reduced perioperative complications,although the utilization of such techniques is limited by lesion characteristics,such as involvement of the visceral or renal arteries(RA)and/or presence of a sealing *** SUMMARY A 60-year-old male presented with a Crawford type iv complex thoracoabdominal aortic aneurysm(CAAA)starting directly distal to the diaphragm extending to both common iliac arteries(CIAs).The CAAA consist of a proximal and distal aneurysmal sac separated by a 1 cm-healthy zone in the infrarenal *** to the poor performance of the patient and the expansive disease,we planned a stepwise-combined surgery and EVAR to minimize invasiveness.A branched graft was implanted after surgical debranching of the visceral and *** the patient had renal and liver injury after surgery,the second stage EVAR was performed 10 mo *** stent graft was implanted from the distal portion of surgical branched graft to both CIAs during *** patient has been uneventful for 5-years after discharge and is being followed in the outpatient *** The current case demonstrates that the surgical graft can provide a landing zone for second stage EVAR to avoid aggressive surgery in patients with poor performance with a long hostile CAAA.

关键词： Complex thoracoabdominal aortic aneurysm Abdominal aortic aneurysm surgery Endovascular aortic repair Common iliac artery aneurysm Case report

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Impact of emergency percutaneous coronary intervention on outcomes of ST-segment elevation myocardial infarction patients complicated by out-of-hospital cardiac arrest

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Chinese Medical Journal 2012年第8期125卷 1405-1409页

作者： LIU Hong-wei PAN Wei WANG Lan-feng SUN Yan-ming LI Zhu-qin WANG Zhong-hua Coronary Care Unit Division of CardiologyFirst Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiang 150001China

Background Cardiac arrest is one of the most serious complications of acute myocardial infarction （AMI）, especially in the out-of-hospital patients. There is no general consensus as to whether percutaneous coronary intervention （PCI） is effective in treating ST-segment elevation myocardial infarction （STEMI） patients complicated by out-of-hospital cardiac arrest （OHCA）. In our study, we evaluated the efficacy of PCI in treating STEMI patients complicated by OHCA through observing their clinical conditions in hospital; including total mortality, adverse cardiac events, stroke, acute renal failure, and gastrointestinal bleeding events. Methods A total of 1827 STEMI patients were enrolled in this study, where 81 were STEMI with OHCA. Between the patients with and without OHCA, and the OHCA patients with and without PCI, we compared the clinical characteristics during hospitalization, including total mortality and incidences of adverse cardiac events, and stroke. Results Compared to the patients without OHCA, the OHCA patients had significantly lower systolic blood pressure （P 〈0.05） and a faster heart rate （P〈0.05）, and a higher percentage of Killip class iv or Glasgow coma scale （GCS）〈7 on admission （P 〈0.001）. And the in-hospital mortality was higher in the OHCA patients （55.6% vs. 2.4%, P 〈0.001）. Comparing the OHCA patients without PCI to the patients with PCI, there was no obvious difference of heart rate, blood pressure or the percentage of Killip class iv and GCS -〈7 on admission, but the incidences of cardiogenic shock, stroke were significantly lower in the with-PCI group during hospitalization （P 〈0.001, P 〈0.05）. And the in-hospital mortality of the OHCA patients receiving PCI was significantly lower （36.7% vs. 84.3%, P 〈0.001）. Conclusions During hospitalization, the incidence of adverse events and mortality are higher in the STEMI with OHCA patients, comparing with the STEMI without OHCA. Emergency PCI reduces the incidence of adverse events and decreases

关键词： percutaneous coronary intervention out-of-hospital cardiac arrest ST-elevation myocardial infarction prognosis

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Parasympathetic Dysfunction in Black African Patients with Heart Failure:A Cross-Sectional Study in Sub-Saharan Africa

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World Journal of Cardiovascular Diseases 2020年第4期10卷 178-187页

作者： Ba Hamadou Sylvie Ndongo Amougou Ismaila Daouda Chris Nadege Nganou-Gnindjio Liliane Mfeukeu-Kuate Jerome Boombhi Ahmadou Musa Jingi Alain Menanga Samuel Kingue Department of Medicine and Specialties Faculty of Medicine and Biomedical SciencesUniversity of Yaounde IYaoundeCameroon cardiology Unit Central Hospital of YaoundeYaoundeCameroon cardiology Unit University Teaching Hospital of YaoundeYaoundeCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon cardiology Unit Medicine BGeneral Hospital of YaoundeYaoundeCameroon

Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-iv, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.

关键词： Heart Failure Parasympathetic Dysfunction Heart Rate Variability Deep Breathing Test

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Current treatment status in patients with severe aortic valve stenosis and outcome of long term follow-up at advanced age： a Chinese single center study

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Chinese Medical Journal 2011年第18期124卷 2879-2882页

作者： PEI Han-jun WU Yong-jian YANG Yue-jin XU Bo CHEN Ji-lin QIAO Shu-bin LI Jian-jun QIN Xue-wen YAO Min YUAN Jin-qing CHEN Jue LIU Hai-bo YOU Shi-jie GAO Run-lin Department of cardiology Cardiovascular Institute and Fu WaiHospital Chinese Academy of Medical Sciences and Peking UnionMedical College Beijing 100037 China

Background Surgical aortic valve replacement is the standard treatment for patients with severe aortic stenosis, but some registries have indicated that 30% to 60% of these patients are not treated surgically, usually due to advanced age and/or comorbidities. This single center study in China investigated the current treatment status in the patients with severe aortic stenosis and evaluated the long term clinical outcome in advanced age patients whether or not undergoing aortic valve replacement. Methods Clinical data of 867 consecutive patients with severe aortic stenosis between January 2000 and December 2006 were retrospectively analyzed. The patients 〉65 years old were followed up by telephone or information from medical records. The primary end-point was all-cause mortality. Results The patients＇ average age was （52±19） years （range, 1-91 years）, and 34% were women. The percentages of the patients aged 〈15 years, between 15 and 34 years, between 35 and 54 years, between 55 and 64 years, between 65 and 74 years, and 〉75 years who underwent surgical aortic valve replacement were 82.3%, 87.2%, 88.8%, 78.2%, 65.3% and 22.2% respectively. In the patients （n=256）〉65 years old, 43.4% had New York Heart Association class III and iv symptoms, 39.1% had hypertension, 33.2% had coronary heart disease, and 3.1% had stroke. In the patients not undergoing aortic valve replacement, 1.6% had renal insufficiency, 4.7% had chronic obstructive pulmonary disease, 2.0% had critical hematopathy, and 0.4% had mammary cancer. A total of 186 （72.7%） patients finished the follow-up, and the average duration of the follow-up was （60±2.6） months. In the patients between 65 and 74 years old, the total deaths and cardiac deaths in the patients undergoing aortic valve replacement decreased significantly compared with those with conservative treatment （10.3% vs. 53.7%, P 〈0.001 and 6.3% vs. 50.7%, P〈0.001）. Similarly, in the patients ≥75 years old, there was a significant difference between

关键词： aortic stenosis aortic valve replacement advanced age comorbidity

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Evaluation of Application Value of Brain Natriuretic Peptide in the Clinical Treatment of Cardiovascular Diseases

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Journal of Clinical and Nursing Research 2018年第3期2卷 10-12页

作者： Ke Qin Department of cardiology Hospital Affiliated to Chifeng CollegeChifeng 024000Inner MongoliaChina

Objective:To explore the application value of brain natriuretic peptide in the clinical treatment of cardiovascular ***:Choose 48 patients with cardiovascular diseases treated in our hospital from March 2015 to March 2016 and divide them into the treatment group and control group according to different treatment drugs and there are 24 cases in each *** control group was treated with astragaloside iv,and the treatment group was treated with brain natriuretic *** compare their treatment effect,rehospitalization rate,the time of angina pectoris induced by exercise,the concentration of serum brain natriuretic peptide in patients under different cardiac function status between two ***:The clinical effect of treatment group was better than the control *** readmission rate was lower than the control *** time of inducing angina pectoris by exercise was longer than the control *** concentration of brain natriuretic peptide of the patients under different cardiac function status was better improved than the control *** difference between them was significant(P<0.05)and has statistical ***:It is of great significance to use brain natriuretic peptide in patients with cardiovascular disease which can improve the treatment effect,reduce the readmission rate of patients,prolong the time of angina induced by exercise,improve the concentration of brain natriuretic peptide of the patients in different cardiac functional status and provide a outstanding basis for patients in clinical treatment of the disease.

关键词： Brain natriuretic peptide Clinical cardiovascular diseases Application value

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Practical update on imaging and transcatheter aortic valve implantation

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World Journal of cardiology 2015年第4期7卷 178-186页

作者： Gisela Feltes iván J Nú ez-Gil Cardiovascular Unit Centro Médico Paris Interventional cardiology Hospital Clínico San Carlos

After very rapid advances in the development of the technique and devices,transcatheter aortic valve implantation(named TAVI or TAVR),is today a reality that is here to *** has become the minimallyinvasive treatment option for high-risk and non-surgical patients with severe symptomatic aortic *** the participation of a multidisciplinary team for its implementation,cardiac imaging plays an important *** pre-assessment to determine the suitability of the patient,the access site,the type of device,to the guidance during the procedure,and ultimately the long term monitoring of the *** selection of the patient and device,correct placement of the stent-valve and early detection of complications are of paramount importance for procedural success and for patient *** technique has advantages and disadvantages,being the cardiologist who will determine the best approach according to the type of patient and the expertise of the center in each one of *** article summarizes the last contributions of the most common used imaging techniques,in each step of the procedure.

关键词： TAVI TAVR Echocardiography Multislice tomography Cardiac magnetic resonance Aortic stenosis

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ROS-responsive&scavenging NO nanomedicine for vascular diseases treatment by inhibiting endoplasmic reticulum stress and improving NO bioavailability

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Bioactive Materials 2024年第7期37卷 239-252页

作者： Jian Li Jvhong Zhang Pengcheng Yu Han Xu Meihui Wang Zhebin Chen Bo Yu Jing Gao Qiao Jin Fan Jia Jian Ji Guosheng Fu Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province Department of CardiologySir Run Run Shaw HospitalZhejiang UniversityHangzhou310016PR China MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education Department of Polymer Science and EngineeringZhejiang UniversityHangzhouPR China

Vascular diseases seriously threaten human life and *** delivery of nitric oxide(NO)represents an effective approach for maintaining vascular homeostasis during pathological ***,the overproduction of reactive oxygen species(ROS)at vascular injury sites would react with NO to produce damaging peroxynitrite(ONOO􀀀)species and limit the therapeutic effect of ***,we design a ROS-responsive NO nanomedicine(t-PBA&NO NP)with ROS scavenging ability to solve the dilemma of NO-based therapy.t-PBA&NO NP targets NO and anti-oxidant ethyl caffeate(ECA)to the injury sites via collagen iv homing *** ROS-triggered ROS depletion and ECA release potently alleviate local oxidative stress via ROS scavenging,endoplasmic reticulum and mitochondrial *** subsequently maximizes vascular modulation effects of NO,without production of harmful compounds,reactive nitrogen species(RNS).Therefore,it significantly increases competitiveness of human umbilical vein endothelial cells(HUVECs)over human aortic smooth muscle cells(HASMCs)both in vitro and in *** strategy proved effective in inducing faster re-endothelialization,inhibiting neointimal formation and restoring vascular *** synergy between ROS depletion and NO therapy served as a new inspiration for the treatment of cardiovascular diseases and other ROS-associated illnesses.

关键词： Cardiovascular diseases Nitric oxide Reactive oxygen species Endoplasmic reticulum stress Nanomedicine

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Relationship between excessive erythrocytosis and acute mountain sickness: A field study

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Journal of Medical Colleges of PLA(China) 2014年第2期29卷 84-88页

作者： Xiao-Han Ding Ji-Hang Zhang Bin Cui Lan Huang Institute of Cardiovascular Diseases of PLA Department of cardiology Xinqiao Hospital Third Military Medical University

Background: Alterations in hematology, especially erythroid changes, may be involved in acute mountain sickness(AMS) at high altitude. This study aimed to identify the relationship between excessive erythrocytosis and AMS following different durations of high-altitude ***: A total of 692 healthy young Chinese men were recruited for the study in June and July of 2012 and were divided into the following five groups: I) the 24-h group(24 hours after arrival at Lhasa, 3,700 m, n=261); II) the 7-d group(exposed at Lhasa, 3,700 m for seven days, n=99); III) the re-exposure group(re-exposed at Yang Bajing, 4,400 m for seven days after >1 year of acclimation at 3,700 m, n=94); iv) the acclimated group(>1 year of acclimation at 3,700 m, Lhasa, n=42); and V) the sea-level control(control group, Chengdu, n=196). Case report forms were used to record the subjects’ demographic information and AMS-related symptoms. All of the subjects underwent routine blood ***: The red blood cell(RBC) count fell slightly but was not significant upon acute exposure to high altitude, whereas the hemoglobin concentration([Hb]) increased significantly. After high-altitude re-exposure, both of the [Hb] and RBC count showed significant increases. The incidence of AMS was 65.1%, 26.3% and 51.1%, respectively in the 24-h, 7-d and re-exposure groups. The [Hb](P=0.024) and hematocrit(P=0.017) were greater in the AMS+ individuals than in the AMS– individuals in 7-d group. A correlation analysis revealed that the [Hb] and hematocrit were closely related with AMS score in 7-d and re-exposure groups, while the RBC showed a correlation with AMS score only in the re-exposure group. The AMS incidence was lowest when the [Hb] was between 140 and 160 g/L in the 24-h and 7-d ***: AMS is associated with both [Hb] and excessive erythrocytosis. Additionally, our findings indicate the existence of an optimal [Hb] for preventing AMS.

关键词： hematology high altitude exposure acute mountain sickness

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Resetting of Cardiac Ventricular Tachycardia Storm with Intravenous Potassium Chloride: A Case Report

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Case Reports in Clinical Medicine 2018年第2期7卷 154-161页

作者： Gal Sella Sharon L. Kracoff Department of cardiology Kaplan Medical Center Rehovot Israel Department of Anesthesiology Kaplan Medical Center Rehovot Israel

Ventricular Tachycardia Storm (VTS) with hemodynamic instability is a life-threatening arrhythmia more often presents in patients with structural heart disease. Lack of response to cardioversion and/or antiarrhythmic drugs will have fatal consequences. We report a case of a hemodynamically unstable patient with Ventricular Tachycardia Storm refractory to intravenous antiarrhythmic medications, which finally responded to a slow bolus of iv potassium chloride. This case emphasizes the importance of identifying an electrolyte imbalance as a possible cause of a Ventricular Tachycardia storm and its rapid correction as an addition to the usual pharmacological treatment.

关键词： VT Storm Arrhythmia Potassium Hypokalemia

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Treatment of in stent coronary restenosis with excimer laser angioplasty

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Chinese Medical Journal 2000年第1期113卷 14-17页

作者： Meilin Liu W.H.Chow O.H.Kwok M.H.Jim A.Yip K.Fan E.Chan Department of cardiology First Teaching HospitalBeijing Medical UniversityBeijing 100034China Cardiac Medical Unit Grantham HospitalHong KongChina

OBJECTivE: To evaluate the efficacy and safety of excimer laser coronary angioplasty (ELCA) with adjunctive balloon angioplasty in patient with in-stent restenosis. METHODS: ELCA was performed in 20 patients of instent restenosis. All patients were symptomatic and had class III-iv angina. ELCA was performed with the Spectranetics CVX-300 System. The laser catheter of Vittesse C (concentric) and E (eccentric) with diameter of 1.4-2.0 mm was used. RESULTS: Laser catheter crossed all stenotic stents without difficulty. The lesion length was 4.6-51.2 mm, mean 20.7 +/- 13.7 mm, including 14 lesions > 10 mm. Laser treatment alone increased minimal lumen diameter (MLD) from 0.3 +/- 0.3 mm to 1.4 +/- 0.3 mm (P

关键词： Angioplasty, Balloon, Laser-Assisted Stents Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary Coronary Restenosis Female Humans Male Middle Aged

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