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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

Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

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World Journal of Transplantation 2024年第2期14卷 107-118页

作者： Sophia Hatzianastasiou Paraskevas Vlachos Georgios Stravopodis Dimitrios Elaiopoulos Afentra Koukousli Josef Papaparaskevas Themistoklis Chamogeorgakis Kyrillos Papadopoulos Theodora Soulele Despoina Chilidou Kyriaki Kolovou Aggeliki Gkouziouta Michail Bonios Stamatios Adamopoulos Stavros Dimopoulos Microbiology department and Infection Control Office Onassis Cardiac Surgery CenterAthens 17674Greece Heart Transplantation Unit Onassis Cardiac Surgery CenterAthens 17674Greece cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive *** To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart *** This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation *** was collected regarding MDROs commonly encountered in critical *** Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was *** acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

关键词： Heart transplantation Multi drug resistant organisms Transplantation complications Transplantation outcome

IL13RA2 promotes progression of infantile haemangioma by activating glycolysis and the Wnt/β-catenin signaling pathway

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Oncology Research 2024年第9期32卷 1453-1465页

作者： ZIYONG LIU TAO MA JINFANG LI WEI REN ZHIXIN ZHANG department of Cardiothoracic Surgery 970th Hospital of the People’s Liberation ArmyWeihai264209China department of cardiac Ultrasound Weihai Municipal HospitalWeihai264200China

Background:Interleukin 13 receptor subunit alpha 2(IL13RA2)plays an essential role in the progression of many ***,the role of IL13RA2 in infantile haemangioma(IH)is still *** and Methods:IL13RA2 expression in IH tissues was analyzed using western blot,qRT-PCR,and *** role of IL13RA2 in haemangioma-derived endothelial cells(HemECs)was determined following knockdown or overexpression of IL13RA2 using CCK-8,colony formation,apoptosis,wound healing,tubule formation,Transwell,and western ***:IL13RA2 expression was upregulated in IH ***13RA2 overexpression promoted proliferation,migration,and invasion of HemECs and induced glycolysis,which was confirmed with a glycolysis ***,IL13RA2 interacted withβ-catenin and activated the Wnt/β-catenin pathway in HemECs,which were involved in the above-mentioned effects of ***:These findings revealed that targeting IL13RA2 is a potential therapeutic approach for IH.

关键词： Infantile haemangioma IL13RA2 Glycolysis Wnt/β-catenin pathway

Management of a patient with an unusual trajectory of a temporary trans-venous pacing lead

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World Journal of Cardiology 2024年第6期16卷 314-317页

作者： Metesh Acharya Ethan Kavanagh Sheena Garg Davorin Sef Fabio De Robertis department of cardiac Surgery University Hospitals of Leicester NHS TrustLeicester LE39QPUnited Kingdom department of cardiac Surgery King’s College LondonLondon WC2R 2LSUnited Kingdom department of cardiac Surgery Royal Brompton and Harefield HospitalsLondon UB96JHUnited Kingdom

Perforation of the right ventricle during placement of pacing wires is a welldocumented complication and can be potentially *** of temporary pacemaker,helical screw leads and steroids use prior to implant are recognised as risk factors for development of post-permanent pacemaker *** reported an unusual case of pacing wire perforating interventricular septum into the left ventricle that occurred during the implant procedure performed in another *** the preoperative work-up and transfer to our tertiary cardiothoracic centre,the patient underwent successful surgical *** conclusion,early recognition and timely diagnosis using advanced multimodality imaging can guide surgical intervention and prevent unfavourable consequences of device-related complications.

关键词： Ventricular perforation Lead perforation Pacing

Use of Patient-Specific “4D” Tele-Education to Enhance Actual and Perceived Knowledge in Congenital Heart Disease (CHD) Patients

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Congenital Heart Disease 2024年第1期19卷 5-17页

作者： Molly Clarke Karin Hamann Nancy Klein Laura Olivieri Yue-Hin Loke department of Inpatient Cardiology Boston Children’s HospitalBoston02115USA department of Cardiology Children’s National HospitalWashington20001USA department of Cardiology Noninvasive Cardiac ImagingUniversity of Pittsburgh Medical Center Children’s Hospital of PittsburghPittsburgh15224USA

Background:Patients with congenital heart disease(CHD)will transition to lifelong adult congenital cardiac ***,their structural heart disease is challenging to convey via two-dimensional *** study utilized a tele-educational environment,with personalized three-dimensional(3D)modeling and health Details(3D+Details=“4D”),to improve actual and perceived knowledge,both important components of transition readiness in CHD ***:Participants aged≥13 years with a history of CHD and cardiac magnetic resonance imaging(MRI)studies were *** MRI datasets were then used to segment and create 3D heart models(using Mimics,Materialize Inc.).Participantsﬁrst completed the MyHeart Questionnaire,a validated survey of actual knowledge.A tele-educational session was then scheduled,during which participants were shown a 3D model of a normal heart,followed by their personal 3D heart model and speciﬁc health *** then repeated the actual knowledge survey,in addition to questionnaires assessing perceived knowledge pre-and post-session,as well as a satisfaction ***:Twenty-two patients were *** knowledge increased from 75%±15%to 89%±20%(p=0.00043)and perceived knowledge increased inﬁve of seven *** knowledge correlated with perceived knowledge(r=0.608,p<0.0001).Ninety-one percent of participants ranked the 3D model as“very satisfactory”and ninety-ﬁve percent ranked the educational session as“very help-ful”or“extremely helpful.”Conclusions:The use of“4D”tele-education increased both actual and perceived knowledge and may help improve transition readiness in CHD patients.

关键词： Congenital heart disease tele-education transition

Carotid versus axillary artery cannulation for descending aorta remodeling in type A acute aortic dissection

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World Journal of Cardiology 2024年第10期16卷 564-573页

作者： Qin Jiang Tao Yu Ke-Li Huang Ke Liu Xi Li Sheng-Shou Hu department of cardiac Surgery Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610072Sichuan ProvinceChina cardiac Surgery Center Sichuan Academy of Medical Sciences&Sichuan Provincial People’s HospitalChengdu 610072Sichuan ProvinceChina

BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)*** descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic *** A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the *** these,209 received right AA cannulation and 234 received bilateral CA *** primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA *** The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.

关键词： Acute type A aortic dissection Bilateral carotid arterial cannulation Descending aortic remodeling False lumen area ratio Prognosis

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

Improving lung allograft function in the early post-operative period through the inhibition of pyroptosis

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Medical Review 2024年第5期4卷 384-394页

作者： Doug A.Gouchoe Zhentao Zhang Jung-Lye Kim Yong Gyu Lee Bryan A.Whitson Hua Zhu department of Surgery Division of Cardiac SurgeryThe Ohio State University Wexner Medical CenterColumbusOHUSA COPPER Laboratory The Ohio State University Wexner Medical CenterColumbusOHUSA cardiac Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210USA

Lung transplantation is the only deﬁnitive ther-apy for end-stage pulmonary *** than 20%of offered lungs are successfully transplanted due to a limited ischemic time window and poor donor lung quality man-ifested by pulmonary edema,hypoxia,or ***,poor donor organ recovery and utilization are signiﬁcant barriers to wider implementation of the life-saving therapy of *** ischemia reperfusion injury(IRI)is often identiﬁed as the underlying molecular insult leading to immediate poor lung function in the post-operative period,this injury encompasses several pathways of cellular injury in addition to the recruitment of the innate immune system to the site of injury to propagate this inflammatory *** is a central molecular inflammatory pathway that is the most signiﬁcant contributor to injury in this early post-operative *** is another form of pro-grammed cell death and is often associated with *** mitigation of pyroptosis in the early post-operative period following lung transplantation is a potential novel way to prevent poor allograft function and improve outcomes for all *** we detail the pyroptotic pathway,its importance in lung transplantation,and several therapeutic modalities that can mitigate this harmful inflammatory pathway.

关键词： lung transplantation pyroptosis ischemia reperfusion injury IRI ex vivo lung perfusion EVLP

Relationship among Parkinson’s disease, constipation, microbes, and microbiological therapy

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World Journal of Gastroenterology 2024年第3期30卷 225-237页

作者： Xin-Yang Yuan Yu-Sen Chen Zhou Liu department of Neurology Affiliated Hospital of Guangdong Medical UniversityZhanjiang 524000Guangdong ProvinceChina Institute of Neurology Guangdong Key Laboratory of Age-Related Cardiac and Cerebral DiseasesZhanjiang 524000Guangdong ProvinceChina

This comprehensive review elucidates the complex interplay between gut microbiota and constipation in Parkinson’s disease(PD),a prevalent non-motor symptom contributing significantly to patients’morbidity.A marked alteration in the gut microbiota,predominantly an increase in the abundance of Proteobacteria and Bacteroidetes,is observed in PD-related *** treatments,although safe,have failed to effectively alleviate symptoms,thereby necessitating the development of novel therapeutic *** interventions such as prebiotics,probiotics,and fecal microbiota transplantation(FMT)hold therapeutic *** prebiotics improve bowel movements,probiotics are effective in enhancing stool consistency and alleviating abdominal *** shows potential for significantly alleviating constipation symptoms by restoring gut microbiota balance in patients with *** promising developments,the causal relationship between changes in gut microbiota and PD-related constipation remains elusive,highlighting the need for further research in this expanding field.

关键词： Parkinson disease Constipation Gut microbiota Prebiotics Probiotics Fecal microbiota transplantation

Impact of Atrial Septal Defect Closure on Mortality in Older Patients

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Congenital Heart Disease 2024年第1期19卷 93-105页

作者： Sipawath Khamplod Yodying Kaolawanich Khemajira Karaketklang Nithima Ratanasit Division of Cardiology Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Her Majesty cardiac Center Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand department of Medicine Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left *** closure of ASD has been associated with excellent outcomes and lower complication ***,there is limited evidence regarding the prognosis of ASD closure in older *** study aims to evaluate the mortality rates in older ASD patients with and without ***:A retrospective cohort study was conducted on patients aged 40 years or older with ASD between 2001 and *** were followed up to assess all-cause *** and multivariable analyses were performed to identify the predictors of mortality.A p-value of<0.05 was considered statistically signiﬁ***:The cohort consisted of 450 patients(mean age 56.6±10.4 years,77.3%female),with 66%aged between 40 and 60 years,and 34%over 60 *** the cohort,299 underwent ASD closure(201 with transcatheter and 98 with surgical closure).During the median follow-up duration of 7.9 years,51 patients *** unadjusted cumulative 10-year rate of mortality was 3%in patients with ASD closure,and 28%in patients without ASD closure(log-rank p<0.001).Multivariable analysis revealed that age(hazard ratio[HR]1.04,95%conﬁdence interval[CI]1.006–1.06,p=0.01),NYHA class(HR 2.75,95%CI 1.63–4.62,p<0.001),blood urea nitrogen(BUN)(HR 1.07,95%CI 1.03–1.12,p<0.001),right ventricular systolic pressure(RVSP)(HR 1.07,95%CI 1.003–1.04,p=0.01),and lack of ASD closure(HR 15.12,95%CI 5.63–40.59,p<0.001)were independently associated with ***:ASD closure demonstrated favorable outcomes in older ***,NYHA class,BUN,RVSP,and lack of ASD closure were identiﬁed as independent factors linked to mortality in this population.

关键词： Atrial septal defect congenital heart disease defect closure long-term survival mortality