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Neocuspidization of the Pulmonary Valve with Autologous Pericardium in the adult Patient with Ventricular Septal Defect and Infective Endocarditis: A Case Report and Review of the Literature

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Congenital Heart Disease 2022年第6期17卷 641-646页

作者： Igor Mokryk Vitaly Demyanchuk Volodymyr Vashkeba Ilya Nechay Borys Todurov Department of Adult Cardiac Surgery Heart InstituteKyivUkraine department of Pediatric cardiac surgery Heart InstituteKyivUkraine

Congenital heart disease (CHD) is one of the risk factors for developing infective endocarditis (IE). Right-sided IEoccurs in 5%–10% of endocarditis cases, and pulmonary valve (PV) is involved in less than 2% of such patients.Literature data are few, and optimal treatment methods, indications for surgery, and types of operative techniquesare still under debate. We present an adult patient with a rare combination of the ventricular septal defect (VSD)and PV IE who underwent surgical treatment. Neocuspidization with autologous pericardium was utilized for thereconstruction of his PV. We discuss details of this novel surgical technique.

关键词： Infective endocarditis pulmonary valve neocuspidization ozaki technique congenital heart disease

Association of dissected ascending aorta diameter with preoperative adverse events in patients with acute type A aortic dissection

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World Journal of Cardiology 2022年第4期14卷 231-238页

作者： George Samanidis Meletios Kanakis Charalampos Georgiou Konstantinos Perreas Department of Adult Cardiac Surgery Onassis Cardiac Surgery CenterAthens 17674Greece department of Pediatric and Congenital Heart surgery Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Acute type A aortic dissection(ATAAD)is a life-threatening disease associated with high morbidity and mortality.AIM To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse events.METHODS A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this study.Demographic characteristics and perioperative data were recorded.In all patients,preoperative chest and abdomen computed tomography(CT)scans were performed.RESULTS Median age of the patients was 61.5(52.5-70.5)years and median body mass index(BMI)was 28.2(25.1-32.6)cm^(2).The number of female patients was 37(25%).Median diameter of the ascending aorta was 5.0(4.5-6)cm and 53.8%of the patients had an aortic diameter5.5 cm,most of the patients with ATAAD had an aortic diameter of less than 5.5 cm.The diameter of the ascending aorta in patients diagnose with ATAAD is not associated with preoperative adverse events.

关键词： Acute Aortic dissection Type A Ascending aorta Diameter

Expert consensus on the use of human serum albumin in adult cardiac surgery

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Chinese Medical Journal 2023年第10期136卷 1135-1143页

作者： Fei Xiang Fuhua Huang Jiapeng Huang Xin Li Nianguo Dong Yingbin Xiao Qiang Zhao Liqiong Xiao Haitao Zhang CuiZhang Zhaoyun Cheng Liangwan Chen Jimei Chen Huishan Wang Yingqiang Guo Nan Liu Zhe Luo Xiaotong Hou Bingyang Ji Rong Zhao Zhenxiao Jin Robert Savage Yang Zhao Zhe Zheng Xin Chen on behalf of Chinese Association of Cardiovascular Surgeons Chinese Society of Thoracic and Cardiovascular surgery Chinese Society of Cardiothoracic and Vascular Anesthesiology department of Thoracic and Cardiovascular surgery Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China department of Anesthesiology and Perioperative Medicine University of LouisvilleLouisvilleKentucky 40292United States department of Cardiovascular surgery Zhongshan HospitalFudan UniversityShanghai 200031China department of Cardiovascular surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430000China department of Cardiovascular surgery the Second Affiliated HospitalArmy Medical UniversityChongqing 400037China department of Cardiovascular surgery Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200031China department of Critical Care Fuwai HospitalChinese Academy of Medical SciencesBeijing 100033China department of Critical Care Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China department of cardiac surgery People’s Hospital of Henan ProvincePeople’s Hospital of Zhengzhou UniversityFuwai Central China Cardiovascular Disease HospitalZhengzhouHenan 450003China department of cardiac surgery Fujian Medical University Union HospitalFuzhouFujian 350001China department of Cardiovascular surgery Guangdong Cardiovascular InstituteGuangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdong 510050China department of Cardiovascular surgery General Hospital of Shenyang Military Area CommandShenyangLiaoning 110055China department of Cardiovascular surgery West China Hospital of Sichuan UniversityChengduSichuan 610041China Center for cardiac Intensive Care Beijing Anzhen HospitalBeijing Institute of HeartLung and Blood Vessel DiseasesCapital Medical UniversityBeijing 102218China department of Cardiopulmonary Bypass Fuwai HospitalChinese Academy of Medical SciencesBeijing 100033China department of Cardiovascular surgery Xijing HospitalFourth Militar

Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic pressure.Albumin helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and pasteurization.The medical use of HAS could date back to approximately the time of World War II.

关键词： Albumin drugs surgery

Incidence and Outcomes of Surgical Site Infections after adult cardiac surgery: A Single-Center Experience

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World Journal of Cardiovascular Diseases 2023年第11期13卷 764-779页

作者： Ibraheem H. Alharbi Hasan I. Sandogji Ahmed M. Shabaan Khaled M. Sayed Bilal A. Rahmani Mohamed A. Elmetwali Nouf A. Lami Thikra S. Alkhalaf Shyelene T. Utuanis Ayman R. Abdelrehim Cardiology department Madinah Cardiac Center Madinah Saudi Arabia cardiac surgery department Madinah Cardiac Center Madinah Saudi Arabia Cardiothoracic surgery department Faculty of Medicine Suez Canal University Isma&iumllia Egypt Infection Prevention and Control department Madinah Cardiac Center Madinah Saudi Arabia Clinical Nurse Unit Cardiac Surgery Department Madinah Cardiac Center Madinah Saudi Arabia Cardiothoracic surgery department Faculty of Medicine Menoufia University Menoufia Egypt

Background: Surgical site infections (SSIs) remain a challenging medical problem, especially in cardiac surgery patients. There is a lack of studies evaluating the rate of and outcomes of SSIs following cardiac surgeries in Saudi Arabia. Aims: This study aimed to determine the incidence of SSIs after adult cardiac surgeries that were done in Madinah cardiac Center, Saudi Arabia. Further, to identify the outcomes and risk factors contributing to death among surgical site infection patients. Methods: This was a 6-year, single-center, retrospective cohort study that included 93 consecutive patients who underwent adult cardiac surgery between August 2016 and August 2022. All adult patients aged 18 years or older who had clinical evidence of postoperative surgical wound infection were included. Preoperative, operative, and postoperative data (early and late) were collected from medical records. Microbiological culture reports and clinical outcomes were also recorded. Results: The study revealed a 9.1% (93/1021) incidence rate of SSIs. Of the 93 patients with SSIs, 60 had superficial incisional infections and 33 had deep infections with incidence rates of 5.9% and 3.2%, respectively. In-hospital mortality due to SSI was recorded in 4 out of 93 patients with an incidence rate of 4.3%. There was a significant association between the in-hospital mortality and the type of SSIs (p = 0.014). All non-survivors had deep SSIs. The type of cardiac surgery also showed a significant association with the in-hospital mortality (p = 0.017). Furthermore, the median duration of antibiotic administration was significantly longer in the non-survivors than in the survivors (72.5 vs 17, respectively, p Conclusions: In conclusion, the incidence of surgical wound infections following cardiac surgery is not low (9.1%);of which 3.2% were deep infections. The in-hospital mortality rate after treatment of SSIs was fortunately low (4.3%), and all non-survivors had deep SSIs. The non- survivors showed a significantly longer duration of antibiotics

关键词： Surgical Site Infection cardiac surgery Mortality Risk Factors Outcomes

Optimal timing of same-admission orthotopic heart transplantation after left ventricular assist device implantation

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World Journal of Cardiology 2017年第2期9卷 154-161页

作者： Gunsagar Gulati David Ouyang Richard Ha Dipanjan Banerjee Depart-ment of Medicine Stanford University School of Medicine department of Cardiothoracic surgery Division of Adult Cardiac SurgeryStanford University

AIM To investigate the impact of timing of same-admission orthotopic heart transplant(OHT) after left ventricular assist device(LVAD) implantation on in-hospital mortality and post-transplant length of stay.METHODS Using data from the Nationwide Inpatient Sample from 1998 to 2011, we identified patients 18 years of age or older who underwent implantation of a LVAD and for whom the procedure date was available. We calculated in-hospital mortality for those patients who underwent OHT during the same admission as a function of time from LVAD to OHT, adjusting for age, sex, race, household income, and number of comorbid diagnoses. Finally, we analyzed the effect of time to OHT after LVAD implantation on the length of hospital stay post-transplant.RESULTS Two thousand and two hundred patients underwent implantation of a LVAD in this cohort. One hundred and sixty-four(7.5%) patients also underwent OHT duringthe same admission, which occurred on average 32 d(IQR 7.75-66 d) after LVAD implantation. Of patients who underwent OHT, patients who underwent transplantation within 7 d of LVAD implantation("early") experienced increased in-hospital mortality(26.8% vs 12.2%, P = 0.0483) compared to patients who underwent transplant after 8 d("late"). There was no statistically significant difference in age, sex, race, household income, or number of comorbid diagnoses between the early and late groups. Post-transplant length of stay after LVAD implantation was also not significantly different between patients who underwent early vs late OHT. CONCLUSION In this cohort of patients who received LVADs, the rate of in-hospital mortality after OHT was lower for patients who underwent late OHT(at least 8 d after LVAD implantation) compared to patients who underwent early OHT. Delayed timing of OHT after LVAD implantation did not correlate with longer hospital stays post-transplant.

关键词：机械循环支持 Orthotopic 心移植桥牌将移植留给室帮助设备结果

Multimodal Imaging with 3D-Holograms for Preoperative Planning in Pediatric cardiac surgery:A Unique Case Report

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Congenital Heart Disease 2022年第4期17卷 491-494页

作者： Federica Caldaroni Massimo Chessa Alessandro Varrica Alessandro Giamberti department of Congenital cardiac surgery IRCCS Policlinico San DonatoSan Donato MilaneseMilanItaly ACHD Unit–Pediatric and adult Congenital Heart Centre IRCCS Policlinico San DonatoSan Donato MilaneseMilanItaly

Multimodal imaging,including augmented or mixed reality,transforms the physicians’interaction with clinical imaging,allowing more accurate data interpretation,better spatial resolution,and depth perception of the patient’s anatomy.We successfully overlay 3D holographic visualization to magnetic resonance imaging images for preoperative decision making of a complex case of cardiac tumour in a 7-year-old girl.

关键词： Hologram augmented reality multimodal imaging 3D CHD cardiac tumour arrhythmia anatomy

Near-infrared spectroscopy in adult cardiac surgery： between conflicting results and unexpected uses

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Journal of Geriatric Cardiology 2017年第11期14卷 659-661页

作者： Antonio Nenna Raffaele Barbato Salvatore Matteo Greco Giuseppe Pugliese Mario Lusini Elvio Covino Massimo Chello department of Cardiovascular surgery Universita Campus Bio-Medico di Roma Rome Italy

Neurological complications after cardiac surgery, rang- ing from permanent stroke to transient dysfunction, repre- sent a key issue in the management of geriatric patients. Many patients aged 70 or more have history of neurological dysfunctions, which increases the risk of complications and sequelae, Severe neurologic diseases, such as strokes, occur in up to 6% of patients undergoing cardiac surgery. Therefore, in the setting of fragile patients, prevention is more important than treatment. There are several intraop- erative mechanisms of neurological injury, such as embo- lism, inflammation, intraoperative anemia

关键词：外科心脏光谱学红外线成年机能障碍神经病并发症

Contemporary perspective on endogenous myocardial regeneration

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World Journal of Stem Cells 2015年第5期7卷 793-805页

作者： Dejan Milasinovic Werner Mohl department of Cardiology Clinical Centre of Serbia department of cardiac surgery Medical University of Vienna

Considering the complex nature of the adult heart, it is no wonder that innate regenerative processes, while maintaining adequate cardiac function, fall short in myocardial jeopardy. In spite of these enchaininglimitations, cardiac rejuvenation occurs as well as restricted regeneration. In this review, the background as well as potential mechanisms of endogenous myocardial regeneration are summarized. We present and analyze the available evidence in three subsequent steps. First, we examine the experimental research data that provide insights into the mechanisms and origins of the replicating cardiac myocytes, including cell populations referred to as cardiac progenitor cells(i.e., c-kit+ cells). Second, we describe the role of clinical settings such as acute or chronic myocardial ischemia, as initiators of pathways of endogenous myocardial regeneration. Third, the hitherto conducted clinical studies that examined different approaches of initiating endogenous myocardial regeneration in failing human hearts are analyzed. In conclusion, we present the evidence in support of the notion that regaining cardiac function beyond cellular replacement of dysfunctional myocardium via initiation of innate regenerative pathways could create a new perspective and a paradigm change in heart failure therapeutics. Reinitiating cardiac morphogenesis by reintroducing developmental pathways in the adult failing heart might provide a feasible way of tissue regeneration. Based on our hypothesis "embryonic recall", we present first supporting evidence on regenerative impulses in the myocardium, as induced by developmental processes.

关键词： cardiac regeneration cardiac development Embryonic recall Pressure-controlled intermittentcoronary sinus occlusion Heart failure Myocardialinfarction

Validation of four different risk stratification models in patients undergoing heart valve surgery in a single center in China

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Chinese Medical Journal 2011年第15期124卷 2254-2259页

作者： ZHANG Chun-xiao XU Jian-ping GE Yi-peng WEI Yu YANG Yan LIU Feng SHI Yi department of Cardiovascular surgery Adult Cardiac Surgery Center Cardiovascular Institute and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical CollegeBeijing 100037 China department of Cardiovascular surgery Beijing Anzhen Hospital Capital Medical University ＆ Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background Several risk stratification models have been developed for cardiac surgery. This study aimed to evaluate the accuracy of four existing risk stratification models, the Fuwai System for cardiac Operative Risk Evaluation （FuwaiSCORE）, the Society of Thoracic Surgeons 2008 cardiac surgery risk model for isolated valve surgery （the STS model）, the European System for cardiac Operative Risk Evaluation （EuroSCORE） and the initial Parsonnet＇s score （the Parsonnet model） in predicting prolonged intensive care unit （ICU） stay in Chinese patients undergoing heart valve surgery. Methods Data were collected retrospectively from records of 1333 consecutive patients who received heart valve surgery in a single center between November 2006 and December 2007. Prolonged ICU stay was defined as not less than 124 hours. Calibration was assessed using the Hosmer-Lemeshow （H-L） goodness of fit test. Discrimination was assessed using the receiver-operating-characteristic （ROC） curve area. Results The FuwaiSCORE showed good calibration and discrimination compared with other risk models. According to the H-L statistics, the value of the FuwaiSCORE was 12.82, P 〉0.1. The area under ROC curve of the FuwaiSCORE was 0.81 （95%C/0.78-0.84）. Conclusions Our study suggests that the FuwaiSCORE is superior to the other three risk models in predicting prolonged length of ICU stay in Chinese patients with heart valve surgery. Having fewer variables, the system is much easier for bedside use than other systems.

关键词： heart valve surgery risk stratification model intensive care unit stay FuwaiSCORE EuroSCORE