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Open Journal of Thoracic surgery 2023年第1期13卷 1-5页

作者： Abdoulaye Kanté Bréhima Coulibaly Mamadou Diakité Mamadou A. Keita Bakary Keita Drissa Traoré Nouhoum Ongoïba Patrice Binuani Christophe Baufreton department of Thoracic and Cardiovascularsurgery CHU Point G Bamako Mali cardiac surgery department of the University Hospital of Angers Angers France Cardiology department CHU Point G Bamako Mali Commune II Reference Health Center Bamako Mali

Arteriovenous fistulas have a substantial impact on systemic hemodynamics, however their effect on extracorporeal circulation is not well understood. We report our clinical observation on the management under extracorporeal circulation of a patient with renal insufficiency with a high-flow arteriovenous fistula. This is a 59-year-old man who was referred to us for surgical treatment of ischemic coronary artery disease in a context of anuric chronic renal failure. Hypothermia at 32°C is started from the start in CEC due to hyperflow at the level of the arteriovenous fistula. We performed two coronary artery bypasses of the marginal and IVA via the two internal thoracic arteries. The patient is hemofiltered in order to avoid hyperkalaemia and possibly avoid fluid overload related to filling per CEC. The clamping time was 71 minutes and the SCC lasted 141 minutes. There was no homologous transfusion in the operating room. It turns out that the input/output balance is zero at the end of the CEC. The postoperative course was simple.

关键词： Coronaryartery by Pass Grafting High Flow Arteriovenous Fistula Extracorporeal Circulation Hypothermia

Current role of extracorporeal membrane oxygenation for the management of trauma patients:Indications and results

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World Journal of Critical Care Medicine 2025年第1期14卷 42-48页

作者： Mohammed Abdulrahman Maryam Makki Malak Bentaleb Dana Khamis Altamimi Marcelo AF Ribeiro Junior department of surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates department of surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates department of surgery Sheikh Shakhbout Medical CityAbu Dhabi 91888ADUnited Arab Emirates department of surgery R Adams Cowley Shock Trauma CenterUniversity of MarylandBaltimoreMD 21201United States

Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional *** allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon *** blood is then reintroduced into the patient’s circulatory *** process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant ***-venous(VV)ECMO primarily supports respiratory function and indicates respiratory ***,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related *** study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated ***,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and *** studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV *** plays a critical role in managing trauma patients,particularly those with acute respiratory *** research is necessary to explore the full potential of ECMO in trauma *** should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.

关键词： Extracorporeal membrane oxygenation treatments Multiple trauma Respiratory distress syndrome Cardiogenic shock Contraindications Anticoagulants

Left ventricular pseudoaneurysm formation: Two cases and review of the literature

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World Journal of Clinical Cases 2014年第10期2卷 581-586页

作者： Emmanouil Petrou Vasiliki Vartela Anna Kostopoulou Panagiota Georgiadou Irene Mastorakou Nektarios Kogerakis Petros Sfyrakis George Athanassopoulos George Karatasakis Division of Cardiology Onassis Cardiac Surgery Center Imaging department Onassis Cardiac Surgery Center Third department of cardiac surgery and Transplantation Services Onassis Cardiac Surgery Center

Left ventricular wall rupture(LVWR) comprises a complication of acute myocardial infarction(AMI). Acute LVWR is a fatal condition, unless the formation of a pseudoaneurysm occurs. Several risk factors have been described, predisposing to LVWR. High index of suspicion and imaging techniques, namely echocardiography and computed tomography, are the cornerstones of timely diagnosis of the condition. As LVWR usually leads to death, emergency surgery is the treatment of choice, resulting in significant reduction in mortality and providing favorable short-term outcomes and adequate prognosis during late follow-up. Herein, we present two patients who were diagnosed with LVWR following AMI,and subsequent pseudoaneurysm formation. In parallel, we review the aforementioned condition.

关键词： Pseudoaneurysm Left ventricle rupture Myocardial infarction

Cardioprotective Effects of Melatonin on Recovery of Rat Donor Hearts after 12-Hour Preservation

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2003年第4期23卷 407-410页

作者：高思海李平潘铁成杨辰垣 department of Thoracic and cardiac surgery

The cardioprotective effects of melatonin on recovery of rat donor hearts after 12 h of preservation were investigated. Wistar rats weighing 200 to 250 g ( n =24) were randomly divided into 3 groups. In the non storage group ( n =8), donor hearts were not stored. In the melatonin group ( n =8), donor hearts were stored in 4 ℃ St. Thomas solution with melatonin (0.1 mmo1/L). In the control group ( n =8), donor hearts were stored in 4 ℃ St. Thomas solution only. The coronary flow (CF), cardiac function, coronary vasodilatory response, creatine kinase (CK) and high energy phosphate levels were measured after the hearts had been preserved for 12 h. Transmission electron microscopy was used to examine the microstructural changes after 12 h of preservation. The recovery of cardiac function and coronary vasodilatory response were significantly improved in the melatonin group ( P <0.01). CK release decreased greatly in the melatonin group ( P <0.01). High energy phosphate levels were significantly better preserved in the melatonin group ( P <0.01). Histological findings were much better in the melatonin group than in the control group. These results suggest that melatonin has cardioprotective effects on the recovery of rat donor hearts after 12 h of preservation.

关键词： melatonin donor heart preservation transplantation ischemia reperfusion

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 *** 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

Conduction abnormalities after transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2018年第1期15卷 105-112页

作者： Panagiotis Karyofillis Anna Kostopoulou Sofia Thomopoulou Martha Habibi Efthimios Livanis George Karavolias Vassilis Voudris department of Invasive Cardiology Onassis Cardiac Surgery Centre Athens Greece

In the last few years, transcatheter aortic valve implantation （TAVI） has become an alternative procedure in patients with severe aortic stenosis and high risk for surgical aortic replacement. Due to the anatomic correlation between aortic valve structure and conduction system of the heart, one of the most common complications after TAVI is conduction system disturbances which including bundle branch block, complete heart block and need for permanent pacemaker implantation. Although these disturbances are usually not lethal, they may have a great influence on patients＇ state and long term-survival. Several risk factors for conduction disturbances have been identified which including age, anatomy of the heart, periprocedural factors, type of implanted valve, preexisting abnormalities and comorbidities. As this technique becomes more familiar to physicians, patients should be carefully screened for risk factors for the development of conduction abnormalities after TAVI in order to provide effective prevention and proper treatment.

关键词： Atrioventricular block Bundle branch block Pacemaker Transcatheter aortic valve implantation

THE STUDY ON THE CHANGES OF ZINC, COPPER, CALCIUM AND MAGNESIUM IN PLASMA AND ERYTHROCYTES DURING CARDIOPULMONARY BYPASS

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Journal of Pharmaceutical Analysis 2004年第1期16卷 71-74页

作者：耿希刚李兆志李明师桃 department of cardiac surgery

Objective To study the changes and their influence factors involved of zinc, copper, calcium and magnesium in plasma and erythrocytes during cardiopulmonary bypass(CPB). Methods Zinc, copper, calcium and magnesium values in plasma and erythrocytes were measured by atomic absorption spectrophotometer during CPB. Results Zinc and copper levels in plasma were significantly elevated above preinduction level before perfusion, but calcium and magnesium levels did not change significantly; zinc, copper and calcium levels in plasma were significantly below preoperation level during CPB, but magnesium level in plasma was significantly increased above preoperation; zinc level in plasma was increased to preoperation level after CPB and began to decrease again at 8 hours after CPB, copper level in plasma was increased to preoperation level at 20 hours after CPB, calcium in plasma was increased significantly from beginning to 8 hours after CPB, magnesium level in plasma was decreased to preoperation level at 8 hours afterCPB. Concentration of zinc , copper, calcium and magnesium in erythrocytes did not change significantly. Conclusion During CPB, the changes of zinc, copper, calcium and magnesium had relation to hemodilution, operative wound, carrier protein, stress and component of priming solution and cardioplegic solution, but no relation to transfer from plasma erythrocytes. The results indicate that it is beneficial to patient's recovery to supplement zinc, copper, calcium and magnesium properly by different ways during cardiac perioperation.

关键词： cardiopulmonary bypass cardiac surgery zinc copper calcium magnesium

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 *** To evaluate the diameter of dissected ascending aorta in patients diagnosed with ATAAD and whether the aortic diameter is associated with preoperative adverse *** A total of 108 patients diagnosed with ATAAD who underwent emergency operation under hypothermic circulatory arrest were enrolled in this *** characteristics and perioperative data were *** all patients,preoperative chest and abdomen computed tomography(CT)scans were *** 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 *** 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

Heart rate variability： a new tool to predict complications in adult cardiac surgery

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Journal of Geriatric Cardiology 2017年第11期14卷 662-668页

作者： Antonio Nenna Mario Lusini Cristiano Spadaccio Francesco Nappi Salvatore Matteo Greco Raffaele Barbato Elvio Covino Massimo Chello department of Cardiovascular surgery Universitgt Campus Bio-Medico di Roma Rome Italy department of cardiac surgery Golden Jubilee National Hospital Glasgow UK department of cardiac surgery Centre Cardiologique du Nord de Saint-Denis Paris France

Heart rate variability （HRV） refers to the variations between consecutive heartbeats, which depend on the continuous modulation of the sympathetic and parasympathetic branches of the autonomic nervous system. HRV has been shown to be effective as a predictor of risk after myocardial infarction and an early warning sign of diabetic neuropathy, and in the cardiology setting is now recognized to be a useful tool for risk-stratification after hospital admission and after discharge. Recent evidences suggest that HRV analysis might predict complications even in patients undergoing cardiac surgery, and the present review summarizes the importance of HRV analysis in adult cardiac surgery and the perspectives for HRV use in current clinical practice. Although future larger studies are warranted before HRV can be included into daily clinical practice in adult cardiac surgery, HRV is a novel tool which might detect autonomic instability in the early postoperative phase and during hospital stay, thus predicting or prompt-diagnosing many of the post-operative complications.

关键词： cardiac surgery Complications Heart rate variability Predictive values

Redo Coronary Artery Bypass Grafting: On-Pump and Off-Pump Coronary Artery Bypass Grafting Revascularization Techniques

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Chinese Medical Sciences Journal 2015年第1期30卷 28-33页

作者： Song Wu Feng Wan Zhe Zhang Hong Zhao Zhong-qi Cui Ji-yan Xie department of cardiac surgery Peking University Third Hospital

Objective To analyze the short-term outcomes of redo coronary artery bypass grafting(CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the department of cardiac surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique(redo-ONCAB group) and 40 underwent off-pump CABG technique(redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group(all P>0.05), except for incidences of renal dysfunction and pulmonary disease(all P0.05). Conclusion Redo CABG is the safe

关键词： reoperation coronary artery bypass grafting on pump off pump transmyocardial laser revascularization