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Considerations for the use of porcine organ donation models in preclinical organ donor intervention research

Animal Models and Experimental Medicine 2024年第3期7卷 283-296页

作者： Frazer I.Heinis Shaheed Merani Nicholas W.Markin Kim F.Duncan Michael J.Moulton Lance Fristoe William E.Thorell Raechel A.Sherrick Tami R.Wells Matthew T.Andrews Marian Urban School of Natural Resources Institute of Agriculture and Natural ResourcesUniversity of Nebraska-LincolnLincolnNebraskaUSA division of Transplantation and vascular Surgery Department of SurgeryUniversity of Nebraska Medical CenterOmahaNebraskaUSA Department of Anesthesiology University of Nebraska Medical CenterOmahaNebraskaUSA division of cardiothoracic Surgery Department of SurgeryUniversity of Nebraska Medical CenterOmahaNebraskaUSA Clinical Perfusion Nebraska Medicine-Nebraska Medical CenterOmahaNebraskaUSA Department of Neurosurgery University of Nebraska Medical CenterOmahaNebraskaUSA Nutrition and Health Sciences College of Education and Human SciencesUniversity of Nebraska-LincolnLincolnNebraskaUSA Department of Comparative Medicine University of Nebraska Medical CenterOmahaNebraskaUSA

Use of animal models in preclinical transplant research is essential to the optimization of human allografts for clinical transplantation.Animal models of organ donation and preservation help to advance and improve technical elements of solid organ recovery and facilitate research of ischemia-reperfusion injury,organ preservation strategies,and future donor-based interventions.Important considerations include cost,public opinion regarding the conduct of animal research,translational value,and relevance of the animal model for clinical practice.We present an overview of two porcine models of organ donation:donation following brain death(DBD)and donation following circulatory death(DCD).The cardiovascular anatomy and physiology of pigs closely resembles those of humans,making this species the most appropriate for pre-clinical research.Pigs are also considered a potential source of organs for human heart and kidney xenotransplantation.It is imperative to minimize animal loss during procedures that are surgically complex.We present our experience with these models and describe in detail the use cases,procedural approach,challenges,alternatives,and limitations of each model.

关键词： animal model brain death circulatory death organ transplantation

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Carotid-subclavian bypass and endovascular aortic repair of Kommerell’s diverticulum with aberrant left subclavian artery:A case report

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World Journal of Clinical Cases 2023年第33期11卷 8038-8043页

作者： Wajeehullahi Akilu Yi Feng Xiao-Xue Zhang Shi-Liang Li Xian-Tao Ma Min Hu Cai Cheng division of cardiothoracic Surgery and vascular Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.

关键词： Kommerell’s diverticulum Left common carotid artery Aberrant left subclavian artery Carotid-subclavian bypass Medtronic stent catheter endovascular repair Case report

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A Rare Case of Late LAD Reimplantation after Arterial Switch Operation

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Congenital Heart Disease 2022年第1期17卷 99-106页

作者： Yannick Kabulo Kolela Maureen Klepper Geoffroy de Beco Thierry Sluysmans Alain Poncelet Department of Cardiovascular and Thoracic Surgery Cliniques Universitaires Saint-LucBrusselsBelgium Pôle de Recherche Cardiovasculaire Institut de Recherche Expérimentale et Clinique(IREC)Universite Catholique de Louvain and Division of Cardiothoracic and Vascular SurgeryCliniques Universitaires Saint-LucBrusselsBelgium Department of Pediatric Cardiology University Hospital Saint-LucBrusselsBelgium

Arterial switch operation(ASO)is a complex neonatal operation in which transfer of the coronary arteries origins is the key to success.Coronary events after a successful ASO are not uncommon.We describe a rare case of a child who underwent an ASO in the neonatal period with one coronary(LAD)described as atretic left in place.At age seven,he developed myocardial ischemia due to retrograde flow with a steal phenomenon from the LAD into the pulmonary artery.The patient underwent a late LAD reimplantation.This case underscores that even very small ostia should be translocated at the time of ASO.

关键词： Late LAD reimplantation arterial switch operation transposition of the great arteries congenital surgery

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Combined cavo-atrial thrombectomy and hepatectomy in hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 329-333页

作者： Julian Tsang Albert Chan Kenneth Chok Flora Tsang Chung Mau Lo division of Hepatobiliary & Pancreatic Surgery and Liver Transplantation Queen Mary Hospital University of Hong Kong Hong Kong China division of cardiothoracic Surgery Queen Mary Hospital University of Hong Kong Hong Kong China

To the Editor： Hepatocellular carcinoma （HCC） remains one of the commonest cancers worldwide especially in hepatitis B endemic regions. Its aggressive behavior is characterised by the natural history of increasing size, a tendency for vascular invasion into the hepatic veins and portal veins. Further growth into the inferior vena cava （IVC） and right atrium （RA） is an infrequent finding but signifies a pre-terminal event with a dismal prognosis.

关键词： in on as or HCC IVC Combined cavo-atrial thrombectomy and hepatectomy in hepatocellular carcinoma

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Diagnostic Yield of Non-Invasive Testing in Patients with Anomalous Aortic Origin of Coronary Arteries:A Multicentric Experience

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Congenital Heart Disease 2022年第4期17卷 375-385页

作者： Alberto Cipriani Pietro Bernardo Dall’Aglio Laura Mazzotta Domenico Sirico George Sarris Mark Hazekamp Thierry Carrel Alessandro Frigiola Vladimir Sojak Mauro Lo Rito Jurgen Horer Regine Roussin Julie Cleuziou Bart Meyns Jose Fragata Helena Telles Anastasios C.Polimenakos Katrien Francois Altin Veshti Jukka Salminen Alvaro Gonzalez Rocafort Matej Nosal Eleftherios Protopapas Roberto Tumbarello Patrizio Sarto Cinzia Pegoraro Raffaella Motta Giovanni Di Salvo Domenico Corrado Vladimiro LVida Massimo A.Padalino Department of Cardio-Thoracic Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly Department of Woman and Child’s Health Pediatric CardiologyUniversity of PadovaPadovaItaly Athens Heart Surgery Institute and Iaso Children’s Hospital AthensGreece Department for Cardiovascular Surgery University Medical CenterLeidenThe Netherlands Department for Cardiovascular Surgery University Hospital BernBernSwitzerland Department of Congenital Cardiac Surgery IRCCS Policlinico San DonatoSan Donato MilaneseItaly Department of Pediatric Cardiology and Congenital Heart Disease Hôpital Marie LannelongueUniversitéParis-SudLe Plessis-RobinsonFrance Deutsch Herz Zentrum MunichGermany Katholieke Universiteit Leuven LeuvenBelgium cardiothoracic Surgery Hospital de Santa Marta Rua LisbonPortugal Department of Pediatric cardiothoracic Surgery Children’s Hospital of GeorgiaGeorgiaUSA Department of Cardiac Surgery University Hospital GhentGhentBelgium division of Cardiac Surgery University Hospital Center of TiranaTiranaAlbania Department of Pediatric Cardiac Surgery Hospital for Children and AdolescentsUniversity of HelsinkiHelsinkiFinland Congenital Cardiac Surgery Department Hospital Universitario La PazMadridSpain Department of Pediatric Cardiac Surgery National Institute of Cardio-Vascular Diseases-Children’s Heart CenterBratislavaSlovakia division of Pediatric Cardiology Ospedale BrotzuCagliariItaly division of Sport Medicine Ospedale Ca’FoncelloTrevisoItaly Department of Medicine Radiology ClinicUniversity of Padua Medical SchoolPadovaItaly

Background:Anomalous aortic origin of a coronary artery(AAOCA)is a congenital heart disease with a 0.3%−0.5%prevalence.Diagnosis is challenging due to nonspecific clinical presentation.Risk stratification and treatment are currently based on expert consensus and single-center case series.Methods:Demographical and clinical data of AAOCA patients from 17 tertiary-care centers were analyzed.Diagnostic imaging studies(Bidimensional echocardiography,coronary computed tomography angiography[CCTA]were collected.Clinical correlations with anomalous coronary course and origin were evaluated.Results:Data from 239 patients(42%males,mean age 15 y)affected by AAOCA were collected;154 had AAOCA involving the right coronary artery(AAORCA),62 the left(AAOLCA),23 other anomalies.211(88%)presented with an inter-arterial course.Basal electrocardiogram(ECG)was abnormal in 37(16%).AAOCA was detected by transthoracic echocardiography and CCTA in 53%and 92%of patients,respectively.Half of the patients reported cardiac symptoms(119/239;50%),mostly during exercise in 121/178(68%).An ischemic response was demonstrated in 37/106(35%)and 16/31(52%)of patients undergoing ECG stress test and stress-rest single positron emission cardiac tomography.Compared with AAORCA,patients with AAOLCA presented more frequently with syncope(18%vs.5%,P=0.002),in particular when associated with inter-arterial course(22%vs.5%,P<0.001).Conclusion:Diagnosis of AAOCA is a clinical challenge due to nonspecific clinical presentations and low sensitivity of first-line cardiac screening exams.Syncope seems to be strictly correlated to AAOLCA with inter-arterial course.

关键词： Anomalous coronary arteries congenital echocardiography coronary computed tomography angiography

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Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Europe and China:An Analysis of the European Congenital Heart Surgeons Association Congenital Heart Surgery Database

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Congenital Heart Disease 2021年第1期16卷 17-25页

作者： Claudia Herbst Haibo Zhang Renjie Hu Jürgen Hörer Masamichi Ono Vladimiro Vida Tjark Ebels Andrzej Kansy Jeffrey P.Jacobs Zdzislaw Tobota Bohdan Maruszewski Department of Surgery Division of Cardiac Surgery and Pediatric Heart CenterMedical University ViennaViennaAustria Department of Pediatric cardiothoracic Surgery Shanghai Children’s Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina Department for Congenital and Pediatric Heart Surgery German Heart Center MunichTechnische Universität MünchenDivision for Congenital and Pediatric Heart SurgeryUniversity Hospital of MunichLudwig-Maximilians-UniversitätMunichGermany Pediatric and Cardiac Surgery Unit Department of Cardio Thoracic Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly Department of cardiothoracic Surgery University Medical Center GroningenGroningenThe Netherlands cardiothoracic Surgery Amsterdam University Medical CenterAmsterdamThe Netherlands Pediatric cardiothoracic Surgery Children’s Memorial Health InstituteWarsawPoland St.Petersburg FLUSA

Background:The European Congenital Heart Surgeons Association(ECHSA)Congenital Heart Surgery Database(CHSD)was founded in 1999 and is open for worldwide participation.The current dataset includes a large amount of surgical data from both Europe and China.The purpose of this analysis is to compare patterns of practice and outcomes among pediatric congenital heart defect surgeries in Europe and China using the ECHSA-CHSD.Methods:We examined all European(125 centers,58,261 operations)and Chinese(13 centers,23,920 operations)data in the ECHSA-CHSD from 2006-2018.Operative mortality,postoperative length of stay,median patient age and weight were calculated for the ten benchmark operations for China and Europe,respectively.Results:Benchmark procedure distribution frequencies differed between Europe and China.In China,ventricular septal defect repair comprised approximately 70%of procedures,while Norwood operations comprised less than one percent of all procedures.Neonatal cardiac procedures were rare in China overall.For procedures in STAT mortality category 1,Chinese centers had lower operative mortality rates,while procedures in categories 3 and 5 mortality is lower in European centers.Operative mortality over the time period decreased from 3.89%to 1.64%for the whole cohort,with a sharper decline in China.This drop coincides with an increase of submitted procedures over this 13-year-period.Conclusion:Chinese centers had higher programmatic volume of congenital heart surgeries,while European centers have a more complex case mix.Palliation for patients with functionally univentricular heart was performed less commonly in China.These comparison of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement.

关键词： Outcomes congenital heart surgery China Europe database

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Surgical treatment of hepatocellular carcinoma with inferior vena cava tumor thrombus: a new classification for surgical guidance

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Hepatobiliary & Pancreatic Diseases International 2013年第3期12卷 263-269页

作者： Ai-Jun Li Wei-Ping Zhou Chuan Lin Xi-Long Lang Zhen-Guang Wang Xiao-Yu Yang Qing-He Tang Ran Tao Meng-Chao Wu division of Special Treatment Ⅱ Eastern Hepatobiliary Surgery Hospital Second Military Medical University division of Hepatic Surgery Third Eastern Hepatobiliary Surgery Hospital Second Military Medical University Department of cardiothoracic Surgery Changhai Hospital Second Military Medical University Center for Organ Transplantation and Department of General Surgery Ruijin Hospital

BACKGROUND: Hepatic resection is the main treatment modality for hepatic tumors. Advances in diagnostic technique, preoperative preparation, surgical technique, and postoperative management increased the success rate. The present study aimed to evaluate hepatectomy and resection of inferior vena cava tumor thrombus (IVCTT) in patients with hepatocellular carcinoma, and the relationship between IVCTT classification and selection of surgical technique. METHODS: We retrospectively reviewed 13 patients with hepatocellular carcinoma who had undergone hepatectomy with IVCTT resection between May 1997 and August 2009. Age, gender, diagnosis, findings of physical examination, results of preoperative laboratory investigations, radiological examination, criteria for resection, postoperative pathological results, incisions, operative technique, intraoperative transfusion, drains, and intraoperative and postoperative complications were evaluated for all patients. RESULTS: Type Ⅰ IVCTT (10 patients) was posterior to the liver and below the diaphragm; type Ⅱ IVCTT (2 patients) was above the diaphragm but still outside the atrium; and type Ⅲ IVCTT (1 patient) was above the diaphragm and in the right atrium. Type Ⅰ was treated by radical hepatectomy and removal of IVCTT with total hepatic vascular exclusion. Type Ⅱ was treated by radical hepatectomy and removal of IVCTT by incision of the diaphragm. Type Ⅲ was treated by hepatectomy and resection of the thrombus from the right atrium under cardiopulmonary bypass. There were no surgical complications and one patient has been survived for 4 years with cancer-free status. The median survival time was 18.2 months, and the 1-and 2-year survival rates were 53.8% and 15.4%, respectively. CONCLUSION: Surgical treatment is safe and feasible for treatment of IVCTT in patients with hepatocellular carcinoma, and surgical resectability can be judged according to the classification of tumor thrombus.

关键词： liver tumor inferior vena cava hepatectomy tumor thrombus total hepatic vascular exclusion

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The SUPER reporting guideline suggested for reporting of surgical technique

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 534-544,I0024-I0026页

作者： Kaiping Zhang Yanfang Ma Jinlin Wu Qianling Shi Leandro Cardoso Barchi Marco Scarci Rene Horsleben Petersen Calvin S.H.Ng Steven Hochwald Ryuichi Waseda Fabio Davoli Robert Fruscio Giovanni Battista Levi Sandri Michel Gonzalez Benjamin Wei Guillaume Piessen Jianfei Shen Xianzhuo Zhang Panpan Jiao Yulong He Nuria M.Novoa Benedetta Bedetti Sebastien Gilbert Alan D.L.Sihoe Alper Toker Alfonso Fiorelli Marcelo F.Jimenez Toni Lerut Aung Y.Oo Grace S.Li Xueqin Tang Yawen Lu Hussein Elkhayat Tomaz Stupnik Tanel Laisaar Firas Abu Akar Diego Gonzalez-Rivas Zhanhao Su Bin Qiu Stephen D.Wang Yaolong Chen Shugeng Gao Editorial Office AME Publishing CompanyHong KongChina School of Chinese Medicine Hong Kong Baptist UniversityHong KongChina Department of Cardiovascular Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina Evidence-based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhouChina Lanzhou University Institute of Health Data Science LanzhouChina Digestive Surgery division Department of GastroenterologyUniversity of Sao Paulo School of MedicineSão PauloBrazil Department of cardiothoracic Surgery Imperial College Healthcare NHS TrustLondonUK Department of cardiothoracic Surgery University Hospital of CopenhagenRigshospitaletCopenhagenDenmark The Chinese University of Hong Kong Prince of Wales HospitalShatinNew TerritoriesHong KongChina Department of Surgical Oncology Roswell Park Cancer InstituteBuffaloNYUSA Department of General Thoracic Breast and Pediatric SurgeryFukuoka UniversityFukuokaJapan Department of Thoracic Surgery AUSL RomagnaS.Maria delle Croci Teaching HospitalRavennaItaly Clinic of Obstetrics and Gynecology University of Milan-BicoccaSan Gerardo HospitalMonzaItaly division of General Surgery and Liver Transplantation S.Camillo HospitalRomeItaly Service of Thoracic Surgery Lausanne University Hospital(CHUV)LausanneSwitzerland division of cardiothoracic Surgery Department of SurgeryUniversity of Alabama BirminghamBirminghamALUSA University of Lille CNRSInsermCHU LilleUMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to TherapiesLilleFrance Department of cardiothoracic Surgery Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityLinhaiChina The First School of Clinical Medicine Lanzhou UniversityLanzhouChina Thoracic Surgery Service University Hospital of SalamancaBiomedical Institute of SalamancaSalamancaSpain Department of Thoracic Surgery Helios Clinic Bonn/Rhein SiegBonnGermany division of Thoracic Surgery Department of SurgeryThe Ottawa

Background:Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical technique.The Surgical techniqUe rePorting chEcklist and standaRds(SUPER)aims to address this gap by defining reporting standards for surgical technique.The SUPER guideline intends to apply to articles that encompass surgical technique in any study design,surgical discipline,and stage of surgical innovation.Methods:Following the EQUATOR(Enhancing the QUAlity and Transparency Of health Research)Network approach,16 surgeons,journal editors,and methodologists reviewed existing reporting guidelines relating to surgical technique,reviewed papers from 15 top journals,and brainstormed to draft initial items for the SUPER.The initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and regions.The final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER consultants.Results:The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique reporting.The items are divided into six sections:background,rationale,and objectives(items 1 to 5);preoperative preparations and requirements(items 6 to 9);surgical technique details(items 10 to 15);postoperative considerations and tasks(items 16 to 19);summary and prospect(items 20 and 21);and other information(item 22).Conclusions:The SUPER reporting guideline has the potential to guide detailed,comprehensive,and transparent surgical technique reporting for surgeons.It may also assist journal editors,peer reviewers,systematic reviewers,and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique.

关键词： Surgical technique surgical innovation reporting guideline reporting checklist Surgical techniqUe rePorting chEcklist and standaRds(SUPER)

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Rapid right ventricular pacing for balloon valvuloplasty in congenital aortic stenosis:A systematic review

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World Journal of Cardiology 2020年第11期12卷 540-549页

作者： Konstantinos S Mylonas Ioannis A Ziogas Charitini S Mylona Dimitrios V Avgerinos Christos Bakoyiannis Fotios Mitropoulos Aphrodite Tzifa Department of cardiothoracic Surgery Yale New Haven HospitalNew HavenCT 06510United States Medical School Aristotle University of ThessalonikiThessaloniki 54124Greece Department of Pediatrics Trikala General HospitalTrikala 42100Greece Department of cardiothoracic Surgery New York Presbyterian HospitalNew YorkNY 10065United States division of vascular Surgery First Department of SurgeryLaiko General HospitalNational and Kapodistrian University of AthensAthens 11527Greece Department of Pediatric Cardiac Surgery Mitera Children’s HospitalAthens 15123Greece Department of Pediatric Cardiology and Adult Congenital Heart Disease Mitera Children’s HospitalAthens 15123Greece

BACKGROUND Balloon aortic valvuloplasty(BAV)is a well-established treatment modality for congenital aortic valve stenosis.AIM To evaluate the role of rapid right ventricular pacing(RRVP)in balloon stabilization during BAV on aortic regurgitation(AR)in pediatric patients.METHODS A systematic review of the MEDLINE,Cochrane Library,and Scopus databases was conducted according to the PRISMA guidelines(end-of-search date:July 8,2020).The National Heart,Lung,and Blood Institute and Newcastle-Ottawa scales was utilized for quality assessment.RESULTS Five studies reporting on 72 patients were included.The studies investigated the use of RRVP-assisted BAV in infants(>1 mo)and older children,but not in neonates.Ten(13.9%)patients had a history of some type of aortic valve surgical or catheterization procedure.Before BAV,58(84.0%),7(10.1%),4(5.9%)patients had AR grade 0(none),1(trivial),2(mild),respectively.After BAV,34(49.3%),6(8.7%),26(37.7%),3(4.3%),patients had AR grade 0,1,2,and 3(moderate),respectively.No patient developed severe AR after RRVP.One(1.4%)developed ventricular fibrillation and was defibrillated successfully.No additional arrhythmias or complications occurred during RRVP.CONCLUSION RRVP can be safely used to achieve balloon stability during pediatric BAV,which could potentially decrease AR rates.

关键词： Congenital aortic stenosis Rapid right ventricular pacing Balloon aortic valvuloplasty Congenital heart disease Systematic review Aortic regurgitation

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CPB的冠脉手术病人主要麻醉方法的选择影响术后ICU住院时间

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国外医学（麻醉学与复苏分册） 2004年第4期25卷 249-252,256页

作者： Stefan G.De Hert Philippe J.Van der Linden Stefanie Cromheecke Roel Meeus Pieter W.ten Broecke Ivo G.De Blier Bernard A.tockman Inez E.Rodrigus 刘功俭(译) 曾因明(审) director of the division of cardiothoracic and vascular anesthesia University Hospital Antwerp Department of Anesthesiology University Hospital Antwerp Department of Anesthesiology Brugmann-HUDERF University Hospital BrusselsBelgium. Department of Cardiac Surgery University Hospital Antwerp 不详

研究背景:挥发性麻醉药在冠脉手术期间可以保护心肌.本研究旨在和全凭静脉麻醉相比较,说明挥发性麻醉药的应用与ICU住院天数和总住院天数(LOS)减少有关。

关键词： CPB 冠脉手术麻醉选择术后 ICU住院时间

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