检索结果-南通市图书馆

Strategy and technique for surgical treatment of Ebstein’s anomaly

中华医学杂志(英文版) 2024年第10期137卷 1218-1224页

作者： Wu Qingyu Zhang Xiaoya Zhang Mingkui Li Hongyin Zhang Dongya Wang Lianyi Wu Qingfeng cardiac center Division of Cardiac Surgery The First Hospital of Tsinghua University Beijing China

Background: Ebstein’s anomaly (EA) is a rare and complex congenital heart anomaly, and the effect of surgical treatment is not ideal. This study aims to introduce our experience in management strategies, surgical techniques, and operative indications for patients with Ebstein’s anomaly.Methods: A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020. 32 patients had previously received cardiac surgery in other hospitals. The clinical data including diagnosis, operative indications, techniques, pathological changes, and survival rates were collected and analyzed.Results: Anatomical correction was performed in 203 (78.7%) operations, 1? ventricle repair in 38 (14.7%) operations, tricuspid valve repair only in four operations (1.6%), tricuspid valve replacement in ten (3.9%), total cavopulmonary connection (TCPC) in two (0.8%), and Glenn operation in one operation (0.4%). Reoperation was performed in five patients (2.0%) during hospitalization. Among them, tricuspid valve replacement was performed in one patient, 1? ventricle repair in two patients, and tricuspid valve annulus reinforcement in two patients. Five patients died with an early mortality rate of 2.0%. Complete atrioventricular conduction block was complicated in one patient (0.4%). A total of 244 patients was followed up (four in the 253 patients lost) with a duration of 3.0-168.0 (87.6 ± 38.4) months. cardiac function of 244 patients improved significantly with mean New York Heart Association (NYHA) functional class recovery from 3.5 to 1.1. The mean grade of tricuspid valve regurgitation improved from 3.6 to 1.5. Three late deaths (1.2%) occurred. The survival rates at five and ten years after surgery were 98.6% and 98.2%, respectively. Reoperation was performed in five patients (2.0%) during the follow-up period.Conclusion: Based on our management strategies and operative principles and techniques, anatomical correction of EA is c

关键词： Ebstein’s anomaly Anatomical repair Surgical treatment Long-term result

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

Portal vein pulsatility:An important sonographic tool assessment of systemic congestion for critical ill patients

引用

World Journal of Cardiology 2024年第5期16卷 221-225页

作者： Stavros Dimopoulos Michael Antonopoulos cardiac Surgery ICU Onassis Cardiac Surgery CenterKallithea 17674Greece

In this editorial we comment on the article by Kuwahara et al,published in the recent issue of the World Journal of Cardiology.In this interesting paper,the authors showed a correlation between portal vein pulsatility ratio,examined by bedside ultrasonography,and prognosis of hospitalized patients with acute heart failure.Systemic congestion is being notoriously underdetected in the acutely ill population with conventional methods like clinical examination,biomarkers,central venous pressure estimation and X-rays.However,congestion should be a key therapeutic target due to its deleterious effects to end organ function and subsequently patient prognosis.Doppler flow assessment of the abdominal veins is gaining popularity worldwide,as a valuable tool in estimating comprehensively congestion and giving a further insight into hemodynamics and patient management.

关键词： Systemic congestion Organ perfusion Hemodynamics Central venous pressure Point of care ultrasound Venous excess ultrasound

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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 procedures.AIM 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 transplantation.METHODS This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation center.Data was collected regarding MDROs commonly encountered in critical care.RESULTS 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 noted.MDRO 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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effectiveness of cardioneuroablation in different subtypes of vasovagal syncope

引用

Journal of Geriatric Cardiology 2024年第6期21卷 651-657页

作者： Bin TU Zi-Hao LAI Ai-Yue CHEN Zhi-Yuan WENG Si-Min CAI Zhu-Xin ZHANG Li-Kun ZHOU Li-Hui ZHENG Yan YAO arrhythmia center Fuwai HospitalNational Center for Cardiovascular DiseasesNational Key LaboratoryChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina cardiac center Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Cardiovascular Department The First Affiliated HospitalFujian Medical UniversityFujian Institute of HypertensionFujianChina Department of Cardiovascular The Second Affiliated Hospital of Zhejiang University School of MedicineZhejiangChina

BACKGROUND Cardioneuroablation(CNA)has shown encouraging results in patients with vasovagal syncope(VVS).However,data on different subtypes was scarce.METHODS This observational study retrospectively enrolled 141 patients[mean age:40±18 years,51 males(36.2%)]with the diagnosis of VVS.The characteristics among different types of VVS and the outcomes after CNA were analyzed.RESULTS After a mean follow-up of 4.3±1.5 years,41 patients(29.1%)experienced syncope/pre-syncope events after CNA.Syncope/pre-syncope recurrence significantly differed in each subtype(P=0.04).The cardioinhibitory type of VVS had the lowest recurrence rate after the procedure(n=6,16.7%),followed by mixed(n=26,30.6%)and vasodepressive(n=9,45.0%).Additionally,a significant difference was observed in the analyses of the Kaplan-Meier survival curve(P=0.02).Syncope/pre-syncope burden was significantly reduced after CNA in the vasodepressive type(P<0.01).Vasodepressive types with recurrent syncope/pre-syncope after CNA have a lower baseline deceleration capacity(DC)level than those without(7.4±1.0 ms vs.9.0±1.6 ms,P=0.01).Patients with DC<8.4 ms had an 8.1(HR=8.1,95%CI:2.2-30.0,P=0.02)times risk of syncope/pre-syncope recurrence after CNA compared to patients with DC≥8.4 ms,and this association still existed after adjusting for age and sex(HR=8.1,95%CI:2.2-30.1,P=0.02).CONCLUSIONS Different subtypes exhibit different event-free rates.The vasodepressive type exhibited the lowest event-free rate,but those patients with DC≥8.4 ms might benefit from CNA.

关键词： syncope subtypes diagnosis

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Femoral Access with Ultrasound-Guided Puncture and Z-Stitch Hemostasis for Adults with Congenital Heart Diseases Undergoing Electrophysiological Procedures

引用

Congenital Heart Disease 2024年第1期19卷 85-92页

作者： Fu Guan Matthias Gass Florian Berger Heiko Schneider Firat Duru Thomas Wolber arrhythmia and Electrophysiology Division Department of CardiologyUniversity Heart Center ZurichZurichSwitzerland Children’s Research center Zurich University Children’s HospitalZurichSwitzerland center for Integrative Human Physiology University of ZurichZurichSwitzerland

Aims:Although the application of ultrasound-guided vascular puncture and Z-stitch hemostasis to manage femoral access has been widely utilized,there is limited data on this combined application in adult congenital heart disease(ACHD)patients undergoing electrophysiological(EP)procedures.We sought to evaluate the safety and efﬁcacy of ultrasound-guided puncture and postprocedural Z-stitch hemostasis for ACHD patients under-going EP procedures.Methods and Results:The population of ACHD patients undergoing transfemoral EP pro-cedures at the University of Zurich Heart center between January 2019 and December 2022 was observed and analyzed.During the study period,femoral access(left/right,arterial/venous)was performed under real-time ultrasound guidance.At the end of the procedure,a single Z-stitch was performed at the puncture site.We eval-uated the incidence of in-hospital complications associated with femoral access puncture in this population.Among 101 patients who had a total of 147 previous ipsilateral vascular punctures(mean 1.5 per person),100 patients underwent successful femoral vascular access for EP procedures.The median age of the patients was 47±15 years and 34(34%)were male.Z-stitches were performed after the procedure in 100 patients with 303 femoral vascular accesses(mean 3 punctures per person).No patient developed vascular puncture relevant inguinal hematoma,pseudo aneurysm,arteriovenousﬁstula,venous or arterial thrombosis.Conclusion:In ACHD patients undergoing EP procedures,optimal femoral access management can be achieved with ultra-sound-guided puncture and postprocedural Z-stitch hemostasis.

关键词： Congenital heart disease cardiac electrophysiology cardiac catheterization femoral access hemostasis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Coronary Artery Patterns in Diabetic Patients Undergoing Diagnostic Coronary Angiography-Data from a Major cardiac center in Yemen

引用

World Journal of Cardiovascular Diseases 2024年第4期14卷 268-281页

作者： Mohammed M. Al-Kebsi Yehia Al-Ezzy Amatasamad Al-Tanobi Ayman A. Mohammed Department of Cardiology Faculty of Medicine and Health Sciences Sana&#8217a University Sana&#8217a Yemen cardiac center Al-Thawra Modern General Hospital Sana&#8217a Yemen

Background: Diabetes mellitus (DM) is independently associated with an increased risk of cardiovascular mortality and morbidity, including coronary artery disease (CAD). CAD is a shared burden disease and the leading cause of death in developed and developing countries. We aimed to assess the angiographic patterns of coronary arteries in patients with DM in a developing country (Yemen) as the first study. Methods: This study is a cross-sectional, prospective, observational study that includes a total of 250 patients who were admitted for elective diagnostic coronary angiography. Results: 96 (38.4%) patients were diabetics;68% were male;mean age was 57 ± 11 years. The incidence of three-vessel disease was 31.2% of patients. Considering the severity of lumen occlusion, (11.2%) of patients had non-significant lesions, (37.6%) of patients had significant lesions, and (32%) had total occlusive lesions. Lesions were of LAD in 76%, RCA in 60%, and LCX in 52% of the population. Among diabetics, two and 3-vessel diseases (33.3% vs. 20.8% & 50% vs. 19.5%, P = 0.001), left main lesion (10.4% vs. 2.6%, P = 0.012), significant stenosis (41.7% vs. 35.1%, P = 0.032), total occlusion of coronary arteries (43.8% vs. 19.5%, P = 0.032) and type C lesion (66.7% vs. 35.1%, P = 0.010) were more frequent than non-DM patients. Conclusion: The burden of significant and severe coronary lesions is more common among DM, which may be the major cause of morbidity and mortality of DM in developing countries.

关键词： Diabetes Mellitus Coronary Artery Diseases Coronary Angiography

来源：

维普期刊数据库博看期刊评论

在线全文

学校读者我要写书评

暂无评论

Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump cardiac Surgery Patients: A Single-center Investigation in Bangladesh

引用

World Journal of Cardiovascular Diseases 2024年第6期14卷 363-373页

作者： Md. Ahaduzzaman Md. Abir Tazim Chowdhury Munama Magdum Md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari Md. Abul Bashar Maruf Md. Alauddin Omar Sadeque Khan Md. Mostafizur Rahman Mirza Md. Nazmus Saquib Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of cardiac Surgery National Heart Foundation Hospital & Research Institute Dhaka Bangladesh Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of cardiac Surgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cyst

关键词： Acute Kidney Injury (AKI) On-Pump cardiac Surgery Serum Cystatin C Serum Creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-center Study Bangladesh

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy

引用

World Journal of Cardiology 2024年第2期16卷 67-72页

作者： Christos Kourek Stavros Dimopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece Clinical Ergospirometry Exercise&Rehabilitation Laboratory1st Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece

Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.

关键词： cardiac rehabilitation cardiac surgery Cardiopulmonary exercise testing Early mobilization Treatment Technology

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

A case report of chylous ascites after cardiac surgery

引用

Emergency and Critical Care Medicine 2024年第1期4卷 42-45页

作者： Shuaishuai Yuan Pailing Xie Xiantao Liu Peijun Li The University of Hong Kong-Shenzhen Hospital Cardiovascular Medicine center cardiac Intensive Care Unit ShenzhenGuangdongChina.

Background:Chylous ascites(CA),an emulsion rich in triglycerides,is a rare type of ascites,especially after cardiac surgery.Also,there are few reports of the occurrence of CA after mitral valve replacement,aortic valve replacement,tricuspid valvuloplasty,and coronary artery bypass grafting.Case presentation:We report the case of a 53-year-old man who underwent surgery for a diagnosis of mitral incompetence,aortic incompetence,tricuspid incompetence,and coronary atherosclerotic heart disease.Fifteen days after surgery,3000 mL of milky-yellow ascites appeared in the abdominal cavity,diagnosed as CA by laboratory examination.The ascites gradually disappeared after being drained,and the patients improved.The curative was objective,but the exact cause is not clear.Conclusion:Although CA is rare,it may occur during the surgical intervention in cardiac surgery.

关键词： cardiac intensive care unit cardiac valve replacement Case report Chylous ascites Coronary artery bypass graft Department of cardiac surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effects of combined aerobic,resistance and inspiratory training in patients with pulmonary hypertension:A systematic review

引用

World Journal of Critical Care Medicine 2024年第2期13卷 168-179页

作者： Christos Kourek Antonia Zachariou Eleftherios Karatzanos Michalis Antonopoulos Theodora Soulele Andreas Karabinis Serafim Nanas Stavros Dimopoulos Department of Clinical Ergospirometry Exercise and Rehabilitation Laboratory1^(st)Department of Critical Care MedicineEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Department of Cardiology 417 Army Share Fund Hospital of AthensAthens 11521Greece cardiac Surgery ICU Onassis Cardiac Surgery centerAthens 17674AtticaGreece cardiac Surgery ICU Onassis Cardiac Surgery CenterAthens 17674Greece cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece Department of Clinical Ergospirometry Exercise and Rehabilitation LaboratoryNational and Kapodistrian University of AthensAthens 10676Greece

BACKGROUND Pulmonary hypertension(PH)is a serious progressive disorder of the modern world,characterized by endothelial dysfunction and impaired vasoreactivity.Patients with PH usually present exercise intolerance from the very early stages and reduced exercise capacity.Exercise training has been shown to have beneficial effects in patients with cardiovascular comorbidities.However,data regarding the effects of combined exercise training programs in patients with PH still remains limited.AIM To investigate the effects of combined exercise training programs on exercise capacity and quality of life in patients with PH.METHODS Our search included all available randomized controlled trials(RCTs)regarding combined aerobic,resistance and inspiratory training programs in patients with PH in 4 databases(Pubmed,PEDro,Embase,CINAHL)from 2012 to 2022.Five RCTs were included in the final analysis.Functional capacity,assessed by peak VO_(2)or 6-min walking test(6MWT),as well as quality of life,assessed by the SF-36 questionnaire,were set as the primary outcomes in our study.RESULTS Peak VO_(2)was measured in 4 out of the 5 RCTs while 6MWT was measured in all RCTs.Both indices of functional capacity were significantly increased in patients with PH who underwent combined exercise training compared to the controls in all of the included RCTs(P<0.05).Quality of life was measured in 4 out of 5 RCTs.Although patients improved their quality of life in each group,however,only 2 RCTs demonstrated further improvement in patients performing combined training compared to controls.CONCLUSION By this systematic review,we have demonstrated that combined aerobic,resistance and inspiratory exercise training is safe and has beneficial effects on aerobic capacity and quality of life in patients with PH.Such exercise training regimen may be part of the therapeutic strategy of the syndrome.

关键词： Pulmonary hypertension Exercise training Peak VO2 Functional capacity Quality of life

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：