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Congenital Heart Disease 2022年第5期17卷 533-539页

作者： Qi Liu Shoujun Li Zhongdong Hua pediatric cardiac Surgery center of Fuwai Hospital BeijingChina

Background:Double aortic arch(DAA)with distal left-sided aortic arch atresia(LAAA)can form complete vascular ring by ligamentum *** aimed to introduce an uncommon DAA-LAAA diagnosis and treatment by the minimally invasive surgical technique(MIST).Methods:We retrospectively reviewed 7 cases of DAA-LAAA that were treated from January 2017 to July *** infant patients underwent surgical repair by minimally invasive surgical *** follow-up was 14.43 months(range,5–21 months).Results:There were seven patients with DAA-LAAA,including six males and one *** age was 19.29 months(range,9.0–29.0 months).Median weight was 11.30 kg(range,9.6–13.0 kg).Three patients were found severe tracheal compression by cardiac computed tomography angiography(cCTA).Six patients with isolated DAA-LAAA were performed operations through left subaxillary minithoracotomy,and one patient with ventricular septal defect(VSD)was performed operation concurrently under the cardiopulmonary bypass(CPB)through right subaxillary *** patients had symptom improvement in the postoperative period and discharged ***-up data showed good results in ***:We introduce a new surgical pathway for DAA-LAAA treatment with good symptomatic relief in *** is a safe,feasible and economical approach for infant patients.

关键词： Double aortic arch complete vascular ring minimally invasive surgical technique

Postoperative jaundice after cardiac surgery

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Hepatobiliary & Pancreatic Diseases International 2007年第4期6卷 383-387页

作者： Aikaterini Mastoraki Emmanouil Karatzis Sotiria Mastoraki Ioannis Kriaras Petros Sfirakis Stefanos Geroulanos Department of Surgical intensive Care Unit Onassis Cardiac Surgery Center356 Sygrou Ave17674 AthensGreece

BACKGROUND:The frequency and pattern of hyperbili-rubinemia after open-heart surgery and its severe perioperative complications are not well clarified. The purpose of this study was to investigate the incidence and nature of postoperative jaundice in patients undergoing cardiac operation,to analyze the determinants,and to identify the clinical significance of this complication with regard to the associated morbidity and mortality. METHODS:A prospective observational study was made during the period of 2003-2004 in a Surgical intensive Care Unit of a cardiac Surgery center,Athens. One hundred twenty-eight adult patients for open heart surgery were divided into three groups. Group A included 50 patients who underwent coronary artery bypass crafting(CABG),group B 31 patients who were subjected to aortic valve replacement(AVR)+CABG and group C 47 patients who underwent mitral valve replacement(MVR)+CABG. Aminotransferases,alkaline phosphatase,gamma-glutamyl-transpeptidase and both types of bilirubin were determined at admission,24 hours after the operation and thereafter according to clinical evolution. The presence of jaundice was associated with elevated serum bilirubin above 3 mg/dl. RESULTS:Hyperbilirubinemia developed in 34 patients(26.5%). The incidence of postoperative jaundice was higher in patients who were subjected to MVR+CABG than to CABG and AVR+CABG. Hyperbilirubinemia was correlated with prolonged cardiopulmonary by-passtime(P<0.001),aortic cross-clamping time(P<0.001),the use of intra aortic balloon pumping(P<0.001),the administration of inotrops and the number of blood and plasma transfusions. Postoperative jaundice resulted mainly from an increase in conjugated bilirubin. CONCLUSIONS:Although hyperbilirubinemia seems to be multifactorial,the type of operation,the preoperative hepatic dysfunction due to advanced heart failure(NYHA Ⅱ-Ⅲ) and the decreased hepatic flow during the operation seem to determine the incidence of jaundice.

关键词： jaundice conjugated bilirubin cardiac surgery prognosis

Single institution experience with the Ladd's procedure in patients with heterotaxy and stage Ⅰ palliated single-ventricle

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World Journal of Clinical pediatrics 2016年第3期5卷 319-324页

作者： Kurt D Piggott Grace George Harun Fakioglu Carlos Blanco Sukumar Saguna Narasimhulu Kamal Pourmoghadam Hamish Munroe William Decampli the Heart center at Arnold Palmer Hospital for Children Pediatric Cardiac Intensive Care Medicine

AIM:To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's ***:We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation.A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time *** reviewed each patients chart to determine if significant intraoperative or post-operative morbidity or mortality *** also described our protocolized management of these patients in the cardiac intensive care unit,which included pre-operative labs,echocardiography,milrinone infusion,as well as protocolized fluid administration and anticoagulation *** also reviewed the literature to determine the reported morbidity and mortality associated with the Ladd's procedure in this particular cardiac physiology and if other institutions have reported protocolized care of these ***:A total of 8 patients were identified to have heterotaxy with an intestinal rotation anomaly and single-ventricle heart disease that was status post single ventricle *** of these patients were palliated with a Blaylock-Taussig shunt,one of whom underwent a Norwood *** two other patients were palliated with a stent,which was placed in the ductus *** eight patients all underwent elective Ladd's procedure at the time of gastrostomy tube *** our protocol,all patients remained on aspirin prior to surgery and had no period where they were without *** patients remained on milrinone during and after the procedure and received fluid administration upon arrival to the cardiac intensive care unit to account for *** 8 patients experienced no intraoperative or post-o

关键词： Congenital heart disease Heterotaxy Single-ventricle pediatrics Ladd’s procedure Congenital heart disease

Signaling pathways and intervention therapies in sepsis

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Signal Transduction and Targeted Therapy 2021年第12期6卷 3567-3602页

作者： Yun-yu Zhang Bo-tao Ning Department of pediatric intensive Care Unit Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong University200127 ShanghaiChina

Sepsis is defined as life-threatening organ dysfunction caused by dysregulated host systemic inflammatory and immune response to *** decades,advanced understanding of host–microorganism interaction has gradually unmasked the genuine nature of sepsis,guiding toward new definition and novel therapeutic *** clinical manifestations and outcomes among infectious patients have suggested the heterogeneity of immunopathology,while systemic inflammatory responses and deteriorating organ function observed in critically ill patients imply the extensively hyperactivated cascades by the host defense *** focusing on microorganism pathogenicity,research interests have turned toward the molecular basis of host *** progress has been made regarding recognition and management of clinical sepsis,incidence and mortality rate remain ***,clinical trials of therapeutics have failed to obtain promising *** far as we know,there was no systematic review addressing sepsis-related molecular signaling pathways and intervention therapy in *** studies have succeeded to confirm novel functions of involved signaling pathways and comment on efficacy of intervention therapies amid ***,few of these studies attempt to elucidate the underlining mechanism in progression of sepsis,while other failed to integrate preliminary findings and describe in a broader *** review focuses on the important signaling pathways,potential molecular mechanism,and pathway-associated therapy in ***-derived molecules interacting with activated cells possess pivotal role for sepsis pathogenesis by dynamic regulation of signaling ***-talk and functions of these molecules are also discussed in ***,potential novel therapeutic strategies precisely targeting on signaling pathways and molecules are mentioned.

关键词： sepsis mentioned finding

Preoperative intra-aortic balloon pump improves the clinical outcomes of off-pump coronary artery bypass grafting in left ventricular dysfunction patients

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中国循环杂志 2016年第Z1期31卷 -页

作者： Feng Yang Xiaotong Hou Hong Wang center for cardiac intensive Care Beijing Anzhen Hospital Capital Medical University Beijing China

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

Acute acalculous cholecystitis in children

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World Journal of Gastroenterology 2018年第43期24卷 4870-4879页

作者： Dimitri Poddighe Vitaliy Sazonov Department of Medicine School of MedicineNazarbayev University pediatric intensive Care Unit UMC National Research Center for Mother and Child Health

Acute acalculous cholecystitis(AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. AAC is estimated to represent at least 50% to 70% of all cases of acute cholecystitis during childhood. Although this pathology was originally described in critically ill or post-surgical patients, most pediatric cases have been observed during several infectious diseases. In addition to cases caused by bacterial and parasitic infections, most pediatric reports after 2000 described children developing AAC during viral illnesses(such as Epstein-Barr virus and hepatitis A virus infections). Moreover, some pediatric cases have been associated with several underlying chronic diseases and, in particular, with immune-mediated disorders. Here, we review the epidemiological aspects of pediatric AAC, and we discuss etiology, pathophysiology and clinical management, according to the cases reported in the medical literature.

关键词： Acute acalculous cholecystitis Children Viral biliary disorders

Re-emergence of Ebola virus disease in Uganda:Should Southeast Asia countries be worried?

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Journal of Safety Science and Resilience 2023年第3期4卷 262-264页

作者： Haruna Muhammad Daiyab Farouq Muhammad Dayyab Department of Medicine Murtala Mohammed Specialist HospitalKanoNigeria cardiac intensive Care Unit Mohammed Bin KhalifaBin Salman Al Khalifa Cardiac CenterAwaliBahrain

An outbreak of Ebola virus disease(EVD)(Sudan virus)was first reported in the Republic of Uganda on September 20,*** of November 17,2022,151 confirmed cases have been reported,including 55 deaths(with a case fatality rate among confirmed cases of 39%).During the EVD outbreak in 2013–2016,international travel played a significant role in the spread of the disease across national *** that time,several tasks requiring improvement were identified in the World Health Organization(WHO)Southeast Asia Region(SEAR),including inadequate risk communication and risk assessment,data management gaps for surveillance purposes,inadequate capacity in molecular diagnostic techniques,lack of adequate planning for a surge of cases,and inadequate isolation *** is therefore recommended that all countries of the WHO SEAR revisit their level of Ebola preparedness and address existing *** emergence and rapid global spread of coronavirus disease 2019(COVID-19)have reiterated that the world has become a global *** was confirmed by the spread of the monkeypox virus with cases reported in the WHO ***,given the weak health infrastructure in the region,complacency could wreak havoc on the healthcare system if another epidemic emerges without an adequate level of preparedness.

关键词： Ebola Uganda Southeast Asia Outbreak

Combined Echocardiography and Lung Ultrasound for Extubation Outcome Prediction in Children after cardiac Surgery

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Congenital Heart Disease 2022年第3期17卷 231-244页

作者： Muzi Li Hong Meng Liang Zhang Yuzi Zhou Chao Liang Zhiling Luo Hao Wang Department of Echocardiography Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of pediatric cardiac Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina pediatric intensive Care Unit Department of Pediatric Cardiac SurgeryFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Echocardiography Fuwai Yunnan Cardiovascular HospitalKunmingChina

Background:Children are at risk of extubation failure after congenital heart disease *** cases should be identified to avoid possible adverse consequences of failed *** study aimed to identify ultrasound predictors of successful extubation in children who underwent cardiac ***:Children aged 3 months to 6 years who underwent cardiac surgery(if they were intubated for>6 h and underwent a spontaneous breathing trial)were included in this ***:We included 83 children who underwent surgery for congenital heart *** echocardiography and lung ultrasound were performed immediately before spontaneous breathing *** spontaneous breathing trial completion,respiratory parameters,including arterial blood gas analysis and frequency-to-tidal volume ratio,were similarly *** outcome assessment,all children were followed up for 48 h after *** successfully extubated 57 children(68.7%).These children were significantly older and weighed more but had shorter aortic cross-clamp and cardiopulmonary bypass *** who could not be weaned or extubated had prolonged total mechanical ventilation and pediatric intensive care unit *** the multivariate regression analysis,a lung ultrasound score≥12 and ejection fraction≥40%immediately before spontaneous breathing trials were the only independent predictors of successful *** combined,the lung ultrasound score and an ejection fraction≥40%showed a better diagnostic performance than every other isolated variable(lung ultrasound,N-terminal-pro-B-type natriuretic peptide,and frequency-to-tidal volume ratio).Conclusions:The combination of lung ultrasound and transthoracic echocardiography immediately before the spontaneous breathing trial effectively predicts extubation outcomes in children after cardiac surgery.

关键词： Lung echocardiography intensive care units pediatric airway extubation ventilator weaning pro-brain natriuretic peptide

The impact of frailty on in-hospital complications in elderly patients with acute coronary syndrome

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Journal of Geriatric Cardiology 2023年第3期20卷 174-184页

作者： Wojciech Nowak Ilona Kowalik Michał Nowicki Tomasz Cichocki Janina Stępińska Department of intensive cardiac Therapy National Institute of CardiologyWarsawPoland Clinical Research Support center National Institute of CardiologyWarsawPoland Department of Coronary Artery Disease and cardiac Rehabilitation National Institute of CardiologyWarsawPoland

BACKGROUND Acute coronary syndrome(ACS)is linked to a range of in-hospital complications,and age is recognized as risk factor for adverse *** between physiological and chronological age are explained by ***,the relationship between frailty and in-hospital complications is not *** Assessment of frailty in patients was carried out using the FRAIL ***-hospital complications assessed included,bleeding,infection,arrhythmia,acute kidney injury(AKI),delirium,stroke/transient ischemic attack(TIA),liver injury,hypoglycemia,length of stay in the cardiac care unit(CCU).RESULTS Of the 174 patients,frailty was identified in 39.1%and pre-frailty in 29.9%.Frailty was associated with a higher incidence of all types of bleeding(frail ***:45.5%vs.16.7%,P3 days)(OR:3.7[1.9-7.3]).CONCLUSIONS Frailty was associated with an increased risk of numerous in-hospital complications in elderly patients who had been

关键词： patients complications coronary