Objective:To assess outcomes of patients with severe pulmonary regurgitation under different types of surgery.Method:A retrospective analysis of 5 cases with pulmonary valve replacement(PVR) and 6 patients with pulmonary valve plasty(PVP) contraction were conducted.Result:All patients successfully passed the operation period and were discharged from the hospital,pulmonary regurgitation disappeared or significantly relieved,right ventricular and right atrial size significantly reduced,and clinical symptoms alleviated.Follow-up for 4-38 months,2 cases with cardiac function of grade Ⅰ,9 cases of grade Ⅱ,all the cases had a good quality of life.Conclusion:Positive surgical interventions,such as PVR and PVP,should be considered in severe pulmonary valve reflux,which could significantly improve long-term prognosis.
Changes of erythrocyte membrane fluidity(FLU) and plasma lipid peroxidation (LPO) and SOD in erythrocyte were observed in 25 patients undergoing heart operations during cardiopulmonary bypass (CPB) and after CPB.The results indicate: the LPO was significantly increased and the FLU was greatly decreased at 60 min after the start of CPB. During CPB the activity SOD in erythrocyte was significantly increased, at 24 h the end of CPB, the activity returned to the level before CPB. The decrease of FLU was correlated negatively with the level of LPO. This suggests that the increase of LPO might be one of the causes of the decrease of FLU in patients undergoing CPB and after CPB.
To investigate the surgical and anesthetic management strategy of tracheal compression caused by mediastinal goiter.We retrospectively analyzed a patient with an anterior mediastinal mass in whom cardiopulmonary bypass was kept on standby via femoral vessels before induction of anesthesia. Bronchoscope guided tracheal intubation was done and tumor was removed via a cervical approach. Relative literature was reviewed.CPB via femoral vessels before induction of anesthesia help the patient recover from the perioperative period safely. While bronchoscope slipped beyond the obstruction smoothly and spent less time. The apparently narrow trachea easily distended and did not impair passage of the tube into the trachea opposed to being predicted preoperatively. The histopathological diagnosis confirmed the tumor as a nodular goiter with the formation of hematoma.CPB via femoral vessels before induction of anesthesia during surgical management of tracheal compression caused by mediastinal goiter is justified while bronchoscope guided tracheal intubation to establish the tracheal patency is a safe and feasible alternative.
Objective To evaluate the therapeutic effect of non-surgical division of the bridging leaflets using the double-patch technique on patients with complete atrioventricular septal defect (CAVSD)weighing less than 5 kg at operations.Methods From January 2002 to June 2007,15 consecutive patients with CAVSD underwent primary repair using a two-patch technique with no surgical division of the bridging leaflets,with the mean age of 3.4±0.7 months(ranging from 2 to 6 months)and with the mean body weight of 4.4±0.2 kg(ranging from 3.75 to 5.0 kg).Preoperative echocardiographic atrioventricular valve regurgitation was mild in 2 cases,moderate in 10 and severe in 3.All patients were type A according to the Rastelli classification.Two patients(13.3%)got the complication of Down's syndrome.Results One patient died of severe left atrioventricular valve regurgitation (LAVVR).One patient had temporary hemoglobinuria,and 1 patient had I°atrioventricular block.None got complete atrioventricular block.The mean follow-up period was 1.92±0.25 years(ranging from 0.5 to 3 years).Follow-up electrocardiography showed that all patients remained in sinus rhythrm Two cases had mild LAVVR,and 2 cases had mild to moderate LAVVR.No patients got residual ventricular septal defect and left ventricular outflow tract obstruction by cross-sectional echocardiography.Conclusions We may conclude that repair of CAVSD with no surgical division of the bridging leaflets can be carried out successfully in patients weighing less than 5 kg.
Key words:
Heart septal defects; atrial; Heart septal defects,ventricular; Heart diseases; congenital
Objective To review the surgical results of aortic dissecting aneurysm. Method from June 1992 to June 1998,15 patients with aortic dissecting aneurysm underwent surgical treatment. The procedures performed included 6 Cabrol operation, 4 Bentall procedure, one of closure of dissection with aortic valvular plasty and 4of deviation bypassing the dissected aorta. Results There was 1 postoperative death with a mortality of 6 6%. The cause of death was leakage of the anastomosis of left coronary in Bentall procedure. Conclusion The modification of Cabrol operation could improve surgical outcome of type II aortic dissection aneurysm. A selfblood infusion system bypass is created in case of hemostatic failure between right atrium and aneurysmal sac sewn around the dacron graft. For type IIIa aortic dissection aneurysm, a dacron graft was implanted between ascending aorta and abdominal aorta to bypass the dissected aorta, the results are encouraging.
OBJECTIVE To summarize the management of the fluid balance in extracorporeal circulation(ECC)for 53 cases of low-weight infants.METHODS The clinical data of 53 lowweight(≤8kg)infants with congenital heart disease were retrospectively analyzed from Jan,2006 to June,2006.All of the cases underwent ECC and much attention was paid to the fluid balance in ECC,especially about the drainage and perfusion,the dilution and concentration,the crystalloid and colloid,and electrolytes.RESULTS No severe complications associated with ECC occurred.There was one death with a mortality of 1.8%.CONCLUSION The improved management of the fluid balance in ECC could decrease the complications and mortality occurred after ECC for low-weight infants.
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