Shengwei Wang

Wuyi University

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Changsheng Zhu

Fu Wai Hospital

Hao Cui

Beijing Chao-Yang Hospital

Yongqiang Lai

Beijing Anzhen Hospital

Huang Xiao-hong

Chinese Academy of Medical Sciences & Peking Union Medical College

Rong Wu

Chinese Academy of Medical Sciences & Peking Union Medical College

Bing Tang

Beijing Anzhen Hospital

Shengshou Hu

Chinese Academy of Medical Sciences & Peking Union Medical College

Qinjun Yu

Chinese Academy of Medical Sciences & Peking Union Medical College

Changpeng Song

Peking Union Medical College Hospital

Shuiyun Wang

Chinese Academy of Medical Sciences & Peking Union Medical College

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Chinese Academy of Medical Sciences & Peking Union Medical College

141

Peking Union Medical College Hospital

Fu Wai Hospital

Capital Medical University

Beijing Anzhen Hospital

State Key Laboratory of Cardiovascular Disease

Ningbo No.6 Hospital

Chinese Academy of Sciences

Sun Yat-sen University

Huazhong University of Science and Technology

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[Surgical treatment for hypertrophic obstructive cardiomyopathy: a report of 118 cases].

PubMed (2013)

Mingyao Luo Shengwei Wang Yun-hu Song Chao-hua Yin Hongtao Sun

To assess the clinical outcomes of transaortic extended septal myectomy on early and midterm survival of patients with hypertrophic obstructive cardiomyopathy (HOCM).From October 2009 to April 2012, 118 consecutive patients underwent extended Morrow's procedure for HOCM. There were 69 males and 49 females with an average age of (46 ± 13) years. Their clinical data were analyzed retrospectively. Preoperative transthoracic, intraoperative transoesophageal and postoperative transthoracic echocardiography was performed to assess septal thickness, left ventricular outflow tract (LVOT) gradient, mitral valve function and systolic anterior motion (SAM) of anterior mitral valve leaflet, etc. Concomitant surgical procedures were performed if other cardiac diseases required surgical interventions. Follow-up study was carried out during subsequent clinic visits at outpatient department and through telephone interviews with patients and their relatives.The septal thickness was (25 ± 7) mm. SAM was detected in all. The in-hospital mortality was 0.8% (1/118) since one patient died of multiple organs failure one week later. Postoperative echocardiography demonstrated marked reduction in LVOT gradient (92 ± 22 vs 13 ± 10 mm Hg (1 mm Hg = 0.133 kPa), P = 0.000), New York Heart Association (NYHA) class (2.9 ± 0.6 vs 1.2 ± 0.4, P = 0.000) and significant improvement in mitral regurgitation. Concomitant surgical procedures were performed in 45 cases (38.1%, all for preexisting conditions). Complications included complete atrioventricular block (n = 3), first degree atrioventricular block (n = 6), complete left bundle branch block (n = 51), intraventricular conduction delay or left anterior division block (n = 26), transient renal dysfunction (n = 2) and intra-aortic-balloon-pumping (n = 2). No other severe complication was observed. During a follow-up period of 1 - 27 (7 ± 6) months, there was no readmission or death. All patients reported significant increase in physical ability and obvious decrease in limiting symptoms. At the latest follow-up, the NYHA functional class maintained grade I-II in all. And mitral regurgitation remained absent or mild.Surgical procedure for HOCM patients is both safe and efficacious. It provides an excellent relief of LVOT obstruction.

Septal myectomy

Ventricular outflow tract

Concomitant

Outpatient clinic

Atrioventricular block

Mitral valve replacement

Alcohol septal ablation

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Citations (1)

Surgical septal myectomy outcome for obstructive hypertrophic cardiomyopathy after alcohol septal ablation

Journal of Thoracic Disease (2021)

Qiulan Yang Changsheng Zhu Hao Cui Bing Tang Shengwei Wang

Background: Although surgical treatment of residual obstruction after alcohol septal ablation (ASA) is often challenging in patients with obstructive hypertrophic cardiomyopathy (OHCM) there are very few relevant clinical reports. Thus, outcomes of surgical septal myectomy (SSM) in this subgroup of patients remain to be determined. Therefore, this study aimed to determine the surgical and follow-up outcomes in patients with OHCM exhibiting residual obstruction after ASA. Methods: We collected case data for 62 patients with OHCM and residual obstruction after ASA who underwent SSM at Fuwai Hospital between January 2002 and June 2019. Propensity score matching with patients having had a myectomy as the only invasive procedure—was conducted in a 1:2 ratio. Echocardiography parameters, surgery results, and follow-up outcomes were compared between the groups. Results: The prior ASA group had a higher incidence of complete atrioventricular block (AVB) and subsequently postoperative permanent pacemaker (PPM) implantation than the primary myectomy group (9.7% vs. 1.6%, P=0.01). Two patients died within 30 days after surgery in the prior ASA group, and one patient died in the primary myectomy group, with an operative mortality rate of 3.2% and 0.8%, respectively (P=0.2). The 5-year event-free survival rate was 86.0% in the prior ASA group (median follow-up period: 3.2 years; mean: 3.9±2.6 years; maximum, 10.6 years) and 88.5% in the primary myectomy group (median follow-up period: 2.4 years; mean 2.8±1.7 years; maximum, 9.1 years) (P=0.2). During follow-up, four of 62 (6.5%) patients in the prior ASA group and one of 124 (0.8%) patients in the primary myectomy group progressed to advanced heart failure (P=0.025). Conclusions: Patients with OHCM following ASA are at an increased risk of developing AVB after SSM. Their surgical outcomes, and long-term survival rate were satisfactory and, osimilar to those for patients having had a myectomy as the only invasive procedure. In addition, they had an increased risk of advanced heart failure after SSM in the present study.

Alcohol septal ablation

Septal myectomy

Obstructive hypertrophic cardiomyopathy

10.21037/jtd-20-2779

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Citations (9)

Obstructive sleep apnea causes impairment of the carotid artery in patients with hypertrophic obstructive cardiomyopathy

Respiratory Medicine (2019)

Shengwei Wang Hao Cui Changsheng Zhu Rong Wu Liukun Meng

Intima-media thickness

10.1016/j.rmed.2019.03.002

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Citations (7)

mTOR pathway in human cardiac hypertrophy caused by LEOPARD syndrome: a different role compared with animal models?

Orphanet Journal of Rare Diseases (2019)

Hao Cui Lei Song Changsheng Zhu Ce Zhang Bing Tang

Abstract Background Animal studies suggested that blocking the activation of the mammalian target of rapamycin (mTOR) pathway might be effective to treat cardiac hypertrophy in LEOPARD syndrome (LS) caused by PTPN11 mutations. Results In the present study, mTOR pathway activity was examined in human myocardial samples from two patients with LS, four patients with hypertrophic cardiomyopathy (HCM), and four normal controls. The two patients with LS had p.Y279C and p.T468 M mutations of the PTPN11 gene, respectively. Although PTPN11 mutation showed initially positive regulation on phosphoinositide 3-kinase, overall the mTOR complex 1 pathway showed widely attenuated activity in LS. This included mildly hypophosphorylated mTOR and ribosomal protein S6 kinase and significantly hypophosphorylated Akt 308 and ribosomal protein S6, which is similar to HCM. Akt 473 is a basal molecule of the mTOR complex 2 pathway. Akt 473 was less affected and showed hyperactivity in LS compared with HCM and normal controls. Additionally, MAPK/ERK kinase and ERK1/2 were significantly more phosphorylated in both HCM and LS than normal controls. Conclusions In LS, the mTOR signaling pathway shows similar activity to HCM and is attenuated compared with normal controls. Thus, caution should be applied when using rapamycin to treat heart hypertrophy in LS.

RPTOR

PTPN11

10.1186/s13023-019-1204-4

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Citations (6)

Preoperative NT‐proBNP Predicts Midterm Outcome After Septal Myectomy

Journal of the American Heart Association (2019)

Changpeng Song Shengwei Wang Ying Guo Xinxin Zheng Jie Lü

Background The prognostic value of N-terminal pro-brain natriuretic peptide ( NT -pro BNP ) in patients with hypertrophic cardiomyopathy who underwent septal myectomy has not been well studied. Methods and Results We retrospectively evaluated NT -pro BNP levels in 758 patients (46.1±13.8 years; median follow-up, 936 days) who underwent septal myectomy in our center between March 2011 and April 2018. The median NT -pro BNP level was 1450.5 (interquartile range 682.6-2649.5) pg/mL. Overall, 22 (2.9%) patients died during follow-up; of these, 86.4% were cardiovascular deaths. The 3-year survival free from all-cause mortality by tertile was 95.2% (95% CI 91.1% to 97.4%; NT -pro BNP >2080 pg/mL), 98.3% (95% CI 94.6% to 99.5%; NT -pro BNP , 947-2080 pg/mL), and 99.2% (95% CI , 94.4% to 99.9%; NT -pro BNP <947 pg/mL). The 3-year survival rate free from cardiovascular mortality by tertiles was 95.2% in the highest tertile, 98.8% in the middle tertile, and 99.2% in the lowest tertile. Cox regression analysis indicated that Ln( NT -pro BNP ) was a significantly independent predictor of all-cause mortality (hazard ratio 2.380, 95% CI 1.356-4.178, P=0.003) and cardiovascular mortality (hazard ratio 2.788, 95% CI 1.450-5.362, P=0.002). In addition, concomitant coronary artery bypass grafting for coronary artery disease was also an independent predictor of cardiovascular mortality (hazard ratio 5.178, 95% CI 1.597-16.789, P=0.006). Conclusions Increased preoperative NT -pro BNP level is a strong predictor of midterm mortality in patients undergoing septal myectomy.

Interquartile range

Septal myectomy

Brain natriuretic peptide

10.1161/jaha.118.011075

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Citations (15)

Surgical treatment of adult patients with anomalous left coronary artery from the pulmonary artery

Chinese Journal of Thoracic and Cardiovaescular Surgery (2016)

Changwei Zhang Yunhu Song Jianping Xu Shengwei Wang Hansong Sun

Objective To review the experience of the surgical treatment of adult patients with anomalous left coronary artery from the pulmonary artery(ALCAPA). Methods A retrospective, single institution review was conducted on nineteen adult patients with ALCAPA surgical treatment from February 2006 to October 2012. Of these patients, five were males and fourteen were females. The age was(35.3±11.7)years. The weight was(61.2±9.4) kg. Most patients showed some evidence of myocardial infarction or ischemia with either abnormal Q waves(4) or ST-T abnormality(13). Twelve patients with coronary angiography and four patients with coronary CT scan showed good coronary collateralization. The preoperative UCG showed the mean left ventricular ejection fraction(LVEF) was 0.60±0.07, and the mean left ventricular end-diastolic dimension(LVEDD) was(52.4±4.4) mm. Severe mitral regurgitation(MR) was seen in two patients, moderate in three patients and mild in four patients. The operative procedures included Takeuchi operation in seven patients, ligation of left coronary artery concomitant with coronary artery bypass graft in two patients, coronary artery re-implantation in ten patients. Of the ten patients with coronary artery re-implantation, two patients underwent mitral valve repair. Results There was no operative mortality. The mean cardiopulmonary bypass time was(144.5±66.9) min and cross-clamp time was(96.4±38.8) min, respectively. The mean mechanical ventilation time was(12.9±3.7) h and intensive care unit time was(39.2±12.5) h, respectively. The mean postoperative LVEF was 0.62±0.04. No significant reduction in LVEDD(45.8±5.5) mm, P>0.05. Mild and trivial MR were observed in one and four patients, respectively. Sixteen patients(84.2%) completed the follow up with a mean time of 19.2 months. All the patients survived with New York Heart Association classⅠor Ⅱ. During the follow up period, no patient required reoperation or readmission. At the latest echocardiography, the mean LVEF of 0.63±0.05 and mean LVEDD of(49.2±4.6) mm did not significantly improved compared with the data preoperatively or postoperatively. Mild MR was detected in six patients, trivial in three patients during the follow-up period. Conclusion The adult patients with ALCAPA have a dormant disease process. Surgical treatment has been recommended at the time of diagnosis and the coronary re-implantation could be the first choice. As for the concomitant MR, the guideline for the adult MR should be followed. Key words: Anomalous Left Coronary Artery From the Pulmonary Artery; Takeuchi Operation; Coronary Artery Re-implantation

Left coronary artery

10.3760/cma.j.issn.1001-4497.2016.08.003

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Anatomic ligament reconstruction using Scheker technique for treatment of DRUJ instability

Zhonghua shouwaike zazhi (2013)

Xin Wang Shengwei Wang Jiadong Pan XU Ji-hai Haoliang Hu

Objective To evaluate the short and mid term curative effect of Scheker procedure to anatomically reconstruct distal radio-ulnar ligament in the treatment of distal radio-ulnar joint (DRUJ) instability.Methods From March 2007 to May 2011,15 consecutive patients with DRUJ instability including 11 males and4 females with an average age of 29 years (range,18 to 55 years) were treated with Scheker procedure.There were 12 cases of chronic instability and 3 cases of acute instability.Anatomic reconstruction of the distal radio-ulnar ligament was done using autologous or allogeneic tendon graft.All of them began their active forearm rotation exercises 6 weeks after the surgery.Results All patients were follow-up for 9 to 21 months,with an average of 15 months.Stability of the DRUJ was restored in all of them.The postoperative range of forearm rotation was (60.82 ± 5.13) ° in pronation and (72.70 ± 3.52) ° in supination.Except for the mild wrist pain in 2 cases,all were symptom free.Grip strength increased significantly.Activities of daily living and working requirements were satisfied.Conclusion Scheker procedure for anatomic ligament reconstruction is an effective treatment for DRUJ instability and is worthy of being widely applied clinically. Key words: Carpal joints; Joint instability; Tendon graft

Druj

Wrist pain

10.3760/cma.j.issn.1005-054x.2013.03.011

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Citations (0)

Dried tangerine peel polysaccharide (DTPP) alleviates hepatic steatosis by suppressing TLR4/MD-2-mediated inflammation and endoplasmic reticulum stress

Bioorganic Chemistry (2024)

Lingzhi Wang Wenxi Li Yinggang Li Gengrui Chen Lijuan Zhao

Steatosis

10.1016/j.bioorg.2024.107369

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Citations (6)

Survival Following Alcohol Septal Ablation or Septal Myectomy for Patients With Obstructive Hypertrophic Cardiomyopathy

Journal of the American College of Cardiology (2022)

Hao Cui Hartzell V. Schaff Shengwei Wang Brian D. Lahr Ethan J. Rowin

There is little information regarding long-term mortality comparing the 2 most common procedures for septal reduction for obstructive hypertrophic cardiomyopathy (HCM), alcohol septal ablation (ASA), and septal myectomy.This study sought to compare the long-term mortality of patients with obstructive HCM following septal myectomy or ASA.We evaluated outcomes of 3,859 patients who underwent ASA or septal myectomy in 3 specialized HCM centers. All-cause mortality was the primary endpoint of the study.In the study cohort, 585 (15.2%) patients underwent ASA, and 3,274 (84.8%) underwent septal myectomy. Patients undergoing ASA were significantly older (median age: 63.0 years [IQR: 52.7-72.8 years] vs 53.7 years [IQR: 44.9-62.8 years]; P < 0.001) and had smaller septal thickness (19.0 mm [IQR: 17.0-22.0 mm] vs 20.0 mm [IQR: 17.0-23.0 mm]; P = 0.007). Patients undergoing ASA also had more comorbidities, including renal failure, diabetes, hypertension, and coronary artery disease. There were 4 (0.7%) early deaths in the ASA group and 9 (0.3%) in the myectomy group. Over a median follow-up of 6.4 years (IQR: 3.6-10.2 years), the 10-year all-cause mortality rate was 26.1% in the ASA group and 8.2% in the myectomy group. After adjustment for age, sex, and comorbidities, the mortality remained greater in patients having septal reduction by ASA (HR: 1.68; 95% CI: 1.29-2.19; P < 0.001).In patients with obstructive hypertrophic cardiomyopathy, ASA is associated with increased long-term all-cause mortality compared with septal myectomy. This impact on survival is independent of other known factors but may be influenced by unmeasured confounding patient characteristics.

Alcohol septal ablation

Septal myectomy

Heart septum

10.1016/j.jacc.2022.02.032

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Citations (67)

Mini perforator propeller flaps for coverage of soft tissue defects of the finger

Zhonghua shouwaike zazhi (2016)

Haoliang Hu Xueyuan Li Shengwei Wang Lingfeng He Xiaoling Zhou

Objective To discuss the surgical technique and clinical outcomes of digital artery perforator mini propeller flap for soft tissue coverage of finger defects. Methods Soft tissue defects of the fingers in 18 patients were repaired with digital artery perforator mini propeller flap from December 2013 to December 2014. The defects involved the thumb in 8 cases, the index finger in 5 cases, the middle finger in 3 cases, and the ring finger in 2 cases. The size of the defect ranged from 1.5 cm×0.9 cm to 3.5 cm×2.0 cm. Tendon or bone exposure existed in all the cases.The flap size ranged from 2.5 cm×1.1 cm to 5.0 cm×2.5 cm. The donor sites could be closed directly in 8 cases while skin graft was required in 10 cases. Results Flaps in 15 cases survived uneventfully, while those in 3 cases had venous crisis which was resolved by removing some of the stitches. All but 2 patients had 3 to 12 months postoperative follow-up, with an average of 8 months. The flaps had satisfactory appearance and pliable texture. According to the upper limb functional assessment criteria formulated by the Hand Surgery Society of the Chinese Medical Association, the results were excellent in 8 cases, good in 6 cases, and fair in 2 cases. Conclusion Digital artery perforator mini propeller flap is a good option for soft tissue coverage of finger defects. The procedure is relatively simple with less damage to the donor site. Aesthetic and functional outcomes are satisfactory. Key words: Hand injuries; Microsurgery; Propeller flaps; Digital artery

Digital artery

Middle finger

Perforator flaps

Little finger

10.3760/cma.j.issn.1005-054x.2016.03.014

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