ABSTRACT
Objective To summarize the experience of microinvasive surgical occlusion for ostium secundum atrial septal defects (ASD). Methods A total of 43 patients with ostium secundum ASD was given microinvasive surgical occlusion. The diameter of ASD was 9.8~36.3 mm. An incision 2~3 cm in length was made on the right anterior chest. A special occluder was inserted to close the ostium under the guidance of transesophageal echocardiography. Results All of the patients were successfully occluded. Transient third degree AV block happened in 2 patients during the procedure. Moderate amount of pleural effusion occurred in 3 patients (cured). Echocardiography at 3 months after operation showed significant relief of pulmonary artery hypertension (from 52?21 mm Hg to 38?16 mm Hg; t=2.917, P=0.005). The patients were followed for 3~21 months (13.6?8.3 months), no dislocation of the device or atrial shunt was found. Conclusions Microinvasive surgical occlusion is safe and efficient for the closure of ostium secundum ASD. It is suitable for all patients in various age ranges.
ABSTRACT
AIM: The aim of this study was to investigate the hemodynamic characteristics of the denervated orthotopic transplanted hearts. METHODS: Eighteen patients with end - stage cardiopathy underwent orthotopic cardiac transplantation received immunosuppressive induction therapy. The changes of hemodynamics were closely monitored during the perioperative period and the periodic check-up of echocardiogram and electrocardiograph were followed up in the postoperative long-term period. RESULTS: All recipients were received vasoactive drug and active diuretic therapy during the perioperative period. An increase in central venous pressure in concomitance with decrease in cardiac output, cardiac index and mixed venous oxygen saturation within 24 to 48 hours and tend to stable 48 hours postoperation were detected. In the follow - up period, the cardiac functions of allografts were all recovered well. No recipient complained angina pectoris. CONCLUSIONS: The hemodynamic characteristics and clinical pharmacological therapeutic implications of cardiac denervation are very unique. Rational application of inotropic support and diuretic therapy and vasodilatation combined with prudent administration of some agents, which affect the physiology of denervated heart, are the most effective measures for the prevention of postoperative complications of cardiac allograft.
ABSTRACT
Kaneko's rahbit heart-lung transplant model was used xo investigate the effect of low flow perfusion(LFP)on rabbit heart-lung preservation.Thirty-two healthy rabbits were randomly divided into control group and experimental group.The donors in the experimental group were continuously perfused via aorta and pulmonary artery at low flow rate with the same perfusates during preservation.After heart-lung transplanted, the donors' LVsp, LVedp, RAP and Paw, and PaO2 were measured every 30 min for 90 min to evaluate the function of heart and lung.After finishing the trial, the contents of MDA in heart and lung were determined and the water weight gain calculated.The results showed that the rabbits in the experimental group had a significantly lower water weight gain and better cardiac and pulmonary function than in the control group.The experimental group produced less levels of MDA in heart and lung than did the control group.It is concluded that LFP is more effective than cold storage on rabbit heart-lung preservation.