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Objective The aim of this study was to determine the effect of a new method of cardiac assistant therapy with an extra-aortic balloon pump on the experimental dogs in which myocardial ischemia or infarction were induced, and to ob serve its effectiveness and feasibility. Methods Twelve animal models of myocardia 1 infarction were established with the method of left anterior descending coronary artery ligation. They were divided randomly into two groups, six in the experimental group and six in the untreated group. The end points observed were the differences between the two groups in the blood pressure, cardiac function, myocardial enzymes, infarction size and routine blood variables before procedure, 1,2, 3, 4, 5 and 6 hours after myocardial infarction. Results All six dogs in the experimental group were survived, with a mortality rate of 0.The number of death in the control group was three, with a mortality rate of 50%. Measurements such as mean blood pressure,cardiac output, cardiac index in the experimental group were better than those in the control group ( P ＜ 0.05 ). Mean heart rate before myocardial infarction in the experimental group was 156 beats per minute, as compared with 148 beats per minute in the control group, and was 128 vs. 67 beats per minute respectively six hours after myocardial infarction. The cardiac output was 3.48 vs. 4.98 liters per minute before myocardial infarction and was 6.10 vs. 0.85 liters per minute six hours after myocardial infarction. The average pressure was 94 mm Hg vs. 99 mm Hg before myocardial infarction and was 70 mm Hg vs. 33 mm Hg six hours after myocardial infarction. Conclusion The extra-aortic balloon pump significantly improved the hemodynamic variables of the experimental animals after myocardial infarction and reduced mortality. Injury to the blood cells may be the potential disadvantage.
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Objective To analyze the clinical characters in old patients undergoing coronary artery bypass grafting (CABG). Methods The clinical data of 426 patients undergoing CABG from January 2000 to April 2009 in our hospital were retrospectively analyzed. One hundred eighteen patients were 70-82 years old (older group), 308 patients were 24-69 years old (younger group). The perioperative risk factors, surgical complication and outcomes between the two groups were compared.Results The older group had higher incidences of post-operative complications than younger group.Pre-operative risk factors included the female, chronic obstructive pulmonary disease, peripheral vessel disease, New york heart association(NYHA) class Ⅳ, unstable angina requiring intravenous nitrates until arrival in the anaesthetic room, left ventricular ejection fraction ＜30%. The older group showed higher incidences of postoperative severe complication, operative mortality, and more grafts and longer time in intensive care unit (ICU), and had lower incidents of valve disease and less use of left internal mammary artery [16 patients (13. 6%) vs. 152 patients (49.4%), all P＜0. 05].Conclusions The many CABG risk factors in China are different from those in the western countries.Although the higher incidents of postoperative severe complication and higher operative mortality are found in the older patients, the recovery period after operation isn't obviously prolonged. The operative outcomes are satisfactory.
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Objective To discuss related factors of perioperative pulmonary complications in infants with congenital heart disease and provide a scientific basis to improve the quality of intensive care in in-fants with congenital heart disease after surgery. Methods Tracking survey was carried out in 225 cases of infants with congenital heart disease in our city to observe the perioperative lung condition from March 2005 to May 2007. Every process that might occur pulmonary complications,such as preoperative care of children,anesthesia and cardiopulmonary bypass surgery (CPB) management and postoperative monitoring was closely observed. Statistical analysis was conducted according to emerging problems and summarized the relevant factors and nursing methods. Results 225 infant patients passed the operation with no seri-ous complications.Conclusions Effective treatment and nursing during every process of perioperation was the key factor to reduce pulmonary complications.
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Objective:To introduce the experience of using the fresh autologous pericard ium in cardiac operation. Methods:Fresh autologous pericardium unprepared by 0.5% glutardaldehyde was used in cardiac operations in 321 patients.It was used not only in repair of at rial septal defect and ventricular septal defect,but also in operations of many complicated congenital heart diseases,such as tetralogy of Fallot,double outlet of right ventricle,atrioventricular canal,single atrium anomalous pulmonary veno us connection,Ebstein's anomaly,tricuspid atresia,pulmonary atresia,single vent ricle,complete transposition of the great ateries.Autologous pericardium was als o used for enlargement aortic root in rheumatic heart disease and repairing of a trial septium after resection of the left atrial myxoma. Results:Twenty patients (6.1%) died within 30 days after operation.The resi dual shunt was found in one patient with tetralogy of Fallot and three patients with ventricular septal defect.Two hundred and fourty-three patients (75.7%) w ere followed-up.No patient had hemolysis,embolism,infectious endocarditis,patch calciflcation or other complications concerned with the use of the autologous p ericardium after operation. Conclusion:The fresh autologous pericardium is a good material for repairing cardiac defects.
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0.05), while CO, CI in both groups and SVI in OPCAB group increased significantly ( P 0.05). SVRI and PVRI were significantly lower in OPCAB group than those in CABG group (P