Surgical Treatment of Single Ventricle With Total Anomalous Pulmonary Venous Connection in Relevant Patients / 中国循环杂志

Objective: To summarize surgical result of single ventricle with total anomalous pulmonary venous connection (TAPVC) in relevant patients. Methods:A total of 25 patients of single ventricle with TAPVC treated in our hospital from 2008-09 to 2016-03 were summarized. The patients were between 5 days to 14 years of age with body weight at (3.3-49.5) kg. There were 22 patients with supracardiac type TAPVC, 1 with infracardiac type TAPVC and 2 with mixed type TAPVC;in addition,17 cases having complete atrio-ventricular canal defect, 2 having tricuspid atresia, 4 having more than moderate atrio-ventricular valve regurgitation, 5 having pulmonary atresia and 9having pulmonary venous obstruction. Results:There were 5/25 (20%) patients died at the early stage for low cardiac output syndrome. Followed-up study was conducted in 20 survivals for (1-65) months and 7 patients had re-surgery including 5 with modified Fontan operation, 1 with atrio-ventricular valve replacement due to severe atrio-ventricular valve regurgitation, 1 with pulmonary venous stenosis repair+atrio-ventricular valve replacement due to pulmonary venousobstruction and severe atrio-ventricular valve regurgitation. 3 patients died during followed-up period because of low cardiac output syndrome, protein lost intestine disease and neurological injury respectively. The rest survivals had good general condition, no residualpulmonary venous obstruction was found. Conclusion: The patients of single ventricle with TAPVC were frequently associated with right atrial isomerism and complex cardiac anomaly;surgical treatment still having the high mortality.

Analysis of 112 cases of infectious endocarditis / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the clinical manifestations, epidemiological features, pathogens, treatment and outcomes of 112 patients with infectious endocarditis.</p><p><b>METHODS</b>The clinical data were reviewed for all the patients with the diagnosis of infectious endocarditis in Nanfang Hospital over the period from 2002 to 2012.</p><p><b>RESULTS</b>The average age of disease onset was 46∓17.1 years among these cases. Seventy patients (62.5%) had underlying cardiac conditions, including, in the order of frequency, rheumatic heart disease, congenital cardiovascular anomalies, and senile valve degeneration. Clinically the patients presented with fever, anemia, congestive heart failure, and embolism events, etc. Echocardiography found endocardial neoplasms in 105 cases, and the mitral valve was often involved. Blood culture yielded positive results in 61 cases, and the most common causative bacteria were Streptococcus (20.5%), Staphylococcus (19.6%) and Enterococcus (5.4%). Surgical intervention was performed in 78 cases. Ninety-one patients were cured or improved after comprehensive treatment, and 10 discontinued treatment for financial reasons; 11 died of cardiac failure (8 cases), pulmonary embolism (2 cases) and central nervous system events (1 case).</p><p><b>CONCLUSION</b>Infectious endocarditis shows a significant change in the clinical profiles and its mortality remains high despite improved diagnostic and therapeutic procedures.</p>

Comparative analysis of mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the complications associated with mechanical and manual cervical esophagogastric anastomosis following esophagectomy for esophageal cancer.</p><p><b>METHODS</b>From September, 2004 to June, 2007, 227 patients with middle and upper thoracic esophageal cancer underwent cervical esophagogastric anastomosis after esophagectomy. The patients were randomized into two groups and cervical esophagogastric anastomosis was performed using a stapler (n=102) or manually (n=125). The incidence of postoperative complications and operative time were compared between the two groups.</p><p><b>RESULTS</b>In manual anastomosis group, anastomotic leak and anastomotic stricture occurred in 14.4% (18/125) and 8.8.% (11/125) of the patients, significantly higher than the incidences of 2.9% (3/102) and 3.9% (4/102) in the mechanical anastomosis group (P<0.01). Manual anastomosis required a significantly longer operative time than mechanical anastomosis (52∓12 vs 25∓5 min, P<0.01).</p><p><b>CONCLUSION</b>The use of circular mechanical stapler in cervical esophagogastric anastomosis is associated with a lower rate of anastomotic leak and a shorter operative time, and is easy to learn and standardize to reduce the complications of the anastomosis.</p>

Blood flow dynamic changes after mitral valve replacement operation in patients with mitral valve stenosis by color Doppler echocardiography / 中华超声影像学杂志

Objective To study the blood flow dynamic c hanges after mitral valve replacement(MVR) operation in patients with mitral valve stenosis by color Doppler echocardiography. Methods Thirty-seven- patients with mitral stenosis after MVR operation were analyzed with color Doppler echocardiography retrospectively, the observed items including dimension of left atrium, tricuspid valve backflow velocity, pulmonary artery systolic pressure(PAPS) and left ventricular ejection fraction(LVEF).Relativity analysis was conducted between PAPS and trans-mitral valve pressure(MV?P). Results All the patients survived healthy, the average follow-up time was 15.8- months. The follow-up data suggested that the dimension of left atrium, tricuspid valve backflow velocity and PAPS decreased significantly while LVEF increased significantly to the pre-operation. PAPS was in positive correlation with MV?P and the difference between PAPS and MV?P increased according to MV?P.Conclusions MVR can ameliorate flow dynamics effectively in patients with mitral stenosis, PAPS is in positive correlation with MV?P, senior stenosis existed within pulmonary circulation in patients with severe pulmonary hypertension.

Non-invasive monitoring of acute rejection after heart transplantation / 医学研究生学报

Heart transplantation(HT) has been an effective method to treat end-stage heart disease, one main factor affecting the long-term survival rate is acute and/or chronic rejection after HT. Trans internal jugular endomyocardial biopsy(EMB) has been the "gold standard" to judge the rejection after HT, but it is also limited. Electrocardiogram ,echocardiogram, immunological monitoring and imaging monitoring can judge the rejection after HT and induce the EMB.