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@#To clarify the efficacy and safety of Warden series operation in partial anomalous pulmonary venous connection (PAPVC). Methods Six patients with PAPVC (pulmonary vein drainage to superior vena cava), who were treated in cardiac surgery of Tianjin Chest Hospital from January 2016 to March 2018, were included in this study. All 6 patients underwent Warden series operation, including 3 with Warden surgery and another 3 with modified Warden surgery. Two patients underwent modified Warden surgery were rebuilt by autologous pericardial patch and 1 cases were connected to the superior vena cava and the right atrium with Gor-Tax vessels. The echocardiography and electrocardiogram were reviewed regularly after operation (1 month, 3 months, 6 months and 1 year after operation，1 time a year for more than 1 year after the operation). The changes of cardiac structure, superior vena cava and pulmonary venous reflux and arrhythmia were observed. Results All patients were discharged successfully. The patients were followed up for 3 months to 2 years. No residual anomalous shunt was found in reexaminating echocardiography, and superior vena cava and pulmonary venous return were unobstructed. Electrocardiogram showed sinus rhythm and no obvious abnormality. Conclusion The application of Warden series operation in partial anomalous pulmonary venous connection is safe and effective.
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Objective To analyze the related risk factors of postoperative delirium(POD)in patients with Stanford type A aortic dissection, and to guide clinical practices. Methods The clinical data of 118 cases [81 males and 37 females, average age (55.0 ± 10.3) years] with Stanford type A aortic dissection in Tianjin Chest Hospital from January 2016 to December 2017 were analysed in this study. According to whether developed delirium after surgery, the patients were divided into POD group(n=56)and Non-POD group(n=62).The preoperative,perioperative,and postoperative clinical data were collected.The univariate and multivariate Logistic regression analysis was used to investigate the risk factors of POD in patients with the Stanford type A aortic dissection. Results Single factor analysis showed that the proportions of drinking and cerebrovascular history significantly increased,the proportions of early electrolyte disorder and hypoxemia significantly increased, the levels of granulocytes / lymphocytes, circulatory time and blood volume during operation increased significantly, and the duration from onset to operation was decreased, but fibrinogen level decreased significantly in POD group than those of Non-POD group (P < 0.05). Multivariate Logistic analysis indicated that the more intraoperative consumption of blood (OR=1.733, 95% CI:1.409-2.129) and early postoperative electrolyte disorder (OR=10.500, 95% CI:2.930-37.622)were independent risk factors of POD,while the higher level of preoperative fibrinogen(OR=0.157,95% CI:0.050-0.635) and longer time from onset to surgery (OR=0.871, 95% CI:0.808-0.943) were protective factors of POD in patients with Stanford type A aortic dissection.Conclusion The early identification of risk factors of POD,and the active intervention of POD have a positive significance to reduce the occurrence of POD.
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Objective To investigate the relationship between calcific aortic valve stenosis and inflammatory cells in peripheral blood and dyslipidemia in elderly patients(age ≥65 years).Methods A total of 76 elderly patients(≥65 years old)diagnosed as calcific aortic stenosis in our hospital from June 2015 to June 2017 were selected as the case group,and 78 seniors(excluding valvular heart disease)hospitalized due to chest discomfort were selected as the control group.The white blood cell count (WBC), neutrophil ratio (N%), neutrophil count (N), lymphocyte count (L), neutrophil lymphocyte ratio (NLR),hypersensitive C-reactive protein(hs-CRP),N-terminal B-type natriuretic peptide(NT-pro BNP),total cholesterol (TC),triglyceride(TG),apo-α,high-density lipoprotein(HDL),low-density lipoprotein(LDL),very low-density lipoprotein (VLDL)and other indicators were tested on admission.All these indicators were compared between the two groups. Results The levels of WBC, N%,N,NLR, hs-CRP, NT-pro BNP,VLDL were higher in the case group than those in the control group.The levels of L and HDL were significantly lower in the case group than those of the control group(P<0.05).Multiple regression analysis showed that smoking, the increased hs-CRP and NT-pro BNP levels were independent risk factors for senile calcific aortic stenosis.Conclusion Senile calcific aortic stenosis is not a simple degenerative disease.It is closely related to systemic inflammatory response and abnormal lipid metabolism.