ABSTRACT
Objective To investigate the myocardial protective effect of isehemic post-conditioning in total repair for tetralogy of fallot,in order to improve short-term prognosis of infant patients.Methods 64 cases of TOF infant patients were randomly divided into two groups,32 cases in the control group:conventional surgery without ischemic post-conditioning,and other 32 cases in the experimental group:given three cycles of ischemic post-conditioning.Then the clinical indieators:cardiopulmonary bypass time,aortic cross-clamping time,automatic re-jump rate,the latter parallel to the off-line time,the off-line blood pressure,the offline dopamine usage,extubation time,ICU stay time,postoperative complications,and the testing laboratory indicators:the cTnI and CK-MB levels in plasma after anesthesia induction,10min after aortic cross-clamping,10min after aortic opening,ICU1h,1d after surgery,and 2d after surgery were observed.Results Two patients were died and,mortality rate was 3.1%.The remaining patients were discharged from hospital.Laboratory indicators of the control group and the experimental group had significant differences (all P＜0.05),while the clinical indicators of the two groups had no significant differences(all P＞0.05).But for the sub-group which the aortic cross-clamping time were more than 60min,the clinical indicators were significantly different(all P＜0.05).Conclusion Ischemic post-conditioning could enhance myocardial protection in total repair for tetralogy,of fallot.for the cases aortic cross-clamping time was more than 60min,their clinical meanings were more obvious.
ABSTRACT
Objective To summarize the diagnosis and surgical treatment of 61 cases with infective endocarditis.Methods From January 1995 to April 2008,61 cases with infective endocarditis underwent operation in our hospital.The outcomes of these patients were summarized.Results There were 4 eases of early-death.Early mortality after heart operations was 6.6%.Fifty-seven patients were followed-up for 6 months to 13 years.Five were dead.Others'cardiac function(NYHA)was as follows:classⅡin 43 cases,class Ⅲ in 9 cases.Condusion Early diagnosis,optimal surgical timing,combined internal medicine and surgical treatment are the critical factors treatment of cases with infective endocarditis.
ABSTRACT
Objective To compare the efficacy between thoracoscopic and open cardiac surgery in the treatment of congenital heart diseases. Methods A total of 62 patients with congenital heart diseases were divided into two groups according to patients’ preference. There were 24 patients in the Thoracoscopic Group. The thoracoscopic operations were performed under extracorporeal circulation, including atrial septal defect repair in 8 patients and ventricular septal defect repair in 16 patients. The Open Group consisted of 38 patients, including atrial septal defect repair in 14 patients and ventricular repair in 24 patients. Results Fatal cases happened in neither of groups. There were no significant differences between the two groups in the bypass time (74?28 min vs 71?24 min; t=0.449, P=0.655), the ascending aorta cross-clamping time (29?13 min vs 28?12 min; t=0.309, P=0.758), and the postoperative mechanical ventilation time (3.2?1.1 h vs 3.3?1.1 h;t=-0.349, P=0.729), respectively. No significant variation in incidence of postoperative complications was observed between the two groups (?~2=2.646,P=0.104). As compared with the Open Group, the Thoracoscopic Group had a significantly less chest drainage volume (32?18 ml vs 66?28 ml;t=-5.290,P=0.000) and a significantly shorter postoperative hospital day (6.1?1.2 d vs 7.6?2.2 d;t=-3.059,P=0.003). Conclusions Thoracoscopic cardiac surgery for congenital heart diseases is a safe and effective technique with little invasion, quick recovery and good cosmetic results.