ABSTRACT
Objective To explore the operative indication operation time and post-operative care for infants with large ventricular septal defects (VSD).Methods Eighty-eight infants who suffered from large VSD were selected,male 53 cases,female 35 cases,aged from 3 to 18 months[average (7.5-±2.9) months],weight from 5 to 13 kg [average (7.9 ± 1.9) kg].All patients underwent VSD repair and other accompanied anomaly corrections under cardiopulmonary bypass.Fifty-eight cases were operated through right atrium,14 cases through pulmonary artery and 16 cases through right ventricle.Patch repairs were done in all patients,78 cases given bovine pericardium patches,10 cases given self pericardium patches treated by Glutaral.Patients were sent to the intensive care unit after surgery,vasoactive drugs were used as a routine method.Antibotics were selected based on their sputum cultures postoperatively.Nutritional support was given in the earlier stage.Results There were no hospital death,average hospitalization days were (15.2 ± 5.9) days (from 11 to 32 days).The main complication were pneumonia (5 cases),bad coalesce of incision (4 cases),atelectasis (3 cases),minimal residual shunt of VSD (3 cases).All patients were discharged from hospital,76 cases were followed up from 1 to 12 months,2 cases had residual shunt of VSD,the residual shunt of the other case disappeared;76 patients had no clinical symptom,28 patients body weight returned to normal after 6 months of operation.There was no other complication and death.Conclusion Early surgical treatment for infants with large VSD is a safe and effective way with a better prognosis.
ABSTRACT
Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe tricuspid regurgitation in patients with congenital heart disease. Methods From April 2001 to Mar. 2010, severe tricuspid regurgitation was corrected with a flexible band anuloplasty and edge-to-edge valve plasty technique in 14 patients with congenital heart disease. The age ranged from 7 years to 62 years [average (31.2 ± 16.1 ) years]. Congenital cardiac anomalies include: atrioventricular canal in 5 cases, secundum atrial septal defect in 6 cases, secundum atrial septal defect with mitral valve regurgitation in 2 cases and cor triatriatum in 1 case. Results No hospital death or postoperative morbidity occurred. No or trivial tricuspid regurgitation was present in 11 cases and mild tricuspid regurgitation in 3 cases at discharge. The follow-up ranged from 3 month to 97 months [average (51.6 ± 26.8 ) months]. No tricuspid stenosis was found. No or trivial tricuspid regurgitation was present in 5 cases. Mild tricuspid regurgitation was present in 8 cases, and moderate tricuspid regurgitation in 1 case at the latest followup. Conclusion Edge-to-edge valve plasty is an easy, effective and important procedure to correct severe tricuspid regurgitation in patients with congenital heart disease.
ABSTRACT
Objective To investigate the pathogen culturing of the catheter related infection(CRI),cathe-ter related bloodstram infection(CRB)and risk factors after central venous catheter(CVC)of cardiovascular surgery in order to provide the beneficial reference.Methods From Jan 2005 to Dec 2005,a total of 300 cases central ve-nous cathers were determined,and the cusp of the catheters was determined by bacteria cultivation,and blood bacte-ria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%.CRB rate was 1.7%.54.3%pathogens were gram-positive cocci,34.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginose,and Candiadia albicans.The infection rate increased obviously when the dwelling time>6 d.Conclusion CRI and CRB are the most severe complication of CVC,and it is important to cut down the death with the early diagnosis and applying antibiotics rationally.