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Objective To discuss the methods and experience of using short term left ventricular assist devices (LVADs) in patients after congenital heart disease(CHD) corrective surgery.Methods This study included 17 postoperative cases using short term LVAD support.The device used was a Maquet Rotaflow system, and the clinical patient data was collected and eval-uated retrospectively.Results The 17 patients were divided into two groups by the clinical outcome as follows: 6 cases in the early death group(Group D) and 11 cases in the survival group(Group S).The pre-support time[(9.00 ±9.95)h vs. (23.83 ±13.23)h, P＝0.042]and the lactate level values[(4.01 ±2.15)mmol/L vs.(9.30 ±4.90)mmol/L, P＝0.045] were significantly lower and more favorable in Group S.Patients in Group S also received a longer support time than patients in Group D.Conclusion Using the Maquet Rotaflow system is generally safe and efficient, when used as a short term LVAD in postoperative pediatric patients.The selection of patients, the timing of support, and reasonable management were the keys to patient survival.
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Objective To study the relation between the level of serum carbohydrate antigen-125 (CA125) and heart function as well as the myocardial remodeling in patients with congestive heart failure(CHF). Methods 79 patients with CHF were divided into three groups based on the standard of New York Heart Association Classification. 25 healthy persons were served as control group. Level of CA125 was measured by MEIA. NT-proBNP was detected by Roche Cardiac Reading instrument. TNF-? was measured by radioimmunoassay. Left ventricular mass index (LVMI),left atrial volume index (LAVI) and left ventricular ejection fraction (LVEF) were detected by echocardiography. The levels of CA125,NT-proBNP,TNF-?,LVMI,LAVI and LVEF in different groups were compared.The relationship between CA125 and NT- proBNP,TNF-?,LVMI,LAVI and LVEF was evaluate.Results Levels of CA125,NT-proBNP,TNF-?,LVMI and LAVI in patients with CHF were much higher than those without CHF. The LVEF was much lower in NYHA Ⅲ and NYHA Ⅳ group than that in without CHF and NYHAⅠgroup. Conclusion CA125 was positively associated with the NT-proBNP,TNF-? and LVMI.
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Objective To evaluate the effect of catheter ablation for atrial fibrillation on left ventricular function in patients with heart failure.Methods We retrospectedly studied 10 consecutive patients with congestive heart failure and a left ventricular ejection fraction of less than 45 percent who underwent catheter ablation for atrial fibrillation.The change in left ventricular function before and after catheter ablation was monitored during a short-term follow-up period.Results Nine patients underwent catheter ablation successfully.After a mean(SD) of 2.78?1.78 months,the patients showed improvement in left ventricular function through improvement in the left ventricular ejection fraction from 0.41?0.01 to 0.46?0.06,the left ventricular diastolic diameter decreased from 56.00?7.21 mm to 53.33?6.42 mm and the left atrial diameter decreased from 44.22?5.91mm to 42.11?4.65 mm,P
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Objetivo - Avaliar o padrão de utilização dos digitálicos, indicações de seu emprego e a freqüência de suspensão do fármaco em pacientes hospitalizados. Métodos - Foram estudados os prontuários de todos os pacientes internados nas enfermarias de medicina interna e especialidades médicas do Hospital de Clínicas de Porto Alegre. A coleta de dados foi realizada em 5 dias, sendo 3 no inverno e 2 no verão, mantendo um intervalo de pelo menos 2 semanas entre cada coleta. A presença de insuficiência cardíaca foi avaliada objetivamente através do escore proposto por Carlson e col. Resultados - De um total de 881 pacientes, 114 (13%) faziam uso de digoxina. A idade média ± DP desses pacientes foi de 66 ± 13 anos, sendo que 47% eram do sexo masculino. Dos pacientes que recebiam digoxina, 32% apresentavam escores compatíveis com insuficiência cardíaca definida ou possível; 26% apresentavam fibrilação ou flutter" atrial; 18% tinham insuficiência cardíaca e taquiarritmia supraventricular; e 24% não tinham indicação precisa segundo os critérios deste estudo. Oitenta e cinco por cento dos pacientes faziam uso prévio de digoxina e em 32% desses, a droga foi suspensa durante a internação. Considerando aqueles pacientes sem indicação para usar digitálicos, apenas 44% tiveram o tratamento com digoxina suspenso. Conclusão - De acordo com critérios contemporâneos, um percentual elevado de pacientes internados recebe digoxina sem indicação precisa. Estes dados sugerem que a reavaliação do uso de digitálicos deve ser incorporada à prática médica
Purpose - To evaluate the pattern of utilization of digitalis in an academic hospital. Methods - Clinical files of all patients admitted in medical wards at the Hospital de Clínicas de Porto Alegre were studied. Data were collected during five different days, three in the winter and two in the summer, keeping an interval of at least two weeks between each data collection. Heart failare diagnosis was evaluated objectively by means of a score proposed by Carlson et al. Results - From a total number of 881 patients, 114 (13%) were receiving digoxin. Mean age was 66 ± 13 years and 47% were males. Considering the patients who were taking digoxin, 32% presented scores compatible with definite or possible heart fuilare; 26% had atrial flutter or fibrillation; 18% had heart failare and supraventricular tachyarrhytmias; and in 24% no clear indications were found according to our criteria. Previous use of digoxin was found in 85% of the patients and 32% were withdrawn during the hospitalization. Considering just the patients who had no reason for using digoxin, only 44% had the drug withdrawn. Conclusion - According to current criteria, many hospitalized patients receive digoxin without a definite indication. These data suggest that reassessment of the use of digitalis should be incorporated into clinical practice