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1.
Chinese Journal of Surgery ; (12): 823-825, 2008.
Artículo en Chino | WPRIM | ID: wpr-245476

RESUMEN

<p><b>OBJECTIVE</b>To summarize the surgical experience of type A aortic dissection.</p><p><b>METHODS</b>From January 2001 to December 2006, 54 cases were admitted for Standford type A aortic dissection, including 36 cases of acute aortic dissection and 18 cases of chronic. Thirty-five cases underwent emergence operation and 11 cases underwent selective/limited operation, while 8 cases received medical treatment According to the modus operandi of root of aorta, 9 cases underwent ascending aorta replacement merely, 11 cases for Bentall operation, 12 cases for Wheat operation and ascending aorta replacement, 14 cases for David operation and ascending aorta replacement. According to the modus operandi of aortic arch and descendens, 6 cases underwent right hemiarch replacement, 25 cases for total arch replacement with four branches aortic graft, 24 cases for stent-graft elephant trunk technique. One patient of coronary heart disease and 1 patient of right coronary fracture underwent coronary artery bypass grafting. Deep hyperthermic circulatory arrest and antegrade selective cerebral perfusion were applied with aortic arch operation. Surface cooling was applied with selective/limited operation.</p><p><b>RESULTS</b>Four patients died in operation group (8.7%) and 8 died in non-operation group (75.0%). Postoperative complication included 1 mental symptom, 3 pleural/pericardial effusion, 1 hoarseness, 1 sternal rupture and poor wound healing. All the complication were cured. The operative out-hospital patients were followed up (13.0 +/- 14.2) months and the quality of life was satisfied.</p><p><b>CONCLUSIONS</b>Standford type A aortic dissection should be operated aggressively. Expected outcome could be acquired with optimum modus operandi, proper cerebral protection and dealing with postoperative complication timely.</p>


Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Disección Aórtica , Cirugía General , Aorta , Cirugía General , Aneurisma de la Aorta , Cirugía General , Implantación de Prótesis Vascular , Estudios de Seguimiento , Estudios Retrospectivos , Stents
2.
Chinese Journal of Surgery ; (12): 398-401, 2006.
Artículo en Chino | WPRIM | ID: wpr-317144

RESUMEN

<p><b>OBJECTIVE</b>To report the preliminary experience of 21 orthotopic heart transplantations without early death.</p><p><b>METHODS</b>Between April 2002 and June 2005, 21 patients underwent orthotopic heart transplantation. Recipients' pulmonary vascular resistance ranged from 3.0 to 5.9 wood units [mean (4.3 +/- 1.4) wood units]; Stanford myocardial protective solution or HTK solution was perfused for donor heart myocardial preservation, donor heart cold ischemic period ranged from 52 to 310 min [mean (81 +/- 23) min]; Three patients had previous cardiac operations under cardiopulmonary bypass, conventional Stanford orthotopic cardiac transplantation in 20 cases and total heart technique in 1 case; Recipients received simulect preoperatively and cyclosporine A, cellcept and prednisone postoperatively for prevention of acute allograft rejection; Patients received appropriate medical control of hypertension, hyperglycemia, hypercholesterolemia and uricacidemia.</p><p><b>RESULTS</b>Acute right heart failure in 3 cases and pericardial effusion in 4 cases were observed at the early postoperative stage, but no any infection and acute rejection were found. All patients survived with good life quality.</p><p><b>CONCLUSIONS</b>Heart transplantation may produce satisfying early results. Suitable selection of recipients with low pulmonary vascular resistance, excellent donor heart conservation, practised anastomotic technique, proper immunosuppression treatment and efficient postoperative management are key measures of orthotopic heart transplantation with excellent early outcome.</p>


Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antiinflamatorios , Usos Terapéuticos , Ciclosporina , Usos Terapéuticos , Quimioterapia Combinada , Estudios de Seguimiento , Rechazo de Injerto , Trasplante de Corazón , Métodos , Inmunosupresores , Usos Terapéuticos , Ácido Micofenólico , Usos Terapéuticos , Cuidados Posoperatorios , Métodos , Complicaciones Posoperatorias , Prednisona , Usos Terapéuticos , Cuidados Preoperatorios , Métodos , Calidad de Vida , Estudios Retrospectivos , Factores de Tiempo , Trasplante Homólogo , Resultado del Tratamiento
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