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Objective Summarize the experiences of treating after-operation ventricular electrical storm (VES) with extra-corporeal membrane oxygenation (ECMO) .Methods Examine the clinical data of seven cases of treating after-operation VES with ECMO from January 2013 to April 2014 and analyze the basic pre-operation conditions of the patients ,diagnoses ,causes of VES ,ai-ding processes with ECMO ,and prognoses .Results Seven patients all were successfully separated from the machine after the treat -ment ,one patient infected seriously after being separated from the machine ,having multiple organ failure one week later and dis-charged voluntarily ;one patient having cerebral hemorrhage two days later after being separated from the machine and discharged voluntarily ;the remaining five patients cured and discharged with no complications .Conclusion ECMO can provide effective circu-lar support to patients suffering VES after heart operation ,maintaining coronary blood supply ,avoiding further myocardial damage , stabilizing electrolytes and the internal environment ,and gain time for restoration of heart rhythm and treatment according to the causes and triggers .
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Introduction: The paper presents lateresults of surgical correction of the patientswith acquired heart disease.Materials and method: Two hundredfifty one patients had surgical defectcorrection from 2000 to 2016 years. Lateresults were observed in 134 patients. It wasrevealed that subgroup with aortic, mitral andmitral-aortic stenosis and in the subgroupwith aortic insufficiency, systolic functionof the left ventricular was significantlyincreased and heart cavities were positivelyremodeled.Results: Five-year survival rate in subgroupwith initial aortic stenosis and insufficiencywas 100% , in subgroup with initial mitralstenosis - 78.4%, with mitral insufficiency- 75.0%, with mitral-aortic stenosis - 94.1%and with mitral-aortic insufficiency - 49.1%.Conclusion: Risk factors of late mortalityof the patients with valve pathology andsystolic dysfunction of left ventricular aftersurgical correction are: IV NYHA, chronicheart failure, the heart-lung coefficientmore than 65%, high lung hypertension(systolic pressure in pulmonary artery morethan 60 mm.Hg), size of the left ventricularmore than 60 mm and index of end-diastolicvolume of left ventricular more than 110 ml/m2.
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Objective To investigate the clinical value of simultaneous assessment of cardiac troponin I,Btype natriuretic peptide,and C-reactive protein in prediction of long-term cardiac outcome after cardiac surgery.Methods 224 patients undergoing cardiac surgery were included and followed up within 12 months after surgery.Serial blood samples were drawn in all patients the day before surgery,at the end of surgery,and 6,24,and 120h after surgery.Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia,myccardial infarction,congestive heart failure,the need for myocardial revascularization,and/or death from cardiac cause.Predictive ability of each cardiac biomarker was assessed using logistic regression.Results Accuracies of C-reactive protein,cardiac troponin I,and B-type natriuretic peptide,considered as continuous variables to predict the occurrence of major adverse cardiac events were limited(area under receiver operating characteristic curve:0..54[0.47 ～0.60],P =0.42,0.62[0.55 ～0,68],P =0.01,and 0.68[0.61 ～0.74],P ＜0,001,respectively).When biomarkers were considered as 75％ specificity dichotomized variables,evaluated C-reactive protein(＞ 180mg/L),cardiac troponin I(＞ 3.5ng/ml),and B-type natriuretic peptide (＞ 880pg/ml)were independent predictors of major adverse cardiac events(odds ratio:2.14[1.03 ～4.49],P =0.043,2.37 [1.25 ～ 5.64],P =0.011,and 2.65 [1.16 ～ 4.85],P =0.018,respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score.Conclusion Simultaneous measurement of cardiac troponin I,B-type natriuretic peptide,and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.
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Objective:Study of aprotinin effect on patients immunity system and complement during open heart operation.Methods:Ig and complement in patients' blood were measured respectively before operation and on the operative day and the first,second,third postoperative day.Results:In both aprotinin and comparative groups,the plasma levels of IgG,IgA,IgM,IgE and complement C3,C4,CH50 dropped remarkably and began to rise from the first postoperative day.On the third postoperative day, the plasma levels of IgG,IgA and complement C3,CH50 basically restored to the levels before operation.While IgM,IgE and complement C4 in aprotinin group and all Ig with complement in comparative group did not.Conclusion:Aprotinin has not a protective function to patients' immnunity system and complement during open heart operation but it can improve their restoration postoperatively.
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Objective To provide a strategy for open heart surgical procedures of reducing allogeneic transfusion in the perioperative periods.Methods A comprehensive blood conservation program and new transfusion criteria[haemoglobin(Hb)were0.05).The Hct was down after operation in both groups.In the test group the Hct decreased in to 30% at day7 postoperation and regained gradually after 14 days of operation.Conclusion The dininishing allogeneic transfusion can be achieved by application of comprehensive blood conservation techniques and new transfusion criterion during the perioperative periods of open heart surgical procedures.The operative curative effect is not influence thereby.
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Serum cTnT, CK-MB and LDI were measured in 30 patients with AMI, 76 patients with VMC, 12 patients who had undergone operation without cardioplegia, 16 patients who had received open heart operation, 15 patients who had undergone thoracotomy for non-heart surgery and 55 healthy people. Concentration of serum cTnT was 0.057±0.056 μg/L in healthy people,0.069±0.032 μg/L in patients who underwent thoracotomy for non-heart surgery, 0.328±0.472μg/L in patients with VMC, 0.388±0.279 μg/L in patients with DCM, 4.259±4.619 μg/L in patients with AMI, 8.55±6.78 μg/L in patients who had undergone operation without cardioplegia and 16.03±6.01 μg/L in heart operation patients. In patients with VCM and DCM, serum cTnT was more specific and sensitive than CK-MB and LDI for diagnosing myocardial injury. In patients with AMI and heart operation patients, the increasing multiple of serum cTnT was obviously higher than that of CK-MB and LDI. 72 h after heart operation, cTnT was still higher than normal, while CK-MB had returned to normal level. Serum cTnT had higher specificity and sensitivity and longer diagnostic period in diagnosing myocardial injury. Moreover, cTnT assay could indicate the degree of myocardial injury. So, quantitative analysis of cTnT can be used as a routine examination in the diagnosis of myocardial injury.
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Serum cTnT, CK-MB and LDI were measured in 30 patients with AMI, 76 patients with VMC, 12 patients who had undergone operation without cardioplegia, 16 patients who had received open heart operation, 15 patients who had undergone thoracotomy for non-heart surgery and 55 healthy people. Concentration of serum cTnT was 0.057±0.056 μg/L in healthy people,0.069±0.032 μg/L in patients who underwent thoracotomy for non-heart surgery, 0.328±0.472μg/L in patients with VMC, 0.388±0.279 μg/L in patients with DCM, 4.259±4.619 μg/L in patients with AMI, 8.55±6.78 μg/L in patients who had undergone operation without cardioplegia and 16.03±6.01 μg/L in heart operation patients. In patients with VCM and DCM, serum cTnT was more specific and sensitive than CK-MB and LDI for diagnosing myocardial injury. In patients with AMI and heart operation patients, the increasing multiple of serum cTnT was obviously higher than that of CK-MB and LDI. 72 h after heart operation, cTnT was still higher than normal, while CK-MB had returned to normal level. Serum cTnT had higher specificity and sensitivity and longer diagnostic period in diagnosing myocardial injury. Moreover, cTnT assay could indicate the degree of myocardial injury. So, quantitative analysis of cTnT can be used as a routine examination in the diagnosis of myocardial injury.
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Objectives: To discuss the effective method of nutritional support in children after heart operation. Methods: Of the total of 60 cases, the experimental group was composed of 40 cases,and the control group was composed of 20 cases. All patients were provided with parenteral nutrition.The growth hormone was used 48 hours after operation in the experimental group for 7 days.The body weight, arm circuit, urine creatinine, serum transferrin, serum pre albumin, serum albumin immune globumins, serum total bilirubin, hemoglobin and red blood cell count were measured. Results:The percentage of patients without body weight loss was 52.5% in experimental group,and 20.0% in control group.( P
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The authors studied the changes of myocardial enzymes (CPK, CPK-MB, LDH) in the wall of the right atrium during cardioplegic arrest in ninsecutive patients who had an open heart operation, observed the changes of these enzymes in seium as well The results indicate that when the crystalloid cardioplegic solution, systemic moderate hypothermia and decp local hypothermia are used to protect the myocardium, the right atrium can get satisfactory protection during cardioplegic arrest and there is no statistical differences of enzyme changes between samples taken from the right atrium before and after the arrest. The article still discussed the possibility of using the changes of atrial myocardial enzymes as an index to reflect the extent of myocardial protion. The authors consider that the change of myocardial enzyme can better reflect the metabolic activity of myocardium during cardioplegic arrest.