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Objective To evaluate the results of surgical treatment for patients with heterotaxy syndrome and cardiac anomaly.Methods From September 2008 to October 2013,34 patients with heterotaxy syndrome underwent 46 cardiac operations at Guangzhou Women and Children Medical Center.22 were male,and 12 female.Mean age at operation was 22 months (4 months to 14 year).There were right atrial isomerism 24 cases,left atrial isomerism 10 cases.Only one had a single VSD,and others were all with complex cardiac anomaly,including complete atrioventricular canal defect 26 cases,tricuspid atresia 4 cases,mitral atresia 1 case,anomalous pulmonary venous connection 18 cases,pulmonary venous stenosis 4 cases,double superior vena cava 17 cases,and interrupted hepatic portion of the inferior vena cava 5 cases.Fontan procedure was performed in 5 patients,bidirectional Glenn in 13,Kawashima in 3,central shunt in 1,atrioventricular valve replacement in 5,and pulmonary artery banding in 5.Results There were 4 died during hospitalization.The follow-up duration was 1 month to 5 years.There were 2 died.The early to middle term mortality was 17.6％ (6/34).In the same period the mortality for 103 patients without heterotaxy syndrome underwent univentricular repair was 4.8％ (5/103).There was significant statistical difference (P ＜ 0.05).Conclusion Right heart bypass operation remains the preferred palliative procedure for patients with heterotaxy syndrome,and the eraly and middle term results were satisfied.
RESUMO
Objective To evaluate the relationship between the change of Heart-fatty acid-binding protein and myocardial injury/infarction in postoperative of off-pump coronary artery bypass grafting (OPCAB).Methods 59 patients (male 37 and female 22,from 46 to 83 years old) who were the first time to undergoing OPCAB were included in this study.Serial venous blood samples were taken at after induction of anesthesia,the OPCAB finished (after the last anastomosis),entered ICU,2,4 and 8 hours after the patient entered ICU,and at 1 and 2 day postoperative to test H-FABP.The cTnI and CK-MB were tested at 4 and 8 hours,after entering ICU,and at 1 and 2 days postoperative.Patients were divided into 3 groups by the changes of ECG and the level of cTnl at 8 hours after they entered ICU:normal group (group I,cTnI ＜0.1 ng/ml),myocardial injury group(group Ⅱ,cTnI 0.l-1.0 ng/ml) and.myocardial infarction group(group Ⅲ,cTnI ＞ 1.0 ng/ml).Results The level of H-FABP released was significantly higher in the myocardial infarction group than normal group and myocardial injury group (P ＜ 0.01).There is good correlation between the H-FABP and cTnI or CK-MB.But the peak level of H-FABP is earlier (finished OPCAB) (P ＜ 0.05),and it peaked early at 2h after entered ICU (P ＜ 0.01),it began to decrease at 4 hours after entered ICU and returned to baseline at 1 day postoperative,while the cTnI and CK-MB peaked at postoperative day 1 and 8h after entered ICU respectively,and maintained in higher level at postoperative 2 days.Conclusion There is good correlation between the H-FABP and perioperative myocardial infarction in OPCAB,and it has superiority compared with cTnI,which is as gold standard for perioperative myocardial infarction,on a certain degree.It can benefit from early detection of H-FABP for myocardial infarction in perioperative of OPCAB.