Heart Surgery Forum

BACKGROUND: Intraoperative aortic dissection is an extremely serious complication that should be prevented whenever possible. When it does occur, it requires urgent clinical management. CASE PRESENTATION: We report the case of a 78-year-old man with Marfan syndrome who developed an intraoperative complicated type B aortic dissection with a distal anastomosis entry site during total arch replacement for a chronic dissection. CONCLUSION: Performing immediate thoracic endovascular aortic repair, we were able to improve malperfusion to the lower extremities occurred during total arch replacement...

A 63-year-old woman with a five-month history of pulmonary epithelioid hemangioendothelioma (PEH) presented to the emergency department, due to worsening dyspnea and chest pain. The electrocardiography showed a pattern of ST-segment elevation in leads I, AVL, and poor R-wave progression consistent with anterolateral ischemia. Emergent coronary angiography revealed severe stenosis of the left main coronary artery. Then, contrast-enhanced computed tomography scan indicated the right pulmonary artery and left main coronary artery narrowing by compression of metastasized PEH...

BACKGROUND: The optimal revascularization strategy for isolated left anterior descending (LAD) coronary artery lesion between minimally invasive direct coronary artery bypass (MIDCAB) and percutaneous coronary intervention (PCI) remains controversial. This updated meta-analysis aims to compare the long- and short-term outcomes of MIDCAB versus PCI for patients with isolated LAD coronary artery lesions. METHODS: The Pubmed, Web of Science, and Cochrane databases were searched for retrieving potential publications from 2002 to 2022...

OBJECTIVE: The emergence of critical values gives a warning to the medical safety of hospitalized patients, especially Cardiosurgery Intensive Care Unit (CSICU) patients. The aim of this study was to investigate the association between early postoperative critical values and the prognosis of patients after cardiac surgery. METHODS: Clinical data of the patients were obtained from the Cardiac Critical Care Clinical Database of the Cardiovascular Intensive Care Unit of Nanjing First Hospital...

BACKGROUND: Due to its high morbidity and mortality after open-heart surgery, sternal wound infection (SWI) is one of the most important consequences to avoid and manage. AIM: To assess the incidence, risk factor, causative organisms, and mortality of SWIs in patients who had open-heart surgery over a 9-year period at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. METHODS: A retrospective study was done on 634 patients who underwent open heart surgery...

BACKGROUND: Defecation delay is a common symptom in patients after tricuspid valve replacement (TVR). Previous studies have demonstrated that defecation delay was associated with worse clinical outcomes of critically ill patients. Our study aimed to investigate the incidence and risk factors of defecation delay in patients after TVR and its adverse clinical outcomes. METHODS: A retrospective study was conducted in 206 patients undergoing TVR under cardiopulmonary bypass from May 2005 to July 2021...

Due to the specific pathogenesis of Takayasu arteritis, complicated with aortic valve disease, surgical treatment always has been a difficult problem. We report a 26-year-old female patient with Takayasu arteritis who was treated with the Ozaki procedure for aortic valve disease and replacement of the ascending aorta with a straight synthetic graft. The surgery achieved satisfactory early results.

BACKGROUND: Intractable bleeding after cardiac surgery is a well-documented complication. When conservative measures fail to control bleeding, re-exploration is required, and, in some cases, chest packing may be needed. METHODS: The study included 148 patients admitted to eight cardiac surgery centers in Egypt with severe postoperative bleeding. All patients underwent chest re-exploration and chest packing to control postoperative bleeding. RESULTS: The mean age was 62...

BACKGROUND: While prosthetic rings are commonly used for mitral valve repairs, autologous pericardium is an alternative ring material that can be used in these procedures. In this report, we aim to present a comparison of two types of rings used for mitral repair. METHODS: Between January 2005 and January 2009, 107 patients who underwent mitral valve repair surgery were analyzed. Patients were divided into two groups, according to the type of ring that was used for mitral annular stabilization...

BACKGROUND: In the present study, we aimed to identify risk factors of poor prognosis for patients with acute coronary syndrome in the emergency department. METHODS: The study included 2667 patients, who were admitted to the Emergency Department of Chest Pain Center, Fujian Provincial Hospital, due to chest pain from January 1, 2017 to March 31, 2020. Logistic regression was used to identify factors of poor prognosis for patients with ACS in the ED. Receiver operating characteristic (ROC) curve was plotted to assess the performance of the multivariate logistic regression model...

OBJECTIVE: To clarify the effects of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) on the clinical outcomes of patients with coronary heart disease (CHD) complicated with reduced ejection fraction heart failure (HFrEF) through meta-analysis. METHODS: Three major literature databases - PubMed, Web of Science, and Cochrane - were searched by search terms and the literature retrieval time was publications dating from January 2007 to December 2021...

Objective :To investigate the predictive value of no reflow phenomenon in interventional therapy by measuring plaque quantitatively with optical coherence tomography (OCT).  Methods:196 patients with acute ST segment elevation myocardial infarction who visited the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were selected as the study objects. According to whether there was no reflow during the operation, they were divided into no reflow group (46 cases) and normal flow group (150 cases)...

BACKGROUND: To investigate the effect of individualized cardiac rehabilitation (CR) on cardiac function, time consumption, and quality of life (QoL) in post-CABG patients. METHODS: Two different CR strategy: basic rehabilitation and individualized rehabilitation was designed. The patients were screened and randomized into the two groups: the basic rehabilitation group (BRG) and individualized rehabilitation group (IRG). Data, such as clinical characteristics, LVEF, 6MWD (6-min walk distance), BNP, LVEDD (left ventricular end diastolic dimension), SF-36 score, and time consumption were collected and recorded...

This study aimed to investigate electrophysiological features of radiofrequency ablation surgery in patients with the atrial fibrillation (AF). Fifty patients were included in this study and evenly divided, with 25 AF patients in the experiment group and 25 patients with arrhythmias in the control group. General clinical materials in the two groups were collected. Then, patient number of pulmonary vein antrum potential trial, intra-right atrial conduction time, intra-left atrial conduction time, interatrial conduction time, conduction time between atrium, and pulmonary veins trials were utilized to measure the efficacy of radiofrequency ablation surgery in patients with AF and clarify the relationship between AF and electrophysiological features in the atrium and pulmonary veins...

Dealing with coronary arteries caused by aortic dissection remains a great challenge in the treatment of aortic dissection. Here, we present the case of a 57-year-old woman, who initially detected chest pain, and electrocardiography showed ST-elevation myocardial infarction. After the primary percutaneous coronary intervention, aortic dissection was accidentally detected. She then received central repair and had a satisfactory outcome. We proved that percutaneous coronary intervention as a bridge therapy for aortic dissection-related coronary malperfusion might be efficient...

BACKGROUND: Acute type A aortic dissection complicated by limb malperfusion presents a risk of mortality to the patients. Debates exist regarding management, whether focused on reperfusion first or immediate repair. Here, we aimed to describe our experience with the management of acute type A aortic dissection (ATAAD) complicated by limb malperfusion. METHODS: From January 1, 2020 to December 31, 2021, 22 consecutive patients were admitted to Xiamen Cardiovascular Hospital, due to acute type A aortic dissection complicated by limb malperfusion...

Anesthetists are concerned about the causes and management of hypoxia during one-lung ventilation (OLV). Here, we report a hypoxic case during OLV and video-assisted thoracic surgery (VATS) for pulmonary lobectomy. The preoperative management of hypertension with amlodipine was considered to be responsible for the hypoxia. As a calcium channel blocker, amlodipine may inhibit hypoxic pulmonary vasoconstriction (HPV) and contribute to the reduction of the ventilation/perfusion ratio (or V/Q ratio). The hypoxia efficiently was treated by atropine, where both tracheal effects and the enhancement of HPV through muscarinic receptor blocking may work...

A 44-year-old female patient with chemotherapy-induced cardiomyopathy presented with acute cardiogenic shock requiring ECMO support. Multiple failed weaning trials from temporary mechanical circulatory assistance prompted a transition to staged durable biventricular support. Her course was complicated with recurrent RVAD stoppages. The initial event was treated with pump exchange, while for the subsequent RVAD standstill, we employed a device wash-out and reimplantation strategy. A brief period of circulatory arrest was employed to explore the right-sided cardiac chambers using a single-use bronchoscope...

BACKGROUND: This study aimed to investigate if surgery before pregnancy would result in better maternal and fetal outcomes in patients with congenital heart disease. METHODS: A retrospective study was conducted using data collected from the medical records of pregnant patients with congenital heart disease, who were seen at Beijing Anzhen Hospital between 2010 and 2019. The patients were divided into surgical and non-surgical groups, and the differences in outcomes were compared...

BACKGROUND: The aim of this study was to compare the early results of rapid deployment aortic valves (RD-AVR) and aortic valve neocuspidization (AVNeo) techniques. METHODS: Between December 2019 to May 2022, 104 patients were operated on with aortic stenosis by RD-AVR (N = 52) and AVNeo (N = 52) techniques. Patients with isolated aortic valve stenosis and aortic stenosis concomittant with planned other cardiac surgeries were included. RESULTS: The mean age of patients in the RD-AVR and AVNeo groups were 67...