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find Author "王东进" 29 results
  • Prognostic significance of test of cardiac troponin T and renal function in acute type A aortic dissection

    Objective To measure the rate of changes of the cardiac troponin T (cTnT) and serum urea nitrogen (N), serum creatinine (Cr), estimated glomerular filtration rate (eGFR) of acute type A aortic dissection (AAAD) patients before and after surgery, and to explore the prognostic significance of the rate of changes. Methods We retrospectively analyzed 77 AAAD patients' clinical data between August 2015 and March 2016 from the department of the cardiothoracic surgery in Nanjing Drum Tower Hospital. There were 57 males and 20 females with an average age of 51.1±13.1 years. The test results of cTnT, N, Cr, eGFR were recorded. Patients were divided into three groups based on the duration of ventilation: less than 48 hours, 48 hours to 7 days, longer than 7 days, and divided into two groups based on whether postoperative dialysis was performed: dialysis group and non-dialysis group. Results In the groups with different duration of ventilation, the rate of cTnT change differed significantly. The rate of Cr and eGFR change in the group with the duration of ventilation longer than 7 days showed significantly different compared to other two groups. We found that the rate of Cr and eGFR change were statistically significant between the dialysis group and the non-dialysis group. In the receiver operating characteristic curve (ROC), the optimal cut-off value of the Cr growth rate for predicting postoperative dialysis therapy was 58.1%, and the optimal cut-off value of the eGFR decline rate was 45.5%. Conclusion The rate of changes in cTnT, N, Cr and eGFR can be used as a reliable mean to evaluate respiratory and renal function for AAAD patients in the early stage, which will facilitate an early assessment of the prognosis of AAAD patients.

    Release date:2017-03-24 03:45 Export PDF Favorites Scan
  • Advances of aortic valve repair for aortic regurgitation

    The first aortic valve repair was performed in 1958, but the clinical outcome was limited. Since the invention of prosthetic valves, aortic valve replacement has become and still maintained the dominated surgical treatment option. As the impact of the prosthetic valve-related event to quality of life of the patients and the studies of the mechanism of aortic regurgitation and the functional anatomy of aortic root grow, the application of aortic valve repair gets more popular, and the short- and mid-term outcomes are good.

    Release date:2018-01-31 02:46 Export PDF Favorites Scan
  • 同种肺动脉瓣治疗肺动脉瓣缺如综合征一例

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  • 主动脉瓣成形术治疗先天性主动脉瓣关闭不全12例

    Release date:2016-08-30 06:18 Export PDF Favorites Scan
  • APPLICATION AND RESEARCH PROGRESS OF ARTIFICIAL CHORDAE TENDINEAE

    Object ive To summar ize recent advance in the appl icat ion and research of ar t i f icial chordae tendineae. Methods The cl inical and experimental research l iterature was extensively reviewed and analyzed. Results The follow-up results showed that artificial chordae tendineae replacement was superior to other operation methods in valve repair. But, it was compl icated and difficult-to-learn. In recent years with the development of many surgical skills and new techniques, good cl inical results were achieved. Conclusion With the development of surgical equi pment, chordae material, and implanting skills, artificial chordae tendineae implanting will be easier and the scope of appl ication will be larger.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • Risk Factor Analysis of Delayed Recovery of Consciousness after Aortic Arch Surgery

    Objective To determine risk factors of delayed recovery of consciousness after aortic arch surgery underdeep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP). Methods We retrospectively analyzed clinical data of 113 patients who underwent aortic arch surgery under DHCA+ASCP in the Affiliated Drum Tower Hospital, Medical School of Nanjing University from October 2004 to April 2012. According to whether they regained consciousness within 24 hours after surgery, all the 113 patients were divided into normal group (73 patients including 55 males and 18 females with their average age of 48.1±10.9 years) and delayed recovery group (40 patients including 29 males and 11 females with their average age of 52.2±11.4 years). Risk factors of delayed recovery of consciousness after surgery were evaluated by univariate analysis and multivariate logistic regression analysis. Results Nine patients (8.0%) died postoperatively, including 5 patients with multi-organ failure, 2 patients with heart failure, 1 patient with mediastinal infection, and 1 patient with pulmonary hemorrhage. There were 7 deaths (17.5%) in the delayed recovery group and 2 deaths (2.7%) in the normal group, and the in-hospital mortality of the delayed recovery group was significantly higher than that of the normal group (P=0.016). A total of 94 patients (including 65 patients in the normal group and 29 patients in the delayed recovery group) were followed up for 4-95 months. Eight patients (including 5 patients in the normal group and 3 patients in the delayed recovery group) died during follow-up, including 2 patients with stroke, 3 patients with heart failure, 2 patients with pulmonary hemorrhage and 1 patient with unknown cause. Ten patients were lost during follow-up. Univariate analysis showed that age (P=0.042), hypertension (P=0.017), emergency surgery (P=0.001), cardiopu- lmonary bypass (CPB) time (P=0.007), aortic cross-clamp time (P=0.021), and blood transfusion(P=0.012)were risk factors of delayed recovery of consciousness after aortic arch surgery. Multivariate logistic regression showed that emergency surgery (P=0.005) and CPB time>240 minutes (P=0.000) were independent risk factors of delayed recovery of consciousness after aortic arch surgery. Conclusion Delayed recovery of consciousness after aortic arch surgery is attributed to a combination of many risk factors. Correct patient diagnosis, lesion site and involved scope should be made clear preoperatively in order to choose appropriate surgical strategies. During the surgery, strengthened brain protection, shortened operation time, improved surgical techniques, and perioperative stable circulation maintenance are all important measures to prevent delayed recovery of consciousness after aortic arch surgery.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • Therapeutic Progress of Congestive Heart Failure Treated with Mesenchymal Stem Cells

    Congestive heart failure is a complication of myocardial infarction threatening human health. Although the pharmacotherapy is effective, it is still a worldwide challenge to thoroughly repair the injured myocardium induced by myocardial infarction. It has been demonstrated that mesenchymal stem cells (MSCs) can repair infarcted myocardium. Much evidence shows that MSCs can generate new myocardial cells in both human and animals' hearts. This review aims at discussing the therapeutic progress of the congestive heart failure treated with MSCs.

    Release date:2016-11-04 06:36 Export PDF Favorites Scan
  • 同种瓣的制作与临床应用

    目的报告液氮深低温下保存同种带瓣血管的制作方法、组织活性及临床应用效果。方法制作同种瓣24个、抗生素灭菌、梯度降温后置于液氮中保存,并测定冷冻保存后同种瓣的组织活性。同种瓣临床应用5例,其中法洛四联症、肺动脉闭锁2例,先天性主动脉瓣狭窄1例,法洛四联症术后发生室间隔缺损残余漏伴肺动脉瓣重度关闭不全1例,Bentall术后发生感染性心内膜炎1例。结果抗生素灭菌、液氮深低温技术保存同种瓣具有良好的组织活性,糖代谢测定24h葡萄糖消耗大于16mg/dl,组织培养见成纤维细胞生长良好。临床移植5例均成功,术后随访3~8个月,同种瓣无狭窄或关闭不全。结论液氮深低温保存同种瓣安全可靠,临床应用早期效果良好。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • Mid-to Long-term Results of Edge to Edge Mitral Repair

    ObjectiveTo summarize mid- to long-term results of edge to edge mitral repair for mitral regurgitation (MR). MethodsClinical data of 31 patients who underwent edge to edge mitral repair in Nanjing Drum Tower Hospital from June 2002 to June 2008 were retrospectively reviewed. There were 13 male and 18 female patients with their age of 14-77 (43±21) years. Clinical and echocardiographic data were analyzed. ResultsThree patients died in hospital,and 28 patients finished mid- to long-term follow-up for 5-10 years. During follow-up, 1 patient died of acute decompensated heart failure in the 2nd year after discharge. Two patients had recurrent moderate MR, and 6 patients had recurrent moderate-to-severe MR including 3 patients who underwent mitral valve replacement in the 5th,6th and 7th postoperative year respectively because of severe MR. Five-year reoperation-free rate was 88.9% (24/27). Five-year mortality was 3.6% (1/28). The incidence of recurrent moderate or severe MR within 5 postoperative years was 28.6% (8/28). ConclusionFor complex MR or as an emergency substitute strategy for failed routine mitral valvuloplasty, edgeto- edge mitral repair can produce good mid- to long-term outcomes except for Carpentier Ⅲb MR.

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  • Castor stent implantation combined with subclavian artery bypass grafting for the treatment of aortic arch lesions

    ObjectiveTo explore the short- and mid-term efficacy of Castor single branch aortic stent combined with subclavian artery bypass grafting for the aortic arch lesions. MethodsA retrospective analysis of the clinical data of patients with proximal anchor zone insufficiency aortic arch lesions treated with Castor stent combined with carotid-subclavian bypass at the Department of Cardiac Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from August 2020 to November 2023 was performed. ResultsA total of 22 patients were included, including 19 males and 3 females, with an average age of 56±16 years. There were 18 patients of aortic dissection and 4 patients of aortic arch tumors. The success rate of surgical technique was 100.0%, and the average postoperative hospital stay for patients was 10±4 days. The median follow-up time was 20 months. During the follow-up period, there were no major complications such as endoleak, paraplegia, cerebral infarction, renal insufficiency, etc., and all patients had no readmissions. ConclusionFor proximal anchor zone insufficiency aortic arch lesions, the treatment method of using a Castor stent branch placed in the left common carotid artery can effectively extend the anchor zone, avoid the huge trauma of open chest surgery, and achieve good short- and mid-term efficacy.

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