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find Keyword "心脏病" 407 results
  • Open heart operation on neonates with critical congenital heart disease 推荐 CAJ下载 PDF

    Objective To summarize the experience of open heart operation on neonates with critical and complex congenital heart diseases and evaluate the methods of perioperative management. Methods From May 2001 to January 2003, 12 patients of neonates with congenital heart diseases underwent emergency operation. Their operating ages ranged from 6 to 30 days, the body weights were 2.8 to 4.5 kg. Their diagnoses included D-transposition of the great arteries in 4 cases, ventricular septal defect with atrial septal defect in 5 cases, complete atrioventricular septal defect, obstructed supracardiac total anomalous pulmonary venous drainage and cardiac rhabdomyomas in 1 case respectively. 12 cases were operated under moderate or deep hypothermic cardiopulmonary bypass. Results All cases were observed in ICU for 2-11 days and discharged 7-19 days after operation. The postoperative complications included low cardiac output, mediastinal infection, respiratory distress syndrome, systemic capillary leak syndrome and acute renal failure. All cases were cured and the follow-up (from 6 months to 2 years) showed satisfactory outcome. Conclusion A particular cardiopulmonary bypass and proper perioperative management is very important to ensure the successful outcome. Peritoneal dialysis is an effective and safe method for treating acute renal failure after cardiac operation in neonates.

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 先天性心脏病继发感染性心内膜炎的外科治疗

    目的 总结先天性心脏病继发感染性心内膜炎41例外科治疗的经验。方法 手术均在体外循环下进行畸形矫正和赘生物清除。室间隔缺损(VSD)直接缝合16例,补片修补10例;动脉导管未闭(PDA)均采用直视缝合法。同期行肺动脉瓣成形术5例,三尖瓣置换术2例,主动脉瓣置换术12例,主动脉瓣和二尖瓣置换术2例。结果 1例急诊VSD修补同时行主动脉瓣置换术,术后并发脑栓塞死亡;其余患者均痊愈出院。随访35例,随访时间3~102个月,无1例死亡和心内膜炎复发。结论 正确把握手术时机和使用有效抗生素是提高治愈率的关键,应强调对先天性心脏畸形的早期治疗,以防止严重并发症。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • Analysis of risk factors for surgical treatment of congenital pulmonary venous stenosis combined with congenital heart disease

    ObjectiveTo explore risk factors associated with mortality and restenosis after the surgery for congenital pulmonary venous stenosis (CPVS) combined with congenital heart disease.MethodsFrom May 2007 to August 2019, 58 patients received surgical relief of CPVS combined with congenital heart disease, including 24 males and 34 females, aged 17.2±26.3 months, weighing 8.8±8.2 kg. Endpoints were death and restenosis, and the risk factors were analyzed. A univariate and multivariate risk analyses were performed.ResultsPreoperative pulmonary venous stenosis severity score (PVSSS) was 4.5±2.7. Average pulmonary vein counts with CPVS was 1.9±1.0. There were 2 (3.4%) early deaths. The mean follow-up time was 2-145 (49.8±40.0) months. The 1-, 2-, 3- and 5-year overall survival rates were 86.7%, 81.3%, 78.5% and 73.6%, respectively, and the pulmonary venous restenosis-free rates were 79.6%, 68.5%, 68.5% and 68.5%, respectively. Preterm birth was an independent risk factor for mortality. The pulmonary venous peak flow rate ≥1.2 m/s at discharge was an independent risk factor for mortality and restenosis.ConclusionThe prognosis of CPVS is still poor. Postoperative residual stenosis at discharge is an independent risk factor for death and restenosis.

    Release date:2021-12-27 11:31 Export PDF Favorites Scan
  • 经胸微创膜部室间隔缺损封堵术围术期炎症因子的变化

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  • 十字交叉心的外科治疗

    目的 总结4例十字交叉心外科治疗的临床经验,以提高对该病的认识。 方法 2004年3月~2008年1月手术治疗4例十字交叉心患者(平均年龄3.2岁;平均体重10.9 kg)。1例采用心内隧道修补术(intravetricular tunnel rapair IVR),1例采用双向Glenn手术,1例采用双侧双向Glenn术,1例采用IVR+大动脉转位术(arterial switch operation, ASO)。 结果 住院死亡1例,为采用IVR者,死于低心排血量综合征。2例行双向Glenn手术患者术后随访6~12个月,生长发育良好,SpO2 88%左右;1例行IVR+ ASO者,随访6个月,心脏较术前略缩小,生长发育良好。结论 十字交叉心病理解剖复杂,必须根据不同的解剖特点选择不同的手术方法,明确的术前诊断是优化手术方式的先决条件。

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Analyzing facial photo to detect coronary artery disease: Artificial intelligence opens a new era of disease screening

    Coronary heart disease is the second leading cause of death worldwide. As a preventable and treatable chronic disease, early screening is of great importance for disease control. However, previous screening tools relied on physician assistance, thus cannot be used on a large scale. Many facial features have been reported to be associated with coronary heart disease and may be useful for screening. However, these facial features have limitations such as fewer types, irregular definitions and poor repeatability of manual judgment, so they can not be routinely applied in clinical practice. With the development of artificial intelligence, it is possible to integrate facial features to predict diseases. A recent study published in the European Heart Journal showed that coronary heart disease can be predicted using artificial intelligence based on facial photos. Although this work still has some limitations, this novel technology will be promise for improving disease screening and diagnosis in the future.

    Release date:2020-12-07 01:26 Export PDF Favorites Scan
  • 先天性心脏病介入治疗48例

    目的 总结对先天性心脏病患者行介入治疗的临床经验,以提高介入治疗的成功率。 方法 48例先天性心脏病患者采用Cardiacure-TM封堵器行介入治疗,其中房间隔缺损(ASD)21例,动脉导管未闭(PDA)12例,室间隔缺损(VSD)12例,ASD合并PDA 1例,VSD合并PDA 2例。 结果 全组患者无死亡,一次性封堵成功44例,介入封堵治疗成功率为91.7%(44/48);15例次 PDA患者介入封堵治疗成功率为100%(15/15); 22例次ASD患者成功率为90.9%(20/22), 14例次VSD患者成功率为85.7%(12/14)。 封堵伞于术中脱落3例,其中ASD伞脱落2例,VSD伞脱落1例;介入治疗未成功1例。4例封堵未成功的患者中3例择期行体外循环修补手术治愈,1例行急诊体外循环修补手术治愈。随访40例,随访时间1~19个月,复查心脏杂音消失,心脏彩色超声心动图提示无残余分流。 结论 介入治疗是治疗先天性心脏病的有效方法,心胸外科医师掌握该项技术有其较多的优势。

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Surgical Treatment of Adult Congenital Heart Disease

    Objective To investigate the results of the surgical treatment of adult congenital heart disease (ACHD). Methods We retrospectively analyzed the clinical data of 502 patients with ACHD underwent operation treatment in Fu Wai Hospital between January 2012 and June 2015. There were 205 males and 297 females at age of 18-65(34.01±11.97) years and weight of 19-96 (58.60±12.60) kg. Results Atrial septal defect had the highest incidence of ACHD, the proportion accounted for 43.8%.The followed was ventricular sepal defect, accounting for 26.6%. And the third is tetralogy of Fallot, accounting for 5.4%. The age ranged from 18 to 65 years. A percentage of 65.13% patients received operation when they are younger than 40 years, with the most patients at age of 20-29 years, the least patients at age of 30-39 years. We completed a total of 471 patients of early orthodontic treatment with operation success rate at 99.57%. We completed 29 patients palliative operation with early operation success rate at 96.55%. And there were 2 patients with re-operation at success rate of 100.00%. The postoperative patients with ventilator assisted time was 19.03 h. The mechanical ventilation time was 19.03 h. ICU treatment time was 2.22 d. Postoperative complications occurred in 51 patients with incidence rate at 10.15%. Conclusion It is very important to impose proper surgical method on different patients. The operation doctor should be trained skillfully. Perioperative management is also a key stage to the success of the operation.

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  • Antenatal Sonographic Diagnosis of Hypoplastic Left Heart Syndrome

    目的 探讨胎儿左心发育不良综合征产前超声诊断方法,提高诊断准确性。 方法 常规产前超声检查方法,应用四腔心切面和三血管气管平面进行胎儿心脏畸形筛查。 结果 2006年1月-2008年12月发现4例左心发育不良综合征,3例并发心内畸形(2例右室双出口及1例室缺),1例并发心外畸形(Dandy-Walker畸形及单脐动脉)。 结论 应用四腔心切面和三血管气管平面筛查心室发育不良简单易行,准确性高。

    Release date:2016-09-08 09:47 Export PDF Favorites Scan
  • Comparison of total arterialized coronary artery bypass grafting and left internal mammary artery plus saphenous vein bypass grafting in three-vessel coronary heart disease patients with diabetes

    ObjectiveTo evaluate the perioperative, short- and mid-term results of total artery bypass grafting and saphenous vein bypass grafting in three-vessel coronary heart disease patients complicated with diabetes.MethodsRetrospective analysis was performed on 46 patients (a TAR group) including 36 males and 10 females with an average age of 65.1±11.3 years who underwent total artery bypass grafting in Renji Hospital affiliated to Shanghai Jiao Tong University Medical College from 2005 to 2014. A total of 46 patients with age and gender matched admitted during the same period were selected as a control group (NCR group), in which left internal mammary artery and great saphenous vein were used as grafting vessels. Preoperative, perioperative, and postoperative (1 year and 5 years) data of the two groups were analyzed.ResultsIn terms of perioperative data, the TAR group was inferior to the NCR group in operation time, postoperative 24 h drainage volume and postoperative 24 h blood transfusion volume. However, there was no difference between the two groups in terms of perioperative mortality, ICU stay, etc. One year after surgery, there was no difference in angina pectoris recurrence, recurrent myocardial infarction or grafting vessel patency rate between the two groups. Five years after the operation, the TAR group was superior to the NCR group in angina recurrence, myocardial infarction, and grafting vessels patency rate.ConclusionFor patients with three-vessel coronary heart disease complicated with diabetes, total arterial bypass grafting can achieve better mid-term effect, although it can prolong the operation time and increase the amount of drainage and blood transfusion 24 h after operation.

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