Objective To investigate the effect of perioperative period D-dimer and tissue factor (TF)-1208 D/I gene polymorphism on the long-term prognosis of patients with off-pump coronary artery bypass grafting (OPCABG). Methods Retrospective analysis of the case data of the first OPCABG patients admitted to Tianjin Medical University General Hospital from May 2015 to May 2016 were enrolled. The general data, operation time, bypass number, left ventricular ejection fraction (LVEF), flow rate of 24-hour pleural effusion, intraoperative heparin dosage, combined anticoagulant and antiplatelet time, and the time of postoperative ventilator were measured. The blood biochemical indexes of 1, 4, 7, 14 days and 1, 2, 3 months after operation, perioperative complications, the level of D-dimer in the patients with different TF-1208 D/I gene polymorphism, and prognosis of 1-year follow-up were recorded. The risk factors of recurrent angina 1 year after operation was analyzed by Logistic regression analysis. Results The level of plasma D-dimer was increased continuously after OPCABG, and reached a peak at 1 month after operation [1.94 (1.07, 2.70) mg/L], then decreased, and decreased to preoperative level 3 months after operation [0.20 (0.10, 0.45) mg/L]. The level of D-dimer in TF-1208 I I genotype was significantly higher than that in TF-1208 DD genotype and TF-1208 D/I genotype group at 14 days and 1 month after operation [mg/L: 4.17 (1.54, 5.09) vs. 1.91 (1.07, 2.26), 1.02 (0.91, 1.88) at 14 days; 5.12 (2.41, 6.32) vs. 1.94 (1.18, 2.70), 1.62 (0.22,1.88) at 1 month, all P < 0.05]. The results of 1-year follow-up showed that 25 patients with recurrent angina pectoris without the occurrence of myocardial infarction. The proportion of recurrent angina pectoris in TF-1208 I I genotype was significantly higher than that in TF-1208 DD genotype and TF-1208 D/I genotype group (χ2= 0.197, P = 0.004). Logistic regression analysis showed that LVEF< 0.50 [odds ratio (OR) = 6.482, 95% confidence interval (95%CI) = 1.365-18.763, P = 0.015] and TF-1208 I I genotype (OR = 8.864, 95%CI = 1.613-46.743, P = 0.012) were independent risk factors for recurrent angina pectoris at 1 year after OPCABG. Conclusions After OPCABG, the body was in a hypercoagulable state and lasted for a long time, and almost recovered 3 months after operation. LVEF < 0.50 and TF-1208 I I genotype were independent risk factors of angina pectoris at 1 year after surgery.

Objective To summarize the surgical experience of surgical management for aortic dissection aneurysm. Methods A total of 265 patients with aortic dissection aneurysm were treated with surgical management and the surgi-cal approach were chosen according to the condition. Results There were 170 cases Stanford A ADAs and 95 Stanford B patients. After following-up for 6 to 12 months, of which 19 and 3 cases died, respectively, and in the survivals, whose CTA displayed artificial vessel were unobstructed,the endovascular stents were fixed well.The heart function re-covered to Ⅱ-Ⅰ stage. Conclusion Surgery is an important method to save the patients with aortic dissection a-neurysm,the choice of surgical procedures depend on the location of intimal tear of aortic dissection. Proper surgical indication,technique and brain protections are the key factors of aortic dissection surgery. EVGE is a minimally inva-sive,effective,safe surgery in treating Stanford type B aortic dissection aneurysm.