1.Risk Factor Analysis of Acute Kidney Injury After Isolated Heart Valve Prosthesis Implantation in Relevant Patients
Xianzeng XU ; Ting ZHOU ; Yangchun LIU ; Jing QIAN ; Xiaoyong XIE ; Binfeng LEI ; Xu FENG ; Baoshi ZHENG
Chinese Circulation Journal 2016;31(8):785-788
Objective: To analyze the risk factors of acute kidney injury (AKI) after isolated heart valve prosthesis implantation (HVPI) in relevant patients. Methods: We retrospectively studied 400 patients who received isolated HVPI in our hospital. The demographic characteristics and pre-, intra-, post-operative information were collected to conduct uni- and multi-variantanalysis. Results: The pre-operative serum creatinine level in 400 patients was 85.0 (72.0, 98.0) μmol/L and post-operative level was 104.5 (80.0, 146.3) μmol/L, the elevation was 20.9% (1.6%, 57.9%),P<0.05. Multi Logistic regression analysis indicated that age>50years (OR=2.12, 95% CI 1.13-3.95),hypertension history (OR=4.07, 95% CI1.23-13.47), cardiopulmonary bypass time>180 minutes (OR=5.38, 95% CI 1.63-17.77), post-operative hemoglobin<70 g/L (OR=0.20, 95% CI 0.06=0.74), serum glutamic-pyruvic transaminase>100 u/L (OR=12.10, 95% CI 2.28-64.23), pleural fluid drainage at the day of operation> 500 ml (OR=2.12, 95% CI 1.13-3.95), extubation after 24 hours of operation (OR=3.94, 95% CI 2.07-7.52), combining low cardiac output syndrome (OR=4.64, 95% CI 1.06-20.29) were the independent risk factors for AKI occurrence in patients after HVPI, allP<0.05. Conclusion: Post-HVPI AKI was associated with many factors. At prior operation, it was mainly related to the age and hypertension; during theoperation, it was mainly related to cardiopulmonary bypass time; at post-operation, it was mainly related to delayed extubation, low cardiac outputsyndrome, anemia, increased pleural lfuid drainage and serum glutamic-pyruvic transaminase.
2.Surgical treatment for acute aortic syndrome and discussion on several problems
Wei LU ; Baoshi ZHENG ; Binfeng LEI ; Xiaoyong XIE ; Jun PENG ; Liuliu HUANG ; Cheng LUO
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(10):591-593
Objective To summarize seven-year experience in therapy for acute aortic syndrome.Methods Between May 2009 and June 2016,103 patients(75 males and 28 females)diagnosed as acute aortic syndrome underwent operation. The mean age was(43.13 ±15.07)years(20 -79 years).We applied hypothermic circulatory arrest and selective antegrade cerebral perfusion to achieve organic protection.92 patients underwent Sun's procedure.Bentall procedure was performed on 63 patients.9 patients accepted aortic valve repair or root plasty.Mitral valve was replaced in 5 patients.Right coronary artery bypass grafting was carried out on 3 patients.Results Mean cardiopulmonary bypass time was(231.7 ±55.9)min, and cross-clamp time was(138.1 ±31.3)min.Selective cerebral perfusion time was(31.0 ±6.8)min.9 patients died within postoperative 30-days.Conclusion Despite of progression of treatment on acute aortic syndrome, further researches are still required for severe complications and strategies of therapy.