Objective To study the clinical features and treatment experience in the treatment of thoraco abdominal injury with diaphragmatic rupture.Methods Clinical data of 27 patients suffering from thoraco-abdominal injury with diaphragmatic rupture were analysed retrospectively.Results Injuries of this kind are usually complicated involving mostly the organ injuries,which are not obvious in clinical indications. In the present study group,27 cases were treated surgically,of whom 24 healed and 3 died(11.1%).Conclusion Early diagnosis and timely operation are the key steps in reducing the complications and mortality.

Objective To report the surgical procedure and its results of enlargement annulus for double valve replacement in small aortic root. Methods There were 7 patients with small aortic root undergoing double valve replacement. Mean age of 42 years (from 34 to 52 years). The diameters of aortic annulus ranged from 17 to 20?mm. The aortotomy was extended through the commissure that separates the left and noncoronary cusps of the aortic valve. The aortic annulus was divided, and the incision was extended into anterior leaflet of the mitral valve as inverse "Y". The anterior leaflet of the mitral valve was excised 3～5?mm to its root. A prosthetic patch was attached to the aortic-mitral valve so the aortic annulus was enlarged. The prosthetic valve was implanted. Moreover, it was attached to the prosthetic patch, at the root of the anterior leaflet of the mitral valve. Results The diameters of aortic annulus after operation were enlarged to 4～7?mm. The prosthetic valve (21～23?mm) was implanted in aortic valve position and the prosthetic valve (25～27?mm) in mitral valve position. There were no operative and postoperative deaths. One patient was re-operated for bleeding. All patients were followed up from 1 to 26 months and their cardiac function was significantly improved. Conclusion This surgical procedure is safe and effective for replacement, for double valve replacement in small aortic root.