This paper presents the results of aortic and double valve replacement with tilting disc valves in 75 patients.Preoperafive diagnosis was rheumatic lesion in 48 cases, bacterial endocarditis in 22, congenital aortic stenosis in 3, and VSD with prolapse of aortic valve in 3.There were 9 early deaths with an overall operative mortality rate of 12%. During the follow-up of 7 months to 7 years and 11 months, there were 66 long-term survivals and 1 late death.The authors conclude that the early operation should be performed on patients with valve lesion or with combination of mitral valve lesions resulting in left ventricular impairment. The protection of the myocardium during operation is the most important procedure in reducing the operative mortality.

Valvular disease is a commonly seen heart disorder,valve replacement is an effective approach to treat valve disorders.Both the mechanic valves and bioprosthesis used now have their own defects,making it important for the cardio surgery field to develop some kind of ideal valves.With the development of tissue engineering techniques,the tissue engineering valves are thought to have great potential and bright clinical future,and now it has become a hot point in cardiac surgery.This article is to evaluate the frame materials,resource of tissue cells and implantation, in vitro pre adaptation testing and in vivo animal experiment results,and the existing problems are pointed out in the present study.

Ischemic preconditioning (IPC), as a powerful endogenous cardioprotective adaptation, has brought a new research field for prevention and inhibition of myocardial ischemic reperfusion injury. This article is to evaluate the current information regarding the process of IPC and the possible mechanisms involved, with special attention paid to the protein kinase C and mitochondrial ATP sensitive potassium channels. The article also pointed out that the future role of IPC in clinical practice would strongly depend on the exact cellular and molecular mechanism underlying the IPC phenomenon. Pharmacological preconditioning seems to represent a perspective role of IPC in clinical practice.

The experiences of surgical treatment of valvular heart diseases in children were reported. Cardiac valve operations were performed in 87 children including 58 males and 29 females between the age of 4 to 14 years ( mean 10 2 years) . Of the 87 patients, 36 underwent mitral valve replacement, 13 aortic valves replacement, 6 mitral and aortic valves replacement, 13 aortic valvuloplasty, and 29 mitral valvuloplasty. Associated cardiac lesions were simultaneously managed. Postoperative complications included low cardiac output syndromes in 7 patients, respiratory failure in 3, and arrhythmia in 5 patients. The operative mortality was 4 60% (4 patients). Follow up was 0 5 to 14 5 years (mean 6 51 years). Late mortality was 3 61% (3 patients). The valvuloplasty operations were first choice for cardiac valve operations in children. It was advisable to use cardiac valve prosthesis of larger size(adult) for valve replacement in children.Anticoagulation with Warfarin was routinely used and the treatment of rheumatic fever should be emphasized postoperatively.

The experiences of coronary artery bypass grafting (CABG ) surgery and perioperative management for critical patients are reported. Forty-five critical CAD patients aged from 41 to 78 years old with 32 male and 13 female underwent CABG.The critical conditions included coronary artery disease complicated with left ventricular dysfunction (LVEF less than 30%) in 7 patients, heart valve disease in 13, postinfarction giant LV aneurysm in 6, aged 75 years or older patients with hypertension, diabetes, and renal or severe lung dysfunction in 8, and emergent CABG because of insufficient blood supply from left coronary artery during cardiac valve replacement or ascending aortic aneurysm operation in 5. Among all the patients, pure CABG was performed in 20, and CABG with other simultaneous procedures in 25. Each of 45 patients received l to 4 bypass grafts with a mean of 2 9. During the early stage of postoperation,there were low cardiac output syndrome in 6 patients, renal failure in 3, pulmonary failure in 2, and MOSF in 1.With the application of IABP, 5 from 6 LCDS patients recovered.Three patients were complicated with renal failure, and they also recovered with the use of peritoneal or blood dialysis postoperatively. During the early stage of postoperation,two patients (4 4%) died of LCOS and MOSF, respectively. One died of arrhythmia 15 months later after operation .The experiences suggest that control of hypertension,heart rate and diabetes before operation, perfect revascularization of ischemic myocardium and effective myocardial protection during operation,prevention of LCOS and renal failure after operation could improve the results of CAD patients undergoing CABG.

Objective:To examine the sodium-hydrogen exchanger(NHE-1) m RNA expression in lung of patients with congenital heart disease,and to explain the cause of pulmonary vascular remodeling.Methods:Twenty-two patients with congenital heart disease were divided into 2 groups:non-pulmonary-hypertension group(s PAP

Surgical outcome of 188 patients with coronary artery disease was analized. 132 of them were male and 56 female (mean age 60 3 yrs).Fifty six patients had acute or post MI, 46 diabetes, 14 renal dysfunction, 26 stroke, 21 valve disease, 7 left ventricular aneurysm, and 1 type I dissecting aneurysm. Cardioplegia was used in 104 patients, intermittent aortic cross clamping in 59, OPCAB in 25, average number of graftings was 2 7 per patient. Concomitant procedures included 8 MVR or MVP, 4 AVR, 9 DVR and 1 Bentall′s procedure. Total early mortality was 5 9%, but the mortality decreased to 3 2% in 124 patients undergone CABG since Jan, 2000. Late death occurred in 2, recurrence of chest pain in 4 patients in 2 to 5 yrs postoperatively. Improved surgical techniques and perioperative management were the main factors reducing early mortality. Timing of operation, respiratory management, prevention of digestive track bleeding, and postoperative rehabilitation, should be emphasized.

With the development of tissue engineering technology .tissue engineering of heart valve by seeding cells and scaffolds has become a hot issue in valve surgery. In this article we reviewed the selection of scaffold. acquirement and culture of seeding cells, in vitro pre-condition and in vivo experiment. The questions need to be resolved in the future study is also put forward.

Objective To evaluate the therapeutic efficacy of peritoneal dialysis(PD) for acute renal failure(ARF) subsequent to cardiac surgical procedures in adults.Method Clinical data of 125 consecutive adult patients,admitted from Feb.1997 to Nov.2007,with ARF subsequent to cardiac surgery and undergone PD,were analyzed retrospectively.The levels of creatinine(Cr),blood urea nitrogen(BUN),albumin and kalium ion([K+]) were compared before and after PD.Results Of 8451 consecutive adult patients undergone operations on heart,358 cases(4.2%) experienced ARF,and 125 cases(1.5%) required PD.In 117 patients performed PD,[K+] declined to normal level within one day,BUN and Cr were 10.5?3.6mmol/L and 129.3?41.6?mol/L at the third day after PD respectively,significantly lower than those before PD(P

Objective: To evaluate the protective effect of bone marrow stromal cells (BMSCs) transferred by Ad?ANG ex vivo on ischemic myocardium. Methods: ELISA method was used to assay the expression and secretion of angiogenin (ANG) after Ad?ANG transfection of BMSCs ex vivo. Then BMSCs with Ad?ANG were transplanted into ischemic myocardium of isogenic Lewis rats. 4 weeks later, the parameters of heart function, such as EF and EDLV, were examined by echocardiography. Survival and differentiation of transplanted BMSCs and angiogenesis were appraised by histology and transmission electron micrography. Results: ANG was found in both lysate and culture medium after transfection of BMSCs. A maximum expression of ANG was observed at 4-7 days after transfection and could still be assayed 15 days later. 4 weeks later after transplantation in the BMSCs with Ad?ANG group, heart function improved better than the single BMSCs group(P