Non-reentrant focal tachycardias occur spontaneously, facilitated by catecholamine infusion, but they cannot be initiated or terminated with programmed stimulation. These tachycardias exhibit early activation before the QRS, however, do not typically show the mid-diastolic potential that is crucial for reentrant tachycardia maintenance. Electrophysiological studies are useful for distinguishing focal from macro-reentrant ventricular tachycardia. We report herein a case of patient without a history of structural heart disease who presented with a focal Purkinje ventricular tachycardia and heart failure. The focal Purkinje ventricular tachycardia was eliminated by radiofrequency catheter ablation. All of the patien's symptoms were improved after ablation.
Adult ; Cardiomyopathies/*surgery ; Catheter Ablation/*methods ; Humans ; Male ; Tachycardia, Ventricular/*surgery ; Ventricular Dysfunction/surgery

Cardiomyopathies ; complications ; surgery ; Child ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; etiology ; surgery ; Mitral Valve Prolapse ; Treatment Outcome

Adult ; Cardiomyopathies ; diagnostic imaging ; surgery ; Echinococcosis ; diagnostic imaging ; surgery ; Echinococcosis, Hepatic ; diagnostic imaging ; surgery ; Female ; Humans ; Mediastinum ; parasitology ; Radiography ; Thoracotomy ; methods

OBJECTIVETo investigate and compare the therapeutic effect of umbilical cord blood stem cell transplantation (UCBSCT) or adult fresh plasma in severe viral hepatitis liver failure with/without heart damage, and to study the effect of UCBSCT on liver lesions in rats.

METHODS83 severe hepatitis patients with/without heart damage were included in the study between January 1994 and June 2003. The patients were treated with UCBSCT or given adult plasma transfusions. The therapeutic effect was evaluated by serial determination of liver function and myocardium enzymes in all patients before and after the treatment. The model of experimental hepatic failure was constructed in SD rats by injecting carbon tetrachloride. Then, the rats were given normal saline, neonate cord blood serum or neonate cord blood stem cells respectively. The expression of human AFP and Alb in SD rat livers was detected by immunohistochemistry; and human special DNA was detected by PCR.

RESULTSThe UCBSCT group had much better effects in the improvement of liver function than the adult plasma group had, no matter whether the patients had heart damage or not. Moreover, UCBSCT can decrease heart impairment of the patients. The animal experiment demonstrated that AFP and Alb positive cells were present in the neonate cord blood stem cell group after 21 days and 1 month; human special DNA was detected by PCR in these SD rat livers.

CONCLUSIONUCBSCT displayed good therapeutic effects on severe viral hepatitis and improvement of heart injury of the patients. The rat liver immunohistochemistry indicated that neonate cord blood stem cell application can decrease the liver damage and increase hepatocellular regeneration. Human umbilical cord blood stem cells can differentiate into liver cells in acute damaged SD rat livers.

Aged ; Cardiomyopathies ; etiology ; surgery ; Cord Blood Stem Cell Transplantation ; Female ; Hepatitis, Viral, Human ; complications ; surgery ; Humans ; Liver Failure ; etiology ; surgery ; Male ; Middle Aged

Peripartum cardiomyopathy (PPCM) is a rare entity, and anesthetic management for cesarean section of a patient with this condition can be challenging. We hereby present the anesthetic management of a patient with PPCM complicated with preeclampsia scheduled for cesarean section, along with a mini review of literature. A 24 year-old primigravida with twin gestation was admitted to our hospital with severe PPCM and preeclampsia for peripartum care, which finally required a cesarean section. Preoperative optimization was done according to the goal of managing left ventricular failure. Combined spinal epidural (CSE) anaesthesia with bupivacaine and sufentanil was used for cesarean section under optimal monitoring. The surgery was completed without event or complication. Postoperative pain relief was adequate and patient required only one epidural top up with sufentanil 6 hours after operation. To the best of our knowledge there is no report in literature of the use of sufentanil as a neuraxial opioid in the anesthetic management of cesarean section in a patient with PPCM. CSE with sufentanil may be a safer and more effective alternative in such cases.
Anesthesia, Epidural/*methods ; Anesthesia, Spinal/*methods ; Cardiomyopathies/*complications ; Female ; Humans ; Peripartum Period ; Pre-Eclampsia/*surgery ; Pregnancy ; Sufentanil/*therapeutic use

Propofol is an intravenous hypnotic agent that is generally used for sedation in the intensive care unit and for induction of anesthesia during minimally invasive surgery, endoscopy, and plastic surgery in local clinics. Low blood pressure and transient apnea might occur under propofol sedation, whereas stress-induced cardiomyopathy is a very rare complication. We herein describe a case involving a 25-year-old woman without cardiovascular risk factors who developed stress-induced cardiomyopathy after propofol injection for anesthesia and was treated with conservative treatment. This case reminds us that clinicians should consider the possible occurrence of stress-induced cardiomyopathy after anesthesia using propofol, even in patients without cardiovascular risk factors.
Adult ; Anesthesia* ; Apnea ; Cardiomyopathies* ; Endoscopy ; Female ; Humans ; Hypotension ; Intensive Care Units ; Propofol* ; Risk Factors ; Surgery, Plastic ; Surgical Procedures, Minimally Invasive

Calcinosis ; etiology ; Cardiomyopathies ; etiology ; Heart Septum ; pathology ; Heart Valve Prosthesis ; adverse effects ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery

OBJECTIVETo summarize experience of perioperative anesthetic management for patients undergone excision of pheochromocytoma and complicated with catecholamine cardiomyopathy.

METHODSPerioperative anesthetic management for surgical treatment of three cases of pheochromocytoma complicated with catecholamine cardiomyopathy was described and discussed according to literature reports.

RESULTSThe catecholamine cardiomyopathy of the three cases presented with left ventricular hypertrophy, congestive cardiac failure and acute myocardial infarction. After removal of the pheochromocytoma under general anesthesia, a prolonged hypotension occurred in all of the three cases. In order to maintain stable hemodynamics, large dose of catecholamine was required after surgery. All of the three patients were survived and discharged.

CONCLUSIONSIt is suggested that myocardial dysfunction may be another important factor for the prolonged hypotension after removal of the tumor. Meticulous preoperative assessment of heart function is of primary importance for the management of anaesthesia during surgical procedures.

Adrenal Gland Neoplasms ; blood ; surgery ; Adult ; Anesthesia, General ; Cardiomyopathies ; blood ; etiology ; Catecholamines ; blood ; Female ; Heart Failure ; blood ; etiology ; Humans ; Male ; Pheochromocytoma ; blood ; surgery

OBJECTIVE: To estimate the therapeutic effect and safety of intra-aortic balloon pumps (IABP) in patients with serious cardiovascular diseases. METHODS: We retrospectively analyzed the clinical data of 68 patients with serious cardiovascular diseases, who were enrolled in Hunan Provincial People's Hospital between 2009 and 2011. All patients received IABP support. The systolic blood pressure, diastolic blood pressure,heart rate, N-terminal precursor of brain natriuretic peptide (NT-proBNP), and renal function of all patients were determined before and after the IABP. Cardiac events and mortality were observed after IABP support. RESULTS: The disease in 51 patients improved after IABP support. The systolic blood pressure, diastolic blood pressure,heart rate, and NT-proBNP were significantly lower than those before the IABP. Thirty-seven patients with acute myocardial infarction successfully completed percutaneous coronary intervention surgery after the IABP support. Five patients had IABP-related complications, but no serious complication occurred. CONCLUSION IABP is an effective and safe procedure for critical cardiovascular patients. IABP should be applied early for the patients with appropriate indications.
Aged ; Cardiomyopathies ; surgery ; therapy ; Critical Illness ; Female ; Humans ; Intra-Aortic Balloon Pumping ; methods ; Male ; Middle Aged ; Myocardial Infarction ; surgery ; therapy ; Retrospective Studies

Objective: To investigate the feature and treatment of atrial tachycardia (AT) originated from right atrial appendage (RAA) in children. Methods: The data of 42 children with AT originated from RAA, who were admitted the First Hospital of Tsinghua University from January 2010 to September 2022 were analyzed retrospectively.The clinical characteristics, treatment and efficacy were analyzed. The children were divided into tachycardia cardiomyopathy group and normal cardiac function group. The differences in the ablation age and the heart rate during AT between two groups were compared by independent sample t-test. Results: Among 42 children, there were 20 males and 22 females. The age of onset was 2.7 (0.6, 5.1) years. Their age at radiofrequency ablation was (6.5±3.6) years, and the weight was (23.4±10.0) kg. Thirty-two children (76%) had sustained AT. The incidence of tachycardia cardiomyopathy was 43% (18/42). Compared to that of the normal cardiac function group, the ablation age and the heart rate at atrial tachycardia of the tachycardia cardiomyopathy group were higher ((8.1±3.8) vs. (5.3±3.1) years, t=-2.63, P=0.012; (173±41) vs. (150±30) beats per minute, t=-2.05, P=0.047. Thirty-eight children (90%) responded poorly to two or more antiarrhythmic drugs. The immediate success rate of radiofrequency ablation (RFCA) was 57% (24/42), and the AT recurrence rate was 17% (4/24). Twenty-two children underwent RAA resection, and their AT were all converted to sinus rhythm after the surgery. During the RAA resection, 10 cases of right atrial appendage aneurysm were found, 9/18 of which failed the RFCA. Conclusions: The AT originated from the RAA in children tend to present with sustained AT, respond poorly to antiarrhythmic drugs, and has a low success rate of RFCA as well as high recurrence rate. Resection of the RAA is a safe and effective complementary treatment.
Male ; Female ; Humans ; Child ; Atrial Appendage/surgery* ; Anti-Arrhythmia Agents/therapeutic use* ; Retrospective Studies ; Catheter Ablation ; Tachycardia/surgery* ; Treatment Outcome ; Cardiomyopathies