1.Difficulties and reflections of clinical nursing teaching in cardiovascular surgery department
Miao CHEN ; Yuan LI ; Chaoyi QIN
Chinese Journal of Medical Education Research 2020;19(8):967-970
Cardiovascular surgery patients have complex and changeable conditions, and the nursing operation is highly specialized, and involves the use of a variety of high-precision instruments and high-risk drugs. Therefore, it's not only required that teachers should have solid theoretical knowledge, rich clinical experience, and good moral quality, but nursing interns also need to have active learning consciousness, adapt to the work intensity of the department in a short time and be familiar with the work content. Starting from the difficulties of clinical nursing teaching in cardiovascular surgery, this study puts forward measures such as attaching importance to the mobilization of nursing students before internship, strengthening the standardized management of clinical teaching, introducing diversified nursing teaching methods, and paying attention to the mental health of intern nurses during the practice, so as to improve the quality of nursing teaching.
2.Remodeling+Ring (modified Yacoub) technique for the treatment of bicuspid aortic valve regurgitation with ascending aortic aneurysm: A case report
Qianlei LANG ; Chaoyi QIN ; Yajiao LI ; Zhenghua XIAO ; Wei MENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(01):138-140
Patients with bicuspid aortic valve are often complicated with aortic dilatation. If the aortic valve is of good quality, aortic root replacement with aortic valve preservation is feasible. A 35-year-old male patient with bicuspid aortic regurgitation complicated with ascending aortic aneurysm underwent Remodeling+Ring (modified Yacoub) operation. Echocardiography showed that there was no aortic regurgitation on the 3rd day after operation, and the patient was discharged satisfactorily on the 6th day after operation. Remodeling+Ring surgery ensures the physiological movement of the aortic valve, solves the enlarged annulus, avoids the problems caused by valve replacement, and significantly improves the quality of life of patients, which is worth popularizing.
3.Application of reimplantation in the treatment of bicuspid aortic valve with aortic root aneurysm
Xiangfeng GONG ; Hao NIU ; Chaoyi QIN ; Haibo SONG ; Wei MENG ; Zhong WU ; Yingqiang GUO ; Jia HU ; Eryong ZHANG ; Zhenghua XIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(10):1347-1353
Objective To evaluate the early clinical effect of reimplantation in the treatment of bicuspid aortic valve (BAV) with aortic root aneurysm. Methods The clinical data of 25 patients with BAV and aortic root aneurysm [mean diameter: 45-63 (52.68±5.55) mm] undergoing reimplantation in West China Hospital from November 2019 to May 2021 were retrospectively reviewed. There were 22 males and 3 females. The mean age was 15-65 (50.00±13.10) years and body surface area was 1.79±0.23 m2. Results The pathological classification of BAV malformation was confirmed during the operation: Type 0 in 3 patients and Type 1 in 22 patients. There were 12 patients undergoing cusp central plication, and 2 patients were sutured with a closed fusion crest. Postoperative valve leaflet coaptation height was 0.78±0.15 cm, and effective height was 1.27±0.19 cm. In operation, maximum aortic valve flow velocity was 1.65±0.42 m/s, pressure difference was 5.46±3.05 mm Hg, and aortic valve annulus diameter was 21.32±0.95 mm. Cardiopulmonary bypass time was 225.84±35.34 min, and aortic block time was 189.60±26.51 min. In-hospital time was 11.64±3.07 d, ICU stay time was 2.64±0.99 d, and mechanical ventilation time was 1.48±0.87 d. The follow-up time was 17.20±4.70 months, and no death or major complications occurred during the follow-up in all patients. The cardiac function of the patients significantly improved postoperatively (P≤0.05). Echocardiography suggested that 12 patients had no aortic regurgitation, 10 minor aortic regurgitation, 3 mild aortic regurgitation, and no patients with moderate or more severe regurgitation. The diameter of the aortic sinus, left ventricular end-diastolic diameter and volume decreased during the follow-up, compared to preoperative ones (P≤0.05). The maximum flow velocity of the aortic valve was 1.54±0.36 m/s, and the pressure difference was 5.17±2.38 mm Hg during the follow-up. Conclusion Reimplantation technology has a good clinical effect for highly selective BAV patients. It can effectively avoid long-term postoperative anticoagulation, but the maximum flow rate after surgery is slightly increased, which may be related to the configuration of BAV itself. While compared with valve replacement, the effect is still worthy of recognition.