BACKGROUND:Brain natriuretic peptide, an important serum marker for diagnosis of cardiovascular diseases, is crucial for risk factor analysis of cardiovascular diseases.
OBJECTIVE: To analyze the relationship between brain natriuretic peptide and hemodynamic parameters before and after coronary artery bypass grafting.
METHODS:Thirty patients with coronary heart disease undergoing coronary artery bypass grafting were selected, including 13 patients with left ventricular ejection fraction≥ 50% (normal heart function) and 17 patients with left ventricular ejection fraction < 50% (cardiac insufficiency). Levels of plasma brain natriuretic peptides were detected at 1 day before transplantation, 7 hours, 1, 3, 5, 7 days after transplantation, and then the correlation between plasma brain natriuretic peptide levels and hemodynamic parameters was analyzed before and after coronary artery bypass grafting.
RESULTS AND CONCLUSION: Preoperative and postoperative levels of plasma brain natriuretic peptides were significantly lower in the patients with left ventricular ejection fraction≥ 50% than those with left ventricular ejection fraction < 50%; while in each group, the level of brain natriuretic peptides was remarkably increased after coronary artery bypass grafting (P < 0.05 orP< 0.001). Preoperative brain natriuretic peptide levels were positively correlated with New York Heart Association classification grading, left atrial diameter and left ventricular diameter (r=0.61;r=0.34;r=0.67), but negatively correlated with echocardiographic left ventricular ejection fraction and cardiac output (r=-0.75;r=-0.70). The postoperative peak level of brain natriuretic peptides was positively correlated with New York Heart Association classification grading, echocardiographic left ventricular end diastolic diameter and pulmonary artery pressure (r=0.72;r=0.70;r=0.45). These findings indicate that the plasma level of brain natriuretic peptides before coronary artery bypass grafting shows a good correlation with left ventricular ejection fraction and left ventricular end diastolic diameter, which accurately reflect the state of cardiac function before coronary artery bypass grafting.

Objective:To investigate the safety and effectiveness of Willis covered stent in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.Methods:A retrospective analysis was performed. Six patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection admitted to the 3 hospitals from May 2016 to December 2019 were chosen; their clinical data were collected. The surgical processes and complications were concluded, and the prognoses were evaluated by modified Rankin scale (mRS).Results:One patient was treated with intraoperative simple tamponade compression for hemostasis, and died for massive intracranial hemorrhage 2 weeks after surgery. Five patients were occluded by Willis covered stents; the occluded success rate was 100% but ophthalmic arteries were blocked in all. During the perioperative period, diabetes insipidus occurred in one patient and incomplete oculomotor paralysis occurred in one patient; 5 patients were followed up for 3-12 months: MRI indicated subtotal resection of tumor in 4 patients and total resection in one patient, no new bleeding or ischemic stroke events occurred in these 5 patients, and the prognosis was good.Conclusion:Willis covered stent is safe and effective in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.