Cardiac Rehabilitation ; Exercise Therapy ; Heart Failure/surgery* ; Heart Transplantation ; Humans

The number of patients with heart failure in China is large, and the proportion of patients with end-stage heart failure continues to increase. The clinical effect of guideline-directed medications therapy for end-stage heart failure is poor. Heart transplantation is the most effective treatment for end-stage heart failure. But it is faced with many limitations such as the shortage of donors. In recent years, the research and development of artificial heart in China has made great progress. Three devices have been approved by the National Medical Products Administration for marketing, and another one is undergoing pre-marketing clinical trial. Since 2017, more than 200 cases of ventricular assist device implantation have been carried out in more than 34 hospitals in China. Among them, 70 patients in Fuwai Hospital, Chinese Academy of Medical Sciences had a 2-year survival rate of 90%. The first patient has survived more than 5 years with the device. More efforts should be put into the training of standardized technical team and quality control. Further research should be carried out in the aspects of pulsatile blood flow pump, fully implanted cable-free device, and improved biomaterial with better blood compatibility.
Humans ; Heart-Assist Devices ; Heart Failure/surgery* ; Heart, Artificial ; Heart Transplantation ; Pulsatile Flow

Myxomas are uncommon primary cardiac tumours that usually affect the left atrium. We herein report the case of a patient who presented with right heart failure and proteinuria, leading to the diagnosis of atrial myxoma. Surgical resection resulted in resolution of the patient's symptoms.
Adult ; Female ; Heart Atria ; surgery ; Heart Failure ; diagnosis ; Heart Neoplasms ; diagnosis ; surgery ; Humans ; Myxoma ; diagnosis ; surgery ; Proteinuria ; diagnosis

Humans ; Atrial Fibrillation/surgery* ; Heart ; Heart Failure/therapy* ; Heart Conduction System

Humans ; Atrial Fibrillation/surgery* ; Heart ; Heart Failure/therapy* ; Heart Conduction System

A 10-year-old boy who had previously undergone surgical correction for tetralogy of Fallot was referred for cardiac catheterization because of recurrent symptomatic postoperative heart failure owing to major aortopulmonary collateral arteries (MAPCAs). A successful occlusion of these MAPCAs was achieved percutaneously using the Amplatzer vascular plug and a detachable coil. Transcatheter occlusion of MAPCAs after surgical correction is an effective method for treatment of post-operative heart failure.
Child ; Collateral Circulation ; Heart Failure ; surgery ; Humans ; Male ; Postoperative Period ; Pulmonary Atresia ; surgery ; Tetralogy of Fallot ; surgery

The intraaortic balloon pump (IABP) is the most effective and widely used device for temporary mechanical assistance of left heart. Considering left and right ventricular (RV) interdependence, IABP may also alleviate predominantly RV dysfunction following cardiac surgery. This is the case of a 61-year-old female patient who had experienced RV failure after cardiac surgery. After tricuspid valve replacement, preexisting RV failure was progressively aggravated and systemic blood pressure could not be maintained in spite of aggressive pharmacological support on second postoperative day. Thus, mechanical support with IABP was considered to increase coronary perfusion pressure in this case. IABP dramatically improved hemodynamics and cardiac function. It was removed on fifth postoperative day and she has remained well. In conclusion, IABP could play a role in RV failure following cardiac surgery and timely treatment of the heart failure with mechanical circulatory assistance would prevent further complications.
Blood Pressure ; Female ; Heart ; Heart Failure ; Hemodynamics ; Humans ; Middle Aged ; Perfusion ; Thoracic Surgery* ; Tricuspid Valve

A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.
Aged ; Anesthesia ; Anesthesia, General ; Dyspnea ; Estrogens, Conjugated (USP) ; Female ; Heart ; Heart Failure ; Humans ; Thoracic Surgery

OBJECTIVETo explore the experience of Abiomed BVS5000 as a mean of left ventricular support on clinical treatment for severe heart failure patients.

METHODSFrom February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 as a left ventricular assist device. The average age was (55.2 +/- 9.6) years old (range from 39 to 68 years old). Mean body surface area was (1.76 +/- 0.1) m2 (range from 1.6 to 1.9 m2). Devices were inserted for post-cardiotomy shock after coronary artery bypass grafting in 11 patients (92%) and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannula in left atrial through bovine jugular vein were used in 7 patients. In this way, the device could be taken off without resternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method.

RESULTSThe average duration of support was (8.8 +/- 11.2) d (range from 3 to 43 d), with support flow rate of 3.8 to 4.5 L/min. There were 9 patients (75%) weaned from support and 8 patients (67%) discharged from the hospital Four patients (33%) were dead. The most common morbidity was adverse neurologic events. There was no statistic difference between modified and routine method on average BVS5000 support duration, assisted flow rate, mechanical ventilation duration, stay of intensive care unit and thoracic drainage.

CONCLUSIONSThe Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use. With using modified cannulating method, the weaning procedure can be effectively simplified.

Objective: To observe the impact and difference of resection of left stellate ganglion (LSG) or right stellate ganglion (RSG) on rats with heart failure. Methods: Thirty male SD rats were divided into 3 groups (n=10 each) by random number table method: control group, LSG group, RSG group. All three groups underwent TAC surgery to establish a pressure-overloaded heart failure model. Then, LSG and RSG were bluntly separated and removed in rats assigned to the LSG group or RSG group by surgery, while rats in the control group underwent sham operation. The changes in blood pressure and heart rate before operation, 30 minutes and 10 weeks after operation were recorded; echocardiography was performed before operation and 10 weeks after operation to detect the thickness of the ventricular septum, left ventricle posterior wall diameter, left ventricular end diastolic diameter, left ventricular end diastolic volume, and calculate the left ventricular fractional shortening and left ventricular ejection fraction. HE staining and Masson staining were performed to observe the degree of myocardial hypertrophy and myocardial fibrosis, and to judge the ventricular remodeling. Results: The heart rates of the three groups of rats were (352.4±4.3), (320.3±4.0) and (297.9±5.9) beats/min, and the blood pressure was (142.8±2.3), (123.4±2.7) and (129.6±2.9) mmHg(1 mmHg=0.133 kPa) at thirty minutes after surgery; the heart rates of the three groups of rats were (352.9±4.0), (321.6±3.4) and (301±4.1) beats/min, and the blood pressure was (145.6±1.9), (124.8±1.7) and (130.4±4.4) mmHg at 10 weeks after surgery. The heart rate and blood pressure in the LSG group and RSG group at 30 min and 10 weeks after surgery were significantly lower than those in the control group; at 10 weeks after surgery, the heart rate in the RSG group was significantly lower than that in the LSG group (P both<0.001). After 10 weeks, rats in the control group developed severe left ventricular dilatation. Degree of left ventricular hypertrophy was significantly reduced in the LSG group and RSG group than in the control group, the thickness of the ventricular septum was (3.2±0.3), (2.5±0.1) and (2.5±0.1) mm; the left ventricular end-diastolic diameters were (7.5±0.3), (5.5±0.3) and (5.7±0.2) mm; the left ventricular end-diastolic volume was (9.5±0.3), (4.5±0.2) and (4.8±0.2) ml; the left ventricular fractional shortening was (21.6±1.3)%, (49.1±3.9)% and (47.4±1.5)%; and the left ventricular ejection fraction was (50.9±2.5)%, (81.9±2.1)% and (80.0±2.3)%, respectively in the control group, LSG group and RSG group. Compared with the control group, the left ventricular posterior wall diameter, left ventricular end-diastolic diameter and left ventricular end-diastolic volume were significantly lower and the left ventricular fractional shortening and left ventricular ejection fraction were significantly higher in the LSG group and RSG group (all P<0.001). 10 weeks after operation, the values of type Ⅰ collagen in the control group, LSG group, and RSG group were (0.354±0.013), (0.211±0.012) and (0.243±0.013), respectively. Ratio of type Ⅰ/Ⅲ collagen was (1.109±0.065), (0.737±0.055) and (0.839±0.075), respectively. Compared with the control group, the ratio of type Ⅰcollagen and ratio of type Ⅰ/Ⅲ collagen were significantly lower in the LSG group and RSG group (P<0.001). Conclusion: Both left and right stellate ganglion resection can similarly reduce ventricular remodeling caused by pressure overload and delay the progression of heart failure in tis TAC rat model.
Animals ; Heart Failure/surgery* ; Heart Ventricles ; Male ; Rats ; Rats, Sprague-Dawley ; Stroke Volume ; Ventricular Function, Left