Objective To evaluate the outcome of endovascular treatment with coarctation of aorta (CoA).Methods Between November 2007 and March 2012,11 patients,including 8 male and 3 female from 17 to 43 years old,with native CoA who were diagnosed by computed tomography angiography accepted the endovascular treatment.The arterial pressure difference between the femoral artery and the narrow segment was measured during the operation,and the stent was released by expanding the balloon.Results Endovascular treatment were successful in all cases without any major adverse events.Significant reduction of systohc blood pressure was observed from (64.09 ± 7.81) mmHg (1 mmHg =0.133 kPa) to (11.18 ± 3.37) mmHg.The mean CoA diameter pre-stent (4.000 ± 0.775) mm,post-stent (17.090 ± 2.427) mm.1 patient associated with patent ductus arteriosis had no persistent left-to-right shunt after covered stent implantation.The follow up range was 33 months.1 patient in simple balloon was retreatment by surgical because of restenosis.And no retraction was observed of 10 patients after stent implantation.Conclusion The early and midterm result of endovascular treatment with CoA is satisfactory,and longer follow-up is needed for its longterm outcomes.

ObjectiveTo evaluate the clinical application of bidirectional Glenn shunt without extracorporeal circulation(ECC) on treatment of children with complicated congenital heart disease (CHD).MethodsForty-six patients with complicated CHD(without ECC group) underwent bidirectional Glenn shunt without ECC,and 40 patients with complicated CHD (with ECC group) underwent bidirectional Glenn shunt with ECC.The therapeutic effect was compared between two groups.ResultsThere was no operative mortality in two groups.The pulmonary artery pressure in without ECC group was significantly lower than that in with ECC group [( 16.7 ± 1.2) mm Hg ( 1 mm Hg =0.133 kPa) vs.( 18.9 ± 1.0) mm Hg,t =4.686,P=0.026 ].Duration of respirator assistance after operation in without ECC group was significantly lower than that in with ECC group [ ( 12.2 ± 2.7) h vs.( 19.2 ± 2.8) h,t =2.972,P =0.041 ].There was no significant difference in saturation of blood oxygen and the rate of chylothorax after operation between two groups (P＞0.05).The symptoms and signs including cyanosis and breath were markedly alleviative in all patients.ConclusionBidirectional Glenn shunt without ECC is an effective and safe method for complicated CHD.

Objective:To explore the effect of perioperative nursing based on enhanced recovery after surgery (ERAS) in patients undergoing off-pump coronary artery bypass (OPCAB) .Methods:From January 2018 to February 2020, 200 OPCAB patients admitted to Affiliated Hospital of Jining Medical University were selected as research subjects using convenience sampling method. The 100 patients admitted from January 2018 to January 2019 served as the control group, while the 100 patients admitted from February 2019 to February 2020 served as the observation group. The control group received routine perioperative nursing, while the observation group received perioperative nursing based on the ERAS. The postoperative ventilator assistance time, Intensive Care Unit (ICU) stay time, anal exhaust time, off-bed time after surgery, and postoperative hospital stay time were compared.Results:The observation group had shorter postoperative ventilator assistance time, ICU stay time, anal exhaust time, off-bed time after surgery, and postoperative hospital stay time compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Perioperative nursing based on the ERAS can accelerate the postoperative recovery process of OPCAB patients, which is worthy of clinical promotion and practice.

Objective:To investigate the effects of different doses of rosuvastatin on blood lipid levels and 1-year outcomes in patients undergoing coronary artery bypass grafting.Methods:A total of 106 patients who underwent coronary artery bypass grafting at the Affiliated Hospital of Jining Medical University from February 2020 to February 2022 were prospectively selected and randomly divided into two groups using a random number table. The high-dose group (53 cases) was treated with 20 mg/d rosuvastatin, while the low-dose group (53 cases) was treated with 10 mg/d rosuvastatin. The two groups were compared after treatment in terms of the clinical efficacy, blood lipid levels [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], cardiac function indicators [left ventricular end diastolic diameter (LVDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF), one-year follow-up [recurrence, readmission, death, major adverse cardiovascular events (MACE)], and adverse reactions (liver injury, elevated creatine kinase, gastrointestinal reactions, rash).Results:The total effective rate of the high-dose group was 94.34%(50/53) higher than that of the low-dose group, which was 77.36%(41/53) ( P<0.05); After treatment, the levels of TC, TG, and LDL-C in both groups decreased, while the level of HDL-C increased (all P<0.05), and the levels of TC, TG, and LDL-C in the high-dose group were lower than those in the low-dose group, while the level of HDL-C was higher than that in the low-dose group (all P<0.05); After treatment, LVDD and LAD in both groups decreased, while LVEF increased (all P<0.05), and LVDD and LAD in the high-dose group were lower than those in the low-dose group, while LVEF was higher than that in the low-dose group (all P<0.05); After a one-year follow-up, the recurrence rate of the high-dose group was 7.55%(4/53), and the readmission rate was 5.66% (3/53), both lower than those of the low-dose group [26.42%(14/53), 20.75%(11/53)] (all P<0.05). There was no statistically significant difference in case fatality rate, MACE, and incidence of adverse reactions between the two groups (all P>0.05). Conclusions:The use of high-dose rosuvastatin in patients undergoing coronary artery bypass grafting can effectively reduce blood lipid levels, improve cardiac function, and has high safety. It is worthy of clinical application.