1.Impact mechanisms, assessment methods, and prevention and management of right heart failure associated with left ventricular assist devices
Kunsheng LI ; Yumeng WANG ; Lin MI ; Wenjie JI ; Yongqing CHENG ; Zhenjun XU ; Dongjin WANG ; Jun PAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1655-1663
Left ventricular assist device (LVAD) serves as a critical therapeutic option for patients with end-stage heart failure, significantly enhancing survival rates and quality of life. However, LVAD implantation exerts complex and profound effects on right ventricular (RV) function, with RV dysfunction emerging as a key factor influencing the prognosis of LVAD patients. This article systematically reviews the relationship between LVAD and RV function, exploring the importance of RV function in LVAD patients, assessment methods, underlying mechanisms of impact, and strategies for prevention and management. Comprehensive evidence suggests that preoperative evaluation of RV function is crucial for predicting the risk of RV dysfunction, while effective prevention and management rely on preoperative optimization, meticulous intraoperative techniques, rigorous postoperative monitoring, and multidisciplinary collaboration. Furthermore, this review discusses the potential and future directions of emerging technologies, such as improved LVAD designs, biventricular assist devices, gene therapy, and personalized medicine, in ameliorating RV dysfunction. In conclusion, RV function is one of the key determinants of successful LVAD therapy. Through comprehensive assessment, prevention, and management of RV function, coupled with the application of novel technologies, the clinical outcomes of LVAD patients can be further improved.
2.Castor stent implantation combined with subclavian artery bypass grafting for the treatment of aortic arch lesions
Shuchun LI ; Min JIN ; Qing ZHOU ; Dongjin WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(12):1733-1737
Objective To explore the short- and mid-term efficacy of Castor single branch aortic stent combined with subclavian artery bypass grafting for the aortic arch lesions. Methods A retrospective analysis of the clinical data of patients with proximal anchor zone insufficiency aortic arch lesions treated with Castor stent combined with subclavian artery bypass grafting at the Department of Cardiac Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from August 2020 to November 2023 was performed. Results A total of 22 patients were included, including 19 males and 3 females, with an average age of (56±16) years. There were 18 patients of aortic dissection and 4 patients of aortic arch tumors. The success rate of surgical technique was 100.0%, and the average postoperative hospital stay for patients was (10±4) days. The median follow-up time was 20 months. During the follow-up period, there were no major complications such as endoleak, paraplegia, cerebral infarction, and renal insufficiency, and all patients had no readmissions. Conclusion For proximal anchor zone insufficiency aortic arch lesions, the treatment method of using a Castor stent branch placed in the left common carotid artery can effectively extend the anchor zone, avoid the huge trauma of open chest surgery, and achieve a good short- and mid-term efficacy.
3.Literature study on traditional Chinese medicine syndrome type and syndrome element distribution of in vitro fertilization and embryo transfer failure
Siyi WU ; Guanmei ZHANG ; Dongjin LU ; Yixuan WANG ; Caifei DING ; Chenye WANG
China Modern Doctor 2025;63(14):22-25
Objective To analyze the clinical research literature of in vitro fertilization and embryo transfer(IVF-ET)failure,and summarize the traditional Chinese medicine(TCM)syndromes and syndrome elements,so as to provide theoretical basis for TCM syndrome differentiation and treatment of IVF-ET failure.Methods Using"in vitro fertilization and embryo transfer""IVF-ET"and"embryo transfer failure"as search terms,the literature related to TCM that had appeared in CNKI and Wanfang Data Knowledge Service Platform were searched since these database was constructed.After excluding irrelevant literature,statistical analysis was performed on the frequency and frequency of symptoms and signs.Results Kidney Yang deficiency,kidney deficiency,blood stasis,kidney Yin deficiency and liver qi stagnation were the common syndroms of failure.The disease location with high frequency of syndrome elements was kidney,and the disease was blood stasis.Conclusion Kidney-Yang deficiency syndrome is the most common type of failure,and TCM disease location syndrome is the most common in kidney.The disease deficiency is mostly Yang deficiency,and the excess is mostly blood stasis.
4.One-year outcomes of a novel domestic transcatheter aortic valve system in severe aortic stenosis: a multicenter cohort study
Yuehuan LI ; Jiawei ZHOU ; Lai WEI ; Yingqiang GUO ; Liang MA ; Huiming GUO ; Xiangbin PAN ; Dongjin WANG ; Fanyan LUO ; Jue WANG ; Minxin WEI ; Deguang FENG ; Yingbin XIAO ; Liming LIU ; Jian′an WANG ; Jiangang WANG ; Haibo ZHANG
Chinese Journal of Surgery 2025;63(11):1052-1058
Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.
5.Effects of light color on serum reproductive hormones and reproductive perform-ance of Fujian white rabbits
Dongjin CHEN ; Shikun SUN ; Lei SANG ; Chengfang GAO ; Jinxiang WANG ; Jie ZHANG ; Ming LIU ; Xiping XIE
Chinese Journal of Veterinary Science 2025;45(8):1776-1783
Healthy female rabbits aged 3.5 to 4.0 months were randomly divided into four groups:the white light group(control group A),the green light group(treatment group B),the red light group(treatment group C)and the blue light group(treatment group D)with 3 replicates in each group,and 12 rabbits in each replicate.The light intensity was set to 80 lx,and the light was 16 h per day for 6 days before artificial insemination.Three reproductive cycles were carried out to de-termine the reproductive performance of female rabbits under different light colors,such as the number of fetuses,total litter size,weaning litter weight and serum reproductive hormone content.The results showed that,according to the comprehensive statistics of three breeding cycles:(1)the melatonin levels in the green group and red group were significantly lower than those in white group(P<0.01),and the green group was significantly lower than the blue group(P<0.05);the levels of luteinizing hormone in green group and red group were significantly higher than those in white group(P<0.01);the follicle stimulating hormone in the green group was significantly high-er than in white group(P<0.05);the estradiol content in the green group was significantly higher than that in the white group and blue group(P<0.01),and significantly higher than that in the red group(P<0.05).(2)the conception rate of the group was significantly higher than that of the white group(P<0.01),and significantly higher than that of the red group and blue group(P<0.05).(3)the number of rabbits in the green group at 30 days of age was significantly higher than that in the red group and the blue group(P<0.05),and the litter weight at 30 days of age was significantly higher than that in the red group and the blue group(P<0.01),and significantly higher than that in the white group(P<0.05).In conclusion,the LED light belt is controlled by a dynamic light control system,the light intensity is set to 80 lx,and the light is 16 h a day for 6 d before artificial insemination.Green light can reduce the serum melatonin of Fujian white rabbits,which has the best comprehensive effect on the same period of conception rate and reproductive performance of Fujian white rabbits.
6.Effects of light color on serum reproductive hormones and reproductive perform-ance of Fujian white rabbits
Dongjin CHEN ; Shikun SUN ; Lei SANG ; Chengfang GAO ; Jinxiang WANG ; Jie ZHANG ; Ming LIU ; Xiping XIE
Chinese Journal of Veterinary Science 2025;45(8):1776-1783
Healthy female rabbits aged 3.5 to 4.0 months were randomly divided into four groups:the white light group(control group A),the green light group(treatment group B),the red light group(treatment group C)and the blue light group(treatment group D)with 3 replicates in each group,and 12 rabbits in each replicate.The light intensity was set to 80 lx,and the light was 16 h per day for 6 days before artificial insemination.Three reproductive cycles were carried out to de-termine the reproductive performance of female rabbits under different light colors,such as the number of fetuses,total litter size,weaning litter weight and serum reproductive hormone content.The results showed that,according to the comprehensive statistics of three breeding cycles:(1)the melatonin levels in the green group and red group were significantly lower than those in white group(P<0.01),and the green group was significantly lower than the blue group(P<0.05);the levels of luteinizing hormone in green group and red group were significantly higher than those in white group(P<0.01);the follicle stimulating hormone in the green group was significantly high-er than in white group(P<0.05);the estradiol content in the green group was significantly higher than that in the white group and blue group(P<0.01),and significantly higher than that in the red group(P<0.05).(2)the conception rate of the group was significantly higher than that of the white group(P<0.01),and significantly higher than that of the red group and blue group(P<0.05).(3)the number of rabbits in the green group at 30 days of age was significantly higher than that in the red group and the blue group(P<0.05),and the litter weight at 30 days of age was significantly higher than that in the red group and the blue group(P<0.01),and significantly higher than that in the white group(P<0.05).In conclusion,the LED light belt is controlled by a dynamic light control system,the light intensity is set to 80 lx,and the light is 16 h a day for 6 d before artificial insemination.Green light can reduce the serum melatonin of Fujian white rabbits,which has the best comprehensive effect on the same period of conception rate and reproductive performance of Fujian white rabbits.
7.Literature study on traditional Chinese medicine syndrome type and syndrome element distribution of in vitro fertilization and embryo transfer failure
Siyi WU ; Guanmei ZHANG ; Dongjin LU ; Yixuan WANG ; Caifei DING ; Chenye WANG
China Modern Doctor 2025;63(14):22-25
Objective To analyze the clinical research literature of in vitro fertilization and embryo transfer(IVF-ET)failure,and summarize the traditional Chinese medicine(TCM)syndromes and syndrome elements,so as to provide theoretical basis for TCM syndrome differentiation and treatment of IVF-ET failure.Methods Using"in vitro fertilization and embryo transfer""IVF-ET"and"embryo transfer failure"as search terms,the literature related to TCM that had appeared in CNKI and Wanfang Data Knowledge Service Platform were searched since these database was constructed.After excluding irrelevant literature,statistical analysis was performed on the frequency and frequency of symptoms and signs.Results Kidney Yang deficiency,kidney deficiency,blood stasis,kidney Yin deficiency and liver qi stagnation were the common syndroms of failure.The disease location with high frequency of syndrome elements was kidney,and the disease was blood stasis.Conclusion Kidney-Yang deficiency syndrome is the most common type of failure,and TCM disease location syndrome is the most common in kidney.The disease deficiency is mostly Yang deficiency,and the excess is mostly blood stasis.
8.One-year outcomes of a novel domestic transcatheter aortic valve system in severe aortic stenosis: a multicenter cohort study
Yuehuan LI ; Jiawei ZHOU ; Lai WEI ; Yingqiang GUO ; Liang MA ; Huiming GUO ; Xiangbin PAN ; Dongjin WANG ; Fanyan LUO ; Jue WANG ; Minxin WEI ; Deguang FENG ; Yingbin XIAO ; Liming LIU ; Jian′an WANG ; Jiangang WANG ; Haibo ZHANG
Chinese Journal of Surgery 2025;63(11):1052-1058
Objective:To examine the safety and effectiveness of a novel domestic transcatheter aortic valve system in addressing severe aortic valve stenosis.Methods:This prospective, multicenter, single-arm target-value clinical trial enrolled patients with severe aortic stenosis meeting inclusion criteria from 13 Chinese centers between July 2021 and April 2022. The primary endpoint was all-cause mortality at 1-year post-procedure. Secondary endpoints included safety outcomes (30-day all-cause mortality, 1-year major adverse cardiovascular events, device success) and efficacy parameters (transvalvular pressure gradient, paravalvular leak severity, New York Heart Association(NYHA)class improvement, and quality of life). Survival analysis was performed using the Kaplan-Meier analysis.Results:The study included 134 patients, 85 males and 49 females, with an age of (73.6±5.6)years (range: 65.1 to 91.8 years). Bicuspid aortic valve morphology was present in 59.7% (80/134). Device success rate was 99.3%, with one case converted to open surgery due to coronary obstruction. All-cause mortality was 0.8% (95% CI: 0.1% to 5.3%) at both 30-day and 1-year follow-up, significantly lower than the 25% target value ( P<0.01). Permanent pacemaker implantation rates remained 2.2% (3/134) at both timepoints. Stroke incidence was 0.7% (1/134) at 30 days and 1.5% (2/134) at 1 year. Myocardial infarction rates were 0.7% (1/134) at both intervals. The postoperative transvalvular pressure gradient of the aortic valve was (6.6±3.1) mmHg(1 mmHg=0.133 kPa) (range: 4 to 8 mmHg). Among the patients, 32 cases (23.9%) had mild paravalvular leakage, 4 cases (3.0%) had moderate paravalvular leakage, and no severe paravalvular leakage was observed. NYHA class Ⅰ and Ⅱ patients increased from 18.7% preoperatively to 99.3% postoperatively. Conclusion:The novel domestic transcatheter aortic valve system demonstrates satisfactory 1-year safety and efficacy outcomes in treating severe aortic stenosis.
9.Current state and progress of left subclavian artery revascularization in thoracic endovascular aortic repair
Wei XIE ; Xichun QIN ; Shuchun LI ; Min JIN ; Qing ZHOU ; Dongjin WANG ; Yunxing XUE
International Journal of Surgery 2022;49(7):499-504
Thoracic endovascular aortic repair has served as the predominant treatment approach for patients with thoracic aortic diseases. In order to ensure the successful release of the stent as well as a good proximal anchoring effect, it is necessary to preserve or reconstruct the left subclavian supply as much as possible. With the advance of various endovascular assistive technologies, different left subclavian artery revascularization techniques have gained widespread acceptance. So far, techniques include carotid-subclavian bypass or transposition, chimney grafts, fenestrations, branched aortic devices can reconstruct the left subclavian artery and other branch vessels on the arch. This article reviewed the present situation of left subclavian artery reconstruction and the selection of surgical methods of thoracic endovascular aortic repair.
10.The risk factors for and outcomes of preoperative hepatic dysfunction in patients who received surgical repair for acute DeBakey type I aortic dissection
Zhigang WANG ; Min GE ; Tao CHEN ; Cheng CHEN ; Lichong LU ; Dongjin WANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2022;38(4):230-234
Objective:To identify the risk factors for and outcomes of preoperative hepatic dysfunction (HD) in patients who underwent surgery for the treatment of acute DeBakey type I aortic dissection (ADIAD).Methods:A retrospective study including 810 consecutive patients between January 2014 and December 2019 in Nanjing Drum Tower Hospital was performed with emergency surgical repair. All patients were divided into non-HD and HD groups according to the Model of End-Stage Liver Disease (MELD) score before surgery and their clinical parameters and clinical outcomes were collected and compared. To determine independent predictors of preoperative HD, multivariate logistic regression analyses were performed using variables with P<0.5 in the univariate analyses. Kaplan-Meier survival analyses were conducted to analyze the association between preoperative HD and postoperative long-term survival. Results:The mean age of the patients was (52.4±12.5) years. 215 patients (26.5%) were identified as the preoperative HD group. In univariate analysis, significant difference was found with respect to the postoperative complications (98.6% vs. 94.5%, P=0.011) and 30-day mortality (20.0% vs. 8.4%, P<0.001) between the two groups. Multivariate logistic analysis showed that elevated serum troponin T levels upon admission( OR=1.921, P<0.001) and preoperative cardiac tamponade ( OR=2.158, P=0.002) were independent risk factors for preoperative HD. The long-term mortality rate was not significantly affected by preoperative HD. Conclusion:Early HD before surgery was commonly observed in patients with ADIAD and was associated with increased postoperative complications and 30-Day mortality. Elevated serum troponin T levels upon admission and preoperative cardiac tamponade were identified as risk factors for preoperative HD.

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