1.Clinical efficacy of minimally invasive coronary artery bypass grafting via left intercostal small incision for multivessel coronary artery disease: A retrospective cohort study
Zeyuan ZHAO ; Zhihua WANG ; Sheng WANG ; Xianjie CHEN ; Zhao LI ; Guoqing LU ; Zhenchang QI ; Zhaoyun CHENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(10):1455-1461
Objective To investigate the early clinical efficacy of minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) via left intercostal small incision for multivessel coronary artery disease. Methods The patients who received off-pump CABG in the Central China Fuwai Hospital of Zhengzhou University from June 2021 to June 2023 were enrolled. Patients were divided into two groups according to the operative technique used, including a traditional midline sternotomy group and a left intercostal small incision group. The clinical data of the two groups were compared. Results A total of 143 patients were enrolled, including 70 patients in the traditional midline sternotomy group and 73 patients in the left intercostal small incision group. The age of the patients in the left intercostal small incision group and the traditional midline sternotomy group was (63.8±8.0) years and (63.0±7.8) years, respectively; the proportions of males were 69.9% and 74.3%, respectively. The differences were not statistically significant (all P>0.05). All patients in the two groups successfully completed the operation, and no patients in the left intercostal small incision group were converted to thoracotomy. The patients in the left intercostal small incision group showed less postoperative drainage within postoperative 24 hours [(239.4±177.7) mL vs. (338.0±151.9) mL, P<0.001], lower perioperative blood transfusion rate [32.9% (24/73) vs. 51.4% (36/70), P=0.028], higher postoperative myoglobin level within postoperative 24 hours [366.1 (247.9, 513.0) ng/mL vs. 220.8 (147.2, 314.9) ng/mL, P<0.001], shorter intensive care unit stay [45.5 (31.5, 67.5) h vs. 68.0 (46.0, 78.5) h, P=0.001] and postoperative hospital stay [(10.8±4.0) d vs. (13.1±5.3) d, P=0.028] compared to the traditional midline sternotomy group. There was no significant difference in the incidence of major adverse cardiac and cerebrovascular event between the two groups [2.7% (2/73) vs. 2.9% (2/70), P=1.000]. Conclusion Compared to the full median sternotomy, MICS CABG leads to a good clinical result with smaller trauma, faster overall recovery, and less perioperative blood transfusion.
2.Clinical outcomes of right anterior mini-thoracotomy aortic valve surgery: A propensity score matching study
Zeyuan ZHAO ; Chenyi CUI ; Jiahui LI ; Xianjie CHEN ; Zhao LI ; Zhenchang QI ; Sheng WANG ; Zhaoyun CHENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(12):1747-1753
Objective To compare perioperative outcomes of minimally invasive aortic valve surgery by a right anterior minithoracotomy (RAMT) and conventional sternotomy. Methods A retrospective analysis of patients who underwent isolated aortic valve surgeries in Central China Fuwai Hospital of Zhengzhou University between May 2021 and August 2023 with a minimal incision via the RAMT approach (a RAMT group) or conventional incision via the full sternotomy approach (a conventional group). A propensity score matching analysis was performed to balance preoperative data and compare perioperative data of the two groups. Results There were 58 patients in the RAMT group, including 46 males and 12 females with an average age of (52.0±14.1) years; 128 patients were enrolled in the conventional group, including 87 males and 41 females with an average age of (60.0±12.4) years. After propensity-score matching, there were 51 patients in each group. The RAMT group had a longer average operation time, cross-clamping time and cardiopulmonary bypass time compared to the conventional group (all P<0.05). However, ICU length of stay, ventilator-assisted time and postoperative hospital stay were significantly shorter in the RAMT group (all P<0.05). Patients in the RAMT group had lower 24 hour chest drain output (P<0.05). RAMT was associated with a trend towards a lower blood transfusion rate in comparison to the sternotomy group, although this was not statistically significant (P>0.05). The occurrence of all-cause death, and perioperative complications was also similar in both groups (P>0.05). Conclusion RAMT has less trauma, faster recovery, less postoperative drainage, and shorter hospital stay than conventional approach. RAMT in patients undergoing isolated aortic valve surgery is a safe approach.
3.Early and long-term outcomes after left-side heart valve replacement and tricuspid valve replacement in rheumatic patients
Xiliang ZHU ; Zhaoyun CHENG ; Sheng WANG ; Xianjie CHEN ; Guoqing LU
Chinese Journal of Thoracic and Cardiovascular Surgery 2022;38(6):327-331
Objective:To evaluate and compare the early and long-term outcomes of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement, and analyze the difference of early mortality and long-term survival rate between mild pulmonary artery systolic pressure (PASP) and moderate to severe PASP patients.Methods:From January 2009 to December 2018, 79 cases of patients were reviewed and summarized. The mean age before operation was (45.7±7.8) years old. These patients were divided into mild PASP group(<50 mmHg, 38 cases) (1 mmHg=0.133 kPa) and moderate-severe PASP group (>50 mmHg, 41 cases) . Kaplan- Meier method was used to estimate the overall long-term survival rate and the incidence of complications, and to compare the long-term survival rate of patients with mild and moderate -severe PASP elevation. Results:The mortality rate of early postoperative patients was 8.9% (7/79). The causes of death included: low cardiac output syndrome in 3 cases, multiple organ failure caused by pulmonary infection in 2 cases, acute renal insufficiency in 1 case, sudden cardiac arrest in 1 case. Although the mortality rate of early moderate-severe PASP group (12.2% vs. 5.3%) was higher than that of mild PASP group, there was no significant difference ( P>0.05). The mean follow-up time was (51.8±31.7) months (3-115 months). Kaplan- Meier method was used to estimate the 10-year survival rate, the rate of avoiding thrombosis, the rate of avoiding serious bleeding event and the rate of avoiding reoperation, which were (67.2±10.6)%, (85.7±6.2)%, (83.4± 6.9)% and (93.7 ± 3.7)%, respectively. Although the long-term survival rate of mild PASP (78.0±10.6) % was higher than that of moderate-severe PASP (62.8 ± 13.4) %, there was no significant difference ( P>0.05). Conclusion:The early mortality rate of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement is still relatively high. The recurrent heart failure is the major causes of long-term death.
4.Biological healing mechanism of magnetic porous Ca3 (PO4) 2: an experimental study
Zhaohui LOU ; Xianjie DONG ; Anmin CHEN ; Zhengcai XIA ; Shuzhen SUN ; Tao CHENG
Chinese Journal of Trauma 2011;27(7):659-662
Objective To study the causes and theoretical basis for good bone healing ability of magnetic Porous Ca3 (PO4) 2 ( MPTCP). Methods Seven MPTCP specimens with size of 2 cm × 1 cm × 0.5 cm were placed in the material physical system for detecting 42 times and the mean detection value was used to measure the MPTCP curve. The attachment 16451B of impedance spectrometer HP RLC was employed to measure dielectric spectroscopy and dielectric spectroscopy of MPTCP. Four-wire method was used to measure the impedance of MPTCP. Results The magnetic intensity changed rapidly when magnetic field was in a range of-10,000-10,000 Oe. The peak of dielectric spectroscopy and impedance of magnetic bioceramics was in the range of 103-104 Hz. When the external electromagnetic wave of frequency was ≤ 1 000 Hz, electrical impedance of MPTCP was large;while when the electromagnetic wave frequency was≥1 000 Hz, the impedance was relatively small and stable. Conclusion The environmental magnetic fields may change the magnetic and electric behavior of MPTCP and promote the biological healing, which may be the cause for the good bone healing ability of MPTCP.
5.Treating superficial hemangioma in children according to local blood flow.
Ranglang HUANG ; Wanpin NIE ; Xianjie CHENG ; Mingzhi XIA ; Rong XIAO
Journal of Central South University(Medical Sciences) 2010;35(8):892-895
OBJECTIVE:
To treat superficial hemangioma in children according to the local blood flow.
METHODS:
A total of 98 children with superficial hemangiomas admitted to our hospital from January 2005 to June 2009, and their clinical data were analyzed.
RESULTS:
According to the local blood flow velocity, 98 children were treated with injections or injection plus surgical treatment, respectively. Ninety-four children (95.9%) were cured.
CONCLUSION
Injection therapy is effective for children with superficial hemangioma, but we should arrange individualized treatment according to the local blood flow in children.
Adolescent
;
Bleomycin
;
administration & dosage
;
analogs & derivatives
;
Child
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Child, Preschool
;
Female
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Glucocorticoids
;
administration & dosage
;
Hemangioma
;
blood supply
;
therapy
;
Humans
;
Infant
;
Injections, Intralesional
;
Male
;
Regional Blood Flow
;
Skin Neoplasms
;
blood supply
;
therapy

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