Objective To investigate the short-term efficacy and safety through analyzing the results of 11 cases of video assisted minimally invasive cardiac surgery. Methods Eleven patients who had underwent video assisted minimally invasive cardiac surgery in the second hospital of Anhui medical university from November 2017 to August 2018 were retrospectively analyzed. One patient underwent simple atrial septal defect repair, 6 patients underwent atrial septal defect repair+tricuspid valve repair, 3 patients underwent mitral valve replacement, and 1 patient underwent mitral valve repair + tricuspid valve repair. Results All patients underwent video cardiac surgery without death, with no major bleeding (need secondary thoracotomy to stop bleeding) and no neurological complications. One patient of incision fat liquefaction healed after dressing change. One patient developed lower limb artery stenosis, which was treated conservatively and discharged after hospitalization. Conclusions Video assisted minimally invasive cardiac surgery can be safely applied to simple congenital heart disease and valve surgery as long as patients are strictly screened. Due to the advantages of small trauma, less bleeding, and quick recovery, it is worth promoting.

Objective To observe the recent clinical effect of application of individual open fenestrated stent graft in type A aortic dissection without developing the greater curve of the arch. Method From December 2014 to November 2016,15 patients of type A aortic dissection without developing the greater curve of the arch un-derwent endovascular total arch replacement using individual open fenestrated stent graft in the Anhui Province Hospital.Among them,8 cases were only operated with open fenestrated stent graft in aortic arch, 7 cases with open fenestrated stent graft in aortic arch added 1 or 2 small stent graft.Result There was 1 postoperative death caused by severe low cardiac output. The rest of the patients were successfully discharged from the hospital, without ner-vous system and related complications. Follow-up computerized tomographic angiography showed all implanted stents were wide expansion and in a good position. No endoleaks and thrombus obliterated of the corresponding false lumen was found. Conclusion Individual open fenestrated stent graft is suitable for type A aortic dissection without developed the greater curve of the arch.Its significantly simplify the total arch replacement operation steps, reduce anastomotic and shorten the lower body arrest time. Consequently, reduce the risk of operation difficulty, postoperative blood loss and other viscera damage probability significantly. The early and middle term clinical re-sults is satisfactory.

Objective:To observe influence of exercise rehabilitation combined diet guidance on cardiac function and quality of life (QOL) in patients after heart valve replacement .Methods:A total of 120 patients after heart valve replacement were selected and randomly divided into control group (n=60 ,received routine health education ) and experiment group (n=60 ,received diet guidance and exercise rehabilitation based on routine health education ) .After discharge ,patients re‐ceived outpatient follow‐up for six months ,body weight ,cardiac function and QOL on six months after surgery were fol‐lowed up and observed in two groups ,and the results were statistically compared .Results:Compared with control group six months after discharge ,there were significant rise in left ventricular ejection fraction [ (51.75 ± 9.30)% vs .(57.73 ± 6.13)% ] andoxygenmetabolicequivalent [(7.05±1.85)METsvs.(11.34±2.18)METs],andeachitemscoreofQOL and total score of QOL [ (4.98 ± 0.40) scores vs .(6.49 ± 0.53) scores] ,P<0.05 or <0.01;and significant reduction in body weight [(67.75 ± 10.67) kg vs .(61.25 ± 10.34) kg] in experiment group ,P<0.01. Conclusion:Exercise rehabili‐tation combined diet guidance can avoid rapid increase in body weight after surgery ,promote recovery of cardiac function and improve quality of life after surgery in patients with heart valvular diseases .

To explore the feasibility of rapid proto-typing ( RP) technology in the treatment of Standford type A aortic dissection. 5 patients with Standford type A aortic dissection received computed tomography angiography (CTA) of their aortas. The CTA images were then processed by 3D reconstruction with MIMICS16. 0 in order to create aortic dissection models through RP technology based on real patient aorta size with a ratio of 1 ∶ 1 . Accord-ing to these models, the surgeons were able to fully understand the aortic diseases of patients, thus establish indi-vidualized treatment strategies for each patient. Besides, the surgeons simulated operations on the models, which helped them achieve better results in real surgery. These patients experienced no post-operative complications and were discharged from hospital with recovery. In conclusion, RP technology can provide adequate preoperotive prep-arations for patients with Standford type A aortic dissection, improve operation efficiency and accuracy in aortic dis-section and guide precise proximal anchoring of stents during intracavitary therapy.

Objective To summarize and analyze clinical diagnosis and surgical treatment methods of 11 cases with congenital coronary arterial fistula (CCAF). Methods The clinical data of 11 patients who were definited by ultrasonic cardiogram, CT angiography (CTA) and coronary angiography were analyzed retrospectively. Four cases were simple CCAF, 7 cases coexisted with other heart abnormalities. Six cases were given surgical closure of fistula without cardiopulmonary bypass. One of the cases adopted coronary artery under the tangent cotton-padded mattress suture, and 4 cases fistula arterial were ligatured directly. Six cases were given surgical closure of fistula under cardiopulmonary bypass. The right coronary arterial was opened in three of the cases with right coronary artery aneurysm to close fistula. The chambers of heart in the others were opened to close fistula. Results All patients received surgical treatment successfully, and no death happened during the operation. The ultrasonic cardiography showed that all patients recovered well. Follow-up was conducted on 10 patients with the time period ranging from 3 months to 5 years. There was no death and no complication. Conclusions Combined application of ultrasonic cardiogram, coronary angiography and CTA increases the accuracy rate of diagnosis greatly and offers visual bases to formulate operation plan. Surgical operation is quite effective for congenital coronary arterial fistula after definite diagnosis. Operator should try to reserve the expanded coronary arterial, strengthen the anticoagulant after opeation to prevent thrombosis.

BACKGROUND:A new type of nano-hydroxyapatite artificial mechanical heart valve has been developed using pulsed laser deposition technology at the Department of Materials, Hefei University and Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, China. OBJECTIVE:To investigate the compatibility of nano-hydroxyapatite artificial mechanical heart valve with human umbilical vein endothelial cels. METHODS:Human umbilical vein endothelial cels were in vitroisolated, cultured and passaged to the 2-4 generations, and then the cel suspension was inoculated onto the nano-hydroxyapatite artificial mechanical heart valve. After 3, 7, 12 days of culture, the cel growth on the artificial mechanical heart valve was observed under scanning electron microscope. In addition, the human umbilical vein endothelial cels were respectively cultured in room-temperature and high-temperature extract liquids of nano-hydroxyapatite artificial mechanical heart valve, high-density polyethylene and phenol solution extracts for 72 hours, and then, the proliferation of cels was detected by MTT method. RESULTS AND CONCLUSION:Under the scanning electron microscope, the human umbilical vein endothelial cels were fusiform- or polygon-shaped with protuberances adhered to the artificial mechanical heart value at 3 days of culture; the cels were stretched thoroughly and fused at 7 days of culture; and the cels were confluent to pieces that tightly overlaid the heart valve surface and the extracelular matrix was formed localy at 21 days of culture. Results from MTT test displayed that the nano-hydroxyapatite artificial mechanical heart valve had no cytotoxicity to the human umbilical vein endothelial cels, indicating a good cytocompatibility.

Objective To summarize the individualized cavity Single branch stent grafting through rebuilding the aortic arch surgery in 26 cases of the application of the Stanford type A aortic dissection. Methods From 2010 January to 2014 October, 26 patients received Stanford type A aortic dissection surgery, 26 patients received individualized cavity single branch stent grafting to rebuild the aortic arch surgery , together with improved myocardial protection fluid. Results In the present study, 26 cases with aortic dissection that were treated with single branch stent grafting for the reconstruction of aortic arch under DHCA and selective cerebral perfusion. Twenty-six patients received individualized cavity single branch stent grafting reconstruction of aortic arch surgery alone, and were stopped by using deep cryogenic loop (DHCA) plus selective cerebral perfusion surgical treatment. One patient suffered from permanent nerve dysfunction iand give up treatment. Conclusion The sexua branch stent grafting in reconstruction of aortic arch operation could simplify the operation procedures , shorten the operation time, and reduce the amount of blood transfusion and postoperative drainage.

BACKGROUND:Pulsed laser deposition synthesis technology has been used to prepare new nano-hydroxyapatite thin film coating by colagen deposition on artificial mechanical heart valve. OBJECTIVE: To investigate the toxicity of new nano-hydroxyapatite thin film on human umbilical vein endothelial cels. METHODS: Human umbilical vein endothelial cels were cultured with nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene and phenol solution. Within 72 hours, cel growth was observed under the inverted phase contrast microscope. At 7 days after culture, cel proliferation and toxicity grading were detected using Cel Counting Kit-8. RESULTS AND CONCLUSION:At 24 hours after culture, cels grew wel, showed fusiform shape, and had strongrefraction in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene groups, and no significant differences in cel morphology and number were detected among above groups. Cels in the phenol solution group were suspended, round, pyknotic and dead. At 48 hours, except phenol solution group, cel number increased significantly, and cel grew densely in other three groups. At 72 hours, cels grew strongly, and the gap became smal obviously. Within 7 days after culture, cel proliferation activity was not significant in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, and high-density polyethylene groups, which was significantly higher than in the phenol solution group (P < 0.05). The toxicity of nano-hydroxyapatite film graded 0 to 1. These results suggested that nano-hydroxyapatite artificial mechanical heart valve has good histocompatibility, but no toxicity.

Objective To investigate the activity of autologous pericardial patch treated by distilled water in right ventricular outflow tract reconstruction of tetralogy of fallot,and to evaluate its clinical effect. Methods The study used 125 patients who had applied correction surgery of tetralogy of fallot and autologous pericardial patch treated by distilled water in the right ventricular outflow reconstruction. 39 cases used fresh autologous pericardial patches,and 86 cases used autologous valved pericardial patch. The degree of insufficiency and activity of the pulmonary valve were compared. Results The mean follow-up time was ( 63 ± 8 ) months in fresh autologous pericardial patches group, while (55 ± 7) months in valved patch group. No significant difference was found in age, body surface area, heart rate, pulmonary artery diameter, cardiopulmonary bypass time and priming volume postoperative between the two groups. The exacerbations of pulmonary valve insufficiency and activity in fresh autologous pericardial patches group were significantly higher than in valved patch group. Conclusion Autologous pericardial patch treated by distilled water was beneficial in right ventricular outflow tract reconstruction of tetralogy of fallot. It reduced pulmo-nary valve insufficiency and sclerosis after the correction surgery and showed good mid-term clinical results .

OBJECTIVETo compare the clinical efficacy between total aortic arch reconstruction with a individualized combined branched stent grafting technique and total aortic arch replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection.

METHODSTotally 44 patients with Stanford A aortic dissection treated with surgical treatment from January 2007 to July 2013 were included in this study. The patients were divided into two groups. Group A (n = 22) patients were treated by total arch replacement with stented elephant trunk procedure. Group B (n = 22) patients received individualized combined branched stent grafting technique. Age, gender and disease severity were similar between the two groups (all P > 0.05). Echocardiography and aortic CT angiography were performed pre-operation and at 1 month after operation.

RESULTSOperation was successful in all 44 patients. Cardiopulmonary bypass time, aortic cross clamp time, circulation arrest time and duration of ventilator assisted breathing were significantly longer, postoperative drainage volume and blood transfusion volume were significantly larger and hospitalization cost was significantly higher in group A patients compared those in group B patients (t = 2.791 to 43.465, all P < 0.05). One month after operation, the maximum internal diameter of aorta was smaller than pre-operation in both group A ((33 ± 1) mm vs. (45 ± 6) mm, t = 10.076, P = 0.000) and group B ((33 ± 2) mm vs. (45 ± 8) mm, t = 5.979, P = 0.000) . Left ventricular ejection fraction had no significant difference before and 1 month after operation in both groups (P > 0.05).

CONCLUSIONThe total aortic arch reconstruction with individualized combined branched stent grafting technique is technically easier, shortens the operation time, reduces the blood transfusion volume compared to the classical aortic arch operation.

Adult ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome