The minimally invasive cardiovascular surgery developed rapidly in last decades. In order to promote the development of minimally invasive cardiovascular surgery in China, the Chinese Minimally Invasive Cardiovascular Surgery Committee (CMICS) has gradually standardized the collection and report of the data of Chinese minimally invasive cardiovascular surgery since its establishment. The total operation volume of minimally invasive cardiovascular surgery in China has achieved substantial growth with a remarkable popularization of concepts of minimally invasive medicine in 2019. The data of Chinese minimally invasive cardiovascular surgery in 2019 was reported as a paper for the first time, which may provide reference to cardiovascular surgeons and related professionals.

Objective    To analyze the clinical efficacy of totally thoracoscopic surgery and conventional thoracotomy in repair of ventricular septal defect (VSD). Methods    We retrospectively reviewed the clinical data of 50 VSD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2017. According to the surgical pattern, they were divided into two groups: a totally thoracoscopic surgery group (21 patients, 13 males, 8 females, aged 38.36±10.02 years), and a thoracotomy group (29 patients, 18 males, 11 females, aged 42.36±13.02 years). The operation time, hospital stay, ventilator-assisted time and thoracic drainage were compared between the two groups. Results    There was no death in two groups. In the thoracoscopic group the duration of cardiopulmonary bypass (CPB) time and the aortic clamping time were longer than those of the thoracotomy group (P<0.05), but postoperative drainage, patients with postoperative use of blood products and postoperative hospital stay were less (P<0.05). There was no statistically significant difference between the two groups in operation time, postoperative ventilator-assisted time or duration of ICU stay. Conclusion     Compared with the conventional thoracotomy, totally thoracoscopic VSD repair with less trauma, quicker recovery and less blood use, is safe and reliable and can be used as a preferred surgical intervention.

Objective To compare the clinical effects of totally thoracoscopic surgery and conventional median thoracoto my surgery in the repair of atrial septal defect(ASD),so as to provide reference for the clinical choice of atrial septal defect repair.Methods 131 patients with ASD from January 2015 to November 2016 in the First Affiliated Hospital of Xinjiang Medical University were divided into two groups according to operation type:totally thoracoscopic group(58 cases),median thoracotomy group.The differences in operative time,cardiopulmonary bypass time(CPB),ventilator assist time,ICU stay time,postoperative hospital stay and other aspects were compared.Results There was no death and no serious complication in the two groups.There was no statistical difference between the two groups (P ＞ 0.05) in sex,weight,age,right atrial size and cardiac function.The time of thoracoscopic surgery [(3.6 ± 1.0) h vs.(2.6 ± 0.6) h] and the duration of CPB [(98.3 ± 35.8)min vs.(32.3 ± 16.1) min] were longer than those of median thoracotomy group (P ＜ 0.05).There was no statistical difference between two groups in the time of mechanical ventilation,ICU stay,postoperative drainage and postoperative hospital stay (P ＞ 0.05).Conclusion Although ASD repair of thoracoscopic surgery is difficult and the learning curve is long,but it can be said that the totally thoracoscopic ASD repair can achieve the same results as conventional median thoracotomy does,and it is effective and safe,and thoracoscopic surgery also has less trauma and cosmetic appearance,no bone structure damage,worthy of clinical promotion.

Minimally invasive surgery has become the guiding principle of the entire surgical treatment.In last 16 years,totally thoracoscopic cardiac surgery(TTCS)has developed rapidly,and achieved good results.However,there are obvious differences between the basic surgical techniques of TTCS and of conventional cardiac surgery.At present,there is still lack of standard and in sufficient evidence in the surgical techniques of TTCS.It requires professional and standardized training and evidence-based research on TTCS,including indication selection and procedure standardization,to improve the therapy level of TTCS further.

Minimally invasive surgery has become the guiding principle of the entire surgical treatment.In last 16 years,totally thoracoscopic cardiac surgery(TTCS)has developed rapidly,and achieved good results.However,there are obvious differences between the basic surgical techniques of TTCS and of conventional cardiac surgery.At present,there is still lack of standard and in sufficient evidence in the surgical techniques of TTCS.It requires professional and standardized training and evidence-based research on TTCS,including indication selection and procedure standardization,to improve the therapy level of TTCS further.

ObjectiveTo Summarize the experience of totally thoracoscopic operation for atrial myxoma.Methods From December 2007 to November 2011,44 patients with atrial myxoma,including 37 cases of Left atrial myxoma,6 cases of Right atrial myxoma,1 case of double atrial myxoma were treated totally under thoracoscope.Surgical procedures were performed through 3 troears inserted at the right chest wall,and catheters were placed in the right femoral artery and vein (or in the right atrium,femoral vein)to set up extracorporeal circulation.The ascending aorta was cross-clamped with long tailor-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid (blood) cardioplegia.ResultsAll the operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were (49 ± 18 )min and (28 ± 10) min respectively.Postoperative ventilation was withdrawn in(3.8 ± 1.4) h,and the patients were discharged from the hospital in (6.8 ± 1.3 ) d.3 of the patients had postoperative complications,including 1 case of fat liquefaction of the incision at the right groin ( delayed healing),2 cases of subcutaneous emphysema ( healed by bandaged chest).No severe complications occurred in this series.UCG performed 3 - 5 days after the operation revealed surgical results were satisfactory.Followup up to 2 months to 4 years were available in all cases.During the period,the heart function was confirmed as level Ⅰ.ConclusionVideo-assisted thoraeoseopie cardiac surgery is feasible,safe,and minimal invasive for patients,resulting in quick recovery and good cosmetic outcomes.

ObjectiveTo summarize the experience of totally thoracoscopic operation for congenital heart diseases.MethodsFrom September 2000 to November 2011,1281 patients with congenital heart disease,including 1016 cases of atrial septal defect,110 cases of ventricular septal defect,61 cases of atrioventricular tube defects,33 cases of tetralogy of Fallot,24 cases of part anomalous pulmonary venous connection,12 cases of pulmonary valve stenosis,9 cases of patent ductus arteriosus,8 case of triatriatum,7 cases of unroofed coronary sinus syndrome,and 1 case of total anomalous pulmonary venous connection were treated totally under thoracoscope.Surgical procedures were performed through 3 troears inserted at the right chest wall,and catheters were placed in the right femoral artery and vein ( or in the right atrium,femoral vein) to set up extracorporeal circulation.The ascending aorta was cross-clamped with long tailor-made forceps and the myocardium was protected by coronary perfusion with cold crystalloid (blood) cardioplegia.ResultsAll the operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were ( 42 ± 16 ) min and ( 21 ± 9 ) min respectively.Postoperative ventilation was withdrawn in(4.1 ± 1.5 ) h,and the patients were discharged from the hospital in(7.1 ± 1.4) d.35 of the patients had postoperative complications,including 16 cases of right pneumothorax (healed by thoracentesis),12 cases of subcutaneous emphysema ( healed by bandaged chest) and 7 cases of fat liquefaction of the incision at the right axillary( 3 cases) and groin(4 cases) ( delayed healing).No severe complications occurred in this series.UCG performed 4 - 8 days after the operation revealed no residual shunt.Follow-up up to 3 months to 9 years were available in 914 cases.During the period,the heart function was confirmed as level Ⅰ - Ⅱ.ConclusionTotally thoracoscopic cardiac surgery is feasible,safe,and minimal invasive for patients,resulting in quick recovery and good cosmetic outcomes.

To explore the anti-angiogenic effects of genistein on synovium in a rat model of type II collagen-induced arthritis (CIA).

Aim To investigate the effect of U50488H(a selective κ-opioid receptor agonist)and isoproterenol(ISO,a β-adrenergic receptor agonist)on ventricular arrhythmias and Cx43 during myocardial ischemia and reperfusion in rats.Methods 60 rats were randomly divided into five groups,ie,normal control group,I/R group,ISO+I/R group,U50488H+ISO+I/R group,Nor-BNI+U50488H+ISO+I/R group.The incidence of ventricular arrhythmias and arrhythmia score were determined. The expression of Cx43mRNA was tested by RT-PCR.The expression of Cx43 protein in myocardial cell was tested by an immunohistochemical approach with a quantitative imaging system.Results ① Compared with the I/R group,arrhythmia score was increased with administration of ISO(P<0.05).U50488H intravenously injected before ISO significantly decreased the arrhythmia score(P<0.05).② Compared with the normal control group,the expression of Cx43 mRNA was decreased in the I/R group(P<0.05).With administration of ISO,the amount of Cx43 mRNA was not significantly increased.③ Compared with normal control group,total and phosphorylated Cx43 proteins were significantly decreased in the I/R group(P<0.05),and the phosphorylated Cx43 was also decreased with administration of ISO.Compared with ISO+I/R group,phosphorylated Cx43 was increased with administration of U50488H (P<0.05).Conclusion κ-opioid receptor agonist U50488 H antagonizes the arrhythmias through the regulation of Cx43 during myocardial ischemia and reperfusion via inhibiting β-adrenergic receptor pathway.

Objective To investigate the effect of genistein (gen) on the secretion of vascular endo-thelial growth factor (VEGF) and matrix metalloproteinases (MMPs-1, 2, 3, 9) by fibroblast-like synoviocytes (FLS) from rats with collagen Ⅱ induced arthritis (CIA). Methods The CIA was induced by collagen Ⅱ and complete Freund's adjuvant (CFA) into rats. The rats were scored based on the arthritis index(AI) once a week. At the sixth week, the X-ray of joints was taken. The synovial tissues from knee joints were examined pathologically. The primary fibroblast-like synowocytes were separated from the synovial tissue by collagenase digestion and cultured. Then the expression of VCAM-1 was estimated by flow cytometry. After adding gen (100, 200, 400 μmol/L) at different concentrations into the FLS, VEGF and MMP-1, 2, 3, and 9 of the supernatants were tested by indirect ELISA. Results After 3 days of type Ⅱ collagen and CFA injec-tion, the rats started to catch arthrocele and their arthritis index increased gradually. The arthrocele was most remarkable at the 3rd week. The AI, X-ray and pathological examination indicated that the model group were significantly different from the control group. After the synoviocytes were cultured to the 4th generation, the expression of VCAM-1 was as high as about 85.5%. It showed that most synoviocytes were changed to fibro-blast-like synoviocytes. Different concentrations of gen (100, 200, 400 μmol/L) added to FLS were compared and revealed that the VEGF and MMP-1, 2, 3, and 9 in the supematants were suppressed evidently and in a dose-dependent manner. Conclusion The CIA model can be successfully constructed by collagen type Ⅱ and CFA. Tthe primary FLS of rats' joint can be separated and cultured well by collagenase digestion. Certain levels of gen can suppress the secretion of VEGF and MMP-1, 2, 3 and 9 hy FLS. The affect is dose-depen-dent.