Background Pulmonary endarterectomy is safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. This study aimed to evaluate the efficacy of pulmonary endarterectomy in treatment of thr...Background Pulmonary endarterectomy is safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. This study aimed to evaluate the efficacy of pulmonary endarterectomy in treatment of thromboembolic pulmonary hypertension. Methods A retrospective study of 15 patients who underwent pulmonary endarterectomy in Beijing Chaoyang Hospital was performed. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results Two patients （2/15） died of residual postoperative pulmonary hypertension and bleeding complication. The other 13 cases had significant decrease in systolic pulmonary artery pressure （（92.8＋_27.4） mmHg vs. （49.3＋18.6） mmHg） and pulmonary vascular resistance （（938.7±464.1） dynes.s.cm5 vs. （316.8±153.3） dynes＇s.cm5）, great improvement in cardiac index （（2.31：LK）.69） L.min-l.m2 vs. （3.85±1.21） L.min-l.m2）, arterial oxygen saturation （0.67±O.11 vs. 0.96±0.22） and mixed venous 02 saturation （0.52±0.12 vs. 0.74±0.16） postoperatively compared to preoperative data. Mid-term follow-up showed that the cardiac function of all cases returned to NYHA class I or II, with great improvement in 6-minute walking distance （（138±36） m） and quality of life. Conclusions Bilateral pulmonary endarterectomy using cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest can effectively reduce pulmonary hypertension and provide good mid-term hemodynamic and symptomatic results with low surgical mortality rate and few complications.展开更多
Background Atrial fibrillation （AF） is one of the most common arrhythmia after coronary artery bypass grafting （CABG）, which not only increases the suffering of the patients, but also prolongs hospital stay and en...Background Atrial fibrillation （AF） is one of the most common arrhythmia after coronary artery bypass grafting （CABG）, which not only increases the suffering of the patients, but also prolongs hospital stay and enhances cost of care, especially for patients older than 70 years. This study was designed to evaluate the efficacy and safety of low-dose amiodarone in the prevention of AF after CABG, especially for the elderly. Methods Two hundred and ten senile patients undergoing off-pump CABG were included in this prospective, randomized, double-blind and placebo controlled study. Patients were given 10 mg/kg of amiodarone （low-dose amiodarone group, n=100） or placebo （control group, n=110） daily for 7 days before surgery and followed by 200 mg of amiodarone or placebo daily for 10 days postoperatively. Results Postoperative AF occurred in 16 patients （16%） receiving amiodarone and in 36 （37.7%） patients receiving placebo （P=0.006）. AF occurred at （58.13±16.63） hours after CABG in the low-dose amiodarone group and at （45.03±17.40） hours in the control group （P=0.018）. The maximum ventricular rate during AF was significantly slower in the low-dose amiodarone group （（121.42±8.91） beats/min） than in the control group （（134.11±30.57） beats/min, P=0.036）. The duration of AF was （10.92±9.56） hours for the low-dose amiodarone group compared with （14.81±10.37） hours for the control group （P=0.002）. The postoperative left ventricular ejection fraction （LVEF） was significantly improved in the low-dose amiodarone group （from （59.9±10.3）% to （63.4±11.4）%, P=0.001）, and significantly higher compared with the control group （（58.5±10.7）%, P=-0.002）. Both groups had a similar incidence of complication other than rhythm disturbances （12.0% vs 16.4%, P=0.368）. The low-dose amiodarone group patients had shorter hospital stays （（11.8±3.2） days vs （13.8±4.7） days, P=-0.001） and lower cost of care （RMB （79 115±16 67展开更多
基金This project was funded by the National Natural Science Foundation of China （General Program, No. 2006BA 101A06）.
文摘Background Pulmonary endarterectomy is safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. This study aimed to evaluate the efficacy of pulmonary endarterectomy in treatment of thromboembolic pulmonary hypertension. Methods A retrospective study of 15 patients who underwent pulmonary endarterectomy in Beijing Chaoyang Hospital was performed. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest. Results Two patients （2/15） died of residual postoperative pulmonary hypertension and bleeding complication. The other 13 cases had significant decrease in systolic pulmonary artery pressure （（92.8＋_27.4） mmHg vs. （49.3＋18.6） mmHg） and pulmonary vascular resistance （（938.7±464.1） dynes.s.cm5 vs. （316.8±153.3） dynes＇s.cm5）, great improvement in cardiac index （（2.31：LK）.69） L.min-l.m2 vs. （3.85±1.21） L.min-l.m2）, arterial oxygen saturation （0.67±O.11 vs. 0.96±0.22） and mixed venous 02 saturation （0.52±0.12 vs. 0.74±0.16） postoperatively compared to preoperative data. Mid-term follow-up showed that the cardiac function of all cases returned to NYHA class I or II, with great improvement in 6-minute walking distance （（138±36） m） and quality of life. Conclusions Bilateral pulmonary endarterectomy using cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest can effectively reduce pulmonary hypertension and provide good mid-term hemodynamic and symptomatic results with low surgical mortality rate and few complications.
文摘Background Atrial fibrillation （AF） is one of the most common arrhythmia after coronary artery bypass grafting （CABG）, which not only increases the suffering of the patients, but also prolongs hospital stay and enhances cost of care, especially for patients older than 70 years. This study was designed to evaluate the efficacy and safety of low-dose amiodarone in the prevention of AF after CABG, especially for the elderly. Methods Two hundred and ten senile patients undergoing off-pump CABG were included in this prospective, randomized, double-blind and placebo controlled study. Patients were given 10 mg/kg of amiodarone （low-dose amiodarone group, n=100） or placebo （control group, n=110） daily for 7 days before surgery and followed by 200 mg of amiodarone or placebo daily for 10 days postoperatively. Results Postoperative AF occurred in 16 patients （16%） receiving amiodarone and in 36 （37.7%） patients receiving placebo （P=0.006）. AF occurred at （58.13±16.63） hours after CABG in the low-dose amiodarone group and at （45.03±17.40） hours in the control group （P=0.018）. The maximum ventricular rate during AF was significantly slower in the low-dose amiodarone group （（121.42±8.91） beats/min） than in the control group （（134.11±30.57） beats/min, P=0.036）. The duration of AF was （10.92±9.56） hours for the low-dose amiodarone group compared with （14.81±10.37） hours for the control group （P=0.002）. The postoperative left ventricular ejection fraction （LVEF） was significantly improved in the low-dose amiodarone group （from （59.9±10.3）% to （63.4±11.4）%, P=0.001）, and significantly higher compared with the control group （（58.5±10.7）%, P=-0.002）. Both groups had a similar incidence of complication other than rhythm disturbances （12.0% vs 16.4%, P=0.368）. The low-dose amiodarone group patients had shorter hospital stays （（11.8±3.2） days vs （13.8±4.7） days, P=-0.001） and lower cost of care （RMB （79 115±16 67
