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find Author "乔帆" 5 results
  • 分段改良De Vega三尖瓣成形术治疗功能性三尖瓣关闭不全

    目的 评价分段改良De Vega三尖瓣成形术治疗功能性三尖瓣关闭不全(FTR)的临床疗效,总结治疗经验。 方法 选择2006年10月至2007年12月在我院手术治疗的风湿性二尖瓣病变合并FTR患者共58例,根据三尖瓣成形手术方式的不同分为两组,改良组:26例,男8例,女18例;年龄49.6±11.8岁;接受分段改良De Vega三尖瓣成形术。传统组:32例,男6例,女26例;年龄47.9±12.8岁;接受传统改良De Vega三尖瓣成形术。于围手术期用超声心动图测量两组患者三尖瓣瞬时反流量、三尖瓣瓣环周径,并随访术后三尖瓣反流情况。 结果 两组术后三尖瓣瞬时反流量均较术前减少(Plt;0.05),组间比较差异无统计学意义(F=1.969,Pgt;0.05);三尖瓣瓣环周径均较术前明显缩小(Plt;0.01),组间比较差异无统计学意义(F=2.336,Pgt;0.05);两组均无因三尖瓣反流再次手术者。随访6~12个月时,两组患者三尖瓣反流情况较出院前明显改善,组间比较差异无统计学意义(Pgt;0.05)。 结论 分段改良De Vega三尖瓣成形术,能较为有效地纠正FTR,并可取得满意的近期疗效。

    Release date:2016-08-30 06:02 Export PDF Favorites Scan
  • Transcatheter tricuspid valve replacement for severe tricuspid regurgitation: a case report and literature review

    ObjectiveTo explore the clinical effect of LuX-Valve implantation in patients with severe tricuspid regurgitation (TR) and review articles about similar devices.MethodsWe reported the data of a 58-year-old male patient with severe TR, who was hospitalized on March 17th, 2020 because of “abdominal distention and edema for 5 years”, and then received LuX-Valve implantation in the Department of Cardiovascular Surgery of Changhai Hospital, Naval Medical University. Articles about transcatheter tricuspid valve replacement were reviewed in PubMed according to the key words including “transcatheter tricuspid valve replacement” “TTVR” and “transcatheter tricuspid valve intervention”.ResultsThe patient with severe TR received LuX-Valve implantation under general anesthesia and the guidance of digital subtraction angiography and transesophageal echocardiography. The patient’s TR was totally corrected after implantation and postoperative one-month follow-up showed well clinical effects. The result of literature review showed that there were two similar devices and both had been implanted in TR patients.ConclusionLuX-Valve is an effective and reliable transcatheter tricuspid valve replacement device.

    Release date:2020-10-26 03:00 Export PDF Favorites Scan
  • Clinical treatment of acute aortic dissection in late pregnancy and puerperium

    Objective To study the clinical characteristics, therapy strategies and the outcomes of female patients with acute aortic dissection during late pregnancy and puerperal period. Methods We retrospectively analyzed the clinical data of 7 patients with acute aortic dissection during late pregnancy and puerperal period in Shanghai Changhai Hospital between August 2012 and June 2017. Five of the 7 patients were late stage pregnancy, 2 were puerperal period (1 at the postpartum night, 1 in 18 days after delivery). There were 6 patients of Stanford type A aortic dissection (85.7%), and 1 patient of type B aortic dissection (14.3%). The age of the patients ranged from 26 to 34 (30.8±3.1) years. Cardiac ultrasonography of patients with type A showed that the maximum diameter of the ascending aortas was 4.2–5.7 (4.7±0.6) cm, of which 2 patients were aneurysm of aortic sinus, 3 patients were with Marfan syndrome. Bentall procedure was conducted in 1 patient, Bentall+Sun’s surgery in 2 patients, ascending aorta replacement+Sun’s+coronary artery bypass grafting surgery in 1 patient, aortic root remodeling+ascending aorta replacement+Sun’s surgery in 2 patients. One patient with Stanford type B acute aortic dissection was performed with thoracic endovascular aortic repair (TEVAR) after cesarean section. Results Aortic blocking time ranged from 51 to 129 (85.5±22.9) min. Cardiopulmonary bypass time was 75–196 (159.0±44.0) min. Moderate hypothermic circulation arrest with selective cerebral perfusion time was 20–30 (23.8±3.5) min. All maternal and fetuses survived. The infant whose mother received aortic repair in early stage and then received cesarean section was diagnosed with cerebral palsy. Maternal and fetuses were followed up for 9 months to 4 years. During the follow up period, all the fetuses grew well except the cerebral palsy one, and all maternal recovered well. The patient who received aortic repair in the early stage, had a sigmoid rupture during cesarean section and was treated with sigmoid colostomy. Another patient with Stanford type A dissection was diagnosed as left renal vein entrapment syndrome after 2 years. Conclusion Type A aortic dissection is more common in late pregnancy and puerperal patients. And Marfan syndrome is a high-risk factor for acute aortic dissection in pregnancy women. Early and appropriate surgical treatment strategy based on the type of aortic dissection and gestational age are the key points to achieve good outcomes both for maternal and fetus.

    Release date:2018-07-27 02:40 Export PDF Favorites Scan
  • Clinical efficacy of transcatheter tricuspid valve replacement in cardiac implantable electronic lead-related tricuspid regurgitation: A multi-center retrospective cohort study

    ObjectiveTo analyze the clinical efficacy of transcatheter tricuspid valve replacement (TTVR) in cardiac implantable electronic lead-related tricuspid regurgitation (TR). MethodsThe patients with severe TR who underwent LuX-Valve TTVR in 9 Chinese medical centers from June 2020 to August 2021 were retrospectively enrolled. They were divided into a cardiac implantable electronic device (CIED) group and a non-CIED group based on whether they had pre-existing CIED implantation. Success of the procedure was defined as safe implantation of the LuX-Valve and complete withdrawal of the delivery system. Prognostic improvement was defined as a decrease of TR grade to≤2+ and an improvement of cardiac function by≥2 grades. Surgical success and postoperative prognosis were compared between the two groups. ResultsA total of 190 patients were collected, including 50 males and 140 females with a mean age of 66.2±7.8 years. There were 29 patients in the CIED group, and 161 patients in the non-CIED group. In the CIED group, 28 patients were implanted with a permanent pacemaker and 1 patient with a cardioverter-defibrillator. Preoperative New York Heart Association (NYHA) cardiac function class, TR degree, left ventricular ejection fraction, tricuspid annular plane systolic excusion, and cardiac risk scores were comparable between the two groups (P>0.05). Postoperative TR was reduced to≤2+ in all patients, and there was no statistical difference in the incidence of perivalvular leakage between the two groups (P=0.270). Postoperative CT of CIED patients showed the valve was in place, and the lead was not extruded, twisted, or deflected. The in-hospital mortality of the two groups were 10.3% and 1.9%, respectively, and the difference was statistically significant (P=0.047). In addition, there was no statistical difference between the two groups in terms of postoperative improvement of cardiac function and mortality in the 1- and 2-year follow-up. ConclusionTTVR is feasible, safe, and effective in patients with CIED implantation, and the pre-existing lead has no significant effect on the clinical efficacy.

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  • Transcatheter tricuspid valve replacement via vena jugularis interna: A case report

    We reported a 54-year-old female patient with severe tricuspid regurgitation, who received mechanic valve in the mitral position 15 years ago. The patient’s Society of Thoracic Surgeons score was 8.27%, and was intolerant to open heart surgery, so she was recommended for transcatheter tricuspid valve replacement via right vena jugularis interna. The procedures were guided by echocardiography and X ray fluoroscopy on November 13, 2021, the prosthesis was implanted successfully, and the patient was recoved without any adverse events. After 1 month follow-up, her general condition was apparently improved.

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