ObjectiveTo investigate the risk factors of dysphagia in lung transplant recipients through meta-analysis. MethodCohort studies and case-control studies on risk factors for dysphagia after lung transplantation in Science, Scopus and ProQuest databases were searched from the establishment of the database to July 2023. After literature screening, data extraction and quality evaluation, Meta-analysis was performed using Rev Man 5.4 and Stata17.0 software. Results12 literatures were included, and the results of meta-analysis showed: The incidence of dysphagia in lung transplant recipients was 67% (95%CI 0.59~0.75, I2 =92.44%, P<0.001). There were three risk factors for dysphagia in lung transplant recipients, namely, reintubation (OR=5.34, 95%CI 3.07~9.28, I2 =0%, P<0.001), mechanical ventilation (OR= 4.25, 95%CI 2.95~6.12, I2 =0%, P<0.001), extracorporeal life support (OR=2.13, 95%CI 1.69~2.67, I2 =0%, P<0.001).ConclusionsLung transplant recipients with re-intubation, mechanical ventilation and extracorporeal life support are more likely to have dysphagia after surgery. Nursing staff can combine risk factors and formulate targeted nursing measures to reduce the incidence of dysphagia after lung transplantation.
ObjectiveTo investigate the feasibility and safety of transcatheter aortic valve replacement (TAVR) through apical approach for aortic regurgitation of large annulus.MethodsFrom November 2019 to May 2020, 10 male patients aged 64.50±4.20 years with aortic valve insufficiency (AI) underwent TAVR in the Department of Cardiovascular Surgery, Xijing Hospital. The surgical instruments were 29# J-valveTM modified and the patients underwent TAVR under angiography. The preoperative and postoperative cardiac function, valve regurgitation, complications and left ventricular remodeling were summarized by ultrasound and CT before and after TAVR.ResultsA total of 10 valves were implanted in 10 patients. Among them, 1 patient was transferred to the aortic arch during the operation and was transferred to surgical aortic valve replacement; the other 9 patients were successfully implanted with J-valve, with 6 patients of cardiac function (NYHA) class Ⅱ, 4 patients of grade Ⅲ. And there was a significant difference between preoperation and postoperation in left ventricular ejection fraction (44.70%±8.78% vs. 39.80%±8.48%, P<0.05) or aortic regurgitation (1.75±0.72 mL vs. 16.51±8.71 mL, P<0.05). After 3 months, the patients' cardiac function was good.ConclusionTAVR is safe and effective in the treatment of severe valvular disease with AI using J-valve.