ObjectiveTo summarize the surgical experience of aortic regurgitation with lower ejection fraction (EF). MethodsWe retrospectively analyzed the clinical data of 34 patients with aortic regurgitation and lower ejection fraction received aortic valve replacement in the General Hospital of Shenyang Military Region between January 2012 and December 2013. There were 27 males and 7 females with age of 21-74 (51.03±12.06) years. All surgical procedures were performed under general anesthesia during cardiopulmonary bypass. ResultsThere was no operative mortality. Cardiopulmonary bypass time was 40-155 (60.92±22.89) minutes, aortic clamping time varied from 24 to 79 (37.12±12.61) minutes. Postoperative ventilator-assisted time was 4 to 67 (16.12±12.74) hours. The patients were discharged 8-15 (11.03±2.04) days after surgery. When discharged, EF value was 30% to 48% (41%±4%) and significantly improved compared with that before operation (P<0.01). Pulmonary artery systolic pressure varied from 33 to 50 (38.35±4.35) mm Hg and decreased significantly than that before operation (P<0.01). Left ventricular end-diastolic volume reduced to 168-380 (269.12±52.01) ml and obviously decreased than that before operation (P<0.01). ConclusionSurgical treatment can be carried out on patients with aortic insufficiency and lower EF. Treatment results are satisfactory.
ObjectiveTo investigate short-term outcomes and surgical techniques of endoscopic saphenous vein harvesting (ESVH) for coronary artery bypass grafting (CABG). MethodsClinical data of 554 patients undergoing CABG with ESVH in General Hospital of Shenyang Military between July 2009 and August 2013 were retrospectively analyzed. There were 372 male and 182 female patients with their age of 38-84(61.3±9.0) years. Clinical outcomes, postoperative lower extremity pain and edema, wound infection and healing were analyzed. ResultsDuring ESVH, 13 patients with very little subcutaneous fat received transition to skin bridge technology or partially open incision. Average number of harvested vein grafts was 1-4 (2.0±0.6), and the quality of the vein grafts was satisfactory. Postoperative lower extremity pain and edema were significantly reduced, and there was no delayed wound healing or infection. Seven patients died postoperatively, including 2 patients with perioperative myocardial infarction, 2 patients with pneumonia, 1 patient with ventricular fibrillation, 1 patient with massive cerebral infarction, and 1 patient with multiple organ dysfunction syndrome. A total of 452 patients were followed up for 120-1 460 (742.6±188.5) days. There was no late death or reintervention during follow-up. ConclusionESVH is a safe and efficacious procedure with less postoperative lower extremity pain and edema, satisfactory vein graft quality, better postoperative recovery and cosmetic results, compared with traditional fully or intermittently open wound for saphenous vein harvesting.