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find Author "吴忠仕" 8 results
  • Research on Hemocompatibility of the Acellular Valved Bovine Jugular Vein Conduit Treated with Polyepoxy Compound

    Objective To investigate the hemocompatibility of the acellular valved bovine jugular vein conduit (BJVC) treated with polyepoxy compound (PC), and discuss its application in cardiovascular surgery and tissue engineering in the future. Methods BJVC treated with PC was regarded as the experiment group and BJVC treated with glutaraldehyde (GA) was considered to be the control group. Rat blood was used for in vitro hemolytic test to calculate hemolytic rates of BJVC, and curve of absorbanceclotting time was drawn. Human blood was used to determine the level of D-dimeride and complement activation C3a des Arg, and test its hemocompatibility in vitro. We divided 20 canines into the experiment group (PC group, n=10) and the control group (GA group, n=10) by random digital table. The BJVC treated with PC or GA were implanted between the pulmonary artery and right ventricle. Ten months after the implantation, thrombus and histological observation were performed to evaluate the blood compatibility in vivo. Results The hemolytic rate in the PC group (0.23%) was lower than that in the GA group (0.35%), which was in accordance with the national standard of hemolytic test (lt;5%). The curve of absorbanceclotting time in the experiment group declined more slowly than that of the control group. The D-dimeride level in the experiment group was significantly lower than that of the control group (0.10±0.01 μg/ml vs. 0.12±0.02 μg/ml , t=3.277, P=0.004), but both of them were within the normal level. The level of complement C3a des Arg in the experiment group was significantly lower than that of the control group (0.74±0.09 μg/ml vs. 1.02±0.19 μg/ml, t=4.183, P=0.001). Eight canines survived 10 months after the implantation in both the two groups, and two other canines in each group died due to ventricular fibrillation. Three canines were discovered to have thrombus in the control group while no thrombus was observed in the experiment group. Conclusion Compared with GA, acellular BJVC treated with PC has superiority in hemocompatibility in vitro and vivo, and has potential application in clinical research and practice.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • Surgical Treatment for Infants Under 6 kg Weight with Ventricular Septal Defect

    Objective To investigate the effect of surgical treatment on ventricular septal defect (VSD) in infants under 6kg weight, including the operative indication, surgical techniques and perioperative therapy. Methods All clinical data of 148 consecutive infants under 6kg weight with VSD were collected and studied retrospectively. The infants, age was 1-13(mean 5.3) months with the body weight of 3.5-6.0 (mean 5.3) kg. VSD was perimembranous in 105 cases, subpulmonary in 25, muscular inlet tract in 8, muscular outlet tract 9, and muscular trabecular in 1 case. Other associated cardiac abnormalities included atrial septal defect in 39, patent ducts arteriosus in 17, insufficiency of mitral valve in 9 and moderate to severe pulmonary hypertension in 52. The operations were performed under cardiopulmonary bypass at moderate to low flow, moderate hypothermia and cold crystalloid cardioplegia. Patch repair was used in 85, direct sutures in 63 and 23 cases repaired with partial sternal incision and beating heart. Results The hospital mortality was 4. 1% (6/148), the causes of death were severe pulmonary hypertention in 2, aortic arch interruption in 2, severe malnutrition in 1 and poor result of mitral valvuloplasty in 1. Other major operative complications included residual shunts (1- 2mm) in 2, and Ⅲ° A-V block in 2, who recoveried 5 days after the operation. The hospital stay was 6 15 (mean 8) days. Follow-up was complete in all 142 survived cases for 4 months-6 years. Two residual shunts healed in first year after the cardiac operation, others recovery smoothly, and are developing well. Conclusion With the improvement of the surgical techniques, the surgical treatment for VSD in infants with low weight is safe and effective, and it is also essential to further improve the effects of surgical treatment in VSD associated with complex abnormalities.

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • 醇类改性牛颈静脉带瓣管道的蛋白吸附实验

    目的 观察丁二醇改性前后的牛颈静脉带瓣管道植入大白鼠体内后蛋白吸附的情况。方法 取新鲜牛颈静脉24根,选择带有瓣膜的血管片置人0.625%的戊二醛液中固定1d,取出后12根置人100%2,3-丁二醇中(丁二醇组),12根置人0.3%戊二醛中(戊二醛组)60d。分别植入大白鼠皮下,3个月后取出。采用考马斯亮兰法测定组织总蛋白含量;采用聚丙烯酰胺凝胶电泳法和光密度法行吸附蛋白的定性和定量分析。结果丁二醇组改性后的管壁及瓣膜组织总蛋白含量均较戊二醛组低(P〈0.05);丁二醇组血管壁有六条带、瓣膜有五条带光密度值均较戊二醛组低(P〈0.05),但分别比戊二醛组多出一根条带(45.5ku和53.5ku)。结论牛颈静脉带瓣管道在机体内钙化与其蛋白吸附有关,2,3-丁二醇改性可能减轻生物组织材料的蛋白吸附,从而减轻钙化。

    Release date:2016-08-30 06:26 Export PDF Favorites Scan
  • Hemodynamic study of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in canine model

    Objective To investigate the hemodynamic performance of valved bovine jugular vein conduits (BJVC) for right ventricular outflow tract reconstruction in canine model. Methods The BJVC that were treated with the glutaraldehyde were implanted between the pulmonary artery and right ventricle in seven young canines. Right ventricular and pulmonary artery pressures were measured directly before and after the implantation. Hemodynamic evaluations were carried out by echocardiography and cardiac catheterization after the implantation. Results Seven canines were survival one year after the implantation. The pulmonary artery pressures (including systolic pressure, diastolic pressure and mean pressure) had not significantly changed after reconstruction with the conduits. The right ventricular diastolic pressures had not increased after the reconstruction, but the right ventricular systolic pressure and mean pressure had increased. One year later, the echocardiography showed valve motion with no obvious thickening of the leaflets. No graft kinking or obvious regurgitation of the valve was observed. Cardiac catheterization and angiography showed that the pressure gradients between the right ventricle and the conduits varied from 3 to 19mmHg, the diastolic pressures in the conduits were higher than that of right ventricle((Plt;)0.01), and the conduits and pulmonary arteries had no obvious obstruction. Conclusion The glutaraldehyde-fixed bovine jugular vein conduit has good hemodynamic performance in the pulmonary circulation.

    Release date:2016-08-30 06:28 Export PDF Favorites Scan
  • CHANGES OF SERAL TNF-α, IL-6 AND IL-10 LEVEL AFTER IMPLANTATION OF VALVED BOVINE JUGULAR VEIN CONDUIT IN COMPLEX CONGENITAL HEART DISEASES

    Objective To study the inflammation response and the biocompatibil ity of valved bovine jugular vein conduit (BJVC) and valved bovine jugular vein patch (VBJV-P) in treating complex congenital heart disease (CHD). Methods From December 2007 to March 2008, 16 patients with complex CHD were treated. Of 16 patients, 6 underwent conjunction right ventricular to pulmonary artery with BJVC and broaden right ventricular outflow tract (RVOT) with VBJV-P (BJVC group), and 10 underwent broaden RVOT with self pericardial patch (control group). In BJVC group, there were 3 males and 3 females, aging (5.6 ± 3.6) years, and including 1 case of type I truncus arteriosus, 1 case of type I truncus arteriosus with ventricular septal defect and patent foramen ovale, 1 case of congenital pulmonary atresia with ventricular septal defect and patent arterial duct, and 3 cases of Fallot’s tetrad. In control group, there were 5 males and 5 females, aging(4.3 ± 3.1) years, all being Fallot’s tetrad. The periphery vein blood of the two groups was collected during operation and after operation, and the levels of cytokine were detected with ELISA method. Meanwhile the cl inical data of the two groups were collected. Results There were no significant differences at levels of TNF-α and IL-6 between BJVC group and control group 1 week after operation (P gt; 0.05), and there was significant difference at level of IL-10 [(25.7 ± 5.0) pg/mL vs (19.5 ± 4.7) pg/ mL, P lt; 0.05]. There were no significant differences at levels of IL-6 and IL-10 within groups both in control group and in BJVC group (P gt; 0.05) between 1 week after operation and the anesthesia inducing period. And there was significant difference at level of TNF-α in BJVC group [(77.0 ± 1.6) pg/mL vs (82.9 ± 1.3) pg/mL, P lt; 0.05] and in control group [(78.6 ± 3.4) pg/mL vs (83.1 ± 1.9) pg/mL, P lt; 0.05] between 1 week after operation and the anesthesia inducing period. There were no statistically significant differences (P gt; 0.05) in leukocyte count and body temperature between BJVC group and control group. The X-ray films showed no abnormal ity in BJVC group and control group before operation and after operation. No hepatic and renal dysfunction occurred in control group; and 2 patients had hepatic dysfunction, which may be caused by antibiotics. Conclusion BJVC has a good biocompatibil ity in treating complexty CHD.

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
  • 全腔静脉肺动脉连接术的临床应用

    目的 探讨全腔静脉肺动脉连接术(TCPC)的手术方法 ,总结其临床应用经验。 方法 回顾分析2004年11月~2006年8月我科施行心内隧道TCPC和心外管道TCPC治疗21例复杂紫绀型先天性心脏病患者的临床资料,比较两种术式间术前、术后的临床指标。 结果 全组共死亡2例,1例死于术后反复发生心室颤动,1例死于低心排血量综合征。术后发生并发症16例,其中胸腔积液或心包积液7例,乳糜胸5例,经行胸腔闭式引流或胸腔穿刺后治愈;心律失常、肺部感染各1例,均经保守治疗治愈。19例生存患者术后紫绀均得到有效改善;除心内隧道TCPC平均手术时间(288.5min vs. 217.1min, Plt;0.05),呼吸机平均使用时间(9。63h vs. 65.8h, Plt;0.05)长于心外管道TCPC外,两种手术方式术后中心静脉压(CVP)、血红蛋白(HGB)、红细胞压积(HCT)、动脉血氧饱和度(SaO2)、平均肺动脉压(MPAP)、上腔静脉吻合口压差(SVCPG)、下腔静脉吻合口压差(IVCPG)等均差异无统计学意义。随访16例,随访时间2个月~2年,无死亡患者。超声心动图、胸部X线片复查结果满意。 结论 TCPC是治疗复杂紫绀型先天性心脏病的有效方法,两种手术方法的疗效相似,但各有利弊,对婴幼儿患者选择心内隧道TCPC较为合适,对年龄较大的患者选择心外管道TCPC为佳。

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • 全腔静脉肺动脉连接术的临床应用

    目的 探讨全腔静脉肺动脉连接术(TCPC)的手术方法 ,总结其临床应用经验。 方法 回顾分析2004年11月~2006年8月我科施行心内隧道TCPC和心外管道TCPC治疗21例复杂紫绀型先天性心脏病患者的临床资料,比较两种术式间术前、术后的临床指标。 结果 全组共死亡2例,1例死于术后反复发生心室颤动,1例死于低心排血量综合征。术后发生并发症16例,其中胸腔积液或心包积液7例,乳糜胸5例,经行胸腔闭式引流或胸腔穿刺后治愈;心律失常、肺部感染各1例,均经保守治疗治愈。19例生存患者术后紫绀均得到有效改善;除心内隧道TCPC平均手术时间(288.5min vs. 217.1min, Plt;0.05),呼吸机平均使用时间(9。63h vs. 65.8h, Plt;0.05)长于心外管道TCPC外,两种手术方式术后中心静脉压(CVP)、血红蛋白(HGB)、红细胞压积(HCT)、动脉血氧饱和度(SaO2)、平均肺动脉压(MPAP)、上腔静脉吻合口压差(SVCPG)、下腔静脉吻合口压差(IVCPG)等均差异无统计学意义。随访16例,随访时间2个月~2年,无死亡患者。超声心动图、胸部X线片复查结果满意。 结论 TCPC是治疗复杂紫绀型先天性心脏病的有效方法,两种手术方法的疗效相似,但各有利弊,对婴幼儿患者选择心内隧道TCPC较为合适,对年龄较大的患者选择心外管道TCPC为佳。

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • Right Ventricular Outflow Tract Reconstruction with Valved Bovine Jugular Vein Patch in Patients with Complex Congenital Heart Disease

    Objective To evaluate early results of valved bovine jugular vein patch for reconstruction of the right ventricular outflow tract (RVOT).?Methods From May 2009 to March 2010, a total of 60 patients with complex congenital heart diseases underwent reconstruction of RVOT with valved bovine jugular vein patch in Wuhan Asia Heart Hospital. There were 42 males and 18 females with their mean age of 6.2±8.9 years (ranging from 5 months to 33 years) and mean body weight of 27.5±24.0 kg, and 34 patients were less than 1 year. Preoperative clinical diagnosis included tetralogy of Fallot (n=38) and double outlet of right ventricle with pulmonary stenosis (n=22). All the patients underwent one-stage surgical repair. Before operation, 4 patients underwent catheter intervention for their major aortopulmonary collaterals. The diameters of pulmonary arterial ring of all the patients were 2 standard deviation less than normal range, and trans-annular patch was chosen for RVOT reconstruction. All the patients were postoperatively followed up for 18 to 26 months (mean 21.2±4.6 months).?Results There was no in-hospital death. And no second surgical intervention was needed for conspicuous RVOT stenosis or pulmonary regurgitation. Three patients needed reintubation for lung edema after extubation as a result of major aortopulmonary collaterals. Four patients underwent reexploration for postoperative bleeding. And all the other patients were discharged uneventfully. Mean cardiopulmonary bypass time was 84.0±22.0 min, and mean aortic cross-clamping time was 42.0±12.0 min. Mean RVOT gradient right after surgery was 18.0±4.5 mm Hg, which was not statistically different from mean RVOT gradient of 19.2±5.4 mm Hg measured by transthoracic echocardiography at their last postoperative follow-up(P>0.05). The degree of pulmonary regurgitation right after surgery was trivial in 32 patients(1+), mild in 28 patients(2+), which were not statistically different from the degree of pulmonary regurgitation at their last postoperative follow-up: trivial in 28 patients (1+), mild in 27 patients(2+), and moderate in 5 patients(3+). Calcification was not observed on the valved bovine jugular vein patch and valve cusp, and the valve cusp motioned well. No thrombosis or endocarditis was observed on the valved bovine jugular vein.?Conclusions For patients with tetralogy of Fallot or double outlet of right ventricle (DORV) and pulmonary stenosis, valved bovine jugular vein patch is a good choice for trans-annular reconstruction of RVOT. There is no severe postoperative complication related to bovine jugular vein, the RVOT pressure gradient does not increase significantly, and anti-regurgitation result is satisfactory in short-term follow-up. Further follow-up is required to evaluate its long-term outcome.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
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