Objective To investigate the short and medium term results of Castor single branched stent combined with parallel stent technique in the reconstruction of supra-aortic branches in total endovascular repair of aortic arch lesions. Methods The clinical data of patients with aortic arch disease who were treated with single-branch stents combined with parallel stents for Z1 anchoring and total endovascular repair from April 2022 to August 2022 in the Department of Cardiovascular Surgery of the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed, and the perioperative and follow-up conditions of the patients were analyzed. ResultsThere were 4 males and 1 female with an average age of 46.2±18.6 years. This study included 1 patient of thoracic aortic aneurysm and 4 patients of acute non-A non-B aortic dissection. The success rate of surgical technique was 100.0%. The operative time was 132.3±45.1 min, the immediate postoperative isolation of lesions was satisfactory, and there were no adverse events and death in perioperative period. The median follow-up time was 13 (11-15) months. During the follow-up period, all patients survived without stent displacement, type Ⅰa endoleak, parallel stent stenosis and occlusion, and no re-operation. Conclusion The short and medium term results of single branched stents combined with parallel stents in total endovascular repair of aortic arch diseases requiring Z1 anchoring is satisfactory.
ObjectiveTo compare the early clinical efficacy and safety of transapical transcatheter aortic valve implantation (TA-TAVI) with surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS). MethodsA retrospective study was conducted on patients with severe AS admitted to the Department of Cardiovascular Surgery, The First Affiliated Hospital of University of Science and Technology of China from January 2020 to March 2024. According to the surgical method, patients were divided into a SAVR group and a TA-TAVI group, and the clinical data of the two groups were compared. ResultsA total of 71 patients were included, with 45 in the SAVR group, including 33 males and 12 females, aged 16-75 (60.89±10.88) years; 26 in the TA-TAVI group, including 15 males and 11 females, aged 61-83 (72.85±5.53) years. The results showed that postoperative aortic valve transvalvular flow velocity (2.31±0.38 m/s vs. 2.60±0.50 m/s, P=0.019) and transvalvular pressure gradient (21.09±6.03 mm Hg vs. 28.20±10.79 mm Hg, P=0.001) in the TA-TAVI group were lower than those in the SAVR group. In terms of left ventricular end-diastolic diameter, both preoperative (56.73±7.74 mm vs. 52.36±7.00 mm, P=0.017) and postoperative (52.61±7.18 mm vs. 48.04±4.78 mm, P=0.010) values in the TA-TAVI group were larger than those in the SAVR group. In terms of left ventricular ejection fraction, the preoperative value in the TA-TAVI group was lower than that in the SAVR group (58.00%±13.84% vs. 64.87%±7.63%, P=0.026), but there was no statistical difference between the two groups after surgery (P=0.670). The operation time and drainage volume on the first day after surgery in the TA-TAVI group were shorter or lower than those in the SAVR group (P<0.05). There was no statistical difference between the two groups in the postoperative hospital stay, ICU stay, or postoperative mechanical ventilation time (P>0.05). In addition, no serious complications occurred in patients after SAVR, while perivalvular leakage (2 patients), third-degree atrioventricular block (1 patient), and death (3 patients) occurred in the TA-TAVI group. ConclusionFor elderly patients with severe AS and poor cardiac function, TA-TAVI technology has minimal surgical trauma, high safety and effectiveness, and is a safe and effective treatment option besides traditional surgical operations.
ObjectiveTo systematically review the prevalence and risk factors of the chronic post-cesarean section pain (CPCSP). MethodsPubMed, EMbase, The Cochrane Library, CINAHL, PsycInfo, CBM, WanFang Data, VIP, and CNKI databases were electronically searched to collect studies on the prevalence and risk factors of CPCSP from inception to August 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 15.1 software. ResultsA total of 43 studies involving 12 435 participants were included. The results of meta-analysis showed that the prevalence of CPCSP for 2 to 5 months, 6 to 11 months, and at least 12 months were 19% (95%CI 15% to 23%), 13% (95%CI 9% to 17%), and 8% (95%CI 6% to 10%), respectively. The risk factors included preoperative pain present elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety, postpartum depression, etc. ConclusionsThe current evidence shows that the overall prevalence of CPCSP is high. Preoperative pain presents elsewhere, postoperative severe acute pain, low abdominal transverse incision, non-intrathecal administration of morphine, preoperative anxiety and postpartum depression may increase the risk of CPCSP.