ObjectiveTo summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) in adult patients with cardiac surgery, analyze the risk factors associated with the mortality and other severe complications and to discuss prevention methods of complications during ECMO treatment.MethodsThe clinical data of 26 patients with cardiac surgery, who underwent ECMO because of cardiopulmonary insufficiency ect in Zhongshan Hospital, Fudan University from January 2012 to September 2017, were retrospectively analyzed. There were 19 males and 7 females aged 24–80 (58.0±13.9) years.ResultsTwelve (42.3%) patients successfully weaned from ECMO and six (23.1%) were discharged from hospital. Among 26 patients, 24 received VA ECMO (veno-arterial ECMO), including 5 after heart transplantation, 9 after heart valve surgery, and 3 were successfully weaned from ECMO. Seven patients with valvular surgery underwent ECMO within 48 hours due to refractory low cardiac output syndrome (LCOS). Eight patients underwent major angioplasty, 3 of whom were successfully weaned from ECMO. Four patients underwent coronary artery bypass grafting and other cardiac surgeries. Patients with VA ECMO were treated with femoral vein-femoral artery cannulation except for 2 patients undergoing femoral vein-radial artery cannulation after major angioplasty. Patients with VV ECMO (veno-venous ECMO) underwent femoral vein-jugular vein cannulation. After ECMO support, 10 patients with bleeding occurred, and 5 patients were successfully weaned from ECMO. All patients had transfusion therapy during the assist period, 7 patients had infection after ECMO support, 4 patients suffered severe distal limb ischemia. There was no significant difference in the lactic acid between the survival and the dead patients before and after ECMO support. However, the decline of serum lactic acid in the survivors was faster than that of the dead patients. The trend was the most significant within 6 h after the operation.ConclusionECMO is one of the significant treatments for LCOS and refractory hypoxemia after cardiac surgery. The type of cardiac surgery and the timing of catheter placement are key factors for the success of ECMO. The different ways of ECMO intubation, prevention and control of bleeding during ECMO, monitoring and management of internal environment and the strategies of anti-infection are all important for success of ECMO.
ObjectiveTo review and analyze the clinical manifestations of common aortitis in cardiac surgery. MethodsWe screened 41 552 patients who were hospitalized in the Department of Cardiac Surgery of Zhongshan Hospital, Fudan University from 2010 to 2020, analyzed the patients' clinical data, and classified according to the type of diseases. Then we summarized all their clinical manifestations. ResultsIn our center 145 patients were operated for aortitis diseases, including 75 males and 70 females, with the age of 24-76 (45.6±11.3) years. There were 61 patients of Takayasu's arteritis, 51 patients of Behcet's disease, 8 patients of syphilitic aortitis, 8 patients of systemic lupus erythematosus, 2 patients of Kawasaki disease, 4 patients of ankylosing spondylitis, 10 patients of dry syndrome, and 1 patient of scleroderma. ConclusionAortitis is not uncommon in cardiac surgery, and awareness of the disease should be enhanced. So that we can distinguish various types of aortitis and to make proper management to improve patients' prognosis.