ObjectiveTo compare short- and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty.MethodsWe conducted a retrospective analysis of 74 patients who underwent mitral valvuloplasty in our hospital from January 2015 to March 2017. The patients were divided into two groups according to the mode of operation: a da Vinci group (n=29, 13 males, 16 females at an average age of 52 years) and a routine group (n=45, 18 males, 27 females at an average age of 53 years). The perioperative data of patients in the two groups were compared and analyzed.ResultsThere was no significant difference in sex, age, weight, height, body mass index (BMI), cardiac function (NYHA), hypertension, diabetes, postoperative blood transfusion and postoperative complications between the two groups (P>0.05). The tracheal intubation time, ICU retention time, hospital stay time, blood loss and postoperative drainage in the da Vinci group were shorter or less than those in the routine group (P<0.05). The operation time, cardiopulmonary bypass time and aortic clamping time in the da Vinci group were longer than those in the routine group (P<0.05). Different surgical procedures had no significant effect on left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) 3 years after operation. There was no interaction between the mode of operation and the time of follow-up. There was no significant difference in echocardiographic evaluation in the same period (P>0.05).ConclusionDa Vinci operation shortens the rehabilitation process of patients compared with traditional surgery. For short- and medium-term follow-up results, there is no difference between Leonardo da Vinci and traditional mitral valve surgeries, and the clinical effect of da Vinci robot-assisted mitral valvuloplasty is satisfactory, which is worthy of further clinical promotion.
ObjectiveTo analyze the effect of carotid artery stenosis degree and intervention for carotid artery stenosis on the incidence of central nervous system complications after off-pump coronary artery bypass grafting (OPCABG) and explore the influencing factors. MethodsA total of 1 150 patients undergoing OPCABG in our hospital from June 2018 to June 2021 were selected and divided into two groups according to whether there were central nervous system complications, including a central nervous system complication group [n=61, 43 males and 18 females with a median age of 68.0 (63.0, 74.0) years] and a non-central nervous system complication group [n=1 089, 796 males and 293 females with a median age of 65.5 (59.0, 70.0) years]. The risk factors for central nervous system complications after OPCABG were analyzed. ResultsUnivariate analysis showed that age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intra-aortic ballon pump (IABP), postoperative arrhythmia, postoperative thoracotomy and blood transfusion volume were associated with central nervous system complications. The incidence of central nervous system complications in patients with severe carotid artery stenosis or occlusion (11.63%) was higher than that in the non-stenosis and mild stenosis patients (4.80%) and moderate stenosis patients (4.76%) with a statistical difference (P=0.038). The intervention for carotid artery stenosis before or during the operation did not reduce the incidence of central nervous system complications after the operation (42.11% vs. 2.99%, P<0.001). Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion were independent risk factors for postoperative central nervous system complications (P<0.05). Conclusion The age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intraoperative use of IABP, postoperative arrhythmia, secondary thoracotomy after surgery, blood transfusion volume and OPCABG are associated with the incidence of postoperative central nervous system complications in patients. Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion are independent risk factors for postoperative central nervous system complications. In patients with severe carotid artery stenosis, preoperative treatment of the carotid artery will not reduce the incidence of central nervous system complications.