Expressions of beclinl and microtubule-associated protein 1 light chain 3(LC3) in type a aortic dissection tissues / 第二军医大学学报

To explore the expressions of Beclinl and microtubule-associated protein 1 light chain 3(1X3) in type A aortic dissection (AD) tissue and to discuss the relevance. Methods Twenty surgical AD specimens were used in this study, and 10 normal control specimens were obtained from autopsy. Immuno-histochemical staining and Western blotting analysis were performed to evaluate the locations and expressions of Beclinl and LC3 proteins. Results It was found that Beclinl and LC3 proteins were mainly located in the vascular smooth muscle cells of the AD tissues, and the expressions in the AD tissues were signicantly higher than those in the control group (P<0. 05). Conclusion Autophagy is activated in the vascular smooth muscle cells of AD tissues, which may play an important role in the development and progression of thoracic aortic dissection.

Methods and results of surgical treatment for aortic root pathology due to Stanford A aortic dissection / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of surgical approaches, outcomes and prognosis of aortic root pathology due to Stanford A aortic dissection.</p><p><b>METHODS</b>Retrospective analysis the clinical data of 161 patients (122 male and 39 female, mean age of (44 ± 21) years) underwent surgical treatment for Stanford A aortic dissection between January 2001 and June 2011. There were 146 patients of acute aortic dissection and 15 patients of chronic aortic dissection. All the patients had aortic root pathologies that included commissural prolapsed in 140 cases, more than moderate aortic insufficiency in 75 cases, aortic sinus intima rupture in 15 cases, right and/or left coronary artery tearing in 8 cases, right and/or left coronary artery dissection in 16 cases, aortic root aneurysm in 31 cases.</p><p><b>RESULTS</b>Aortic root replacement (Bentall procedures) were used in 72 cases, aortic root remodeling (including aortic valve replacement) in 80 cases, aortic root reimplantation (David procedure) in 9 cases. The cardiopulmonary bypass time was shorter in aortic root remodeling group ((193 ± 42) minutes) than the other two groups ((210 ± 61) minutes, (197 ± 34) minutes, F = 3.22, P = 0.04). The in-hospital mortality was 8.1% (13 cases), 5 cases (6.9%) in aortic root replacement group, 7 cases (8.8%) in aortic root remodeling group, 1 case in aortic root reimplantation. The cause of death included respiratory failure (4 cases), permanent neurological deficits (3 cases), multiple organ failure (4 cases), acute renal failure (2 cases). The survivors were followed up for 6 months to 6 years. There was no patient required reoperation for aortic root pathologies. There was no statistically significant difference between aortic root remodeling group and reimplantation group (P > 0.05).</p><p><b>CONCLUSIONS</b>The surgical treatment for aortic root pathology due to Stanford A aortic dissection is challenging. Appropriate procedures according to the specialty of aortic root pathology can be performed with favorable functional results.</p>

Congenital quadricuspid aortic valve: analysis of 11 surgical cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement (AVR). The diagnosis and treatment of the disease were reported in 11 cases.</p><p><b>METHODS</b>Eleven patients (nine men and two women, mean age 33.4 years) with quadricuspid aortic valve were retrospectively evaluated. Medical records, echocardiograms and surgical treatment were reviewed.</p><p><b>RESULTS</b>In accordance with the Hurwitz and Roberts classification, the patients were classified as type A (n = 2), type B (n = 7), type F (n = 1) and type G (n = 1). Three patients were associated with other heart diseases, including infective endocarditis and mitral prolaps, left superior vena cava, aortic aneurysm. All had aortic regurgitation (AR) except two with aortic stenosis (AS), detected by color-flow Doppler echocardiography. The congenital quadricuspid aortic valve deformity in seven patients was diagnosed by echocardiography. All patients underwent successful aortic valve replacement.</p><p><b>CONCLUSION</b>Quadricuspid aortic valve is a rare cause of aortic insufficiency, while echocardiography plays an important role in diagnosing the disease. Aortic valve replacement is the major therapy for the disease.</p>

Chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction: Diagnosis and surgical treatment / 第二军医大学学报

Objective: To investigate the surgical diagnosis and treatment of chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction, so as to deepen our knowledge on chronic stenosis of mechanical prosthetic valve. Methods: The clinical data of 5 patients with chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction were retrospectively analyzed, and the relevant literatures were reviewed. Results: Re-operation (mechanical prosthetic valve replacement) was performed once the diagnoses were confirmed. The patients recovered well; the cardiac function was obviously improved; and there were no early complications. Conclusion: Chronic stenosis of mechanical prosthetic valve should be strongly suspected when they have symptoms indicating valvular stenosis. Complication of acute mechanical prosthetic valve dysfunction is not difficult to diagnose, and prompt operation is important to save the life of patients.