Publications by authors named "Cheng-Nan Li"

Article Synopsis
  • CDI (Clostridioides difficile infection) is a significant post-operative complication with a poor prognosis and no standardized treatment, often caused by various factors affecting the gut environment.
  • A patient with a long history of bowel obstruction underwent surgery for colon issues but developed CDI shortly after, leading to a successful initial treatment, but unfortunately, the patient did not continue medication and later died.
  • The case emphasizes the importance of addressing potential CDI risks in patients with chronic bowel conditions and the necessity of consistent medication to prevent recurrence after treatment.
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Introduction: Acute aortic syndrome (AAS) is a group of acute and critical conditions, including acute aortic dissection (AAD), acute intramural haematoma and penetrating aortic ulcer. High mortality and morbidity rates result in a poor patient prognosis. Prompt diagnoses and timely interventions are paramount for saving patients' lives.

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Background: Aortic regurgitation (AR) related to Behcet's disease (BD) is rare, but usually fatal. Perivalvular leakage (PVL) is high if AR related to BD treated with regular AVR. In this study, we report the surgical management of AR secondary to BD.

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Background: Postoperative acute kidney injury (AKI) is a major complication associated with increased morbidity and mortality after surgery for acute type A aortic dissection (AAAD). To the best of our knowledge, risk prediction models for AKI following AAAD surgery have not been reported. The goal of the present study was to develop a prediction model to predict severe AKI after AAAD surgery.

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Background: Massive bleeding throughout aortic repair in acute type A aortic dissection (ATAAD) patients is a common but severe condition that can cause multiple serious clinical problems. Here, we report our findings regarding risk factors, short-term outcomes, and predicting model for massive bleeding in ATAAD patients who underwent emergent aortic repair.

Methods: A universal definition of perioperative bleeding (UDPB) class 3 and 4 were used to define massive bleeding and comprehensively evaluate patients.

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Aim: To evaluate the effect of packed red blood cells (pRBCs), fresh frozen plasma (FFP), and platelet concentrate (PC) transfusions on acute kidney injury (AKI) in patients with acute Stanford type A aortic dissection (ATAAD) with total arch replacement (TAR).

Method: From December 2015 to October 2017, 421 consecutive patients with ATAAD undergoing TAR were included in the study. The clinical data of the patients and the amount of pRBCs, FFP, and PC were collected.

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Background: This study analyzes the outcomes of a one-stage hybrid procedure combining thoracic endovascular aortic repair (TEVAR) with extra-anatomic bypass in patients with distal aortic arch disease.

Methods: This retrospective study collected 103 hybrid procedures combining TEVAR with extra-anatomic bypass (mean age, 62.2±9.

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Objectives: We seek to report our management protocol and early outcomes of acute type A aortic dissection (ATAAD) repair during the early phase of coronavirus disease 2019 (COVID-19).

Methods: From January 23 to April 30, 2020, we performed ATAAD repair for 33 patients, including three with pregnancy-related TAADs. Confirmation of COVID-19 depended on the results of two nucleic acid tests and pulmonary computed tomography scan.

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Background: The aim of this study was to analyse the differences in renal function among various types of renal artery involvement in acute Debakey Type I aortic dissection.

Methods: From January 2016 to January 2018, 304 consecutive patients with acute Debakey type I aortic dissection with renal artery involvement were included. According to computed tomography angiography (CTA) findings, renal artery involvement on one side can be classified into four types: type A, in which a large intimal tear is near the renal artery orifice; type B, the orifice of the renal artery originates entirely from the false lumen; type C, the orifice of the renal artery originates entirely from the true lumen; and type D, a renal artery dissection is observed.

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Objectives: Pregnancy-related aortic dissection (AoD) in Marfan syndrome is a lethal catastrophe. Due to its rarity and limited clinical experience, there is no consensus regarding the optimal management strategy. We seek to present our 21-year experience in such patients , focusing on management strategies and early and late outcomes.

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Background: Type Ia endoleaks are common after thoracic endovascular aortic repair (TEVAR). However, the repair of type Ia endoleaks involving the distal arch is challenging because of the presence of the interventional endografts, potential damage to the aortic arch vessels, and the location and size of the aneurysmal body. We retrospectively reviewed our experience of the surgical treatment of type Ia endoleaks with distal arch involvement using left subclavian artery (LSCA)-left common carotid artery (LCCA) transposition with a stented elephant trunk.

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Background: Aortic dissection during pregnancy is a rare but life-threatening event for mothers and fetuses. It often occurs in the third trimester of pregnancy and the postpartum period. Most patients have connective tissue diseases such as Marfan syndrome.

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Article Synopsis
  • Acute aorta dissection (AD) is a serious emergency affecting mostly young adults under 45, with a study of 490 patients in China showing a median age of 38, predominantly young men, and high rates of smoking and hypertension.
  • The most common symptom was sudden chest or back pain, and the majority of patients underwent surgical treatment, though a small number experienced serious complications during the perioperative period.
  • The study found that longer cardiopulmonary bypass times and a history of previous heart surgeries were linked to higher rates of surgery-related complications and mortality, highlighting the importance of these factors in managing acute AD.
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Background: Several methods of arch vessel reconstruction, such as (island) and branched graft techniques, have been proposed to treat aortic arch pathologies during total arch replacement (TAR). We seek to review our experience with modified en bloc technique and left subclavian (LSCA)-left carotid artery (LCCA) transposition in TAR and frozen elephant trunk (FET) procedure for chronic type A aortic dissection (CTAAD).

Methods: From September 2010 to September 2016, 35 consecutive patients with CTAAD underwent modified arch reconstruction with LSCA-LCCA transposition during TAR and FET procedure.

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Background: To evaluate one-stage repair with ascending to abdominal aorta extra-anatomical bypass combined with cardiac surgery for adult aortic coarctation (COA) concomitant with cardiac diseases.

Methods: Between February 2009 and September 2016, 24 consecutive patients (79.17% male, mean age 36.

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Background: Hybrid repair of complicated acute type B aortic dissection (ATBAD) with aortic arch involvement is associated with a high rate of endoleak, stroke, and retrograde aortic dissection. Optimal management of this lesion remains uncertain. In this hybrid repair era, surgical results of ATBAD with distal aortic arch involvement using a frozen elephant trunk procedure with transposition of the left subclavian artery (LSCA) to left common carotid artery (LCCA) is reported.

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Article Synopsis
  • Hybrid aortic arch repair, used for distal aortic arch aneurysms, can have complications like stroke and endoleaks, but a study evaluated the effectiveness of a specific approach involving stented elephant trunk implantation combined with artery transposition.
  • A total of 19 male patients, with a median age of 51, underwent this procedure between 2009 and 2016, showing no in-hospital deaths or significant neurological issues post-surgery.
  • The findings suggest that this surgical method produces promising outcomes, has lower risks of complications compared to traditional hybrid repairs, and may result in less frequent need for follow-up surgeries in the future.
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Background: Type Ia endoleaks are not uncommon complications that occur after thoracic endovascular aortic repair (TEVAR). Because aortic arch vessels prevent extension of the landing zone, it is very difficult to manipulate a type Ia endoleak using an extension cuff or stent-graft, especially when the aortic arch is involved. Here, we retrospectively review our experience of surgical treatment of type Ia endoleak after TEVAR using a stented elephant trunk procedure.

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Objective: To analyze the clinical outcome of corticosteroid and/or immunosuppressive treatment preoperatively in patients with Takayasu's arteritis.

Patients And Methods: Forty-six patients with Takayasu's arteritis who received cardiovascular surgery between January 2010 and December 2015 in Beijing Anzhen Hospital were enrolled in this study. Their clinical characteristics, preoperative drug therapy, surgical treatment, and pathological examination results were retrospectively analyzed for the effect of drugs on outcome of the surgery.

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Article Synopsis
  • The management of complicated chronic type B dissection involving the distal aortic arch is debated, with thoracic endovascular aortic repair (TEVAR) often resulting in more late complications than open surgery.
  • A study reviewed the outcomes of 20 patients who underwent left subclavian artery transposition and stented elephant trunk implantation between 2011 and 2015, showing one in-hospital death and generally acceptable surgical outcomes.
  • This technique may serve as a viable alternative to TEVAR for patients with this specific condition.
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Objective: Complete or partial supra-aortic debranching, after thoracic endovascular aortic repair, is appealing treatment for complicated acute type B dissection (ABAD) with aortic arch involvement (AAI) because of reduced surgical trauma. However, unsatisfactory outcomes have been reported. We retrospectively reviewed our experience of left subclavian artery (LSCA) transposition with stented elephant trunk (SET) implantation for complicated ABAD with distal AAI.

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Article Synopsis
  • The study aimed to determine if previous cardiac surgery (PCS) increased the risk of short- and mid-term mortality in patients undergoing total aortic arch replacement for Stanford type A aortic dissection. //! -
  • Out of 384 patients studied, 36 had previous cardiac surgery; logistic regression showed that factors like prolonged cardiopulmonary bypass time and timing of surgery from symptom onset were significant risk factors, while PCS was not linked to higher mortality. //! -
  • Follow-up results showed a 96% five-year survival rate for patients without PCS, compared to 73% for those with PCS, but the difference in survival outcomes was not statistically significant (p=0.84). !*
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Objective: Various techniques have been introduced to treat acute type A dissection during aortic arch reconstruction. We retrospectively reviewed our experience of total arch replacement, with implantation of a stented elephant trunk, using preservation of autologous brachiocephalic vessels in patients with acute type A dissection.

Methods: Between August 2011 and April 2013, 20 patients (16 men, 4 women; mean age, 45 ± 10 years, range, 24-62 years) with acute type A dissection underwent total arch replacement combined with stented elephant trunk implantation, using preservation of autologous brachiocephalic vessels under hypothermic cardiopulmonary bypass with selective antegrade cerebral perfusion.

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Article Synopsis
  • EuroSCORE II is meant to assess risk for patients undergoing total aortic arch replacement but performed poorly in predicting prolonged mechanical ventilation after surgery.
  • The study analyzed data from 240 patients, revealing a 10% overall mortality rate and that 74 patients (approximately 30%) required mechanical ventilation for more than 48 hours post-surgery.
  • Key factors identified as increasing the risk for prolonged ventilation included age over 48.5 years, high preoperative leukocyte count, and symptom onset less than a week prior to surgery.
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