Assessing the cost-effectiveness of replacing antimetabolites with mTOR inhibitors in heart transplant immunosuppression in China: a network meta-analysis-based economic evaluation.

Background: Although several pharmacoeconomic studies have assessed the cost-effectiveness of maintenance immunosuppressive regimens for heart transplant recipients, economic comparisons between various combination drug therapies remain sparse.

Aim: This study used an economic evaluation based on network meta-analysis to assess the cost-effectiveness of four immunosuppressive regimens for adult heart transplant recipients in China.

Method: We conducted a systematic search for clinical trials in PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database.

A Physiologically Based Pharmacokinetic Approach to Recommend an Individual Dose of Tacrolimus in Adult Heart Transplant Recipients.

Tacrolimus is the principal immunosuppressive drug which is administered after heart transplantation. Managing tacrolimus therapy is challenging due to a narrow therapeutic index and wide pharmacokinetic (PK) variability. We aimed to establish a physiologically based pharmacokinetic (PBPK) model of tacrolimus in adult heart transplant recipients to optimize dose regimens in clinical practice.

[Clinical outcomes of radial artery as the second arterial conduit in coronary artery bypass].

To examine the clinical experience and outcomes of coronary artery bypass grafting (CABG) using radial artery as the second arterial graft. Totally 585 patients in whom both left internal thoracic artery and radial artery as arterial conduits were used in CABG in Department of Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University from April 2008 to August 2019 were consecutively enrolled. There were 436 males and 149 females, aging (63±10) years (range: 36 to 86 years).

Longitudinal observation of solitary fibrous tumor translation into malignant pulmonary artery intimal sarcoma.

Background: Pulmonary artery intimal sarcoma (PAIS) is a rare malignant tumor that was usually misdiagnosed as chronic pulmonary thromboembolism.

Case Presentation: We previously reported a solitary fibrous tumor in the pulmonary artery presented with acute pulmonary embolism, which was identified by Tc-Galacto-RGD imaging. However, this patient had a recurrence in situ two-year after surgery, post-operative pathology revealed pulmonary artery intimal sarcoma.

Over-expression of a plasma membrane H-ATPase SpAHA1 conferred salt tolerance to transgenic Arabidopsis.

The SpAHA1 gene, encoding a plasma membrane (PM) H-ATPase (AHA) in Sesuvium portulacastrum, was transformed into Arabidopsis plants, and its expression increased salinity tolerance of transgenic Arabidopsis plants: seed germination ratio, root growth, and biomass of transgenic plants were greater compared to wild-type plants under NaCl treatment condition. Upon salinity stress, both Na and H effluxes in the roots of SpAHA1 expressing plants were faster than those of untransformed plants. Transformed plants with SpAHA1 had lower Na and higher K contents relative to wild-type plants when treated with NaCl, resulting in greater K/Na ratio in transgenic plants than in wild-type plants under salt stress.

[Clinical research of aortic valve replacement in small aortic annulus].

Objective: To compare the effect aortic valve replacement(AVR) combined with aortic root enlargement and simple St.Jude Regent AVR in small aortic annulus patients.

Methods: From June 2008 to June 2012, 62 severe aortic valvular stenosis patients with small aortic annulus (annulus diameter of 15-21 mm) entered the study.

[A clinical study of preoperative prophylactic application of intra-aortic balloon pump in extreme high-risk patients undergoing coronary artery bypass grafting].

Objective: To compare the clinical outcome between the intra-aortic balloon pump (IABP) inserted in the preoperative prophylactic condition and in the emergent condition for the patients with extreme high risks undergoing coronary artery bypass grafting (CABG).

Methods: Totally 92 extreme high risk patients undergoing CABG combined with IABP supporting, whose European System for Cardiac Operative Risk Evaluation were equal or more than 12 points, some also undergoing surgical operations of myocardial infarction mechanical complications from January 2008 to June 2011, were analyzed retrospectively. According to the IABP established time, these patients were divided into two groups: preoperative group (57 cases) and passive group (35 cases).

Should bioprostheses be considered the valve of choice for dialysis-dependent patients?

Background: There is controversy regarding the choice of prosthetic valves in patients with cardiac valve disease and dialysis-dependent patients. This review assesses a 12-year experience and outcomes after valve replacement in patients on chronic preoperative renal dialysis, comparing survival and valve-related outcomes following valve replacement with bioprostheses versus mechanical prostheses in this population in china.

Methods: From January 1999 and October 2011, 73 consecutive dialysis patients underwent cardiac valve replacement.

Surgery for left ventricular aneurysm after myocardial infarction: techniques selection and results assessment.

Background: The most appropriate surgical approach for patients with post-infarction left ventricular (LV) aneurysm remains undetermined. We compared the efficacy of the linear versus patch repair techniques, and investigated the mid-term changes of LV geometry and cardiac function, for repair of LV aneurysms.

Methods: We reviewed the records of 194 patients who had surgery for a post-infarction LV aneurysm between 1998 and 2010.

[The outcomes of restrictive mitral annuloplasty and coronary artery bypass grafting for ischemic mitral regurgitation and reverse left ventricular remodeling].

Objective: To retrospectively summarize and analyze the short and mid term follow-up outcomes of combined coronary artery bypass grafting (CABG) and restrictive mitral annuloplasty in curing ischemic cardiomyopathy and ischemic mitral regurgitation (IMR), and to study its effect on reverse left ventricular remodeling.

Methods: From January 2000 to June 2008, 111 patients of coronary artery disease with moderate to severe IMR underwent combined CABG and restrictive mitral annuloplasty, downsizing by 1-2 ring sizes. There were 81 male and 30 female patients.

[Surgical treatment of post-infarction left ventricular aneurysm: clinical analysis].

Objective: To explore the clinical experiences, efficacies and postoperative left ventricular remodeling changes of surgical ventricular reconstruction in the treatment of post-infarction left ventricular aneurysm.

Methods: The investigators reviewed retrospectively the clinical data, operative approaches and follow-up outcomes of consecutive 194 patients with post-infarction left ventricular aneurysm, who underwent surgical ventricular reconstruction between January 1997 and December 2009. There were 54 cases in the linear group and 137 cases in the endoventricular patch plasty group.

[Experimental study on the option of antispasmodic drugs for radial artery in elderly patients with coronary atherosclerotic heart disease].

Objective: To compare the relief effect of diltiazem, papaverine and nitroglycerin on radial artery spasm in elderly patients with coronary atherosclerotic heart disease.

Methods: Sixty patients aged beyond 70 years underwent coronary artery bypass grafting (CABG) with autologous radial artery from July 2009 to March 2010. Redundant radial artery was collected and the relief function of different drugs was evaluated through "organ bath" technique in vitro.

[The morphometry and eNOS expression of radial artery in elderly patients with coronary atherosclerotic heart disease].

Objective: To compare the morphometry and endothelial nitric oxide synthase (eNOS) expression of radial artery (RA) between young and elderly patients with coronary atherosclerotic heart disease.

Methods: From February 2008 to June 2009, 219 patients underwent coronary artery bypass grafting (CABG) with autologous RA, 57 patients aged beyond 70 years and 64 patients aged under 60 years. Before RA was harvested, a modified Allen test was routinely performed.

[Clinical application of extracorporeal membrane oxygenation for severe heart failure during peri-operative period of end-stage cardiopathy].

Objective: To summarize the clinical effect and experience of extracorporeal membrane oxygenation (ECMO) support for severe heart failure during peri-operative period of end-stage cardiopathy.

Methods: From June 2007 to July 2010, 6 patients with severe heart failure during peri-operative period of end-stage cardiopathy received ECMO support. The changes in the hemodynamics and outcome of the patients during the use of ECMO were investigated.

Is mitral valve repair superior to replacement for chronic ischemic mitral regurgitation with left ventricular dysfunction?

Background: This study was undertaken to compare mitral valve repair and replacement as treatments for ischemic mitral regurgitation (IMR) with left ventricular dysfunction (LVD). Specifically, we sought to determine whether the choice of mitral valve procedure affected survival, and discover which patients were predicted to benefit from mitral valve repair and which from replacement.

Methods: A total of 218 consecutive patients underwent either mitral valve repair (MVP, n = 112) or mitral valve replacement (MVR, n = 106).

Evaluation of preoperative intra-aortic balloon pump in coronary patients with severe left ventricular dysfunction undergoing OPCAB surgery: early and mid-term outcomes.

Background: The purpose of the present study was to evaluate the safety and the cost-effectiveness of using preoperative IABP as support compared with postoperative IABP treatment in coronary patients with severe left ventricular dysfunction (SLVD) who is undergoing off-pump coronary artery bypass surgery (OPCAB), including early outcomes, hospital mortality and morbidity, and mid-term follow-up outcomes.

Methods: Between March 2000 and December 2008, we prospectively and randomly studied the insertion of preoperative IABP in 115 (7.4%) and postoperative IABP in 106 (6.

[Aortic arch operation under deep hypothermic circulatory arrest].

Objective: To summarize the surgical experience of aortic arch operation under deep hypothermic circulatory arrest.

Methods: 22 patients suffering from aortic dissection or descending aorta aneurysm with the involvement of aortic arch received operation under deep hypothermic circulatory arrest. Eight patients underwent ascending aorta and partial aortic arch replacement, one patient received aortic root, ascending aorta, and partial aortic arch replacement, 2 patients received ascending aorta and total arch replacement, 2 patients received aortic valve replacement plus ascending aorta and partial aortic arch replacement, 8 patients underwent ascending aorta and total arch replacement plus elephant trunk technique (stunted elephant trunk used in 6 cases), and 1 patient received left partial aortic arch and descending aorta replacement.

Novel surgical method of proximal anastomosis in off-pump coronary artery bypass grafting.

Background: Cerebral embolization as a result of aortic manipulation has emerged as an important risk factor for the incidence of stroke after off-pump coronary artery bypass grafting (OPACB).

Methods And Results: A new surgical technique for proximal anastomosis without using a side-biting clamp or any proximal anastomotic device in OPACB has been developed and successfully used for proximal anastomosis between a great saphenous vein or radial artery graft and the aorta in OPCAB of 138 patients, with good short-term results.

Conclusions: This novel technique proximal anastomosis in OPACB can be completed in a safe, easy and economical fashion.

[Impact of preoperative clopidogrel in coronary artery bypass grafting].

Objective: To analyze and assess the impact of clopidogrel given preoperatively in coronary artery bypass grafting (CABG) surgery.

Methods: From January 2005 to January 2007, 440 consecutive patients undergoing CABG surgery were divided into two groups: the clopidogrel group (with clopidogrel exposure in 5 days prior to surgery, n = 90) and the control group (without clopidogrel exposure > 5 days prior to surgery, n = 350). Patients undergoing emergency surgery because of failed percutaneous transluminal coronary angioplasty and cardiogenic shock, associated valvular surgery, redo-CABG were excluded.

[Coronary endarterectomy and bypass grafting without cardiopulmonary bypass for patients with diffused coronary artery disease].

Objective: To review and summarize the early outcomes and clinical experience of coronary endarterectomy (CE) and bypass grafting without cardiopulmonary bypass for patients with diffused coronary artery disease.

Methods: From May 2003 to May 2005, 53 patients with diffused coronary artery disease underwent CE and bypass grafting without cardiopulmonary bypass. There were 41 males and 12 females aged from 55 to 79 (mean 64 +/- 7) years old.