The effects of cardiopulmonary bypass on pulmonary function during robotic cardiac surgery.

Background: We aimed to investigate the effects of cardiopulmonary bypass (CPB) on pulmonary function under the conditions of one-lung ventilation (OLV) and carbon dioxide pneumothorax in robotic cardiac surgery.

Methods: Ninety-eight patients underwent robotic cardiac surgery using the da Vinci Surgical System, including 58 on-pump surgeries and 40 off-pump surgeries. Respiratory parameters and arterial blood gases were assessed at the following time points: 25 min after the induction of anesthesia under two-lung ventilation (T1), 25 min after OLV (T2), 25 min after the termination of CPB under OLV in the on-pump group or 25 min after the main surgery intervention in the off-pump group (T3) and 20 min before the end of surgery (T4).

Robotic cardiac surgery: an anaesthetic challenge.

Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart.

[Impact of prior percutaneous coronary intervention on outcome of coronary artery bypass graft surgery].

Objective: To determine the impact of prior percutaneous coronary intervention (PCI) on outcome of coronary artery bypass graft (CABG) surgery.

Methods: Perioperative data were collected from 1306 patients undergoing CABG from January 2002 to November 2010, including 117 patients with prior PCI and 1 189 patients without prior PCI. Among 117 patients with prior PCI, 99 patients had a single PCI procedure and 18 had multiple PCI procedures.

Anesthesia management of totally endoscopic atrial septal defect repair with a robotic surgical system.

Study Objective: To investigate anesthetic techniques for robot-assisted endoscopic atrial septal defect (ASD) repair.

Design: Clinical observational study.

Setting: Operating room of a general military hospital.

Totally endoscopic robotic atrial septal defect repair on the beating heart.

Background: Atrial septal defect (ASD) repairs have successfully been performed on the arrested heart with the da Vinci S Surgical System (Intuitive Surgical). This study assessed the feasibility, safety, and efficacy of the use of the da Vinci S Surgical System for on-pump ASD repairs on the beating heart without cross-clamping the aorta.

Methods: This prospective study included 24 consecutive patients who underwent ASD repair surgery between June 2008 and June 2009.

Pravastatin attenuates cardiac dysfunction induced by lysophosphatidylcholine in isolated rat hearts.

Lysophosphatidylcholine (LPC), which accumulates in the ischemic myocardium, is responsible for mechanical and metabolic derangements of hearts, and also contributes to the development of ventricular arrhythmias. We examined the effects of pravastatin on the LPC-induced cardiac dysfunction in isolated rat hearts. Rat hearts were randomly divided into four groups.

Reconstruction of the architecture of ventricular myocardial fibers in ex vivo human hearts.

Background: The 3-dimensional arrangement of the ventricular mass has been controversial. The aim of the present study was to investigate the macroarchitecture of ventricular myocardial fibers and to analyze whether it is consistent with the helical ventricular myocardial band (HVMB) hypothesis.

Methods: Eight excised human hearts were scanned by diffusion tensor magnetic resonance imaging (DT-MRI).

Clopidogrel and aspirin versus clopidogrel alone on graft patency after coronary artery bypass grafting.

Background: Clopidogrel and aspirin are the most popular antiplatelet agents for anticoagulation management after coronary artery bypass grafting (CABG) in clinical practice, but there is neither a standard antiplatelet therapy for patients undergoing CABG, nor an exact conclusion about its effects on graft patency until now.

Methods: One-hundred and ninety-seven selected patients undergoing CABG were assigned to two groups according to antiplatelet drug: the clopidogrel group of 102 patients who received clopidogrel (75 mg) daily; and the combination group of 95 patients who received clopidogrel (75 mg) plus aspirin (100 mg) daily. Multislice computed tomography angiography was performed to evaluate graft patency at 1 month and 12 months after CABG.

Investigation on the structure of ventricular mass using magnetic resonance diffusion tensor imaging.

Objective: The 3-dimensional arrangement of the ventricular mass remains controversial. In this study, we used magnetic resonance diffusion tensor imaging (MRDTI) in an attempt to determine whether the ventricular mass is arranged in the form of a helical ventricular myocardial band (HVMB) and what the geometrical features of the HVMB are in postmortem pig hearts.

Materials And Methods: Ten pig hearts were harvested from the slaughterhouse, and their whole-body MR images were obtained.

Hybrid coronary revascularization by endoscopic robotic coronary artery bypass grafting on beating heart and stent placement.

Background: Hybrid revascularization has been used in minimally invasive coronary artery bypass grafting and percutaneous coronary intervention for multivessel coronary artery disease (CAD). Very few endoscopic robotic coronary bypasses on the beating heart have been reported. The aim of this study was to assess hybrid revascularization by endoscopic robotic coronary artery bypass on the beating heart with percutaneous coronary intervention in a staged approach.

Comparison of graft patency for off-pump and conventional coronary arterial bypass grafting using 64-slice multidetector spiral computed tomography angiography.

Off-pump coronary artery bypass graft surgery (OPCAB) has been performed for many years and its use is increasing frequently, but it remains an open question whether OPCAB provides similar patency to conventional coronary artery bypass graft (CCABG) surgery with cardiopulmonary bypass. The present study assessed the graft patency in patients that had coronary arterial bypass grafting (CABG) performed on-pump and off-pump. A total of 237 patients with CABG performed by a single surgeon were retrospectively studied, in which 100 patients underwent CCABG and 137 patients underwent OPCAB; the two groups were well matched according to relative factors and no significant differences were found in both groups.

[Protective effects of ulinastatin on ischemia/reperfusion injury in the rabbit lung in traumatic hemorrhagic shock].

Objective: To investigate the effects and mechanisms of ulinastatin on activities of myeloperoxidase (MPO) in lung tissue and neutrophil elastase (NE) in bronchoalveolar lavage fluid and to evaluate the protective effects of ulinastatin on rabbit lung in traumatic hemorrhagic shock.

Methods: Thirty rabbits were randomly assigned to three groups: control group, traumatic hemorrhagic shock group and ulinastatin-treatment group. The traumatic hemorrhagic shock model was reproduced by producing: femur fracture and femoral artery bleeding to reduce the mean artery pressure to (40+/-5) mmHg (1 mmHg=0.

Mitral valve aneurysm with infective endocarditis.

A case of mitral valve aneurysm associated with infective endocarditis is reported. Two-dimensional echocardiography revealed a saccular structure in the anterior leaflet that bulged into the left atrium throughout the cardiac cycle. During operation, the vegetation on the commissure of the right and left aortic leaflet and a 3-mm perforation on the noncoronary leaflet were found.