Introduction: This study report the clinical characteristics, surgical indications, surgical technique and initial outcomes of autologous pericardial aortic valve reconstruction using Ozaki’s procedure. Methods: The study included consecutive patients with isolated aortic valve disease who underwent Ozaki’s procedure between June 2017 and December 2019. Aortic valve cups were reconstructed by autologous pericardium using Ozaki’s procedure. Results: Seventy-two patients were enrolled (mean age 52.9 ± 13 years; 53 males) and consisted of 30 aortic stenosis cases, 20 aortic regurgitation cases, and 22 patients with a combination of both 72 patients, a bicuspid aortic valve was present in 20, and 7 patients had infective endocarditis. Surgery was performed via a full or partial sternotomy. The procedure was successful in 70 case, and two patients were converted to prosthetic valve replacement. The aortic cross-clamp time was 106.3 ± 13.8 minutes, cardiopulmonary bypass time was 136.7 ± 18.5 minutes. One patient died of cardiac tamponade in hospital, and two patients underwent reoperation due to bleeding and sternal infection, respectively, were observed during the follow-up period of 30 days. 1-month postoperative echocardiography revealed that one patient had moderate aortic valve regurgitation, max trans-valvular pressure gradient was 16.1 ± 2.3 mmHg, and aortic valve area was 2.5 ± 0.2 cm ². Conclusions: Aortic valve reconstruction using autologous pericardium by Ozaki’s procedure was feasible, good hemodynamics, and can be applied to all lesions of the aortic valve.
Background: It is important to evaluate the imaging of the left atrium (LA) and pulmonary veins (PV) before performing catheter ablation of atrial fibrillation. Several factors on computed tomography (CT) are related to the outcome of atrial fibrillation (AF) ablation. Methods: From 2/2020 to 5/2022, 45 patients who diagnosed of paroxysmal and persistent atrial fibrillation underwent RF ablation, chest CT scan obtained to evaluate left atrium and pulmonary veins at the Cardiovascular Center – E Hospital. Results: The mean age was 56.1±11.8, male/female was 3/1. Paroxysmal atrial fibrillation accounted for 68.9%. PV dimensions: right superior PV was 18.29 ± 2.39 mm and 16.14 ± 2.26 mm; right inferior PV was 17.63 ± 3.74 mm and 15.07 ± 3.82 mm; left superior PV was 18.60 ± 2.55 mm and 15.79 ± 2.43 mm; left inferior PV was 15.25 ± 1.88 mm and 12.08 ± 1.77 mm. The average diameter of LA measured in the superior-inferior, anterior-posteror directions were: 59.97 ± 7.03 mm, 36.70 ± 5.53 mm and 53.64 ± 8.81 m; respectively. The diameter before-after procedure and the procedure time in the group of patients with persistent AF was larger than that of patients with paroxysmal atrial fibrillation (p<0.05). Patients with paroxysmal AF had a higher success rate of ablation than those with persistent AF (OR=5.27, 95%CI: 1.48-18.80, p < 0.05). Patients who met the criteria for large anterior-posterior LA had a lower successful ablation result than patients without large LA (OR=2.04, 95%CI :1.03-4.04, p < 0.05) . Conclusion: Detailed left atrial and pulmonary venous imaging is essential when performing atrial fibrillation ablation. Paroxysmaltrial fibrillation has a better ablation outcome than persistent atrial fibrillation. Larger left atrial diameter is associated with a lower success rate of ablation.
Objective The study aimed to evaluate the indications and describe the aortic valve reconstruction techniques by Ozaki's procedure in Vietnam and report mid‐term outcomes of this technique in Vietnam. Methods Between June 2017 and December 2019, 72 patients diagnosed with isolated aortic valve disease, with a mean age of 52.9 (19–79 years old), and a male:female ratio of 3:1 underwent aortic valve reconstruction surgery by Ozaki's technique at Cardiovascular Center, E Hospital, Vietnam. Results The aortic valve diseases consisted of aortic stenosis (42%), aortic regurgitation (28%), and a combination of both (30%). In addition, the proportion of aortic valves with bicuspid morphology and small annulus (≤21 mm) was 28% and 38.9%, respectively. The mean aortic cross‐clamp time was 106 ± 13.8 min, mean cardiopulmonary bypass time was 136.7 ± 18.5 min, and 2.8% of all patients required conversion to prosthetic valve replacement surgery. The mean follow‐up time was 26.4 months (12–42 months), the survival rate was 95.8%, the reoperation rate was 2.8%, and rate of postoperative moderate or higher aortic valve regurgitation was 4.2%. Postoperative valvular hemodynamics was favorable, with a peak pressure gradient of 16.1 mmHg and an effective orifice area index of 2.3 cm2. Conclusions This procedure was safe and effective, with favorable valvular hemodynamics and a low rate of valvular degeneration. However, more long‐term follow‐up data are needed.
Background: The limb-lead criterion is a simple new standard with high diagnostic value to distinguish the cause of wide QRS tachycardia, easy to apply in emergency conditions. Methods: A cross-sectional descriptive study of 61 patients with electrocardiogram of wide QRS tachycardia at Cardiovascular Center- Hospital E and Vietnam Heart Institute- Bach Mai Hospital from January 2017 to October -2022. Evaluating the value of limb – leads Criterionand comparing to several other criteria. Results: In 61 patients, 43 patients with VT, 18 patients with SVT, 54.1% male, history of ischemic heart disease (3.3%), heart failure (11.5%), no history structural cardiovascular disease (83.6%). Mean heart rate was 182, 80 ± 20.58 bpm, average QRS width was 137.89 ± 12.59mms. Sensitivity, specificity, positive predictive value, negative predictive value of Brugada criterionwere 97.7%, 88.9%, 95.5%, 94.1%, respectively; of Pava criterionwere 53.5%, 88.9%, 92%, 44.4%; of Vereckei criterionwere 60.5%, 100%, 100%, 51.4%; of limb-leads criterion is 86.1%, 83.3%, 92.5%, 71.4%; when combining Limb lead and Pava criteriawere 90.9%, 82.4%, 93%, 77.8%. Conclusion: The limb-lead criterion is an easy-to-usealgorithm, only using morphology to distinguish wide QRS tachycardias, has high diagnostic value, so it should widely applied in cardiovascular emergency.
Objectives: The study aimed to evaluate clinical and paraclinical characteristics of left atrial myxoma and the early result of minimally invasive left atrial myxoma resection at E hospital. Patients and methods: This is retrospective, descriptive study of consecutive patients, who underwent minimally invasive left atrial myxoma rejection, using total or video-assisted endoscopic technique from October 2016 to March 2021 at E hospital. There were 31 patients, consisting of 27 females and 04 males. The mean age was 53 ± 13 years old (range [17-74]). Results: Preoperative clinical manifestations were diverse. Asymptomatic form was in 3 patients (9.7%), hemodynamic symptoms were in 26 patients (83.9%), embolism were presented in 4 patients (12.9%), systemic symptoms were in 8 patients (25.8%). Anemia and elevated erythrocyte sedimentation rates were observed in 45.2% and 74.2%, respectively. Echocardiography results: the average tumor size was 4.2 ± 1.7 cm (range [1.7-8]), the site of attachment was mainly in the atrial septum (77.4%). Cardiopulmonary bypass time was 158 ± 43 minutes (range [100-252]), cross-clamp time was 84 ± 34.2 minutes (range [42-153]), ventilation time was 10,8 ± 7,0 hours (range [3-30]), intensive care unit stay was 1,5 ± 1,0 days (range [0.5-4]), and in-hospital stay was 9.5 ± 5.0 days (range [3-30]). There was no hospital mortality. Cerebrovascular accident was presented in one (3.2%), femoral artery stenosis was in one (3.2%), atrial fibrillation after surgery was in one(3.2%).There was no bleeding, that require reoperation, and no other serious complications. Conclusions: Initial results of left atrial myxoma resection, using minimally invasive total or video-assisted technique wassafe and effectivewith low complications, could be recommended toapply routinely in cardiac surgery centers.
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