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Background We sought to analyze clinical features and surgical results of 10 cases of cardiac myxomas in Carney complex (CNC). Methods Between January 2003 and December 2013, 10 patients with cardiac myxomas in CNC underwent surgical resection. Associated cardiac lesions included moderate and severe mitral regurgitation in two cases, and moderate tricuspid regurgitation in one case. Age, gender, the incidence of arterial embolism, the rate of multiple cardiac myxomas, and the recurrence rate after resections of cardiac myxoma were compared between isolated cardiac myxomas and cardiac myxomas in CNC. Results The incidence of cardiac myxoma in CNC was 1.74% (10/574). There were no deaths following surgery. There was one late death due to cerebral embolism 40 months following a reoperation (10%). A significant difference was found in the age, the incidence of arterial embolism, the rate of multiple cardiac myxomas, and the recurrence rate after resection of cardiac myxoma between cardiac myxoma in CNC and isolated cardiac myxoma (P < 0.05). There was no significant difference in gender between cardiac myxoma in CNC and isolated cardiac myxoma (P > 0.05). Conclusions Complex myxomas in CNS present at an earlier age, are more prevalent in women than in men, are more often multicentric, with a higher rate of arterial embolism and a high recurrence rate after resection. Close follow‐up for cardiac myxoma in CNC after surgery is necessary due to the high recurrence rate.

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Background It is well established that postoperative atrial fibrillation (POAF) is associated with adverse postoperative outcomes after major cardiac operations. The purpose of this study was to investigate the incidence of new‐onset POAF after successful total arch repair surgery and the association between POAF and in‐hospital mortality. Methods and Results All consecutive patients undergoing total arch repair from September 2012 to December 2019 in Fuwai hospital were enrolled (n=1280). Patients diagnosed with preoperative atrial fibrillation were excluded. POAF was diagnosed as the new‐onset atrial fibrillation or flutter for more than 5 minutes based on continuous electrocardiogram monitoring. A logistic regression model was used to determine predictors of in‐hospital mortality. Multivariable adjustment, inverse probability of treatment weighting, and propensity score matching were used to adjust for confounders. POAF was diagnosed in 32.3% (411/1271) of this cohort population. The occurrence of new‐onset POAF was associated with age (odds ratio [OR], 1.05; 95% CI, 1.04–1.06; P <0.001), male sex (OR, 0.72; 95% CI, 0.52–0.98; P =0.035), and surgery duration (OR, 1.2; 95% CI, 1.12–1.28; P <0.001). The in‐hospital mortality was significantly higher in patients with POAF than those without POAF (10.7% versus 2.4%, P <0.001). Inverse probability of treatment weighting and propensity score matching analyses confirmed the results. The increased in‐hospital mortality in POAF group still existed among subgroup analysis based on different age, sex, hypertension, smoking, and hypokalemia, combined with cardiac surgery, and deep hypothermic circulatory arrest. Conclusions More careful attention should be given to POAF after total arch repair surgery. The incidence of POAF after total arch repair surgery was 32.3% and associated with increased in‐hospital mortality. The elderly female patient who experienced longer operation duration was at highest risk for POAF.

Background: This study employed three surgical techniques: total arch replacement (TAR) with frozen elephant trunk (FET), aortic balloon occlusion technique (ABO) and hybrid aortic arch repair (HAR) on patients with type I aortic dissection in Fuwai Hospital, aiming to compare the early outcomes of these surgical armamentariums.Methods: From January 2016 to December 2018, an overall 633 patients (431 of TAR+FET, 122 of HAR, and 80 of ABO) with type I aortic dissection were included in the study. Thirty-day mortality, stroke, paraplegia, re-exploration for bleeding, and renal replacement therapy were compared using the matching weight method (MWM).Results: After MWM process, the baseline characteristics were comparable among three TAR groups. It showed that ABO group had the longest cardiopulmonary bypass (p &lt; 0.001) and aortic cross-clamp time (p &lt; 0.001), while the operation time was longest in the HAR group (p = 0.039). There was no significant difference in 30-day mortality among groups (p = 0.783). Furthermore, the incidence of stroke (p = 0.679), paraplegia (p = 0.104), re-exploration for bleeding (p = 0.313), and CRRT (p = 0.834) demonstrated no significant difference. Of note, no significant differences were found regarding these outcomes even before using MWM.Conclusions: Based on the early outcomes, the three TAR approaches were equally applicable to type I aortic dissection. We may choose the specific procedure relatively flexibly according to patient status and surgeon's expertise. Importantly, long-term investigations are warranted to determine whether above approaches remain to be of equivalent efficacy and safety.

Bio-based polyimide (PI)/halloysite nanotube (HNT) nanocomposites based on 2,5-furandicarboxylic acid were prepared by in situ polymerization. The pristine HNTs were modified by tetraethoxysilane (TEOS) and 4,4′-oxybisbenzenamine (ODA). The bio-based PI/HNT nanocomposite film exhibited lower moisture absorption than pure bio-based polyimide, showing that the water resistance of the bio-based polyimide film was improved. The thermal stability and glass transition temperature (Tg) of PI/HNTs nanocomposites were improved with the addition of modified HNTs. Both the tensile strength and Young’s modulus of bio-based PI/HNTs nanocomposite films were enhanced. A 37.7% increase in tensile strength and a 75.1% increase in Young’s modulus of bio-based PI/HNTs nanocomposite films, with 1 wt% of the modified HNTs, were achieved. The result confirmed that 2,5-furandicarboxylic acid could replace the oil-based material effectively, thus reducing pollution and protecting the environment. Finally, a preparation mechanism to prepare bio-based PI/HNTs nanocomposite is proposed.

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Objective: The duration of hypothermic circulatory arrest (HCA) is one of the important factors affecting the prognosis of arch surgery, which is still controversial. The purpose of this study was to investigate the effect of HCA duration on early prognosis in type A aortic dissection (TAAD) patients who underwent arch surgery in our center.Methods: All consecutive patients who underwent surgical treatment for TAAD in Fuwai Hospital from January 2013 to December 2018 were included in this study and divided into four quartile groups based on HCA time. Baseline characteristics, perioperative indicators, and early mortality were statistically analyzed by propensity score matching (PSM) and restricted cubic spline (RCS) method. Perioperative adverse events were confirmed according to the American STS database and Penn classification.Results: About 1,018 consecutive patients (mean age 49.11 ± 1.4 years, male 74.7%) with TAAD treated surgically were eventually included in this study. After PSM, with the prolongation of HCA time, the surgical mortality rates of group [2,15], (15,18], (18,22], and (22,73] were 4.1, 6.6, 7.8, and 10.9% with p = 0.041, respectively. As shown in RCS, the mortality rate increased sharply after the HCA time exceeded 22 min. And from the subgroup analysis, the HCA time of 22 min or less was associated with better clinical outcomes (OR 2.09, 95%CI 1.25–3.45, p = 0.004).Conclusions: The early mortality increases significantly with the duration of HCA time when arch surgery was performed. And multiple systems throughout the body can be adversely affected.