Objectives
To compare the advantages and disadvantages of perventricular and
percutaneous procedures for treating isolated ventricular septal defect
(VSD).
Methods
A total of 572 patients with isolated VSD were selected in our hospital
between January 2015 and December 2016. The patients’ median age and weight
were five years (1-26 years) and 29 kg (9-55 kg), respectively. The median
diameter of VSD was 6.0 mm (5-10 mm). Patients were divided into two groups.
In group A, perventricular device closure was performed in 427 patients; in
group B, 145 patients underwent percutaneous device closure.
Results
Four hundred twelve patients in group A and 135 patients in group B underwent
successful closure. The total occlusion rate was 98.5% (immediately) and
99.5% (3-month follow-up) in group A, which were not significantly different
from those in group B (97.7% and 100%, respectively). Patients in group A
had longer intensive care unit (ICU) stay than those in group B, but
patients in group B experienced significantly longer operative times than
those in group A. The follow-up period ranged from 8 months to 1.5 year
(median, 1 year). During the follow-up period, late-onset complete
atrioventricular block occurred in two patients. No other serious
complications were noted in the remaining patients.
Conclusion
Both procedures are safe and effective treatments for isolated VSD. The
percutaneous procedure has obvious advantages of shorter ICU stay and less
trauma than the perventricular procedure. However, the perventricular
procedure is simpler to execute, results in a shorter operative time, and
avoids X-ray exposure.
Objective
To investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD).
Methods
Patients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed.
Results
A total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023–17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991–29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719–7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192–5.106, P = 0.035) were independently associated with an increased risk of longer LOS.
Conclusion
Patients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.
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