Biomedical subjects

Cun-tao Yu

Publications and source records attributed to Cun-tao Yu.

7 recordsLinked to original sources

PubMed2006

[One-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest].

OBJECTIVE: To summarize the experience in one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest. METHODS: From August 2003 to May 2005 38 patients with thoracoabdominal aortic disease, including severe extensive thoracoabdominal aorta of Crawford II type (n = 4), chronic Stanford type B dissecting aneurysm (n = 24), chronic Stanford type A dissecting aneurysm (n = 5), and Marfan's syndrome with chronic Stanford type B dissecting aneurysm (n = 5), 25 males and 13 females, aged 40 +/- 9 (22-58), underwent one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest. RESULTS: Two patients died during the early post-operational period with a mortality of 5.26%. Four patients showed cerebral complications with an incidence of 10.5% and were cured after hydration therapy. Acute kidney dysfunction occurred in 2 patients and was cured by hemodialysis. CONCLUSION: With simplified operational procedure, one-stage total thoracoabdominal aorta replacement with four branch vessel prosthesis under deep hypothermic cardiopulmonary bypass and subsection circulatory arrest significantly shortens the ischemic time of brain, spinal cord, and other major organs and has an excellent effect.

Adult↗

PubMed2005

[Clinical application of total or subtotal aortic replacement on the one stage].

OBJECTIVE: To summarize the experience of the application of total and subtotal aortic replacement on the one stage in the treatment of the patients with extensive aortic aneurysm and chronic Stanford type A dissecting aneurysm. METHODS: From February to November 2004, 8 patients (7 male and 1 female; ranging from 23 to 47 years old) underwent one-stage total or subtotal aortic replacement under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion. Two patients received subtotal aortic replacement (from the aortic valve to the abdominal aorta). Six patients underwent total aortic replacement (from the aortic valve to the aortic bifurcation), of which 3 patients had aortic valve replacement. Patients were with mid-sternotomy and thoracoabdominal incision. The ascending aorta was firstly replaced, following which the aortic arch was reconstructed. Finally, the thoracoabdominal aorta was fully replaced. RESULTS: There was no operative or early postoperative death. One patient had cerebral infarction secondary to embolism. Spinal neurological deficits didn't occur. All 8 patients were alive and had good functional status 2 to 12 months after operation. CONCLUSION: The patients performed with one-stage total and subtotal aortic replacement achieves good results. It can eliminate the risk of remnant aneurysm rupture in staged total aortic replacement.

Adult↗

PubMed2005

[The application of modified classification of the aortic dissection].

OBJECTIVE: To determine the indication, optimal operative procedures, plan and the estimation of the prognosis depending on the subtype of aortic dissection defined by the extension and extent of dissection. METHODS: The outcome of 708 patients with aortic dissection between January 1994 and December 2004 was analyzed. Among them 477 patients suffered from Stanford type A aortic dissection were treated. Type A dissection can be classified into 3 subtypes based on the pathological change of the aortic root. Type A1 (No pathological change type): 212 patients underwent ascending aorta replacements; Type A2 (mild pathological change type): 63 patients underwent ascending aortic replacement with concomitant aortic valve and valsalva sinus plasty and David procedure was performed in 9 patients; Type A3 (severe pathological change type): 193 patients underwent Bentall procedure. The method of aortic arch repair was determined by the pathological type of distal aorta. Total aortic arch replacement was performed in 78 patients with complex type (type C). There hundred and ninety-nine patients with simple type (type S) underwent partial aortic arch replacement. 231 patients suffered from Stanford type B aortic dissection. Type B dissection can be classified into 3 subtypes based on dilated extension of proximal descending aorta. Type B1 (no dilation was confined in the proximal of thoracic descending aorta): endoluminal stent graft repair was performed in 103 patients. Replacement of the partial proximal thoracic descending aorta and replacement combined with stented elephant trunk procedure were performed in 32 and 12 patients respectively; Type B2 (aneurysm in thoracic descending aorta): 32 patients underwent the part proximal thoracic descending aorta replacement combined with aorta plasty. 21 patients underwent the replacement of entire thoracic descending aorta; Type B3 (aneurysm in thoracic descending and abdominal aorta): thoracoabdominal aortic replacement was operated in 31 patients with deep hypothermia circulatory arrest; Type BC (complex type): 44 patients were performed the operation with the use of deep hypothermia circulatory arrest because their left subclavian arteries or distal aortic arch were affected by the dissection; Type BS (simple type): 103 patients were underwent endoluminal stent graft repair. In the 60 patients, the operations were performed by using the technique which preserved blood was transfused back by pump via the femoral artery. Femoro-femoral bypass was performed in 24 patients. RESULTS: Type A: the operative mortality was 4.6% (27/477), and the hospital morbidity was 14.5% (69/477). Type B: the hospital mortality of endoluminal stent graft repair was 1.9% (2/103). 9.7% (10/103) had mild leakage from proximal communications. The morbidity was 2.9% (3/103) in stent group. The mortality was 3.1% (4/128), and the hospital morbidity was 18.8% (24/128) in the operative group. CONCLUSION: The subtype of aortic dissection is much useful in determining the optimal procedure, operative indication and plan, estimating the prognosis.

Adult↗

PubMed2005

[Dexterously use four branch vessel prosthesis on aortic surgery].

OBJECTIVE: To review the experience of various positions aortic replacement by four branch prosthesis vessel. METHODS: From August 2003 to May 2005, we finished aortic procedures with four branch prosthesis vessel for 142 patients, aged (44 +/- 12) (22-78) years, weighted (72 +/- 20) kg (49-130 kg). We performed ascending aorta and total aortic arch replacement for 85 cases during right axillary artery cannulation for cardiopulmonary bypass and selected antegrade cerebral perfusion. 38 patients underwent one-stage total thoracoabdominal aortic replacement during deep hypothermic bypass and subsection circulatory arrest. 8 patients underwent one-stage total or subtotal aortic replacement during deep hypothermic bypass and selected antegrade cerebral perfusion and subsection circulatory arrest. We performed totally aortic arch replacement without utilizing cardiopulmonary bypass and hypothermic for 11 cases. RESULTS: The mortality was 4.2%. Cerebral complications occurred in 16 (11.3%). 2 patients suffered from permanence spinal cord dysfunction. 4 patients suffered from temporary spinal cord dysfunction. CONCLUSION: The four branch vessel prosthesis can be used on aortic surgery dexterously. The approach may shorten she time of aortic arrest and arterial construction.

Adult↗

PubMed2004

[Decellularized human tissue engineering aortic valves conduit].

OBJECTIVE: To explore the suitable method to create a decellularized human tissue engineering homograft aortic valves conduit and to study its biologic, immol/Lunological, and biomechanical properties. METHODS: Human homograft aortic valves conduits donated by healthy adult males undergoing brain death preserved in liquid nitrogen were treated with pH 8.0 hypotonic Tris buffer for 12 hours; then pH 8.0 isotonic buffer with 0.5% DOA, 1% DOA or 1% Triton for 12 hours-24 h; l and then pH 7.6 isotonic buffer with DNAase 200 micro g/ml, RNAase 20 micro g/ml for 2 hours. the histology, HLA-DR antigen, water content, thinkness, denaturation temperature, DNA content, Collagen Contents, stress-strain, destroying stress were examined. RESULTS: In comparison with the standard cryopreserved human homograft aortic valves conduit, the valves, wall and muscle of the homograft aorta treated by 1% DOA for 24 hours were decellularized completely, and the 3-dimensional network structure of elastic fibers and collagenous fibers remained intact. Immol/Lunohistochemistry showed a remarkable decrease of expression of tissue genome DNA contents, a decrease by 91.14% in the valves, and by 91.53% in the wall, and a remarkable decrease of the expression of HLA-DR antigens. However, the water content in the decellular aortic wall was increased significantly (75.4 +/- 1.8 vs 82.0 +/- 0.7, P < 0.05). No significant differences were found in the denaturation temperature, stress-strain, destroying stress parameter, and tissue extension ratio in the decellular human homograft aortic valves conduits. CONCLUSION: The decellularization method by isotonic buffer with 1% DOA-DNAase is effective. The decellularized human homograft aortic valves conduits are unaltered in biologic, biomechanical, and physical properties with lowered immol/Lunogenicity, It can be used as an ideal valve for patients or as a homograft stent for developing tissue engineering valve by host recellularization.

Adult↗

PubMed2004

[Pulmonary artery perfusion with hypothermic solution inhibits the apoptosis of lung parenchymal cells during cardiopulmonary bypass].

OBJECTIVE: To study effects of pulmonary artery perfusion with hypothermic solution on the apoptosis of lung parenchymal cells during cardiopulmonary bypass. METHODS: Forty children with tetralogy of Fallot were divided into control group (n = 20) and protective group (n = 20). The patients in control group were performed using routine approaches. Patients' pulmonary artery were infused with 4 degrees C protective solution during cardiopulmonary bypass in protective group. Lung biopsy specimens were obtained after operations in order to study the apoptosis of lung parenchymal cells using tunnel techniques. At same time, patients' pulmonary functions and clinic index were monitored. RESULTS: The rate of apoptosis cells of lung parenchymal cells was (18 +/- 7)% in control group, whereas (10 +/- 2)% in protective group. There was significant difference between both groups (t = -2.95, P < 0.05). Index O(2) in protective group was higher than that in control group at 0, 6 and 12 hours after operations [(492 +/- 172), (444 +/- 104), (489 +/- 58) mm Hg versus (369 +/- 126), (347 +/- 107), (340 +/- 119) mm Hg, t = 2.59, P < 0.05; t = 2.88, P < 0.01; t = 5.06, P < 0.01, respectively)]. The time of mechanical ventilation was significantly shorter in protective group than in control group [(15 +/- 11) hours versus (26 +/- 15) hours, t = -2.76, P < 0.01]. CONCLUSION: Pulmonary artery perfusion with hypothermic solution can inhibit the apoptosis of lung parenchymal cells and relieve cardiopulmonary bypass-induced lung injury.

Apoptosis↗

PubMed2004

[Quantitative structural study of pulmonary artery in patients with pulmonary atresia with ventricular septal defect ].

OBJECTIVE: In order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group. METHODS: Lung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis. RESULTS: There were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision. CONCLUSIONS: The density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.

Abnormalities, Multiple↗