Biomedical subjects
Publications and source records attributed to Wu-Jun Wang.
Based on the improved design of the existing thoracic cavity closed drainage system, a new multi-functional device is developed and is described here in detail. The device is more convenient and more efficient than the existing system. Besides, it has a function of autotransfusion. Animal experimental results show that it has attained the goal of the improved design.
OBJECTIVE: To study in vivo calcification and biomechanics of the ultra-microporous expanded polytetrafluo- roethylene (UePTFE) in rabbits in comparison with glutaral-treated bovine pericardium (BP), so as to assess the potential of UePTFE as a material for cardiac valve prosthesis. METHODS: Factorial analysis was adopted in the experiment. UePTFE and glutaral-treated BP of appropriate sizes were embedded beneath skin of young New Zealand rabbits, and at 0, 1, 3 and 6 months following the implantation, the materials were measured for the content of calcium and biomechanics properties. RESULTS: Lower level of calcification of the UePTFE occurred after the implantation, as compared with BP, and the biomechanics indices of the former UePTFE were obviously suprior to those of the latter. CONCLUSION: UePTFE is a better material than BP for cardiac valve prosthesis.
OBJECTIVE: To study the echocardiographic features during the period free of acute allograft rejection after heart transplantation by monitoring one patient within one year after heart transplantation. METHODS: The dimension of atrial and ventricular, interventricular septal and ventricular wall thickness, blood flow pattern through the mitral and tricuspid valves, left ventricular muscle weight (LVMW) and LVMW index during different periods were measured by echocardiography, and all these data were compared with those of the donor before operation. RESULTS: The patient recovered well without any signs of acute rejection. Echocardiography revealed that the dimension of right atrial, left and right ventriculars decreased significantly while left atrial showed significant increase, with obvious increase in the interventricular septal and ventricular wall thickness. LVMW and LVMW index were also significantly increased. The peaks E-and A.wave velocifies of the mitral and tricuspid E peak flow velocity decreased significantly, while the A peak flow velocity of the tricuspid did not undergo any significant changes. Mitral back flow occurred 4 months after the operation and tricuspid back flow persisted after operation. CONCLUSIONS: The changes of morphology, structure and function of the transplanted heart during periods without rejection are to some extent specific to this special phase, when some of these changes are similar to those during early acute rejection, and correct diagnosis relies on endo-myocardial biopsy.
OBJECTIVE: To assess the hydrodynamical performance of the valve prosthesis made of expanded ultra-microporous Teflon in vitro. METHOD: Sheets of the expanded ultra-microporous Teflon were sewn onto flexible bracket to prepare artificial valve prosthesis. The leakage and steady flow of the valve prosthesis was tested in vitro with Baxter valve prosthesis as control. RESULTS: The rate of leakage of this new valve prosthesis was similar to that of Baxter valve prosthesis (P>0.05), and the systolic pressure gradient of the former was much lower than control(P<0.05). CONCLUSION: This new artificial valve prosthesis has good in vitro hydrodynamical properties, which are superior to Baxter valve.
A 23-year-old male patient, who was stabbed in the left chest at the fourth intercostal space leaving a 4-cm wound, was in agonal state with blood pressure of 0/0 kPa when admitted. The patient underwent emergency room thoractomy on stretcher through the left fourth intercostal anterior lateral incision 16 min after injury. The exploration revealed 2 500 ml blood in the plural cavity, 4-cm wound in the pericardium, 2-cm wound in the right ventricle of the heart without asystole, and 5-cm wound in the left upper lobe of the lung. Within 4 min the wound in the heart was sutured with the pericardium as the backing. The patient was discharged with full recovery 8 d after injury.
Coronary artery bypass grafting and mitral valve replacement was performed simultaneously under cardiopulmonary bypass in a patient suffering from both coronary artery disease and severe mitral incompetence. The operation was completed smoothly with uneventful postoperative recovery of the patient. The author called for due attention to the importance of precise preoperative diagnosis and addressed the issues of the operation procedure and protection of myocardium.
OBJECTIVE: To provide a systemic evaluation of left parasternal approach (LPSA) for its clinical application. METHODS: LPSA was performed in 6 randomly-chosen formalin-preserved adult cadavers and the excisions were evaluated in external light of the external appearance, extent of traumatic injury and exposure of the structures in the thoracic cavity. RESULTS: LPSA left only short and less obvious skin incisions, thus causing minimal exterior appearance impairment. With a small operative field and only a few structures injured by this approach, LPSA had acceptable traumatic lesions and when the adequate intercostal level was chosen, the lateral structures on the left of the heart could be well exposed. CONCLUSION: LPSA is less invasive and involves acceptable external appearance impairment. Though satisfactory in exposing the structures on the left of the heart, LPSA can not properly expose the structures on the right side.
Based on the experience in coronary artery bypass grafting (CABG), the author addresses some problems emerging from the practice of this surgery. The author proposes that (1) Coronary artery diseases with extensive myocardial infarction and chronic congestive heart failure may not be the absolute contraindications to CABG, and the decision for the operation should be derived from the presence of extensive stunned myocardium and a careful evaluation if the artery in the infarcted area can afford CABG. (2) To decide on the presence of stunned myocardium in the infarcted area, examination with positive electron tomography (PET) should be performed. (3) In recent years, CABG has been successfully performed in some cases of serious heart failure (with left ventricular eject fraction<30%) with the support of intraaortic balloon pump during and after operation. Intraaortic balloon pump has made off-pump CABG possible for patients that used to be denied this chance. (4) Similar to standard CABG procedures, off-pump CABG is by no means faultless and its indications at the time being have not yet been well defined. (5) Sequential anastomosis also has its disadvantages. When not a few large target arteries need anastomosis while graft vessels are not sufficient and serious atherosclerosis of the ascending aorta is present, this technique should been adequately applied. (6) Endarterectomy may give rise to thrombosis but in some cases it seems to be compulsory. The author suggests 3 indications for considering endarterectomy.
OBJECTIVE: To explore the approach for coronary artery bypass grafting without cardiopulmonary bypass and assess the feasibility and safety of this procedure. METHODS: The clinical data of 6 patients receiving coronary artery bypass grafting without cardiopulmonary bypass were reviewed. RESULTS: No death occurred in these patients during the operation and the follow-up visit for 3 to 12 months found no incidence of angina pectoris, and the life quality of the patient was obviously improved. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass is applicable in patients with multiple coronary artery disease, especially those at high risk for cardiopulmonary bypass procedures.
OBJECTIVE: To review our experience in surgical treatment of ascending aortic aneurysm (AAA) with aortic insufficiency in 14 cases of by Bentall's procedure. METHODS AND RESULTS: All the patients underwent replacement of the ascending aorta and aortic valve with composite valved vascular prosthesis and received direct implantation of the aortic graft of the coronary orifices (Bentall's procedure) with satisfactory results. Five patients had ascending aortic dissection and 4 had typical Marfan's syndrome. All the patients suffered severe aortic insufficiency while 2 had mitral insufficiency. Coronary orifices were implanted in situ in 13 cases while in 1 case, Cabrol's method was adopted. No death occurred during the surgery and in the subsequent follow-up, and all the patients had good recovery. CONCLUSION: Bentall's procedure can be effective in the treatment of AAA with aortic insufficiency.