Recently, almost all heart disease can be surgical, and get good results. However, because cardiac arrest marks the termination of human life, so heart surgery is very dangerous. Cardiac surgery the last two decades or so there has been new development in the artificial heart-lung machine running under, so that the heart stops beating, and then carry out complex heart surgery, greatly enhance the safety of surgery, so many complex heart surgery Ai was a success, there are many large and medium-sized hospitals for heart surgery in Japan more than 400 hospitals.
1. Artificial heart-lung machine (cardiopulmonary bypass machine)
Open heart surgery is not to leave the artificial heart-lung machine. When the heart is stopped, the patient must rely on the maintenance of life on the artificial heart-lung machine supply the brain and kidneys, lungs, liver and other vital organs of the fresh blood. Its not only plays the role of the heart pump, but also in cardiac arrest, the pulmonary blood can not run, it also has the role of blood oxygenation.
Artificial Heart-Lung Machine as a result of rapid development, no matter what time can replace the heart and lungs, continuous supply of fresh blood into the body, because it safe and easy to master, so to be widely available, and thus promoted the development of cardiac surgery, but despite Artificial Heart-Lung Machine assisted circulation, surgery should be possible to gain time to complete a good quick and appropriate surgery.
2. Hypothermia anesthesia
In cardiac surgery, the heart throb to stop after the artificial heart and lung in addition to assisted circulation outside the body, but also to the cooling cycle of blood, so the temperature dropped to below 30 ℃. This is from the hibernating animals have been inspired. Because at low temperature, the organ and systemic oxygen consumption decreased, thus ensuring a long time in the off-pump surgery security.
Infants and young children's heart surgery will be available to a large number of ice cooling the body, even if it does not use artificial heart-lung machine, simply use low-temperature anesthesia safety also small and medium-sized heart surgery.
3. Myocardial Protection Act
10 ~ 20 degrees Celsius below glucose and potassium, calcium mixed coolant into the coronary artery, not only make the heart to stop, but rather make it to relax, so that heart surgery can proceed smoothly. In addition to reduce myocardial damage during cardiac arrest, after the end of the operation, enabling the rapid resumption of the heart jump, and maintain a good function, like this is known as myocardial protection laws. At the same time, the use of the above-mentioned three methods to further improve the success rate of cardiac surgery.
4. Congenital heart surgery
Some heart disease in infants after birth without immediate surgery, children to survive. Such as complete transposition of the great arteries, pulmonary valve atresia completely, pulmonary vein the Director-General also satisfied abnormal huge VSD, coarctation of the aorta syndrome, tricuspid atresia, which accounts for about 20% of first heart, four weeks after birth if not surgery may be dead. Recently, for such severe congenital heart disease in infants and young children to take early diagnosis, early surgical treatment, to obtain good results, so many infants dying patients saved.
The first such severe heart infant patients with severe cardiac dysfunction and purple thread, the use of drugs and oxygen therapy can not be cured. Therefore can be radical surgery or bypass surgery. Here are three types of bypass surgery.
① increased pulmonary blood flow in surgery. Purple junction for serious heart disease, the use of the great arteries with pulmonary short-circuit operation (subclavian artery, pulmonary artery anastomosis, aortic on the gear and the right pulmonary artery anastomosis), pulmonary atresia at the time of lung incision (using catheter-type knife, do not thoracotomy, intravenous insertion in the X-ray carried out under the cut.) also falls in such.
② surgery to reduce pulmonary blood flow. VSD by giant excessive pulmonary blood flow will be available pulmonary narrow band, this method can prevent cardiac dysfunction.
③ so scared arterial blood mixed with static surgery.
In complete transposition of the great arteries, the blood from the body back into the heart through the atrial septal openings reduce cyanosis. Recently, under the X-rays without thoracotomy, heart catheter inserted through the femoral vein right atrium beam. Atrial septal wear.
Heart surgery is the most VSD, in the absence of natural healing and hope after off-pump, open there for VSD ventricular repair larger defects, the need to increase polyester patch Lun. Atrial septal defect is also required to repair, but the surgery than simple VSD.
Patent ductus arteriosus surgery can be cut off after the suture line or neutered, this surgery outside the heart, without the artificial heart-lung machine.
Law Lemin tetralogy is the most common type of congenital heart disease Zijin Gan, and sometimes can cause severe purple pliers and convulsive seizures. To school-age children in the artificial heart-lung machine to conduct Tetralogy levy radical mastectomy. However, infants and young children period in order to increase pulmonary blood, viable subclavian artery and pulmonary artery or aorta and right pulmonary artery anastomosis.
For pulmonary valve stenosis, or coarctation of the aorta, endocardial cushion defect, anomalous pulmonary venous disease, Ebstein malformation are also feasible surgery.
For congenital atrioventricular block, pulse 40-50 times per minute in less, if there is loss of consciousness and heart failure symptoms, they can put the artificial pacemaker.
Infant heart surgery is safe, but sometimes it is very difficult. Post-operative care is also very difficult. In particular, respiratory management, such as breathing disorders, then there is the risk of death.
Of newborns with congenital heart disease, such as can be equivalent to life-saving surgery, so with obstetric and pediatric physicians and nurses linked to those at risk of death in children as soon as possible to be able to carry out heart surgery hospital.
5. Acquired heart surgery
Valvular disease
As a result of repeated seizures caused by rheumatic valve disease with chronic damage. For rheumatic mitral stenosis, in the past after open heart surgery without opening the heart, only in the left atrial appendage and the left ventricle of the beating a small hole with his hands or the expansion of mitral valve open browser mouth, because the result is not really and easy to cause recurrence. The recent use of artificial heart-lung machine, open the heart, in the open under the knife and scissors mitral cross-linked Department incision. If, after the cut valve dysfunction may remove the entire valve, mechanical valve with artificial and biological valve replaced.
Mitral insufficiency, the most common is residual disease or rheumatic fever caused by mitral valve prolapse. Can be carried out under direct vision or Mitral valve replacement (with artificial mechanical valve or biological valve substitute).
Aortic stenosis and insufficiency, in the artificial heart-lung machine under artificial valve replacement. In addition to outside rheumatism also arteriosclerosis caused by aortic stenosis and insufficiency, there are uncommon due to aortic diseases syphilis and Marfan syndrome.
Mitral valve disease, such as the heart of a serious expansion, often complicated with tricuspid valve insufficiency, and more need for surgery. In order to prevent blood reflux, the tricuspid valve plasty, serious when the need for tricuspid valve replacement.
More than two valve disease, particularly mitral and aortic valve was found, usually known as Keidanren valvular disease, the current can also be safely carried out mitral valve replacement.
Coronary Heart Disease
Refers to coronary artery conditions, sometimes lead to angina coronary twins recover from illness or lead to heart attack because of coronary artery obstruction. If medical treatment fails, coronary angiography is feasible, clear the site of coronary artery stenosis, in the off-pump, and lines across the great saphenous vein bypass graft stenosis Department. This surgery to many patients with coronary artery disease has brought the gospel. In the acute phase of myocardial infarction, cardiac catheterization can be used in coronary artery blockage, such as thrombolytic enzyme urokinase PTAR therapy for chronic phase patients, can be used with balloon catheterization heart coronary obstruction expansion (FTCA therapy ), the two laws for the majority of patients, easy to accept, but good effect. However, the latter so that the risk of coronary artery ruptured, so there must be backed by surgery.
Acute myocardial infarction period, the legacy of the necrotic area convex outward to form a heart aneurysm, disease often caused by heart failure reasons, most scholars through surgery to remove lesions Department patch.
Due to cardiac rupture caused by acute myocardial infarction or ventricular septal perforation, can also lead to mitral insufficiency. Cardiac rupture often leads to sudden death, so as soon as possible complications of such surgery.
Cardiomyopathy
Of dilated cardiomyopathy can not surgery, for hypertrophic cardiomyopathy have ventricular outflow tract obstruction may be open in the off-pump left ventricular hypertrophy of cardiomyocytes will be removed, so that the expansion of outflow tract.
Arrhythmia
The so-called complete atrioventricular block is the heart rate in the 30-40 times per minute or so, often caused by cardiac syncope syndrome or heart failure, serious arrhythmias. Sick sinus syndrome, often caused by vein ease (heart rate per minute at 60 times below) or pulse frequency (heart rate of 100 times per minute and above). Regardless of complete atrioventricular block or sick sinus syndrome, as long as it is so difficult to sustain life and daily life can be placed in permanent artificial cardiac pacemaker, the current technology to improve the battery life, is now generally 7-8 only to be replaced every year, we have 90-year-old patient to carry out the surgery very safe and smooth, postoperative patients happy life.
Wednesday, January 14, 2009
Gene deletion can lead to heart disease
Ping'an Hospital of Zhengzhou City Professor Wang Xuehai a latest research results confirm that: gene deletion can lead to congenital heart disease. A few days ago, to participate in identification of experts believe that "the results of the study reached the international advanced level."
China-born babies each year, approximately 150,000 newborns suffer from congenital heart disease, of which one third due to lack of timely diagnosis and treatment of children and mortality. Critically ill children with congenital heart disease in conotruncal heart defect accounts for about 80%. Ping'an Hospital of Zhengzhou City,丁主任, applications such as Professor Wang Xuehai experimental embryology and molecular biology technology, the Chinese tetralogy of Fallot children with genes related to basic research, first reported the Chinese people tetralogy integrated gene in patients with 22q11 microdeletion incidence rate of 24.24 percent and for the first time the use of experimental embryology and molecular biology technology research conotruncal defect-related genes, were also reported for the first time the Chinese people and the Williams Syndrome supravalvular aortic stenosis in patients with elastin gene and LIM kinase 1 gene deletions.
Experts point out that the results of the study will clarify the causes of congenital heart disease and pathogenesis, and for the early diagnosis and pathogenesis of congenital heart block, have a positive significance.
China-born babies each year, approximately 150,000 newborns suffer from congenital heart disease, of which one third due to lack of timely diagnosis and treatment of children and mortality. Critically ill children with congenital heart disease in conotruncal heart defect accounts for about 80%. Ping'an Hospital of Zhengzhou City,丁主任, applications such as Professor Wang Xuehai experimental embryology and molecular biology technology, the Chinese tetralogy of Fallot children with genes related to basic research, first reported the Chinese people tetralogy integrated gene in patients with 22q11 microdeletion incidence rate of 24.24 percent and for the first time the use of experimental embryology and molecular biology technology research conotruncal defect-related genes, were also reported for the first time the Chinese people and the Williams Syndrome supravalvular aortic stenosis in patients with elastin gene and LIM kinase 1 gene deletions.
Experts point out that the results of the study will clarify the causes of congenital heart disease and pathogenesis, and for the early diagnosis and pathogenesis of congenital heart block, have a positive significance.
Blood protein linked with heart disease
According to a new study, blood lipoprotein A high level of people 10 years after the development of high-risk for heart disease by 70%. When British researchers from 27 to analyze the results of the study found that apolipoprotein A, or Lp (a) the high level independently predict the risk of heart disease.
Oxford University's Dr. John Danesh and his colleagues in the September 5 issue of "recycling" (Circulation) magazine reported on their findings: After an average of more than 10 years of investigation, Lp (a) the highest levels of research subjects than the minimum the level of human development as the high risk of heart disease by 70%.
Dr. Danesh told reporters: Lp (a) by an LDL "bad cholesterol" section and a protein composition of the material. Its exact function still do not understand, and it may be in the role of heart disease studies have produced conflicting results. He said that although still not clear whether it is worthwhile to screening and treatment of high Lp (a), but the studies have shown Lp (a) and heart disease risks have a clear relationship.
According to Danesh said: with an identified risk factors for heart disease, high cholesterol different, healthy, low-fat diet does not seem to reduce the high Lp (a). In fact, patients with Lp (a) controlled by genetic factors - such as blacks and whites have a higher level compared to the trend.
Danesh said that tests Lp (a) in the heart of the importance of the only way is to observe the lower the high level of Lp (a) whether it can reduce the risk of heart disease.
Oxford University's Dr. John Danesh and his colleagues in the September 5 issue of "recycling" (Circulation) magazine reported on their findings: After an average of more than 10 years of investigation, Lp (a) the highest levels of research subjects than the minimum the level of human development as the high risk of heart disease by 70%.
Dr. Danesh told reporters: Lp (a) by an LDL "bad cholesterol" section and a protein composition of the material. Its exact function still do not understand, and it may be in the role of heart disease studies have produced conflicting results. He said that although still not clear whether it is worthwhile to screening and treatment of high Lp (a), but the studies have shown Lp (a) and heart disease risks have a clear relationship.
According to Danesh said: with an identified risk factors for heart disease, high cholesterol different, healthy, low-fat diet does not seem to reduce the high Lp (a). In fact, patients with Lp (a) controlled by genetic factors - such as blacks and whites have a higher level compared to the trend.
Danesh said that tests Lp (a) in the heart of the importance of the only way is to observe the lower the high level of Lp (a) whether it can reduce the risk of heart disease.
Psychological factors root causes of non-induced heart disease
People have always thought that, it was depression, anxiety, hostility, it will increase the risk of heart disease. But now scientists have discovered, these factors affect the physical changes in cardiovascular What role can not afford to go. Doctors have long suspected that certain psychological conditions will have the role of the deterioration of heart disease, and suspected that psychological factors can improve myocardial infarction or other heart disease. Some studies even believes that these psychological factors can trigger a heart attack led to some of the early physical changes. However, only minimal evidence to support these theories. The study found that 600 of depression, anxiety, hostility or pressure people, and the absence of these psychological factors, in the heart of intimal plaque formation, made little difference.
Repeated abortions of female susceptibility to heart disease
Studies have shown that many times women abortion increased risk of heart disease. Published in the recently published "The British Medical Association," the journal said the research report, and no women had abortions compared to abortion more than once because of heart or a heart attack really hospitalization probably 5%. University of Cambridge professor of obstetrics and gynecology, said Smith, and together with other research shows that women of pregnancy-related complications may be a long-term health problems indications. Pregnancy complications of cardiovascular disease may be potentially the first clinical manifestation, it will ultimately be manifested as symptoms of a heart attack.
Smith and his colleagues on the 1981 to 1985 between 12,929 births in Scotland, the first women were studied to check whether their previously flowing through the middle class and who was subsequently developed heart disease. Eventually they found: abortion more than once 5 percent increased risk of heart disease, miscarriage risk of heart disease for more than three times is not abortion twice, but because the conditions for the latter too small number of women, the researchers could not determine whether or not this is true after a . The researchers hope that through further study of women's reproductive history can be integrated into her overall assessment of cardiovascular risk, but also more research is needed to determine both the relevant mechanism to develop effective interventions.
Smith and his colleagues on the 1981 to 1985 between 12,929 births in Scotland, the first women were studied to check whether their previously flowing through the middle class and who was subsequently developed heart disease. Eventually they found: abortion more than once 5 percent increased risk of heart disease, miscarriage risk of heart disease for more than three times is not abortion twice, but because the conditions for the latter too small number of women, the researchers could not determine whether or not this is true after a . The researchers hope that through further study of women's reproductive history can be integrated into her overall assessment of cardiovascular risk, but also more research is needed to determine both the relevant mechanism to develop effective interventions.
Menopausal women susceptible to heart disease
Menopausal women did not enter until the body's hormones protect the heart function, so the risk of women suffering from heart disease much lower than men. However, after entering the menopause, women suffer from heart disease to catch up with the men on the possibility.
Women and men suffering from heart disease as a causal factor in whether or not the same?
Women and men generally have the same pathogenic factors, including:
* Blood cholesterol levels high
* Hypertension
* Smoking
* Obesity
* Diabetes
* Lack of exercise
However, some pathogenic factors in which women and men played different roles. For example, women with diabetes can make the body's blood lipid and blood cholesterol levels increased more than male patients. Therefore, women with diabetes have to atherosclerosis and the possibility of heart disease than their male patients will be high. In addition, smoking has also led to the age of 60 women's blood cholesterol level than their male smokers increased even more.
Women and men have the same symptoms of a heart attack it?
The most common symptoms of heart disease is chest pain oppressive. This symptom in male patients were more common, the general female patients displayed symptoms are ambiguous and innocuous. Therefore, female patients are generally in the disease more serious, will be diagnosed.
Women with symptoms that may arise with different men, including:
* Extreme fatigue - so that she could not complete the day-to-day work
* Dizziness
* Nausea - especially after the forced
* Heart beating jump or jerks
* Fainted
* Shortness of breath - especially in the up after
* Chest pain or upper body back, feeling the pressure
Do not underestimate these symptoms. If you are a woman with a family medical history (especially before the age of 55), overweight, smoking, diabetes, high blood pressure or high cholesterol or high blood cholesterol, you should seek medical checkup.
Estrogen how to protect women from suffering from heart disease?
Estrogen can help menopausal women to increase the body's high-density lipoprotein cholesterol (good cholesterol), in order to reduce the risk of suffering from heart disease. This helps to eliminate the blood of low-density lipoprotein cholesterol (bad cholesterol), reducing blood fat deposits or prevent atherosclerosis formation. Therefore, estrogen can help blood vessels to maintain strong, flexible and open, so that the smooth flow of blood to the heart, this will help women reduce the risk of suffering from heart disease.
Hormone replacement therapy for women suffering from heart disease and other diseases have any impact?
Hormone replacement therapy can help menopausal women to supplement Gengnian'an arising due to the shortage of female hormones (estrogen or progesterone), which contribute to the reduction of general menopausal symptoms, such as **** drying, such as mood swings and flushing.
Hormone replacement therapy can reduce atherosclerosis and hypertension, to help women reduce the possibility of suffering from heart disease. At the same time, it also can help women reduce the risk of stroke, and prevent the occurrence of osteoporosis. Many studies show that the use of small amounts of estrogen and will not increase the risk of breast cancer risk, even if there are, the danger is not high. Therefore, the majority of women can benefit from hormone replacement therapy. If you want to receive hormone replacement therapy can be made to the doctor.
Women and men suffering from heart disease as a causal factor in whether or not the same?
Women and men generally have the same pathogenic factors, including:
* Blood cholesterol levels high
* Hypertension
* Smoking
* Obesity
* Diabetes
* Lack of exercise
However, some pathogenic factors in which women and men played different roles. For example, women with diabetes can make the body's blood lipid and blood cholesterol levels increased more than male patients. Therefore, women with diabetes have to atherosclerosis and the possibility of heart disease than their male patients will be high. In addition, smoking has also led to the age of 60 women's blood cholesterol level than their male smokers increased even more.
Women and men have the same symptoms of a heart attack it?
The most common symptoms of heart disease is chest pain oppressive. This symptom in male patients were more common, the general female patients displayed symptoms are ambiguous and innocuous. Therefore, female patients are generally in the disease more serious, will be diagnosed.
Women with symptoms that may arise with different men, including:
* Extreme fatigue - so that she could not complete the day-to-day work
* Dizziness
* Nausea - especially after the forced
* Heart beating jump or jerks
* Fainted
* Shortness of breath - especially in the up after
* Chest pain or upper body back, feeling the pressure
Do not underestimate these symptoms. If you are a woman with a family medical history (especially before the age of 55), overweight, smoking, diabetes, high blood pressure or high cholesterol or high blood cholesterol, you should seek medical checkup.
Estrogen how to protect women from suffering from heart disease?
Estrogen can help menopausal women to increase the body's high-density lipoprotein cholesterol (good cholesterol), in order to reduce the risk of suffering from heart disease. This helps to eliminate the blood of low-density lipoprotein cholesterol (bad cholesterol), reducing blood fat deposits or prevent atherosclerosis formation. Therefore, estrogen can help blood vessels to maintain strong, flexible and open, so that the smooth flow of blood to the heart, this will help women reduce the risk of suffering from heart disease.
Hormone replacement therapy for women suffering from heart disease and other diseases have any impact?
Hormone replacement therapy can help menopausal women to supplement Gengnian'an arising due to the shortage of female hormones (estrogen or progesterone), which contribute to the reduction of general menopausal symptoms, such as **** drying, such as mood swings and flushing.
Hormone replacement therapy can reduce atherosclerosis and hypertension, to help women reduce the possibility of suffering from heart disease. At the same time, it also can help women reduce the risk of stroke, and prevent the occurrence of osteoporosis. Many studies show that the use of small amounts of estrogen and will not increase the risk of breast cancer risk, even if there are, the danger is not high. Therefore, the majority of women can benefit from hormone replacement therapy. If you want to receive hormone replacement therapy can be made to the doctor.
Artists who are susceptible to heart disease
What kind of heart disease? Why in the performing arts sector, heart attack will be a series? Yesterday, I devoted to the Beijing University of Chinese Medicine, to ask the well-known Chinese medicine experts, China Prescription chairman Professor Xie Ming Society. Professor Xie said:
Stars susceptible to a heart attack the main incentive
Both physical and mental labor. Most stars are frankly very tired, and in the long-term lack of sleep state. A lot of stars also often get busy on the day and night连轴转. Whether it is physical or mental fatigue are, it will significantly increase the burden on the heart, a sudden increase in myocardial oxygen demand, short-term hypoxia-ischemia can cause arterial spasm, increasing myocardial ischemia, myocardial infarction will lead to serious.
Irregular sleep. Movie star or a major performing arts activities mostly at night, early morning sleep one or two points is a common occurrence. From an overall point of view, their sleep pattern is not strong. Long-term irregular sleep will lead to serious endocrine disorders, mental depression, will also affect the regulatory function of the heart.
Alcoholic drinks and tobacco had Anopheles. Although many stars a good public image, but in order to stay up all night and entertainment, but also had a chain smoker, wine nothing, not teenage star is no exception. Excessive alcohol and tobacco, will lead to vascular spasm, may also increase the risk of a heart attack.
The pressure was too great. The entertainment industry is extremely competitive and cruel, under pressure to make stars easy to produce tense, angry and so emotional. Often emotional instability, and excited, will cause serious endocrine disorders, so that high blood pressure, catecholamine secretion increased significantly heavier load caused by left ventricular myocardial oxygen demand surged, adding to coronary insufficiency, and induce a heart attack.
Blind weight loss. A lot of stars for their own image and the screen image of the request to lose weight, greatly damaging the body's immune function, repeated weight loss also easy to damage the stomach and the heart.
Stars susceptible to a heart attack the main incentive
Both physical and mental labor. Most stars are frankly very tired, and in the long-term lack of sleep state. A lot of stars also often get busy on the day and night连轴转. Whether it is physical or mental fatigue are, it will significantly increase the burden on the heart, a sudden increase in myocardial oxygen demand, short-term hypoxia-ischemia can cause arterial spasm, increasing myocardial ischemia, myocardial infarction will lead to serious.
Irregular sleep. Movie star or a major performing arts activities mostly at night, early morning sleep one or two points is a common occurrence. From an overall point of view, their sleep pattern is not strong. Long-term irregular sleep will lead to serious endocrine disorders, mental depression, will also affect the regulatory function of the heart.
Alcoholic drinks and tobacco had Anopheles. Although many stars a good public image, but in order to stay up all night and entertainment, but also had a chain smoker, wine nothing, not teenage star is no exception. Excessive alcohol and tobacco, will lead to vascular spasm, may also increase the risk of a heart attack.
The pressure was too great. The entertainment industry is extremely competitive and cruel, under pressure to make stars easy to produce tense, angry and so emotional. Often emotional instability, and excited, will cause serious endocrine disorders, so that high blood pressure, catecholamine secretion increased significantly heavier load caused by left ventricular myocardial oxygen demand surged, adding to coronary insufficiency, and induce a heart attack.
Blind weight loss. A lot of stars for their own image and the screen image of the request to lose weight, greatly damaging the body's immune function, repeated weight loss also easy to damage the stomach and the heart.
Subscribe to:
Posts (Atom)
