2016年 · 第32卷第04期

Ebstein malformation is rare in congenital heart disease (CAD). Because the degree of valve malformation in patients is very different, the postoperative efficacy of different surgical methods is obviously different, so the surgery should be designed and implemented individually. From February 1999 to April 2015, we performed tricuspid valvuloplasty in 32 patients with Ebstein's malformation using the individualized tricuspid annulus technique.

Paravalvular leakage (PVL) of prosthetic valves is a serious complication after valve replacement, which seriously threatens patients' life. Although surgical repair or re-valve replacement is the gold standard for its treatment, the trauma and risk are greater. According to the etiology and severity of paravalvular leakage, there are also differences in treatment strategies. The clinical data of 17 patients with PVL admitted to our department from January 2010 to December 2014 are summarized, and their treatment experience is discussed.

Hybrid technique Coronary revascularization is a technique that combines minimally invasive coronary artery bypass grafting (MIDCAB) with percutaneous coronary intervention (PCI) for the treatment of multi-vessel coronary artery disease. Stationary Hybrid surgery refers to the technique of combining MIDCAB with PCI to treat multi-vessel coronary artery disease in two stages. The advantage of coronary artery bypass grafting (CABG) lies in the use of the left internal mammary artery (LIMA), which has been shown to be superior to PCI in long-term patency for anterior descending artery lesions^[1]。 However, the efficacy of drug stent in non-anterior descending artery disease is better than that of venous bypass vessel in the medium term^[2]。

At present, thoracoscopic surgery has been widely used in the diagnosis and treatment of chest diseases. With the improvement of laparoscopic instruments, the advancement of surgical techniques and the update of minimally invasive concepts, thoracoscopy has been gradually reduced from the traditional 3~4 incisions to 2 incisions, until 1 incision. The clinical experience of single-port total thoracoscopic anatomical segmentectomy in the Department of Thoracic Surgery of Union Medical College Hospital affiliated to Fujian Medical University for the treatment of pulmonary diseases is summarized and reported below.

Male, 26 years old. Chest tightness and shortness of breath for 3 weeks after activity. Physical examination showed congenital foolishness, widened eye distance, webbed neck, low posterior hairline, funnel pectus, amblyopia, and almost no light sense in the left eye. Grade 4/VI systolic murmur can be heard between 3 and 4 costs at the left margin of the sternum. Eye ultrasound showed: Left eye lens subluxation, total retina detachment. Echocardiography showed thickening of the right ventricular wall with a ventricular septum thickness of 13 mm; Severe pulmonary stenosis, pulmonary artery transvalvular pressure difference 131 mmHg (1 mmHg =0.133 kPa); Secondary foraminal atrial septal defect. Peripheral blood gene detection showed that the patient had a misintended mutation in PTPN11 gene, which confirmed the diagnosis of Noonan syndrome.

Female, 40 years old. Palpitations accompanied by chest tightness and chest pain after activity for more than 5 months. Local hospital echocardiogram showed ventricular septal mass occupation. Four months ago, cardiac CTA examination and plain MRI scan in our hospital (Figure 1) indicates left ventricular mass occupation. The echocardiography of this outpatient review showed an increase of about 10 mm compared with the previous space. No obvious abnormalities were found on admission physical examination. Liver and kidney function and electrolytes were normal.