在區域綜合醫院的新興心血管外科研究：主動脈腔內修復及心率變異的臨床應用

Abstract

1.研究壹: 選擇性使用Perclose ProGlide®設備做血管腔內修復主動脈瘤的研究 本研究評估患者在血管腔內修復主動脈瘤使用股動脈切開手術與Perclose ProGlide®設備相比的療效。股動脈用於血管腔內修復主動脈瘤。選擇性經皮進入股動脈是安全和有效的。併發症可以用術前影像學的特別選擇來降低，在使用Perclose ProGlide®的情況下，可減少術中出血和手術時間。 2.研究貳: 血管腔內修復外傷性胸主動脈剝離的研究 外傷性胸主動脈剝離在臨床上少見;然而它具有較高的合併症和死亡率相關聯。外傷性胸主動脈剝離通常是由交通事故或跌落造成突然減速引起的。鈍性外傷性胸主動脈剝離是一個關鍵條件。患者的損傷程度評分:17〜66。在所有患者中，主動脈損傷常位於左鎖骨下動脈的入口附近。血管腔內修復術是治療外傷性胸主動脈剝離快速的微創治療，並有良好的技術成果。 3.研究參: 血管腔內修復腎下型腹主動脈瘤的研究 這項研究是經由股動脈進行血管腔內修復腎下型腹主動脈瘤和腹主動脈瘤破裂的成果。結果證實血管腔內修復腎下型腹主動脈瘤手術可以安全地進行。 4.研究肆: 姿勢和性別差異影響心臟二尖瓣脫垂和正常成人的心率變異的研究 心臟心率變異性已被證明是在心臟二尖瓣脫垂和健康二尖瓣的自主神經功能的一個有用的度量。然而，姿勢和性別在心臟心率變異性對有症狀心臟二尖瓣脫垂和正常成人的影響尚未闡明。心臟二尖瓣脫垂女性和男性患者有升高的交感神經的水平的結果。 5.研究伍: 術前有心肺復甦術接受急診冠狀動脈繞道手術的研究 急診冠狀動脈繞道手術是心臟血管外科醫師的一個重大挑戰，尤其是心源性休克的患者。本研究是評估在急性心肌梗塞患者心源性休克的緊急冠狀動脈繞道手術的預後因素。緊急冠狀動脈繞道手術的高院內死亡率與患者術前心肺復甦有關。急性心肌梗塞患者有心源性休克但是沒有接受術前的心肺復甦術有一個可接受的存活率。 6.研究陸：急性冠心症與穩定型心絞痛在冠狀動脈繞道手術的結果 急性冠心症在接受冠狀動脈繞道手術是早期死亡率的獨立預測因子。

Research 1: Selective Using Perclose ProGlide® Device of Percutaneous Endovas-cular Aortic Aneurysm Repair in a District General Hospital Experience This study evaluated the safety and efficacy of percutaneous endovascular aortic aneu-rysm repair (EVAR) with Perclose ProGlide® device compared with surgical cut down of common femoral artery in patients at a district general hospital. Selective percutaneous access of the femoral arteries for EVAR is safe and effective in this population. Research 2: Experience of Endovascular Repair of Thoracic Aortic Dissection after Blunt Trauma Injury in a District General Hospital Traumatic thoracic aortic dissection is uncommon in clinical practice; however, it is associated with higher morbidity and mortality. Thoracic aortic dissection is usually caused by sudden deceleration resulting from a traffic accident or fall. The injury severity score (ISS) of the patients ranged from 17 to 66. Endovascular repair is a rapid and minimally invasive therapy for patients with traumatic aortic injury and associated with favorable outcome. Research 3: Clinical Outcomes of Infrarenal Abdominal Aortic Aneurysms that Underwent Endovascular Repair in a District General Hospital The purpose of this study was to compare the outcomes of elective endovascular ab-dominal aortic aneurysm repair (EVAR) and ruptured abdominal aortic aneurysm (rAAA) in patients at a district general hospital. The results confirm that EVAR surgery can be safely performed in a district general hospital with an integrated health care system. Research 4: Posture and Gender Differentially Affect Heart Rate Variability of Symptomatic Mitral Valve Prolapse and Normal Adults Heart rate variability (HRV) has been shown to be a useful measure of autonomic activity in healthy and mitral valve prolapsed (MVP) subjects. The obtunded postural effects on frequency domain measures testified to the autonomic dysregulation of MVP subjects. Research 5: Emergency Coronary Artery Bypass Grafting were Associated with a High In-hospital Mortality Rate for All Patients with Preoperative Cardiopulmonary Resuscitation- a Single Hospital Observational Study Emergency coronary artery bypass grafting (CABG) is a major challenge to cardiovas-cular junior surgeons, especially with cardiogenic shock patients. Emergency CABGs were associated with a high in-hospital mortality rate for all patients with preoperative CPR. AMI patients with cardiogenic shock without preoperative CPR had an acceptable survival rate (90%). Research 6: Results of Coronary Artery Bypass Grafting in Patients with Acute Coronary Syndrome versus Those with Stable Angina Pectoris: a Single Institution Experience Acute coronary syndrome was an independent predictor of early mortality in these pa-tients undergoing CABG, which provides revascularization of most of the epicardial vessels, including the culprit lesion.