Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our ...Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our hospital were consecutively enrolled between October 2020 and January 2022.Core temperature was continuously monitored intraoperatively,and early postoperative complications were collected.By adjusting the logistic regression model for potential confounding factors,the association of postoperative complications with the duration of hypothermia,the lowest body temperature below 36°C,and the hypothermia upon admission to postanesthesia care unit(PACU)or intensive care unit(ICU)were analyzed.Additionally,the potential inflection point in the relationship between the duration of hypothermia and the risk of postoperative complications was explored by using cumulative probability scatter plots and moving average sequences.Results The study included 370 patients,with 193(52.2%)experiencing hypothermia and 177(47.8%)not.Among them,92(24.9%)developed complications.The duration of hypothermia(adjusted odds ratio[OR]for each one-minute increase:1.003;95%confidence interval[CI]:1.000-1.006,P=0.047)and hypothermia upon admission to PACU or ICU(adjusted OR:1.980;95%CI:1.135-3.454,P=0.016)were associated with early postoperative complications.Notably,the cumulative incidence of postoperative complications tended to rise as the duration of hypothermia increased,with a potential inflection point observed at 120 minutes.Conclusions In gynecological surgery,the duration of hypothermia as well as hypothermia upon admission to PACU or ICU are associated with postoperative complications.Minimizing the duration of hypothermia may be clinically beneficial.展开更多
Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examin...Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications.We further tested the role of this mediation effect using mean arterial pressure,a hemodynamic indicator.Methods This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis.We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications.We conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for covariates.Results Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 days.GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;P<0.01).The average causal mediation effect was-0.08(95%CI:-0.15,-0.04;P<0.01).The average direct effect was-0.09(95%CI:-0.20,0.03;P=0.17).The proportion mediated was 49.9%(95%CI:18.3%,140.0%).Conclusions The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications.Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.展开更多
Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk...Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk factors for severe complications after primary total knee arthroplasty.Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital.Postoperative complication≥gradeⅢwas defined as severe complication according to Clavien-Dindo classification system.Binary logistic regression was used to identify the predictive risk factors for severe complications.Results The complication rate after primary total knee arthroplasty was 6.8%and severe complication rate was 2.5%.Male(OR=2.178,95%CI:1.324-3.585,P=0.002),individuals above 75 years old(OR=1.936,95%CI:1.155-3.244,P=0.012),arrhythmia(OR=2.913,95%CI:1.350-6.285,P=0.006)and cerebrovascular disease(OR=2.804,95%CI:1.432-5.489,P=0.003)were predictive risk factors for severe complications after primary total knee arthroplasty.Conclusion Advanced age,male,arrhythmia,and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty.Special attention should be paid to patients with risk factors.展开更多
Background:Intussusception refers to a condition in which a segment of the intestine invaginates into the lumen of an adjacent segment of the intestine.Postoperative intussusception after gastrointestinal surgery is a...Background:Intussusception refers to a condition in which a segment of the intestine invaginates into the lumen of an adjacent segment of the intestine.Postoperative intussusception after gastrointestinal surgery is an uncommon clinical condition,and there is only one case report of small bowel intussusception after rectal cancer surgery.Here,we report a case of spontaneous small bowel intussusception following laparoscopic total mesorectal excision for rectal cancer.Case presentation:A 56-year-old female military officer was referred to the Colorectal Surgical Department for midrectal cancer,8cm from the anal verge.The patient underwent laparoscopic low anterior resection and diverting loop ileostomy.On postoperative day 3,the patient complained of vomiting and abdominal pain,and a follow-up abdomino-pelvic computed tomography scan showed an ileo-ileal type intussusception.After two days of surgical observation,the clinical symptoms were not resolved.The patient underwent exploratory laparotomy.On exploration,intussusception was found 40 cm proximal to the loop ileostomy site.Segmental resection of the ileum was carried out,and there was no pathological leading point on the resected ileum.The patient was discharged on postoperative day 14 after the second operation and has remained in good health for two years.Conclusion:We present a case of spontaneous small bowel intussusception after laparoscopic total mesorectal excision for rectal cancer that was treated by surgical resection 5 days after the index surgery.展开更多
Objective To evaluate the efficacy of ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with mitomycin C （MMC） on reducing intraocular pressure （ IOP）, complications, and co...Objective To evaluate the efficacy of ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with mitomycin C （MMC） on reducing intraocular pressure （ IOP）, complications, and corneal astigmatism in patients with primary angle-closure glaucoma （PACG）. Methods Totally 217 acute or chronic PACG patients with occludable angle above 180℃ and IOP above 21 mm Hg were divided into 3 groups. Patients in group A （98 cases, 128 eyes）, B （71 cases, 95 eyes）, and C （48 cases, 60 eyes） were treated with ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and sureicallv induced astigmatism （SIA） were evaluated oreooerativelv and up to 12 months oostoperatively. Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups （ all P〈0.001）. Success rates （IOP≤20 mmHg） in groupA, B, and C were 87. 91% , 89.23%, and 83.72% respectively at 12 months after treatment （P = 0.256）. The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C （ P 〈 0.05 ）. There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A （1.71 ±1.47D） was higher than that before operation （ 1.28 ± 1.05D, P =0. 126）. With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C （ 1.99 ± 1.20D and 2. 22 ± 1.39D） were significantly higher than those before operation （ 1.20 ± 0. 85D and 1.18 ±0.93D, P =0. 002, P =0. 001 ）, respectively. With 112 months gone, the mean astigmatisms in group B and C （ 1.87 ± 0. 91D and 1.90 ± 1.16D） were still significantly higher than those before operation （P = 0. 001, P = 0. 003 ）. The highest astigmatic polar values in group A, B, and C （ 1.00D, 1.89D, and 1.77D） occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation （0.19 ± 1.32D, 0. 12 ± 1.22D, and 0.17 ± 1.25D, P 〈 0.01 ）, respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26. 37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups. Conclusion ＂Straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with MMC can reduce complications and get satisfactory results in reducing lOP and SIA.展开更多
Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of...Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.展开更多
Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included ...Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included rod fracture in 22 cases(15 Harrington rods,4 Zielke rods,and 3 Luque rods);recurrence of curve severity in 12 cases;broken or loossened luque wires in 15 cases;loss of thoracic kyphosis(flat back) in 6 cases;progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases;and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra.Infection occurred in 8 cases(incision infection 7 cases,deep wound infection in 1 case);and pneumothorax in 1 case.They were induced by biomechanical factors in 23 cases(22 8%),incorrect selections of indications in 29 cases(28 7%),operational mistakes in 37 cases(36 6%),internal fixation factors in 15 cases(14 9%).The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.展开更多
Objective: To assess the outcome of valve replacement under mild hypothermia on pump-beating heart and to discuss the risk factors of cardiac valve surgery. Methods: In the period from November 1997 to May 2003, a tot...Objective: To assess the outcome of valve replacement under mild hypothermia on pump-beating heart and to discuss the risk factors of cardiac valve surgery. Methods: In the period from November 1997 to May 2003, a total of 800 cases of valve replacement were carried out in our institute. The clinical data were reviewed and the technique of mild hypothermia and pump-beating heart to replace cardiac valve was described in detail. Results: 800 patients, 308 male and 492 female, with age range from 8 to 66 years, weighing 19 to 88 kg, underwent operation. The average cardiopulmonary bypass time was (109.38± 40.64) min, the average clamping time of the vena cava was (77.87±27.99) min and the average mechanical ventilation time was (17.78±12.21) h. There were 17 patients died in the early postoperative stage with an early mortality rate of 2.13%. The causes of death were failure in the weaning of extracorporeal circulation in 2 cases, severe low output syndrome in 3 cases, ventricular fibrillation in 3 cases, obstruction of coronary ostium of mechanical prosthetic valve in 1 case, hepatic failure in 2 cases, pulmonary failure in 1 case, multiorgan failure in 4 cases, and prosthetic valve dysfunction in 1 case. Severe postopertive complications occurred in 51 cases (6.375%), which included reexploration because of excessive bleeding in 16 cases (2.0%), lavage of poststernal infection in 2 cases (0.25%), postoperative strike in 7 cases (0.875%), pulmonary failure in 5 cases (0.625%), hepatic failure in 4 cases (0.5%), multiorgan failure in 11 cases (1.375%), ventricular arrhythmia in 5 cases (0.625%) and peripheral circulation failure in 1 case (0.125%). Conclusion: Mild hypothermia and pump-beating heart result in satisfying clinical outcome in patients undergoing valve replacement. The integrated sequenced deairing procedure ensures the avoidance of air embolism during operation. Pump-beating heart technique offers a safe and practical option especially in patients with severe critical valvular disorder.展开更多
基金Capital's Funds for Health Improvement and Research(2018-2-4013).
文摘Objective To investigate the relationship between hypothermia duration and postoperative complications in patients undergoing gynecological surgery.Methods Patients who underwent elective gynecological surgery at our hospital were consecutively enrolled between October 2020 and January 2022.Core temperature was continuously monitored intraoperatively,and early postoperative complications were collected.By adjusting the logistic regression model for potential confounding factors,the association of postoperative complications with the duration of hypothermia,the lowest body temperature below 36°C,and the hypothermia upon admission to postanesthesia care unit(PACU)or intensive care unit(ICU)were analyzed.Additionally,the potential inflection point in the relationship between the duration of hypothermia and the risk of postoperative complications was explored by using cumulative probability scatter plots and moving average sequences.Results The study included 370 patients,with 193(52.2%)experiencing hypothermia and 177(47.8%)not.Among them,92(24.9%)developed complications.The duration of hypothermia(adjusted odds ratio[OR]for each one-minute increase:1.003;95%confidence interval[CI]:1.000-1.006,P=0.047)and hypothermia upon admission to PACU or ICU(adjusted OR:1.980;95%CI:1.135-3.454,P=0.016)were associated with early postoperative complications.Notably,the cumulative incidence of postoperative complications tended to rise as the duration of hypothermia increased,with a potential inflection point observed at 120 minutes.Conclusions In gynecological surgery,the duration of hypothermia as well as hypothermia upon admission to PACU or ICU are associated with postoperative complications.Minimizing the duration of hypothermia may be clinically beneficial.
基金supported by the National High Level Hospital Clinical Research Funding(2022-PUMCHB-119).
文摘Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain unknown.The aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative complications.We further tested the role of this mediation effect using mean arterial pressure,a hemodynamic indicator.Methods This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine arthrodesis.We used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative complications.We conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for covariates.Results Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 days.GDFT was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;P<0.01).The average causal mediation effect was-0.08(95%CI:-0.15,-0.04;P<0.01).The average direct effect was-0.09(95%CI:-0.20,0.03;P=0.17).The proportion mediated was 49.9%(95%CI:18.3%,140.0%).Conclusions The intraoperative blood pressure lability mediates the relationship between GDFT and the incidence of postoperative complications.Future research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.
文摘Objective Total knee arthroplasty is one of the most common orthopedic surgeries.Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons.In this study,we evaluated the risk factors for severe complications after primary total knee arthroplasty.Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital.Postoperative complication≥gradeⅢwas defined as severe complication according to Clavien-Dindo classification system.Binary logistic regression was used to identify the predictive risk factors for severe complications.Results The complication rate after primary total knee arthroplasty was 6.8%and severe complication rate was 2.5%.Male(OR=2.178,95%CI:1.324-3.585,P=0.002),individuals above 75 years old(OR=1.936,95%CI:1.155-3.244,P=0.012),arrhythmia(OR=2.913,95%CI:1.350-6.285,P=0.006)and cerebrovascular disease(OR=2.804,95%CI:1.432-5.489,P=0.003)were predictive risk factors for severe complications after primary total knee arthroplasty.Conclusion Advanced age,male,arrhythmia,and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty.Special attention should be paid to patients with risk factors.
文摘Background:Intussusception refers to a condition in which a segment of the intestine invaginates into the lumen of an adjacent segment of the intestine.Postoperative intussusception after gastrointestinal surgery is an uncommon clinical condition,and there is only one case report of small bowel intussusception after rectal cancer surgery.Here,we report a case of spontaneous small bowel intussusception following laparoscopic total mesorectal excision for rectal cancer.Case presentation:A 56-year-old female military officer was referred to the Colorectal Surgical Department for midrectal cancer,8cm from the anal verge.The patient underwent laparoscopic low anterior resection and diverting loop ileostomy.On postoperative day 3,the patient complained of vomiting and abdominal pain,and a follow-up abdomino-pelvic computed tomography scan showed an ileo-ileal type intussusception.After two days of surgical observation,the clinical symptoms were not resolved.The patient underwent exploratory laparotomy.On exploration,intussusception was found 40 cm proximal to the loop ileostomy site.Segmental resection of the ileum was carried out,and there was no pathological leading point on the resected ileum.The patient was discharged on postoperative day 14 after the second operation and has remained in good health for two years.Conclusion:We present a case of spontaneous small bowel intussusception after laparoscopic total mesorectal excision for rectal cancer that was treated by surgical resection 5 days after the index surgery.
文摘Objective To evaluate the efficacy of ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with mitomycin C （MMC） on reducing intraocular pressure （ IOP）, complications, and corneal astigmatism in patients with primary angle-closure glaucoma （PACG）. Methods Totally 217 acute or chronic PACG patients with occludable angle above 180℃ and IOP above 21 mm Hg were divided into 3 groups. Patients in group A （98 cases, 128 eyes）, B （71 cases, 95 eyes）, and C （48 cases, 60 eyes） were treated with ＂straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and sureicallv induced astigmatism （SIA） were evaluated oreooerativelv and up to 12 months oostoperatively. Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups （ all P〈0.001）. Success rates （IOP≤20 mmHg） in groupA, B, and C were 87. 91% , 89.23%, and 83.72% respectively at 12 months after treatment （P = 0.256）. The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C （ P 〈 0.05 ）. There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A （1.71 ±1.47D） was higher than that before operation （ 1.28 ± 1.05D, P =0. 126）. With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C （ 1.99 ± 1.20D and 2. 22 ± 1.39D） were significantly higher than those before operation （ 1.20 ± 0. 85D and 1.18 ±0.93D, P =0. 002, P =0. 001 ）, respectively. With 112 months gone, the mean astigmatisms in group B and C （ 1.87 ± 0. 91D and 1.90 ± 1.16D） were still significantly higher than those before operation （P = 0. 001, P = 0. 003 ）. The highest astigmatic polar values in group A, B, and C （ 1.00D, 1.89D, and 1.77D） occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation （0.19 ± 1.32D, 0. 12 ± 1.22D, and 0.17 ± 1.25D, P 〈 0.01 ）, respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26. 37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups. Conclusion ＂Straight scleral tunnel incision＂-trabeculectomy with a releasable suture supplemented with MMC can reduce complications and get satisfactory results in reducing lOP and SIA.
文摘Objective To evaluate the efficacy of surgical therapy for carotid body tumors. Methods A retrospective analysis was conducted, covering the diagnosis, surgical procedure, postoperative complications, and prognosis of 120 cases of carotid body tumors in Peking Union Medical College Hospital from 1949 to May, 2011. Results Surgical excision was successfully performed in 111 cases with 117 tumors. In all those cases, 50 underwent simple tumor resection, 42 underwent resection of tumors and ligation of the external carotid arteries, 7 underwent co-resection of tumors and common carotid arteries, internal carotid arteries, as well as external arteries without vascular reconstruction, and the other 12 cases experienced tumor resection and vascular reconstruction as internal carotid arteries were involved. After operation, 3 cases developed cerebral infarction, 30 cases showed cranial nerve palsy, including 15 cases of hypoglossal nerve damage, 10 cases of vagus paralysis, and 5 cases of Horner's syndrome. Conclusion It is essential to make a proper surgical strategy, which can reduce postoperative com- plications.
文摘Complications occur frequently after surgical treatment of scoliosis.In order to prevent from them effectively,101 cases with failure and postoperative complications were analysed.They included rod fracture in 22 cases(15 Harrington rods,4 Zielke rods,and 3 Luque rods);recurrence of curve severity in 12 cases;broken or loossened luque wires in 15 cases;loss of thoracic kyphosis(flat back) in 6 cases;progressive kyphosis with or without paraplegia following incorrect posterior decompression in 5 cases;and increased unbalance of shoulders after instrumentation in 2 cases due to neglect of the tilting of the first thoracic vertebra.Infection occurred in 8 cases(incision infection 7 cases,deep wound infection in 1 case);and pneumothorax in 1 case.They were induced by biomechanical factors in 23 cases(22 8%),incorrect selections of indications in 29 cases(28 7%),operational mistakes in 37 cases(36 6%),internal fixation factors in 15 cases(14 9%).The authors hold that there are quite a lot of factors leading to occurrence of complications and the effective way for prevention from them is to understand the factors and main technical points related to internal fixation.
文摘Objective: To assess the outcome of valve replacement under mild hypothermia on pump-beating heart and to discuss the risk factors of cardiac valve surgery. Methods: In the period from November 1997 to May 2003, a total of 800 cases of valve replacement were carried out in our institute. The clinical data were reviewed and the technique of mild hypothermia and pump-beating heart to replace cardiac valve was described in detail. Results: 800 patients, 308 male and 492 female, with age range from 8 to 66 years, weighing 19 to 88 kg, underwent operation. The average cardiopulmonary bypass time was (109.38± 40.64) min, the average clamping time of the vena cava was (77.87±27.99) min and the average mechanical ventilation time was (17.78±12.21) h. There were 17 patients died in the early postoperative stage with an early mortality rate of 2.13%. The causes of death were failure in the weaning of extracorporeal circulation in 2 cases, severe low output syndrome in 3 cases, ventricular fibrillation in 3 cases, obstruction of coronary ostium of mechanical prosthetic valve in 1 case, hepatic failure in 2 cases, pulmonary failure in 1 case, multiorgan failure in 4 cases, and prosthetic valve dysfunction in 1 case. Severe postopertive complications occurred in 51 cases (6.375%), which included reexploration because of excessive bleeding in 16 cases (2.0%), lavage of poststernal infection in 2 cases (0.25%), postoperative strike in 7 cases (0.875%), pulmonary failure in 5 cases (0.625%), hepatic failure in 4 cases (0.5%), multiorgan failure in 11 cases (1.375%), ventricular arrhythmia in 5 cases (0.625%) and peripheral circulation failure in 1 case (0.125%). Conclusion: Mild hypothermia and pump-beating heart result in satisfying clinical outcome in patients undergoing valve replacement. The integrated sequenced deairing procedure ensures the avoidance of air embolism during operation. Pump-beating heart technique offers a safe and practical option especially in patients with severe critical valvular disorder.
