Journal of Clinical Medicine – Hue Central Hospital

HUMANITARIAN CARDIAC SURGERY, RESULTS OF 20 YEARS ACTION OF THE HUMANITARIAN ASSOCIATION "AIDE AU DÉVELOPPEMENT DE LA SANTÉ" (ADS)

Bernard Eisenmann — 2017-06-19

Many NGOs worked in the field of cardiovascular surgery in "less favored" countries. The association "Aide Au Développement De La Santé" (ADS) has been taking such humanitarian action for nearly 25 years, in collaboration with the department of cardiovascular surgery in the CHU of Strasbourg. 2052 patients with curable cardiovascular disease were treated. If these patients come from close to 20th of countries, two projects are very largely dominant and concern in Ukraine (376 patients) and especially in Laos (1575 patients). 1177 treated patients were treated for congenital heart disease, 780 for valvular disease, only 2 for ischemic heart disease, and 93 for other cardia diseases. While patient care is an important part of the NGO's work, the most essential formation is training, skills transfer, and assistance. In addition to the training, there is an important component of financial support: equipment, other materials, bio-medical engineering assistance and construction of a dedicated institute to perform cardiology and cardiac surgery. These efforts resulted in the creation of a Lao-independent team. Since 2009, they have operated 349 patients without any European presence. The result of this genuine cooperation was successful; the transfer of competence was effective. The level of knowledge of Lao surgeons is increasing. The ambition of local authorities is to continue in the management of heart disease, and to expand to ischemic heart disease. Equipment for several operating rooms is underway, illustrating the progress made since 2001.

EARLY OUTCOME AFTER HEART VALVE REPLACEMENT IN PATIENTS WITH SEVERE REDUCTION OF LEFT VENTRICULAR EJECTION FRACTION

Nguyen Duc Hien — 2017-06-19

Objectives: Evaluate the early outcome after heart valve replacement in patients with severe reduction of left ventricular ejection fraction. Results: 57 patients with heart valve replacement and LVEF < 40% were enrolled in the study. Mean age was 45:68 $ 10.97 yrs. 47.36% had both aortic and mitral valve replacement, 24.56% mitral valve replacement, and aortic valve replacement in 28.08%. 66.67% NYHA class III-IV. ICU stay in 9.29 days. Mean inotrope use time was 8.46 days. Operative mortality was 7.02%. Heart chambers size reduced well postoperative with gradual improvement of LVEF. Conclusion: Heart valve replacement in patients with severe left ventricular dysfunction, although having higher risk of mortality and morbidity, is a method of choice which improves symptoms and LV function, and reduces mortality.

VIDEO ASSISTED MINIMALLY INVASIVE MITRAL VALVE SURGERY VIA RIGHT MINITHORACOTOMY: INDICATIONS, TECHNIQUES AND RESULTS

Nguyen Hoang Dinh — 2017-06-19

Background: Minimally invasive mitral valve surgery (MIMVS) is under rapid development worldwide in recent years. The number of MIMVS is exceeding that of conventinal method via sterotomy in developped countries. Objectives: Assess of indications, techniques, short term result of MIMVS and the experience in building a new technique in our center. Method: Our restrospective reviewed 72 patients underwent minimally invasive mitral valve surgery at the University Medical Center at Ho Chi Minh City from 08/2014 to 08/2016. Results: 72 patients underwent minimally invasive mitral valve surgery. Mean age was 44.87+ 12.2 Male to female ratio was 1.65:1. Patients with mitral valve repair included 45 degenerative valves, 3 post-rheumatic valves, 1 endocarditis and 4 congenital valves. The main mechanism was posterior leaflet prolapse (22 patients), anterior leaflet prolapse consists of 10 patients, there were 4 patients with both leaflets prolapse and 3 patients with anterior leaflet cleft. We encountered 7 complications: 4 hemothorax requiring draining, 1 annular rupture, 1 reoperation due to residual mitral regurgitation and 1 reoperation due to pericardial effusion. Goals of operation were achieved 90.5%. Conclusions: In our experiences with MIMVS procedure, the early outcomes are satisfactory with low morbidity and no mortality, MIMVS is though safe and feasible, provided that patient selection is good and safety protocols are followed.

A REVIEW OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT TREATMENT IN HANOI HEART HOSPITAL

Nguyen Sinh Hien — 2017-06-19

Objective: Evaluation of short-term outcome after treatment of pulmonary atresia with ventricular sep defect in Hanoi Heart Hospital.
Methods: Patient records of 188 patients with PA- VSD treated in Hanoi Heart Hospital from 01/2005 to 10/2016, were retrospectively analysed in this study.
Results: Mean age 3.2 $ 1,5 (0.16 to 25 years); Classification: Type I: 65 patients (34.6%), type II: 56 (29.8%), type III: 47 (25%), type IV: 20 (10.6%); Treatment: Complete repair: 106 (56.4%), MAPCA unifocalization with RV-PA shunt (Sano shunt): 16 (8,5%), MAPCAs unifocalization with BT shunt 13 (6.9%), BT shunt only 53 (28.2%), Early death: 8/188 (4.3%).
Conclusions: Correct diagnostic and surgery indication help improve the outcome of PA-VSD patients.

SURGICAL TREATMENT OF PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT AT HUE CENTRAL HOSPITA

Nguyen Xuan Hung — 2017-06-19

Pulmonary atresia with ventricular septal defect (PA-VSD) is a complex cardiopathy represented by a complete obstruction between the right ventricle outflow and the pulmonary trunk associated with a ventricular septal defect (VSD). Treatment of PAVSD has evolved during recent decades, but it still remains challenging.
Objective: to evaluate the result of surgical treatment for children with PAVSD at Hue Central Hospital.
Methods: A retrospective study was carried out between january 2012 and january 2017, all patients underwent operated PA-VSD at Hue central hospital.
Results: 52 patients included this study; mean age: 2.12 $ 0.46 (0.15-5); classification: type I: 18 (34.6%), type II: 15 (28.9%), type III and IV: 19 (36.5%). Techniques of operation: total repair: 30 (57.7%), blalock shunt: 10 (19.2%) extends to the bifurcation + blalock shunt: 122 (23.1%). Early mortality was 5/52 (9.6%): Early mortality of total repair was 2/30 (6.7%), Early mortality of extends to the bifurcation +blalock shunt was 3/22 (13.6%).
Conclusion: Early diagnosis and surgery in right time bring the good result. Surgical PA-VSD gives good results.

HYBRID SURGERY FOR COMPLEX AORTIC DISSECTING ANEURYSMS

Nguyen Thai An — 2017-06-19

Objective: Estimate the safety and results of TEVAR combined with open surgery for extensive aortic dissecting aneurysms.
Methods: Observational, prospective study from August 2013 to May 2017. Patients with extensive aortic dissecting aneurysms are treated with open replacement of the ascending aorta and arch, then TEVAR which was landing on the prothesis to cover the descending disease.
The oversize rate is 20-30%, and the length of landing zone is >= 5cm.
The patients are followed by contrasted CT scan at 1, 3 and every 12 months post-operatively.
Results: N=22 patients, male: female= 17:5. Average of age was 60.8 ± 10.7 years. Concomittent procedures were 1 case of CABG, 1 case of valve-sparing root replacement. Average number of stent is 1.83. 30-day mortality was 4.5%. No endoleak type 1 and survival rate was 21/22.
Conclusions: TEVAR and open surgery is useful and safe for treatment of complex aortic dissecting aneurysms.

Rib fixation: indication, operation technique and result

Nguyen Viet Dang Quang — 2017-06-19

Abstract in the pdf

Endevascular stent-grafting for treament of descending thoracic aortic aneurysm: Some initial results

Tran Quyet Tien — 2017-06-19

Abstract in the pdf

Transcatheter closure of perimembranous and muscular ventricular septal defects: Short-term and mind-term outcomes

Ho An Binh — 2017-06-19

Abstract in the pdf

Primary percutaneous coronary intervention in patients aged over 75 years old

Nguyen Do Anh — 2017-06-19

Abstract in the pdf

Variations of hs-CRP and hs-Troponin T concentrations after percutaneous coronary intervention

Nguyen Dang Duy Quang — 2017-06-19

Abstract in the pdf

Minimally invasive coronary artery bypass: Coordination strategy between surgeon and cardiologist

Nguyen Hoang Dinh — 2017-06-19

Abstract in the pdf