Huishan Wang

Government of the People's Republic of China, Peping, Beijing, China

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Publications (15)24.78 Total impact

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    ABSTRACT: This study aimed to investigate the impact of different doses of atorvastatin on contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) requiring contrast media by performing a meta-analysis. We searched the Pubmed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure, and VIP database through April 2014. Only randomized controlled trials (RCTs) comparing short-term high-dose atorvastatin with low-dose atorvastatin on contrast-induced acute kidney injury were selected. The main outcomes were the change of acute kidney injury markers and the incidence of contrast-induced nephropathy (CIN). We combined 14 RCTs consisting of 1689 patients. Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a reduction in serum creatinine levels (weighted mean differences [WMD]-0.1mg/dL; 95% CI -0.14– -0.05). In addition, high-dose atorvastatin treatment was also associated with a lower incidence of CIN (risk ratios 0.41; 95% CI 0.29–0.56). This meta-analysis suggests that short-term high-dose atorvastatin therapy appears to be superior to the low-dose atorvastatin in preventing CI-AKI among patients undergoing CAG/PCI requiring contrast media.
    The Journal of Clinical Pharmacology 10/2014; · 2.84 Impact Factor
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    ABSTRACT: Objective Early death following coronary artery bypass graft (CABG) surgery tends to occur in coronary heart disease (CHD) patients with significantly decreased left ventricular function.Methods The clinical data of 231 patients with preoperative left ventricular ejection fraction (LVEF) ≤35% who underwent CABG were retrospectively analyzed from June 2007 to October 2012. The patients were divided into 2 groups: group A contained 39 patients who suffered early postoperative death and group B contained 192 patients who had a successful CABG outcome.ResultsMultivariate analysis demonstrated that only significantly decreased preoperative right ventricular (RV) diastolic function (increase in Et/Et′) and lack of suitable target bypass vessels were independent risk factors for early death after CABG surgery in patients with severely impaired left ventricular function (P = 0.003 and 0.002, respectively). Other factors, including age, intra-aortic balloon pump (IABP) implantation, ischemic mitral regurgitation (IMR) treatment, left atrial internal diameter, and end-diastolic left ventricular internal diameter, were not associated with early death following CABG. Preoperative Et/Et′ ≥10 was significantly associated with early death after CABG in patients with severely impaired left ventricular function (χ2 = 11.55, P < 0.001, odds ratio [OR] = 17.54, 95% confidence interval [CI]: 2.12–383.16).Conclusion Decreased preoperative RV diastolic function and lack of suitable target bypass vessels are independent risk factors for early death following CABG in patients with severely impaired left ventricular function. Therefore, assessment of preoperative RV diastolic function will be helpful in predicting early death after CABG in these patients. Additionally, Et/Et′ ≥10 is significantly associated with early death after CABG.
    Echocardiography 06/2014; · 1.26 Impact Factor
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    ABSTRACT: Aim To evaluate the development of pulmonary arteries (PAs) in patients with pulmonary atresia, ventricular septal defect, and diminutive PAs by using a central end-to-side shunt.Methods A total of 103 consecutive patients (71 male and 32 female) with pulmonary atresia, ventricular septal defect, and diminutive PAs received a central end-to-side shunt between PA and aorta from May 2004 to December 2010. The age and weight ranged between 2 to 86 months and 2.5 to 21.5 kg, respectively. Overall 79 patients with main PA diameters less than 4 mm received a central end-to-side shunt between PA and aorta, and 24 patients with main PAs absence received a modified central shunt between PA branches and aorta.Results There were no deaths during operation and follow-up. Compared with preoperative measures, total PA index increased from mean value 68.8 ± 11.4 mm2/m2 to 129.1 ± 24.9 mm2/m2 (p < 0.001). The increased PA index change at the time of 6 months or final repair after shunt completion was 87.7 ± 27.4% (27-150%). By multivariate regression analysis, age at shunt, shunt procedure, and number of major aortopulmonary collateral arteries were correlated with increasing PA index change.Conclusion The central end-to-side shunt promoted sufficient growth of the diminutive central PAs, especially in infant patients. Due to the risk of a distortion of pulmonary branches, the authors interposed a modified procedure for patients with main PAs absence by anastomosis of left PA and right PA directly in an end-to-side fashion to the both lateral wall of ascending aorta. It is technically easy to perform, warrants low risk of shunt thrombosis, and flow restriction in the early postoperative period.
    The Thoracic and Cardiovascular Surgeon 09/2013; · 0.93 Impact Factor
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    ABSTRACT: Common atrium (CA) is a rare congenital heart defect. We reviewed our experience of surgical treatment of CA and summarize the clinical features of CA and the key techniques for surgical correction. Between August 1984 and August 2010, 37 consecutive cases of CA underwent corrective surgery. There were no clinical findings of Down, asplenia-polysplenia or Ellis-van Creveld syndromes in all cases. Mitral valvuloplasty was performed in 34 cases, and tricuspid valvuloplasty in 20 cases. Complete closure of a mitral cleft was required in 32 cases. All new atrial septa were reconstructed using patches. Follow-up period ranged from 1 to 20 years. There were no hospital deaths or conduction system block. After surgery, mild mitral insufficiency was observed in only one case. Two cases had moderate-severe mitral insufficiency at postoperative years 1 and 3, respectively, that required mitral valve replacements. One patient died of low cardiac output syndrome after reoperation. Long-term survival after surgical correction of CA is good. Routine closure of a cleft in the mitral valve is very important for successful surgery. doi: 10.1111/jocs.12202 (J Card Surg 2013;28:580-586).
    Journal of Cardiac Surgery 09/2013; 28(5):580-6. · 1.35 Impact Factor
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    Hui Jiang, Huishan Wang, Haibo Wu, Xinmin Li
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    ABSTRACT: Bronchogenic cyst is considered as an uncommon congenital anomaly. It can be mostly found in mediastinum or lung. Intracardiac bronchogenic cyst is very rare. We found 2 cases in more than 20000 cardiac surgical cases in our department. The 2 cases bronchogenic cyst arose from interatrial septum (IAS), the preoperative diagnosis were myxoma, but the histological diagnosis were bronchogenic cyst in both cases. Although it is very rare, it should be considered while intracardiac tumor is diagnosed. It is recommended to complete resection of any bronchogenic cyst for primarily diagnostic and potentially therapeutic reasons, and every effort should be made to prevent complications due to injury to nearby tissues.
    Journal of Cardiothoracic Surgery 07/2013; 8(1):171. · 0.90 Impact Factor
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    ABSTRACT: Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the major enzymes responsible for alcohol metabolism in humans. Emerging evidences have shown that functional polymorphisms in ADH and ALDH genes might play a critical role in increasing coronary artery disease (CAD) and myocardial infarction (MI) risks; however, individually published studies showed inconclusive results. The aim of this meta-analysis is to evaluate the associations between the genetic polymorphisms of ADH and ALDH genes with susceptibility to CAD and MI. A literature search was conducted on PubMed, Embase, Web of Science and Chinese BioMedical databases from inception through December 1st, 2012. Crude relative risks (RRs) with 95% confidence intervals (CIs) were calculated. Twelve case-control studies were included with a total of 9,616 subjects, including 2,053 CAD patients, 1,436 MI patients, and 6,127 healthy controls. Meta-analysis showed that mutant genotypes (GA+AA) of the rs671 polymorphism in the ALDH2 gene were associated with increased risk of both CAD and MI (CAD: RR=1.20, 95%CI: 1.03-1.40, P=0.021; MI: RR=1.32, 95%CI: 1.11-1.57, P=0.002). However, there were no significant associations of ADH genetic polymorphisms to CAD and MI risks (CAD: RR=0.92, 95%CI: 0.73-1.15, P=0.445; MI: RR=0.93, 95%CI: 0.84-1.03, P=0.148). In conclusion, this meta-analysis provides strong evidence that ALDH2 rs671 polymorphism may be associated with increased risks of CAD and MI. However, further studies are still needed to accurately determine whether ADH genetic polymorphisms are associated with susceptibility to CAD and MI.
    Gene 05/2013; · 2.20 Impact Factor
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    ABSTRACT: Right-side heart function is essentially externalized during extracardiac total cavopulmonary connection. The Fontan procedure has a certain impact on pulmonary hemoperfusion and may explain various postsurgical complications. In this study, alterations of pulmonary perfusion in patients undergoing the Fontan procedure were analyzed at the 5-year postoperative mark by radionuclide imaging and angiocardiography, and results of both methods were compared. For 43 post-Fontan patients, perfusion ratios of each lung segment were calculated based on radionuclide imaging data. The pulmonary vascular resistance and pulmonary artery index of each patient were also calculated from right angiocardiographic measurements. The radionuclide count and advantage perfusion ratio of right lung at follow-up did not differ significantly from early postoperative values (t=0.38, p>0.05; t=1.12, p>0.05), and superior/inferior vena cava perfusion ratios were stable (t=0.88, p>0.05; t=0.74, p>0.05). The superior/inferior segment perfusion ratio of the whole lung declined significantly (t=2.54, p<0.05), while that of the dorsal lung segment rose significantly (t=2.16, p<0.05). Compared with early postoperative status, the pulmonary arterial index of patients at follow-up were significantly increased (t=2.41, p<0.05), while small pulmonary vascular resistances declined significantly (t=2.08, p<0.05; t=2.69, p<0.05), and arterial oxygen saturation levels were unaltered (t=1.12, p>0.05). The early angiographic and radionuclide perfusion studies of 5 patients did not match. After the Fontan procedure, hypostatic redistribution of pulmonary blood flow is characteristic. The weak pulse of blood, in the absence of ventricular ejection, can promote pulmonary vascular changes, but at later (intermediate) follow-up, the decline in vascular resistance that results carries no benefit in terms of blood perfusion or oxygenation. Microcirculatory arteriovenous shunting is the likely cause. In this study of functional pulmonary hemoperfusion, radionuclide imaging was deemed superior to angiocardiography.
    The Annals of thoracic surgery 02/2012; 93(2):620-5. · 3.45 Impact Factor
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    ABSTRACT: This study was conducted to address whether staged surgical intervention or primary repair would be preferred for treating patients with tetralogy of Fallot and small left ventricle. We retrospectively assessed 28 patients with tetralogy of Fallot and small left ventricle at the Chinese PLA 208th Hospital, Changchun, between January 2005 and December 2008. Of this cohort, 11 patients had undergone a systemic-to-pulmonary arterial shunt with a polytetrafluoroethylene interposition graft (off pump), followed by ancillary repair procedures as a surgically staged group; the remaining 17 patients underwent primary intracardiac repair via cardiopulmonary bypass. The oxygen level as measured by pulse oximetry (SpO2), the McGoon ratio, and the left ventricular end-diastolic volume index (LVEDVI) were measured before shunt procedures and at 6 to 18 months afterwards. All data were analyzed statistically with the paired Student t test. The 2 groups were compared with respect to LVEDVI values and McGoon indices at baseline by the independent t test. None of the patients died as a direct result of the surgery, but 1 fatality due to pneumonia occurred 4 months after shunting. Mean postshunt values for SpO2, the McGoon ratio, and the LVEDVI increased significantly from 76.8% ± 9.0% to 87.5% ± 2.4% (P < .01), from 1.42 ± 0.27 to 1.62 ± 0.32 (P < .05), and from 20.1 ± 7.0 mL/m2 to 34.3 ± 7.4 mL/m2 (P < .01), respectively. Nine patients were fully repaired within the 6- to 18-month time frame after shunting, while 1 patient awaited definitive surgery for pulmonary hypoplasia. In the primary-repair group, in which the increases the LVEDVI and McGoon ratio were comparatively higher, 1 patient died of hypoxemia. A LVEDVI 20 mL/m2 may be an indication for primary repair in patients with tetralogy of Fallot. With values <20 mL/m2, staged procedures (i.e., shunt with a polytetrafluoroethylene interposition graft) can promote left ventricle development and allow safe transition to the final repair.
    Heart Surgery Forum 02/2012; 15(1):E37-9. · 0.63 Impact Factor
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    ABSTRACT: To explore the changes of pulmonary perfusion over 5 years in patients who underwent extracardiac total cavopulmonary connection. Forty-three patients who had undergone extracardiac total cavopulmonary connection were examined with pulmonary perfusion 1 month and 5 years following the operation. 99mTc-MAA was used for perfusion imaging; pulmonary perfusion value and blood distribution were measured and calculated. Vena cava pressure and arterial oxygenation were measured using the right cardiac catheter, and the pulmonary arteriole resistance was calculated. The status of the conduit connection was assessed by computed tomography three-dimensional reconstruction. Radionuclide counts of the follow-up group were similar to those of the early postoperative group, and the ratios of right to left pulmonary perfusion and inferior vena cava perfusion were not changed. However, the ratio of the whole pulmonary superior to inferior segment was remarkably reduced (t=2.54, P<0.05), with a significantly higher perfusion rate in the posterior segment of the lower lobe (t=2.16, P<0.05). The pulmonary arteriole resistance of the follow-up group was reduced significantly (t=2.08, P<0.05). The vena cava pressure was also reduced (t=2.69, P<0.05), but oxygenation was not significantly changed. Five patients showed a mismatch between pulmonary angiography and radionuclide scintigraphy soon after the operation. The pulmonary angiography showed that the anastomosis was patent, and both lungs were demonstrated. However, the radionuclide scintigraphy only demonstrated the unilateral lung soon after the operation, and both lungs were demonstrated during follow-up. Radionuclide scintigraphy is superior to the pulmonary angiography in the study of functional pulmonary perfusion. Fontan circulation may lead to gravity-dependent blood redistribution, and its weak pulsation can promote pulmonary vascular development. However, the reduced pulmonary arterial resistance at mid-term follow-up may not lead to an increased amount of pulmonary perfusion or oxygen supply, which is probably because of the massive opening of the arteriovenous shunt and increased futile circulation.
    Nuclear Medicine Communications 11/2011; 33(2):148-54. · 1.38 Impact Factor
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    ABSTRACT: We aimed to investigate the initial experience of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in Chinese patients. Forty patients scheduled for isolated CABG were prospectively randomized into an EVH group (n = 20) and an open vein harvesting (OVH) group (n = 20). Clinical data were collected, and all of the vein grafts were assessed by macroscopic appearance, histologic quality (endothelial integrity), and functional characteristics of endothelial nitric oxide synthase. The 2 groups were similar with respect to hospital mortality (EVH group, 0; OVH group, 1; P = 1). There were no postoperative myocardial infarctions in either group and no deaths or reinterventions in either group during the follow-up period. Harvesting times in the 2 groups were similar (EVH, 12.15 ± 2.32 min; OVH, 12.55 ± 2.11 min; P = .571). Three patients in the EVH group were converted to a partly open or skin-bridge technique. Electrocautery at least 2 mm distal to the origin of the side branch was the safety margin. The use of EVH in Chinese patients was not related to adverse events and may be safely used for CABG procedures. Preoperative duplex mapping, systemic heparinization before harvesting, minimal surgical manipulation, and sectioning of side branches at least 2 mm distal to the origin may help improve the quality of vein grafts harvested with EVH and maximize the benefit of this less-invasive technique.
    Heart Surgery Forum 10/2011; 14(5):E291-6. · 0.63 Impact Factor
  • International journal of cardiology 08/2011; 152(1):119-21. · 6.18 Impact Factor
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    ABSTRACT: Reducing lung injury during cardiopulmonary bypass (CPB) is important for patients' recovery. The present study was designed to research convenient and effective pulmonary artery perfusion mode during CPB in an animal model. Twelve healthy mongrel dogs were randomly divided into 2 groups: a control group and a perfusion group designed to simulate clinical CPB-induced lung injury. During CPB, pulmonary artery perfusion with modified low-potassium dextran (LPD) solution was performed immediately after the initiation of ischemia and before reperfusion for 3 to 4 minutes each time, with pressure maintained at 15 to 20 mmHg; animals in the control group were not perfused. After pulmonary reperfusion, the changes in pulmonary function and tissue biochemical data were determined. Compared with the control group, lung compliance, oxygenation, and vascular resistance after reperfusion were significantly improved in the perfusion group. The malonaldehyde concentration, neutrophil sequestration ratio, and tissue water content also decreased significantly in the perfusion group. The pulmonary artery perfusion mode used in this experiment could relieve CPB-induced lung injury effectively. Improving cellular tolerance to hypoxia and decreasing inflammatory reaction may be the important mechanisms. Moreover, this mode is convenient and does not interfere with the intended operations, which is promising for clinical use.
    Heart Surgery Forum 02/2011; 14(1):E18-21. · 0.63 Impact Factor
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    ABSTRACT: The goal of our study was to report our experience of using half rotation of the truncus arteriosus plus arterial switch, as a modification of the Nikaidoh procedure, for anatomic repair of transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary outflow tract obstruction (pulmonary stenosis (PS)). From December 2006 to December 2009, 11 patients (six male, five female) underwent half rotation of the truncus arteriosus plus arterial switch for repair of TGA, VSD, and PS or double-outlet right ventricle (DORV) at our heart center. There was no operative death. All patients had relief of left ventricular outflow tract obstruction (LVOTO) as determined by direct pressure measurements intraoperatively. Echocardiography was performed for all patients intraoperatively and before discharge. Two patients had mild aortic regurgitation and two patients had mild pulmonary regurgitation. For a median follow-up of 15 months (range 6-42 months), all patients were alive. Echocardiography was performed at 3, 6, 12, 24 and 36 postoperative months. All patients have normal ventricular function. No evidence of LVOTO was founded in all patients. Two patients had mild aortic regurgitation and three patients had mild to medium pulmonary regurgitation. Half rotation of the truncus arteriosus plus arterial switch, as a modification of the Nikaidoh procedure, is a good alternative treatment for complete anatomic repair for TGA, VSD, and PS or DORV with malposition of great arteries and PS. The technique might allow to reconstruct biventricular outflow tract, preserve competence and growth potential of the pulmonary root with valves and decrease the probability of reoperation. Its long-term benefits need to be evaluated with a large number of patients and longer follow-up.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2010; 40(3):579-83. · 2.40 Impact Factor
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    ABSTRACT: Cardiopulmonary adaptation during exercise was compared in patients with an extracardiac total cavopulmonary connection and controls with biventricular repair of Fallot's tetralogy. Heart rate, blood pressure, respiratory frequency, and transcutaneous oxygen saturation increased with treadmill exercise intensity below grade 3 in patients who had undergone extracardiac total cavopulmonary connection. When exercise intensity exceeded grade 4, blood pressure and oxygen saturation decreased continuously, respiratory rate kept increasing, and heart rate showed no significant change. In cases of fenestrated cavopulmonary connection, heart rate peaked at grade 5 exercise intensity, and blood pressure at grade 4; but both peaked at grade 3 in non-fenestrated patients. During all exercise testing, fenestrated patients had a higher respiratory rate but lower oxygen saturation than those without fenestration. Exercise tolerance was below normal after a cavopulmonary connection, but patients still adapted to exercise below grade 3 with appropriate increases in heart rate and respiratory rate. Due to insufficient right heart systems, patients with a cavopulmonary connection showed obvious exercise limitation at exercise intensity grade 3 or more. Total exclusion of the right heart system may also have adverse effects on the sinoatrial node, leading to impaired heart rate regulation.
    Asian cardiovascular & thoracic annals 02/2009; 17(1):39-44; discussion 45.
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    ABSTRACT: Pulsatile pulmonary blood flow plays an important role in regulating shear-stress-mediated release of endothelium-derived nitric oxide and endothelin-1, and it reduces pulmonary vascular resistance by passive capillary recruitment. The aim of this study was to demonstrate changes in pulmonary capillary structure and endothelial function induced by the chronic nonpulsatile flow of the Fontan circulation. A canine model with nonpulsatile flow in the right lung was established, and sacrificed 3 months later. Compared to the left lung, wall thickness of the pulmonary arterioles was thinner, endothelin-1 expression was weaker, endothelial nitric oxide synthase activity was stronger, and there was a good correlation between the histomorphometric and immunohistochemical findings. These data indicate that long-term nonpulsatile flow can lead to endothelial dysfunction, which may be involved in distention and vascular structure remodeling due to the increase in pulmonary vascular resistance; but it also can lead to increased patency of the arteriovenous shunt, which might be at least partly involved in pulmonary arteriovenous fistula development and exercise limitation after the Fontan operation.
    Asian cardiovascular & thoracic annals 07/2006; 14(3):183-8.