Changqing Gao

307 Hospital of the Chinese People's Liberation Army, Peping, Beijing, China

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Publications (37)49.99 Total impact

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    ABSTRACT: Robotic technology has been applied to atrial septal defect (ASD) repair for more than 10 years, but the number of cases reported is limited and results of long-term follow-up are not clear. This study reports on a large group of patients who underwent totally robotic ASD repair on an arrested or beating heart at a single institution with a 7-year follow-up.
    Interactive Cardiovascular and Thoracic Surgery 09/2014; · 1.11 Impact Factor
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    ABSTRACT: As a cleavage enzyme of precursor TNF-α, the high expression level of ADAM17 in endothelial cells is an important factor in atherosclerosis. In this study, we demonstrate that ADAM17 is the target of miR-152. We found that miR-152 could reduce TNF precursor cleavage and inhibit cell proliferation and migration by targeting ADAM17 in human umbilical vein endothelial cells (HUVECs). Furthermore, the expression pattern of miR-152 and corresponding target ADAM17 was opposite in HUVECs under hypoxic conditions. The levels of circulating miR-152 in AS patient sera were lower than those detected in the sera of normal individuals. Our results indicate that miR-152 may be involved in the development of human atherosclerosis and could be used as diagnostic biomarker or therapeutic target in atherosclerosis.
    FEBS letters 05/2014; · 3.54 Impact Factor
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    ABSTRACT: To summarize the clinical features, pathology and surgical treatment experiences in the patients with aortic paravalvular abscess by infective endocarditis.
    Zhonghua wai ke za zhi [Chinese journal of surgery]. 04/2014; 52(4):263-6.
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    ABSTRACT: Robotic cardiac surgery has been proved safe and feasible in dedicated centers. We systematically analyzed the learning curve issues associated with totally endoscopic coronary artery bypass grafting (TECAB) using a stepwise approach by a single surgeon who had successfully performed >650 cases of various types of robotic cardiac surgery at our single center. From January 2007 to March 2013, 230 patients underwent robotic coronary bypass grafting on the beating heart. Of these patients, 90 had successfully undergone beating heart TECAB using the da Vinci S/Si Surgical System without conversion to sternotomy. All beating heart TECAB procedures were completed using the following modules: endoscopic left internal thoracic artery (LITA) harvesting, pericardiotomy and target vessel identification, and anastomosis of the LITA to the target vessel. The perioperative outcomes were compared among 3 quintiles of 30 consecutive patients each and the learning curve results were evaluated. No in-hospital mortality or severe morbidity occurred. The comparison among the 3 quintiles showed a significant decrease in operative time (P = .000), LITA harvesting time (P = .037), and anastomotic time (P = .000). A significant learning curve was observed for the operative time [y(min) = 223 - 17 × ln(x); r(2) = 0.217, P = .000]; LITA harvesting time [y(min) = 37 - 3 × ln(x); r(2) = 0.097, P = .003]; and LITA-left anterior descending artery anastomotic time [y(min) = 18 - 2 × ln(x); r(2) = 0.298, P = .000]. No differences were found in the mean transit flow (P = .102) or perioperative complications among the 3 quintiles. Modular-based TECAB procedures can be successfully performed; however, each module has a steep learning curve. A stable and well-trained robotic cardiac team and an experienced cardiac surgeon can achieve good, reproducible results after this substantial learning curve.
    The Journal of thoracic and cardiovascular surgery 02/2014; · 3.41 Impact Factor
  • Nan Cheng, Changqing Gao
    Heart Surgery Forum 02/2014; 17(1):E54-60. · 0.63 Impact Factor
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    ABSTRACT: Aortic valve regurgitation caused by a leaflet perforation occurs most often with infective endocarditis involving the aortic valve. Although rare, leaflet perforation can be caused by suture-related injury during cardiac operations, such as mitral valve replacement, ventricular septal defect (VSD) repair, and repair of an ostium primum atrial septal defect. Few reports have described this form of iatrogenic aortic valve leaflet perforation. We used a pericardial patch in a successful repair of an iatrogenic perforation in an aortic valve leaflet that occurred after simple VSD repair.
    Heart Surgery Forum 04/2013; 16(2):E103-6. · 0.63 Impact Factor
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    ABSTRACT: Objective: To retrospectively assess the value of intraoperative transesophageal echocardiography (TEE) during robotic mitral valve (MV) replacement. Methods: Intraoperative TEE was performed in 21 patients undergoing robotic MV replacement for severe rheumatic mitral stenosis between November 2008 and December 2010. During the procedure, TEE was performed to document the mechanism of rheumatic mitral stenosis (leaflet thickening and calcification, commissural fusion or chordal fusion) before cardiopulmonary bypass (CPB). During the establishment of peripheral CPB, TEE was used to guide the placement of the cannulae in the inferior vena cava (IVC), superior vena cava (SVC), and ascending aorta (AAO). After weaning from CPB, TEE was performed to evaluate the effect of the procedure. Results: Accuracy of TEE was 100% for rheumatic mitral stenosis. All the cannuli in the SVC, IVC and AAO were located in the correct position. In all patients, TEE confirmed successful procedure. Conclusion: TEE is useful in the assessment of robotic MV replacement.
    Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences 12/2012; 37(12):1246-9.
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    ABSTRACT: Background: The purpose of this study was to summarize our experience of extended ventricular septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods: Thirty-eight patients (26 men, 12 women) with HOCM underwent extended ventricular septal myectomy. The mean age was 36.3 years (range, 18-64 years). Diagnosis was made by echocardiography. The mean (mean ± SE) systolic gradient between the left ventricle (LV) and the aorta was 89.3 ± 31.1 mm Hg (range, 50-184 mm Hg) according to echocardiographic assessments before the operations. Moderate or severe systolic anterior motion (SAM) of the anterior leaflet of the mitral valve was found in 38 cases, and mitral regurgitation was present in 29 cases. Extended ventricular septal myectomy was performed in all 38 cases. The results of the surgical procedures were evaluated intraoperatively with transesophageal echocardiography (TEE) and with transthoracic echocardiography (TTE) at 1 to 2 weeks after the operation. All patients were followed up with TTE after their operation.Results: All patients were discharged without complications. The TEE evaluations showed that the mean systolic gradient between the LV and the aorta decreased from 94.8 ± 35.6 mm Hg preoperatively to 13.6 ± 10.8 mm Hg postoperatively (P = .0000) and that the mean thickness of the ventricular septum decreased from 28.3 ± 7.9 mm to 11.8 ± 3.2 mm (P = .0000). Mitral regurgitation and SAM were significantly reduced or eliminated. During the follow-up, all patients promptly became completely asymptomatic or complained of mild effort dyspnea only, and syncope was abolished. TTE examinations showed that the postoperative pressure gradient either remained the same or diminished.Conclusions: Extended ventricular septal myectomy is mostly an effective method for patients with HOCM, and good surgical exposure and thorough excision of the hypertrophic septum are of paramount importance for a successful surgery.
    Heart Surgery Forum 10/2012; 15(5):E251-6. · 0.63 Impact Factor
  • Ming Yang, Changqing Gao, Cangsong Xiao
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    ABSTRACT: To summarize the experience with the application of robotic technique in totally endoscopic atrial septal defect closure in a single center. Between January 2007 and September 2011, 115 patients with the diagnosis of secundum type atrial septal defects underwent robotic atrial septal defect repair with the assistance of da Vinci surgical system. The patients had a median age of 35 years and a median defect diameter of 28 mm. Cardiopulmonary bypass was established via peripheral cannulation. Via three 8-mm ports and one 15-mm port in the right chest, the surgeon manipulated the microinstruments to complete the defect closure with or without tricuspid valve plasty. Echocardiography was performed intraoperatively, before discharge and at 30 days after the operation. Atrial septal defect closure was completed on arrested heart in 44 patients and on beating heart in 61 patients. No deaths or conversions to alternate techniques occurred in these cases. No residual shunt was detected by intraoperative or postoperative echocardiography. The mean operating time and cardiopulmonary bypass time on bearing heart group were significantly shorter than those on arrested heart group. The median ventilation time, intensive care unit stay, drainage volume, or length of hospital stay showed no significant differences between the two groups. Secundum type atrial septal defect closure can be successfully performed with the assistance of the robotic system with good surgical results.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 07/2012; 32(7):915-8.
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    ABSTRACT: Patients with Ehlers-Danlos syndrome (EDS) type IV, an inherited connective tissue disorder, are predisposed to vascular and digestive ruptures, and arterial ruptures account for the majority of deaths. A 31-year-old man with EDS presented with an intramural aortoatrial fistula, severe aortic regurgitation, mitral valve prolapse, and severe tricuspid valve insufficiency combined with a severely dilated left ventricle. Determining the best surgical option for the patient was not easy, especially regarding the course of action for the aortic root with a tear in the sinus of Valsalva. The fistula tract was closed at the aorta with suture and with a patch in the right atrium, the mitral valve was repaired with edge-to-edge suture and then annuloplasty with a Cosgrove ring, the aortic valve was replaced with a mechanical prosthesis, and a modified De Vega technique was used for the tricuspid valvuloplasty. The postoperative course was uncomplicated, and the patient was discharged 2 weeks later. The considerations made to arrive at the chosen surgical course of action in this complex case are reviewed.
    Heart Surgery Forum 06/2012; 15(3):E156-7. · 0.63 Impact Factor
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    ABSTRACT: In the present study, we determined the safety and efficacy of robotic mitral valve replacement using robotic technology. From January 2007 through March 2011, more than 400 patients underwent various types of robotic cardiac surgery in our department. Of these, 22 consecutive patients underwent robotically assisted mitral valve replacement. Of the 22 patients with isolated rheumatic mitral valve stenosis (9 men and 13 women), the mean age was 44.7 ± 19.8 years (range, 32-65). Preoperatively, all patients underwent a complete workup, including coronary angiography and transthoracic echocardiography. Of the 22 patients, 15 had concomitant atrial fibrillation. The surgical approach was through 4 right-side chest ports with femoral perfusion. Aortic occlusion was performed with a Chitwood crossclamp, and antegrade cardioplegia was administered directly by way of the anterior chest. Using 3 port incisions in the right side of the chest and a 2.5- to 3.0-cm working port, all the procedures were completed with the da Vinci S robot. All patients underwent successful robotic surgery. Of the 22 patients, 16 received a mechanical valve and 6 a tissue valve. The mean cardiopulmonary bypass time and aortic crossclamp time was 137.1 ± 21.9 minutes (range, 105-168) and 99.3 ± 17.9 minutes (range, 80-133), respectively. No operative deaths, stroke, or other complications occurred, and no incisional conversions were required. After surgery, all the patients were followed up echocardiographically. Robotically assisted mitral valve replacement can be performed safely in patients with isolated mitral valve stenosis, and surgical results are excellent.
    The Journal of thoracic and cardiovascular surgery 02/2012; 143(4 Suppl):S64-7. · 3.41 Impact Factor
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    ABSTRACT: OBJECTIVE: We have previously reported total endoscopic ventricular septal defect repair in the adult using the da Vinci S Surgical System. The optimal results encouraged us to extend the use of this technology to more complicated patients with ventricular septal defect. METHODS: From January 2009 to July 2010, 20 patients underwent total endoscopic robotic ventricular septal defect repair. The average patient age was 29.0 ± 9.5 years (range, 16-45). Of the 20 patients, 9 were female and 11 were male. The echocardiogram demonstrated that the average diameter of the ventricular septal defect was 6.1 ± 2.8 mm (range, 2-15), and 4 patients had concomitant patent foramen ovale. Ventricular septal defect closure was directly secured with interrupted mattress sutures in 14 patients and patched in 6 patients. All the procedures were completed using the da Vinci robot by way of 3 port incisions and a 2.0- to 2.5-cm working port in the right side of the chest. RESULTS: All patients were operated on successfully. The mean cardiopulmonary bypass and mean crossclamp time was 94.3 ± 26.3 minutes (range, 70-140) and 39.1 ± 12.9 minutes (range, 22-75), respectively. The mean operation time was 225.0 ± 34.8 minutes (range, 180-300). The postoperative transesophageal echocardiogram demonstrated an intact ventricular septum. No residual left-to-right shunting and no permanently complete atrioventricular dissociation was found postoperatively. The mean hospital stay was 5 days. No residual shunt was found during a mean follow-up of 7 months (range, 1-22). The patients returned to normal function within 1 week without any complications. CONCLUSIONS: Total endoscopic robotic ventricular septal defect repair in adult patients is feasible, safe, and efficacious.
    The Journal of thoracic and cardiovascular surgery 02/2012; · 3.41 Impact Factor
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    ABSTRACT: To investigate anesthetic techniques for robot-assisted endoscopic atrial septal defect (ASD) repair. Clinical observational study. Operating room of a general military hospital. 56 adult, ASA physical status 1 and 2 patients undergoing elective general anesthesia. After induction of general anesthesia, a left-sided, double-lumen endotracheal tube was positioned to allow single left-lung ventilation and contralateral CO(2) pneumothorax (capnothorax). With ultrasound guidance, peripheral cardiopulmonary bypass (CPB) catheters were placed. All patients tolerated single left-lung ventilation before CPB; however, hypoxia (oxygen saturation < 90%) occurred in 11 (19.6%) patients post-CPB, which required treatment with continuous positive airway pressure. Fifteen (26.8%) patients had hypotension secondary to capnothorax, which was treated with transfusion and vasopressors. Aortic cross-clamp time was 43.6 ± 11.2 minutes, and CPB time was 106.7 ± 12.4 minutes. The median intensive care unit stay was 21 hours and postoperative hospital stay was 4 to 7 days. The key issue for anesthetic management of robot-assisted totally endoscopic ASD repair is maintaining stable hemodynamics and oxygenation, especially during one-lung ventilation and capnothorax.
    Journal of clinical anesthesia 12/2011; 23(8):621-5. · 1.32 Impact Factor
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    ABSTRACT: Congenital mitral valve regurgitation (MVR) is a rare disease found in adults. We report on our 5-year surgical experience with congenital MVR in adults. We reviewed the data for 48 consecutive patients (26 men), aged >18 years (median, 42 years; range, 18-78 years) who underwent operations for severe congenital MVR between June 2005 and May 2010. Patients with atrioventricular septal defect were excluded. Congenital MVR was preoperatively diagnosed in 28 cases (58%). The lesions consisted of annular dilation (100%), valvular cleft (58%), prolapsed leaflet (40%), papillary muscle abnormality (5%), commissure fusion (2%), and leaflet deficiency (2%). Mitral valve repair was performed in 42 cases (88%) by means of Carpentier techniques. The other 6 patients underwent mitral valve replacement; one of these patients died of ventricular fibrillation 2 days after surgery. There were no other hospital deaths or late mortality. At the last follow-up (median, 38 months; range, 2-50 months), all 47 patients were in New York Heart Association functional class I or II. Echocardiography evaluations for the 42 patients who underwent the repairs revealed that 32 (76%) of the patients had no or trivial MVR and 10 patients (24%) had mild MVR. No patient underwent reoperation. Congenital MVR is rare and often misdiagnosed in adults. Mitral valve repair is feasible in the majority of patients, with excellent immediate and medium-term results.
    Heart Surgery Forum 04/2011; 14(2):E114-6. · 0.63 Impact Factor
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    ABSTRACT: Despite the early introduction of totally endoscopic coronary artery bypass on the beating heart, only a limited number of cases have been performed. The limiting factor has been the concern about safety and graft patency of the anastomosis. This study describes our experience with totally endoscopic coronary artery bypass on the beating heart with robotic assistance and its early and midterm results. In 365 cases of robotic cardiac operations, 162 patients underwent robotic coronary artery bypass grafting on the beating heart, of whom 60 patients (46 male, 14 female) underwent totally endoscopic coronary artery bypass on the beating heart. The patients' mean age was 56.97 ± 9.7 years (33-77 years). Left internal thoracic artery to left anterior descending anastomosis was performed using the U-Clip device. We completed 58 totally endoscopic coronary artery bypass procedures, in which 16 patients received hybrid procedures. Two patients had conversions to a minithoracotomy. The average left internal thoracic artery harvesting and anastomosis times were 31.3 ± 10.5 (18∼55) minutes and 11.3 ± 4.7 (5∼21) minutes, respectively. The mean operating room and operation times were 336.1 ± 58.5 (210∼580) minutes and 264.8 ± 65.6 (150∼420) minutes, respectively. The drainage was 164.9 ± 83.2 (70∼450) mL. Before discharge, 50 patients underwent angiography and 8 patients underwent computed tomography angiography, and the study showed that graft patency was 100%. Unexpectedly, the left internal thoracic artery graft developed a collateral branch in 2 patients. After discharge, all patients were followed up by computed tomography angiography. The average follow-up time was 12.67 ± 9.43 (1-40) months. One patient had gastric bleeding after surgery. Totally endoscopic coronary artery bypass on the beating heart is a safe procedure in selected patients and produces excellent early and midterm patency of anastomosis.
    The Journal of thoracic and cardiovascular surgery 03/2011; 142(4):843-9. · 3.41 Impact Factor
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    ABSTRACT: Aortic pseudoaneurysms are rare but life-threatening complications of aortic procedures. Operation on the femorofemoral bypass with hypothermic circulatory arrest has been the method of choice. Iatrogenic ascending aorta pseudoaneurysm combined with infective endocarditis of the aortic valve has never been reported. We describe a case of a pseudoaneurysm of the ascending aorta at the site of an aortotomy site concomitant with infective endocarditis of the aortic valve. A contrast computed tomographic scan was the investigation technology of choice. The operation was performed on femorofemoral bypass without hypothermic circulatory arrest, which provided safe re-entry and an opportunity to replace the infected aortic valve with a mechanical prosthesis and to repair the aortic defect with a patch. The ascending aorta pseudoaneurysm can be safely operated on with femorofemoral bypass without hypothermic cardiac arrest.
    Heart Surgery Forum 02/2011; 14(1):E70-2. · 0.63 Impact Factor
  • Changqing Gao, Rong Wang, Gang Wang, Yao Wang
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    ABSTRACT: (J Card Surg 2011;26:70-70)
    Journal of Cardiac Surgery 01/2011; 26(1):70. · 1.35 Impact Factor
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    ABSTRACT: To investigate the effects of granulocyto-colony stimulating factor (G-CSF) on the mobilization of endothelial progenitor cells (EPCs) in the rats with myocardial infarction (MI), to observe the density of neovascularization and the mRNA expressions of vascular endothelial growth factor (VEGF) and its receptor (Flk-1) in the border area of MI. Thirty-six adult male rats (weighing 250-280 g) were divided randomly into control group, MI group, and G-CSF group. In MI group and G-CSF group, the models of MI were established by left anterior descending coronary artery ligation and were treated with intraperitoneal injection of saline (0.3 mL/d) or G-CSF [30 microg/(kg x d)] for 5 days. In control group, after open chest operation, chest was closed without treatment. The level of EPCs was surveyed and the plasma concentrations of VEGF and C-reaction protein (CRP) were measured at 7 days. The mRNA expressions of VEGF and its receptor Flk-1 in the border area of infarct myocardium were determined through RT-PCR. Compared with control group, the number of circulating white blood cell (WBC) and EPCs levels, and the serum concentrations of VEGF and CRP were all significantly increased in MI group and G-CSF group (P < 0.05); when compared with MI group, the number of circulating WBC and EPCs levels, and the serum concentrations of VEGF were increased and the concentration of CRP was decreased in G-CSF group (P < 0.05). Compared with control group, the mRNA expressions of VEGF and Flk-1, and the density of neovascularization in the border area of infarct myocardium were increased in MI group and G-CSF group, whereas those in G-CSF group were significantly augmented compared with MI group (P < 0.05). In the rats with MI, G-CSF could promote EPCs mobilization, increase the mRNA expressions of VEGF and Flk-1, and augment the density of neovascularization in the border area of infarct myocardium.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 10/2010; 24(10):1239-43.
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    ABSTRACT: The impact of the grafting techniques (individual or sequential grafts) on the graft patency of off-pump coronary artery bypass grafting (OPCAB) has not been reported. The mid-term patency rates for individual and sequential saphenous vein grafts (SVGs) as coronary bypass conduits of OPCAB were compared. A total of 714 distal coronary anastomoses on 448 SVGs were assessed using a 64-multislice computed tomography in 398 patients at an average of 26.4 ± 23.6 months (three months to five years) after an OPCAB procedure. The blood flow of grafts in the proximal segment of individual and sequential SVGs was also compared. The overall patency of sequential SVGs (95.9%) was significantly superior to individual ones (90.6%, p = 0.022). The anastomoses on the sequential conduits had better patency (95.1% vs. 90.1%, p = 0.013). The patency of side-to-side anastomoses (97%) was better than that of end-to-side anastomoses (93.1%) and also better than that of the individual end-to-side anastomoses (90.1%, p = 0.002, p = 0.041). No significant difference was observed between the two approaches in regard to the three major coronary systems; however, anastomoses on sequential grafts had superior patency to those on individual grafts in the right coronary system (p = 0.008). The blood flows of double and triple sequential SVGs were significantly higher than those of individual ones (p < 0.001, p = 0.048, respectively). The mid-term patency of a sequential SVG conduit after OPCAB is excellent and generally superior to that of an individual one. 
    Journal of Cardiac Surgery 10/2010; 25(6):633-7. · 1.35 Impact Factor
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    ABSTRACT: Lysophosphatidylcholine (LPC), which accumulates in the ischemic myocardium, is responsible for mechanical and metabolic derangements of hearts, and also contributes to the development of ventricular arrhythmias. We examined the effects of pravastatin on the LPC-induced cardiac dysfunction in isolated rat hearts. Rat hearts were randomly divided into four groups. The groups comprised a control group (n=10), a group treated with LPC (5 microM) (n=20), a group treated with pravastatin (400 ng/ml) (n=10) and a group treated with both LPC and pravastatin (n=20). Our data suggest that, pravastatin possesses some protective profiles against LPC, as manifested by better recovery of cardiac function (improvement in heart rate, left ventricular developed pressure, maximal and minimal first derivatives of left ventricular developed pressure, coronary flow and coronary resistance, less release of biomarkers of cardiac injury (lactate dehydrogenase, creatine kinase-MB and endothelin-1), and attenuation of ventricular arrhythmias (ventricular tachyarrhythmia and ventricular fibrillation).
    European journal of pharmacology 08/2010; 640(1-3):139-42. · 2.59 Impact Factor