Background Off-pump coronary artery bypass grafting (CABG) is becoming increasingly popular world - wide. But it is not always feasible. Current cardioplegic techniques do not consistently avoid myocardial ischemic da...Background Off-pump coronary artery bypass grafting (CABG) is becoming increasingly popular world - wide. But it is not always feasible. Current cardioplegic techniques do not consistently avoid myocardial ischemic damage. So we use on pump beating heart technique to supplement off-pump CABG. Methods Based on 860 off-pump CABG cases between Aug 1998 to Aug 2000. From Aug 1999 to Aug 2000, 46 CABG cases were performed with on pump beating heart technique at Mani-pal Hospital Heart Foundation, Bangalore, India. All surgeries were performed through a median sternotomy. Exposure techniques were tailored to individual vessels and cardiac regions and local immobilization was performed with octopus. Vascular control was achieved with occluders and shunts. Total cardiopulmonary bypass (CPB) was established before or during CABG and normolthemia was used. Results Among 46 on -pump beating heart CABG patients, 26 patients used CPB before or during OP - CABG because of unstable hemodynamics and electric instability , 7 had very deep intramyocardial left anterior descending arteries, 5 patients had poor LV function (LVEF < 30 % ), 8 patients had cardiomegaly. The average number of grafts was 3.5. No operative mortality. Three patients had postoperative myocardial infarction. Anesthetic time 4. 5±1. 2 hours, extubation time 10±2. 5 hours, blood lost 680±230 mL, blood requirement 540±150 mL, preoperative LVEF 50. 3±13 % , postoperative LVEF 64. 1±14 %, ICU stay 1. 5±0. 5 days, hospi- tal stay 9.2±1.8 days. Conclusion Complete coronary revascularization with on pump beating heart is a supplement for off - pump CABG when it is not feasible. It eliminates intraoperative globe myocardial ischemia and avoids transient myocardial injury during cardioplegic arrest and myocardial reperfusion.展开更多
We study the possible topological phase in a one-dimensional（1D） quantum wire with an oscillating Rashba spin–orbital coupling in real space. It is shown that there are a pair of particle–hole symmetric gaps formi...We study the possible topological phase in a one-dimensional（1D） quantum wire with an oscillating Rashba spin–orbital coupling in real space. It is shown that there are a pair of particle–hole symmetric gaps forming in the bulk energy band and fractional boundary states residing in the gap when the system has an inversion symmetry. These states are topologically nontrivial and can be characterized by a quantized Berry phase ±π or nonzero Chern number through dimensional extension. When the Rashba spin–orbital coupling varies slowly with time, the system can pump out 2 charges in a pumping cycle because of the spin flip effect. This quantized pumping is protected by topology and is robust against moderate disorders as long as the disorder strength does not exceed the opened energy gap.展开更多
文摘Background Off-pump coronary artery bypass grafting (CABG) is becoming increasingly popular world - wide. But it is not always feasible. Current cardioplegic techniques do not consistently avoid myocardial ischemic damage. So we use on pump beating heart technique to supplement off-pump CABG. Methods Based on 860 off-pump CABG cases between Aug 1998 to Aug 2000. From Aug 1999 to Aug 2000, 46 CABG cases were performed with on pump beating heart technique at Mani-pal Hospital Heart Foundation, Bangalore, India. All surgeries were performed through a median sternotomy. Exposure techniques were tailored to individual vessels and cardiac regions and local immobilization was performed with octopus. Vascular control was achieved with occluders and shunts. Total cardiopulmonary bypass (CPB) was established before or during CABG and normolthemia was used. Results Among 46 on -pump beating heart CABG patients, 26 patients used CPB before or during OP - CABG because of unstable hemodynamics and electric instability , 7 had very deep intramyocardial left anterior descending arteries, 5 patients had poor LV function (LVEF < 30 % ), 8 patients had cardiomegaly. The average number of grafts was 3.5. No operative mortality. Three patients had postoperative myocardial infarction. Anesthetic time 4. 5±1. 2 hours, extubation time 10±2. 5 hours, blood lost 680±230 mL, blood requirement 540±150 mL, preoperative LVEF 50. 3±13 % , postoperative LVEF 64. 1±14 %, ICU stay 1. 5±0. 5 days, hospi- tal stay 9.2±1.8 days. Conclusion Complete coronary revascularization with on pump beating heart is a supplement for off - pump CABG when it is not feasible. It eliminates intraoperative globe myocardial ischemia and avoids transient myocardial injury during cardioplegic arrest and myocardial reperfusion.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.115074045 and 11204187)the Natural Science Foundation of Jiangsu Province,China(Grant No.BK20131284)
文摘We study the possible topological phase in a one-dimensional（1D） quantum wire with an oscillating Rashba spin–orbital coupling in real space. It is shown that there are a pair of particle–hole symmetric gaps forming in the bulk energy band and fractional boundary states residing in the gap when the system has an inversion symmetry. These states are topologically nontrivial and can be characterized by a quantized Berry phase ±π or nonzero Chern number through dimensional extension. When the Rashba spin–orbital coupling varies slowly with time, the system can pump out 2 charges in a pumping cycle because of the spin flip effect. This quantized pumping is protected by topology and is robust against moderate disorders as long as the disorder strength does not exceed the opened energy gap.
