Publications by authors named "Shuyang Lu"

25 Publications

  • Page 1 of 1

Identification of Differently Expressed mRNAs in Atherosclerosis Reveals CDK6 Is Regulated by circHIPK3/miR-637 Axis and Promotes Cell Growth in Human Vascular Smooth Muscle Cells.

Front Genet 2021 15;12:596169. Epub 2021 Feb 15.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Atherosclerosis is the leading cause of heart disease and stroke, and one of the leading causes of death and disability worldwide. The phenotypic transformation of vascular smooth muscle cells (VSMCs) plays an important role in the pathological process of atherosclerosis. The present study aimed to identify differently expressed mRNAs in atherosclerosis by analyzing GSE6088 database. Our results revealed there were totally 467 increased and 490 decreased differential expressed genes (DEGs) in atherosclerosis. Bioinformatics analysis demonstrated that the DEGs substantially existed in pathways, including Glyoxylate and dicarboxylate metabolism, Tyrosine metabolism, Tryptophan metabolism, Beta-Alanine metabolism, Fatty acid biosynthesis and Starch and sucrose metabolism. Next, we constructed a protein-protein interaction (PPI) network to identify hub genes in atherosclerosis. Also, we identified CDK6 as a key regulator of atherosclerosis. In this study, we found that CDK6 knockdown suppressed HASMC and HUASMC cell proliferation. Circular RNA (CircRNA) is a non-coding RNA which is reported to have an unusual influence on tumorigenesis process and other aspects in the last few years. Previous studies showed circRNAs could act as miRNAs sponging in multiple biological processes. Bioinformatics prediction and luciferase analysis showed that CDK6 were targeted and regulated by circHIPK3/miR-637. Moreover, silencing circHIPK3 could also significantly induce the arrest and apoptosis of cell cycle. In conclusion, this study discovered the important regulatory role of circHIPK3 in the proliferation and apoptosis of VSMCs by influencing the miR-637/CDK6 axis.
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http://dx.doi.org/10.3389/fgene.2021.596169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917241PMC
February 2021

Construction and performance evaluation of Hep/silk-PLCL composite nanofiber small-caliber artificial blood vessel graft.

Biomaterials 2020 11 13;259:120288. Epub 2020 Aug 13.

Department of Pharmacy, The Third Affiliated Hospital (The Affiliated Luohu Hospital) of Shenzhen University, Shenzhen, Guangdong Province, China. Electronic address:

To meet the growing clinical demand for small-caliber blood vessel grafts to treat cardiovascular diseases, it is necessary to develop safe and long-term unobstructed grafts. In this study, a biodegradable graft made of composite nanofibers is introduced. A composite nanofiber core-shell structure was prepared by a combination of conjugate electrospinning and freeze-dry technology. The core fiber was poly(l-lactide-co-caprolactone) (PLCL)-based and the core fibers were coated with heparin/silk gel, which acted as a shell layer. This special structure in which the core layer was made of synthetic materials and the shell layer was made of natural materials took advantage of these two different materials. The core PLCL nanofibers provided mechanical support during vascular reconstruction, and the shell heparin/silk gel layer enhanced the biocompatibility of the grafts. Moreover, the release of heparin in the early stage after transplantation could regulate the microenvironment and inhibit the proliferation of intima. All of the graft materials were biodegradable and safe biomaterials, and the degradation of the graft provided space for the growth of regenerated tissue in the late stage of transplantation. Animal experiments showed that the graft remained unobstructed for more than eight months in vivo. In addition, the regenerated vascular tissue provided a similar function to that of autogenous vascular tissue when the graft was highly degraded. Thus, the proposed method produced a graft that could maintain long-term patency in vivo and remodel vascular tissue successfully.
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http://dx.doi.org/10.1016/j.biomaterials.2020.120288DOI Listing
November 2020

Simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery.

J Cardiothorac Surg 2020 Jun 18;15(1):146. Epub 2020 Jun 18.

Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, The Shanghai Institute of Cardiovascular Diseases, No. 1609 Xietu Road, Xuhui District, Shanghai, 200032, China.

Background: Redo isolated tricuspid valve surgery is associated with a high morbidity and mortality, and its optimal timing remains controversial. Hence, here we reviewed the early and midterm results of simplified, minimally invasive, beating-heart technique for redo isolated tricuspid valve surgery in patients at high risk.

Methods: A total of 32 consecutive patients underwent a redo isolated tricuspid valve surgery using minimally invasive, beating-heart technique through a right lateral thoracotomy in our center between June 2016 and April 2020. The mean age of patients was 57.4 ± 8.3 years, and 18 patients (56.3%) were women. The mean preoperative EuroSCORE was 7.8 ± 1.4 (range: 6-11). Follow-up was 87.1% complete, with a mean duration of 26.3 ± 12.3 months.

Results: Both in-hospital and 30-day mortalities were 3.1%. Tricuspid valve replacement with bioprosthesis was performed in 30 patients (93.8%), and the remaining two patients (6.2%) underwent tricuspid repair (annuloplasty and leaflet reconstruction). The mean cardiopulmonary bypass time was 81.5 ± 29.0 min. The overall in-hospital duration and intensive care unit (ICU) times were 13.6 ± 7.6 days and 4.1 ± 2.8 days, respectively. Postoperative complications included prolonged ventilation in six patients (18.8%), acute kidney injury in three patients (9.4%), and neurologic event, wound infection, or permanent third-degree atrioventricular block, in one patient (3.1%) each. A total of 96.9% patients were discharged uneventfully. Four patients were lost to follow-up; there were no midterm deaths in patients who were followed up.

Conclusions: Simplified, minimally invasive, beating-heart technique for redo tricuspid valve surgery is both feasible and safe, and the early and midterm results are excellent.
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http://dx.doi.org/10.1186/s13019-020-01192-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301080PMC
June 2020

Optimizations of stent and tissue leaflets in a new surgical bovine pericardial valve.

J Thorac Dis 2019 Nov;11(11):4855-4858

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

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http://dx.doi.org/10.21037/jtd.2019.10.32DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940270PMC
November 2019

LncRNA LOXL1-AS is up-regulated in thoracic aortic aneurysm and regulated proliferation and apoptosis of aortic smooth muscle cells.

Biosci Rep 2019 09 13;39(9). Epub 2019 Sep 13.

Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Xietu Road No. 1609, Shanghai City 200032, P.R. China

Long non-coding RNA LOXL1-AS is up-regulated in several types of cancers. The present study was carried out to explore the potential interactions between LOXL1-AS and lncRNA Giver in thoracic aortic aneurysm (TAA). We found that LOXL1-AS was up-regulated in TAA patients than in healthy controls in aortic media specimens. Altered expression levels of LOXL1-AS distinguished TAA patients from healthy controls. LncRNA Giver was also up-regulated in TAA patients than in healthy controls in aortic media specimens, and was positively correlated with LOXL1-AS. LOXL1-AS overexpression mediated the up-regulation of Giver in human aortic smooth muscle cells, while Giver overexpression failed to significantly affect LOXL1-AS. LOXL1-AS and Giver overexpression resulted in promoted proliferation and inhibited apoptosis of HAOSMC. Giver silencing played an opposite role and attenuated the effect of LOXL1-AS overexpression. Therefore, LOXL1-AS was up-regulated in TAA and regulated proliferation and apoptosis of LOXL1-AS by up-regulating Giver.
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http://dx.doi.org/10.1042/BSR20191649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744585PMC
September 2019

Electrospun Bilayer Composite Vascular Graft with an Inner Layer Modified by Polyethylene Glycol and Haparin to Regenerate the Blood Vessel.

J Biomed Nanotechnol 2019 Jan;15(1):77-84

In this study, we prepared a composite vascular graft with two layers. The inner layer, which was comprised of degradable Poly(lactic-co-glycolic acid) (PLGA)/Collagen (PC) nanofibers modified by mesoporous silica nanoparticles (MSN), was grafted with polyethylene glycol (PEG) and heparin to promote cell proliferation and to improve blood compatibility. The outer layer was comprised of polyurethane (PU) nanofibers in order to provide mechanical support. The growth and proliferation of human umbilical vein endothelial cells (HUVECs) in the inner layer was significant, and blood compatibility testing showed that the inner layer had good blood compatibility. The MSN-PEG-Heparin on the fiber surface was observed during the degradation of the inner layer. After 60 days, the weight of fiber membrane decreased by 92.4%. The inner layer did not cause an inflammatory reaction during the degradation process and there was uniform cellular growth on the PC/MSN-PEG-Heparin fiber membrane. Composite grafts implanted into the rabbit carotid artery were evaluated for 8 weeks by H&E and immunohistochemical staining, demonstrating that a monolayer of endothelium (CD31-labeled) and smooth muscle (SMA-labeled) regenerated on the composite graft. Our results demonstrate that the composite graft, with a functional inner layer, has potential to be used for small-caliber blood vessels with long-term patency.
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http://dx.doi.org/10.1166/jbn.2019.2666DOI Listing
January 2019

A Method for Preparation of an Internal Layer of Artificial Vascular Graft Co-Modified with Salvianolic Acid B and Heparin.

ACS Appl Mater Interfaces 2018 Jun 29;10(23):19365-19372. Epub 2018 May 29.

State Key Lab for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology , Donghua University , Shanghai 201620 , China.

Studies have shown that salvianolic acid B (SAB), which is derived from Chinese salvia ( Salvia miltiorrhiza), a plant used in traditional Chinese medicine, can promote the proliferation and migration of endothelial cells. The inner layer of an artificial vascular graft was fabricated using the coaxial electrospinning method and was loaded with the anticoagulant heparin and SAB. The release of heparin and SAB was sustained for almost 30 days and without an initial burst release of SAB. Furthermore, the combined effect of SAB and heparin contributed to promoting human umbilical vein endothelial cell (HUVEC) growth and improved the blood compatibility of the graft. In addition, upregulation of GRP78 by SAB protected human endothelial cells from oxidative stress-induced cellular damage. In vivo evaluation through Masson's trichrome and H&E staining was performed after the graft was subcutaneously embedded in SD rats for 2 weeks and indicated that the graft possessed satisfactory biocompatibility and did not cause a significant immune response. Hence, the functional inner layer is promising for preventing acute thrombosis and promotes rapid endothelialization of artificial vascular grafts.
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http://dx.doi.org/10.1021/acsami.8b02602DOI Listing
June 2018

hsa-miR-320d and hsa-miR-582, miRNA Biomarkers of Aortic Dissection, Regulate Apoptosis of Vascular Smooth Muscle Cells.

J Cardiovasc Pharmacol 2018 05;71(5):275-282

Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China.

Abnormal expression of microRNAs (miRNAs) has been associated with aortic dissection (AD). Next-generation sequencing was performed to identify the differentially expressed miRNAs in aortic tissue samples between AD and nondiseased individuals. Selected miRNAs, which showed significant variation between the 2 groups, were then transfected into human aortic vascular smooth muscle cells, and assessed for effects on cell migration and induced apoptosis. The changes in gene expression pattern in human aortic vascular smooth muscle cells transfected with the miRNAs were also investigated. Among the 314 miRNAs detected in the aortic tissues from both AD and normal subjects, 46 showed significantly different expression patterns. Only 7 of these differentially expressed miRNAs were found to be enriched in AD, whereas the majority had diminished. hsa-miR-320d and hsa-miR-582 were 2 representative miRNAs that exhibited a decrease of greater than 10-fold. Transfection of hsa-miR-320d and hsa-miR-582 did not affect the migration capability of the vascular smooth muscle cells, but remarkably enhanced the staurosporine and tumor necrosis factor-α-induced apoptosis by 15% and 29%, respectively. Furthermore, the transfection of both miRNAs affected the expression of a vast multitude of genes, most of which were related to apoptotic pathways. The fluorescence reporter assays demonstrated that hsa-miR-320d and hsa-miR-582 bind the 3' UTR region of TRIAP1 and NET1 genes, respectively. These results suggest that hsa-miR-320d and hsa-miR-582 may serve as putative biomarkers for AD research.
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http://dx.doi.org/10.1097/FJC.0000000000000568DOI Listing
May 2018

Risk factors associated with perioperative morbidity and mortality following isolated tricuspid valve replacement.

J Surg Res 2018 01;221:224-231

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Shanghai, China. Electronic address:

Background: Reports of isolated tricuspid valve replacement (iTVR) are relatively rare. The present study aimed to evaluate independent risk factors of perioperative morbidity and mortality after iTVR.

Materials And Methods: We retrospectively reviewed 118 consecutive patients (42 males; mean age, 49.1 ± 12.9 y) who underwent iTVR from May 2003 to April 2016 in our center. The multivariate logistic regression model was used to analyze the independent risk factors associated with perioperative morbidity and mortality following iTVR.

Results: One hundred one patients (85.6%) were classified as New York Heart Association functional class III or IV preoperatively. The overall perioperative mortality was 11.8% (14/118), and a significant difference was observed between the nonreoperative group and the reoperative group (6.7% versus 18.3%, P = 0.047). The multivariate logistic regression analyses identified that preoperative New York Heart Association functional class IV (OR [odds ratio] = 15.43, 95% CI [confidence interval] = 3.46-68.83, P = 0.000) and ascites (OR = 4.88, 95% CI = 1.24-19.27, P = 0.024) were independent risk factors of perioperative deaths. The previous cardiac surgery (OR = 3.28, 95% CI = 1.41-7.62, P = 0.006) was independently associated with perioperative major adverse events.

Conclusions: The present study revealed that iTVR has relatively high mortality and morbidity rates. Timely surgery may be recommended for this high-risk cohort of patients before the development of severe heart and end-organ failure.
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http://dx.doi.org/10.1016/j.jss.2017.08.014DOI Listing
January 2018

Atypical Case of Partial Anomalous Pulmonary Venous Connection Misdiagnosed as Primary Pulmonary Arterial Hypertension.

Heart Surg Forum 2017 10 31;20(5):E231-E233. Epub 2017 Oct 31.

Shanghai Institute of Cardiovascular Disease, China.

In this case report, we present the delayed diagnosis of an atypical partial anomalous pulmonary venous connection, which was initially misdiagnosed as primary pulmonary arterial hypertension. It was difficult to make a conclusive diagnosis using transthoracic echocardiography (TTE), because the two high right superior pulmonary veins drained into the superior vena cava and limited the shunt of patent foramen ovale. Preoperative TTE only showed right heart volume overload, pulmonary arterial hypertension, and severe tricuspid valve insufficiency. A chest CT-angiography (angio-CT) finally found the anomalous right superior pulmonary venous connection, which was further confirmed by surgery. The postoperative course was uneventful.
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http://dx.doi.org/10.1532/hsf.1618DOI Listing
October 2017

Clinical Characteristics and Surgical Treatment of Infective Endocarditis With Bicuspid Aortic Valve.

Int Heart J 2017 Apr 27;58(2):220-224. Epub 2017 Mar 27.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University.

This study aimed to evaluate the clinical characteristics and surgical treatment of bicuspid aortic valve (BAV) infective endocarditis (IE) compared with tricuspid aortic valve (TAV) IE in China.The relevant pre-, intra- and post-operative materials of all IE patients undergoing cardiac surgery in our center between January 2003 and December 2012 were investigated and analyzed retrospectively.From January 2003 to December 2012, 345 consecutive IE patients received surgery in our center. A total of 171 native aortic valve IE patients were enrolled in this study, accounting for 49.6% of the total population. Among these 171 IE patients, 29.8% (n = 51) were BAV, and the remaining (n = 120) were TAV. There was a strong male predominance (92.2% versus 70.8%, P = 0.002) and a higher frequency of aortic perivalvular abscess (45.1% versus 18.3%, P < 0.001) in the BAV IE group compared with the TAV IE group. In multivariate analysis, BAV was the only independent predictor associated with an increased risk of aortic perivalvular abscess (OR = 4.365, 95% CI 1.30-14.65, P = 0.017). Six patients died postoperatively and no significant difference was found about in-hospital mortality between the BAV IE group and TAV IE group (2.0% versus 4.2%, P = 0.793).BAV is common in patients with confirmed aortic valve IE. BAV IE patients have a significantly increased risk of perivalvular abscess. Prompt diagnosis and timely surgery for BAV IE patients might be needed to prevent the formation and extension of perivalvular abscess.
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http://dx.doi.org/10.1536/ihj.16-284DOI Listing
April 2017

Open aortic arch reconstruction for acute type a aortic dissection: a single-center experience with 267 consecutive patients.

J Cardiothorac Surg 2016 Jul 22;11(1):111. Epub 2016 Jul 22.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: This study aimed to analyze the mortality and morbidity of patients undergoing open aortic arch reconstruction for acute type A aortic dissection.

Methods: Between September 2005 and January 2012, 267 consecutive patients underwent open aortic arch reconstruction for acute type A aortic dissection at our center. The mean age was 51.2 ± 10.0 years, and 200 patients were male. Sixty-three and 184 patients underwent hemiarch replacement and total arch replacement, respectively, whereas the remaining 20 patients underwent single- or triple-branched stent graft implantation. Long-term mortality was estimated by Kaplan-Meier method.

Results: The in-hospital and operative mortality rates within 30 days were 11.2 % and 8.2 %, respectively. The cardiopulmonary bypass, myocardial ischemic, and antegrade cerebral perfusion times were 150.2 ± 43.3, 71.9 ± 33.2, and 33.6 ± 14.4 min, respectively. The overall in-hospital and intensive care unit durations and mean ventilation time were 23.9 ± 18.4 and 9.5 ± 12.7 days and 122.7 ± 183.4 h, respectively. We observed new postoperative permanent neurological dysfunction in 29 patients and temporary neurological dysfunction in 17 patients. The mean follow-up duration was 52.4 ± 27.9 months; 76.4 % of patients completed follow-up and 143 remained alive. Overall long-term survival was 82.2 % at 5 years.

Conclusions: The open aortic arch reconstruction technique for acute type A dissection carries a relatively high in-hospital mortality risk, although the late results are encouraging. Patients with an advanced age or impaired renal function may opt for endovascular or modified single- or triple-branched stent graft implantation therapy.
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http://dx.doi.org/10.1186/s13019-016-0500-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957365PMC
July 2016

Early Assistance With Left Ventricular Assist Device Limits Left Ventricular Remodeling After Acute Myocardial Infarction in a Swine Model.

Artif Organs 2016 Mar 2;40(3):243-51. Epub 2015 Sep 2.

Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, China.

Unlabelled: Although left ventricular assist devices (LVADs) have been commonly used for patients with cardiogenic shock after acute myocardial infarction (AMI), their effects on post-AMI prognosis remain to be elucidated. In this study, we aimed to explore the effects of an LVAD on left ventricular (LV) remodeling and function at the postinfarction stage in a swine model. AMI was induced by ligation of the circumflex artery or its branches for 120 min, followed by 120 min of reperfusion. In the assist group (n = 6), LVAD was initiated at 90 min after ischemia and was maintained for support until 120 min after reperfusion, whereas the control group (n = 6) received no support. LV pressure, volume, wall stress, and stroke work were all decreased by LVAD assistance at the ischemia and reperfusion stages, and blood pressure and cardiac output were maintained. All swine were studied 1 month after the procedure, and those in the assist group showed less increased end-diastolic volumes (assist vs.

Control: 57.9 ± 6.6 vs. 79.0 ± 6.7 mL, P = 0.032) and sphericity (assist vs.

Control: 1.33 ± 0.16 vs. 1.51 ± 0.12, P = 0.01), as well as improved ejection fractions (assist vs.

Control: 59.0 ± 7.8 vs. 42.3 ± 6.0%, P = 0.002). Furthermore, despite a presence of a similar initial ischemic area, the percent of infarcted myocardium was reduced by 49.9% in the assist group (assist vs.

Control: 18.1 ± 4.8 vs. 35.3 ± 6.2%, P < 0.001). These results suggested that early assistance with an LVAD in AMI limited LV remodeling, preserved postinfarction systolic function, and improved the prognosis.
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http://dx.doi.org/10.1111/aor.12541DOI Listing
March 2016

Off-pump Skeletonized Versus Pedicled Left Internal Mammary Artery Grafting: Mid-term Results.

J Card Surg 2015 Jun 14;30(6):494-9. Epub 2015 Apr 14.

Department of Cardiac Surgery, Zhongshan Hospital of Fudan University & Shanghai Institute of Cardiovascular Diseases, Shanghai, P. R. China.

Background: Skeletonization of the internal mammary artery for single left internal mammary artery (LIMA) use remains controversial. We sought to elucidate the effect of different harvesting techniques applied in single LIMA grafting.

Method: Between January 2006 and January 2012, 982 patients undergoing off-pump coronary artery bypass with pedicled LIMA conduits (P Group) and 928 patients undergoing the same operation with skeletonized LIMA conduits (S Group) were enrolled. The length and blood flow of the conduits, and in-hospital and mid-term outcomes with one-year postoperative graft angiographic results were analyzed and compared between groups.

Results: Twenty-five (2.7%) patients in the S group died in hospital, compared with 26 (2.6%) in the P group, with similar rates of sternal wound infection, chest wall pain, and low-output syndrome. Although the length and blood flow of conduits were increased in the S Group, postoperative conduit patency was similar between groups (p = 0.470). During a median follow-up of 32.2 months, the groups showed similar total survival (88.3 ± 3.2%, S Group; 85.5 ± 2.0%, P Group; p = 0.118) and cardiac event-free survival (82.7 ± 3.3%, S Group; 80.3 ± 2.0%; P Group; p = 0.129), with similar postoperative complications.

Conclusions: Skeletonization of single LIMA has no extra benefit in early or mid-term outcomes, suggesting no advantage over the pedicled technique.
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http://dx.doi.org/10.1111/jocs.12551DOI Listing
June 2015

One incision, two cannulations for minimally invasive aortic valve surgery.

Int J Cardiol 2015 Mar 3;182:97. Epub 2015 Jan 3.

Shanghai Institute of Cardiovascular Disease, China; Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Electronic address:

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http://dx.doi.org/10.1016/j.ijcard.2014.12.170DOI Listing
March 2015

Delivery of alginate-chitosan hydrogel promotes endogenous repair and preserves cardiac function in rats with myocardial infarction.

J Biomed Mater Res A 2015 Mar 28;103(3):907-18. Epub 2014 May 28.

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Department of cardiology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

The regenerative potential of alginate-chitosan composite in bone and cartilage tissue has been well documented, but its potential utility in cardiac tissue engineering has remained unknown. This study sought to determine whether early intramyocardial injection of alginate-chitosan could prevent left ventricular (LV) remodeling after myocardial infarction (MI), leading to a more favorable course of tissue restoration. In a rat model of acute MI, local injection of alginate-chitosan hydrogel into the peri-infarct zone preserved scar thickness, attenuated infarct expansion, and reduced scar fibrosis after 8 weeks, concomitantly with promoting increased angiogenesis and greater recruitment of endogenous repair at the infarct zone. Furthermore, this treatment prevented cell apoptosis, induced cardiomyocyte cell cycle re-entry. The cardiac function of the control-injected animals deteriorated over the 8-week course, while that of the hydrogel-injected animals did not.In addition, the hydrogel did not exacerbate inflammation in the heart. Intramyocardial injection of alginate-chitosan hydrogel represents a useful strategy to treat MI. It demonstrated marked therapeutic efficacies on various tissue levels after extensive MI, as well as potential to induce endogenous cardiomyocyte proliferation and recruit cardiac stem cells.
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http://dx.doi.org/10.1002/jbm.a.35232DOI Listing
March 2015

Synthetic ePTFE grafts coated with an anti-CD133 antibody-functionalized heparin/collagen multilayer with rapid in vivo endothelialization properties.

ACS Appl Mater Interfaces 2013 Aug 29;5(15):7360-9. Epub 2013 Jul 29.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

An anti-CD133 antibody multilayer functionalized by heparin/collagen on an expanded polytetrafluoroethylene (ePTFE) graft was developed to accelerate early endothelialization. The surface modification of ePTFE grafts demonstrated that the multilayer is stable in static incubation and shaking conditions and that the anti-CD133 antibodies were successfully cross-linked onto the surface. Blood compatibility tests revealed that the coimmobilized heparin/collagen films in the presence or absence of anti-CD133 antibodies prolonged the blood coagulation time and that there was less platelet activation and aggregation, whereas the hemolysis rate was comparable with the bare ePTFE grafts. Cellular proliferation was not inhibited, as the heparin/collagen synthetic vascular grafts coated with CD133 antibody showed little cytotoxicity. The endothelial cells adhered well to the modified ePTFE grafts during a cell adhesion assay. A porcine carotid artery transplantation model was used to evaluate the modified ePTFE grafts in vivo. The results of histopathological staining and scanning electron microscopy indicated that the anti-CD133 antibody was able to accelerate the attachment of vascular endothelial cells onto the ePTFE grafts, resulting in early rapid endothelialization. The success of the anti-CD133 antibody-functionalized heparin/collagen multilayer will provide an effective selection system for the surface modification of synthetic vascular grafts and improve their use in clinical applications.
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http://dx.doi.org/10.1021/am401706wDOI Listing
August 2013

Isolation and culture of smooth muscle cells from human acute type A aortic dissection.

J Cardiothorac Surg 2013 Apr 12;8:83. Epub 2013 Apr 12.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Fenglin Road 180, Xujiahui District, Shanghai 200032, China.

Background: Acute type A aortic dissection (TAAD) is a life-threatening vascular disease. Smooth muscle cells (SMCs) are the main composition of aortic media and dysfunction of SMCs may lead to acute TAAD. The aim of this work was to investigate whether the SMCs of acute TAAD could be isolated and cultured for further research.

Methods: TAAD tissues were obtained from acute TAAD patients who underwent emergent surgical treatment. A simple and economical technique of collagenase digestion method was used to isolate and culture human SMCs. Confocal laser scanning microscopy was applied to identify SMC phenotypes. Purity of isolated and cultured SMCs was analyzed with flow cytometry and fluorescence microscopy respectively.

Results: The purity of isolated SMCs was 78.2%, including α-smooth muscle cell actin positive 13.9%, calponin positive 35.0% and double positive 29.3%. For cultured SMCs, abundant expression of α-smooth muscle cell actin was observed universally under fluorescence microscope. Confocal laser scanning microscope testified that cultured cells were double positive of α-smooth muscle actin and calponin.

Conclusions: This is the first report of successful culture of SMCs isolated from human acute TAAD tissues. Living human SMCs of acute TAAD provides us with a new method for studying formation of acute TAAD.
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http://dx.doi.org/10.1186/1749-8090-8-83DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639144PMC
April 2013

Surgical management for acute type A aortic dissection in patients over 70 years-old.

J Cardiothorac Surg 2013 Apr 11;8:78. Epub 2013 Apr 11.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years.

Methods: From September 2005 to January 2012, eleven patients who were older than 70 years underwent surgical treatment for type A aortic dissection at our center and were included in this study. Total arch replacement was performed in three patients, seven patients underwent subtotal arch replacement and one with single-branched stent graft implantation. One patient underwent a valve-sparing (David) procedure while another underwent a concomitant aortic valve replacement (Wheat procedure). One patient required coronary artery bypass grafting. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion.

Results: There was one in-hospital death (9.1%) and no operative mortality within 30 days. Cardiopulmonary bypass time, myocardial ischemic time and antegrade cerebral perfusion time accounted for 151.4 ± 33.5 minutes, 68.5 ± 41.4 minutes and 30.3 ± 12.9 minutes, respectively. Overall in-hospital duration, intensive care unit (ICU) time and mean ventilation time were 40.9 ± 40.3 days, 16.5 ± 22.5 days and 90.5 ± 139.4 hours, respectively. New postoperative permanent neurological dysfunction and temporary neurological dysfunction were observed in one patient (9.1%) and in three patients (27.3%), respectively. Mean follow-up was 49.0 ± 19.9 months and nine patients are still alive, one patient died of cancer after 24 months postoperation.

Conclusions: Surgical management for acute type A dissection in patients older than 70 years is a safe alternative with acceptable risk of death and the early and late results are satisfactory.
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http://dx.doi.org/10.1186/1749-8090-8-78DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639068PMC
April 2013

Reply: To PMID 22560261.

Ann Thorac Surg 2013 Mar;95(3):1139-40

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http://dx.doi.org/10.1016/j.athoracsur.2012.11.040DOI Listing
March 2013

Open triple-branched stent graft placement for the surgical treatment of acute aortic arch dissection.

J Cardiothorac Surg 2012 Dec 15;7:130. Epub 2012 Dec 15.

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.

Background: The primary experience of open triple-branched stent graft placement for acute aortic arch dissection was reported.

Methods: Between January 2011 and October 2011, 13 well-selected patients (mea age, 46±8.2 years; approximate range, 30~58 years) with acute aortic arch dissection underwent open triple-branched stent graft placement for total arch reconstruction. The triple-branched stent graft was a branched 1-piece graft consisting of a self-expandable nitinol stent and polyester vascular graft fabric (Yuhengjia Sci Tech Corp Ltd, Beijing, China). During hypothermic circulatory arrest, through the transverse incision of the ascending aorta, the main graft of the triple-branched stent graft was inserted into the true lumen of the arch and proximal descending aorta, and then each sidearm graft was positioned one by one into the aortic branch. Once the main graft and sidearm grafts were properly positioned, the restraining strings were withdrawn and then the main graft and sidearm grafts were deployed. Enhanced electric beam computed tomography was performed in each patient before discharge to evaluate the postoperative time course of the residual false lumen.

Results: Open triple-branched stent graft placement was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and arrest time were 138.40±47.75 min, 70.60±28.94 min and 28.60±12.48 min, respectively. All patients were discharged from hospital. Their computed tomographic scans postoperatively showed that all stent grafts were fully opened and not kinked, there was no blood flow surrounding the triple-branched stent graft.

Conclusion: Open triple-branched stent graft placement is a new effective technique for total arch reconstruction in acute arch dissection.
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http://dx.doi.org/10.1186/1749-8090-7-130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608000PMC
December 2012

Surgical correction of giant extracardiac unruptured aneurysm of the right coronary sinus of Valsalva: case report and review of the literature.

Gen Thorac Cardiovasc Surg 2013 Mar 25;61(3):143-6. Epub 2012 May 25.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Fenglin Road 180, Xujiahui District, Shanghai, 200032, China.

We report a quite rare case of giant extracardiac unruptured aneurysm of the right coronary sinus of Valsalva with no clinical findings of Marfan syndrome or Ehlers-Danlos syndrome. A 52-year-old Chinese male was diagnosed having an aneurysm of the right sinus of Valsalva and moderate aortic regurgitation, while Bentall operation was performed successfully. The patient was discharged with no complications. Pathological examination revealed conspicuously medial mucoid degeneration of the aneurismal wall and absence of medial elastic fibers. Immediate results and early follow-up were uneventful.
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http://dx.doi.org/10.1007/s11748-012-0113-4DOI Listing
March 2013

Bilateral versus unilateral antegrade cerebral perfusion in arch reconstruction for aortic dissection.

Ann Thorac Surg 2012 Jun 3;93(6):1917-20. Epub 2012 May 3.

Shanghai Institute of Cardiovascular Disease, Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Background: The superiority of bilateral versus unilateral antegrade cerebral perfusion (ACP) has been the subject of much debate. This study aimed to compare the two methods of cerebral perfusion.

Methods: Between September 2005 and June 2011, 263 patients (median age 51.4±10.1 years, range, 26 to 75; 200 men) underwent open aortic arch reconstruction with hypothermic circulatory arrest and bilateral or unilateral ACP. Among them, 231 patients had acute aortic dissection, 12 had subacute aortic dissection, 20 had chronic aortic dissection, 7 had Marfan syndrome, 8 had reconstruction secondary to endovascular stent graft placement for type B dissection, and 9 had bicuspid aortic valve. Our patient cohort is divided into those protected with hypothermic circulatory arrest and bilateral ACP (group A, n=128) and those with hypothermic circulatory arrest and unilateral ACP (group B, n=135).

Results: There was no significant difference between groups A and B in cardiopulmonary bypass time, cross-clamp time, or cerebral perfusion time. Overall in-hospital mortality was 11.7% for group A and 11.1% for group B (p=0.877). Postoperative temporary and permanent neurologic dysfunction was 5.5% versus 6.7% and 12.5% versus 10.4%, respectively (group A versus group B: p=0.685, p=0.587). Intensive care unit time was 9.4±9.8 days for group A and 8.4±14.0 days for group B (p=0.972). Hospitalization was 24.3±14.6 days for group A and 23.1±21.1 days for group B (p=0.172).

Conclusions: Unilateral ACP with hypothermic circulatory arrest is a safe cerebral protection technique for open aortic arch reconstruction, and is not inferior to bilateral ACP with hypothermic circulatory arrest.
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http://dx.doi.org/10.1016/j.athoracsur.2012.02.090DOI Listing
June 2012

Surgical treatment for retrograde type A aortic dissection after endovascular stent graft placement for type B dissection.

Interact Cardiovasc Thorac Surg 2012 May 22;14(5):538-42. Epub 2012 Feb 22.

Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China.

Retrograde type A aortic dissection (RTAD) is a life-threatening and underestimated complication of endovascular stent graft placement for type B dissection. Here, we retrospectively investigated our experience of surgical treatment for RTAD after endovascular stent graft placement for type B dissection. Between June 2006 and September 2011, nine patients with RTAD were transferred to our department for surgery. Total arch replacement was performed in six patients and three patients underwent subtotal arch replacement. Associated procedures consisted of ascending aorta replacement in nine patients, coronary artery bypass grafting in one patient and aortic valve plasty in two patients. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion. Cardiopulmonary bypass time was 158.33 ± 29.18 min. The myocardial ischaemic time was 78.11 ± 28.30 min. The antegrade cerebral perfusion time was 38.67 ± 12.34 min. The mean ventilation time was 45.63 ± 24.74 h. A tracheotomy was necessary in one patient. The ICU time was 7.00 ± 6.80 days and the in-hospital duration was 25.33 ± 11.95 days. There was no in-hospital mortality. The mean follow-up was 34.79 ± 19.37 months and eight patients are still alive. One patient was lost to follow-up. Surgical treatment for RTAD is a safe alternative and the results are encouraging.
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http://dx.doi.org/10.1093/icvts/ivs043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329296PMC
May 2012

Clinical treatment for pulmonary artery sarcoma.

Eur J Cardiothorac Surg 2010 Jul 26;38(1):115-6; author reply 116-7. Epub 2010 Feb 26.

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http://dx.doi.org/10.1016/j.ejcts.2010.01.033DOI Listing
July 2010