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1.
J Renin Angiotensin Aldosterone Syst ; 16(4): 1185-92, 2015 Dec.
Article in English | MEDLINE | ID: mdl-24961505

ABSTRACT

INTRODUCTION: The aim of this study is to evaluate whether the administration of renin-angiotensin system (RAS) inhibitors, angiotensin-I converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), is associated with treatment outcome in patients with esophageal squamous cell carcinoma. MATERIALS AND METHODS: A total of 141 esophageal squamous cell carcinoma patients receiving esophagectomy were identified, and were divided into two groups: an ACEI/ARB group (n=20), and a non-ACEI/ARB group (n=121). The effect of ACEIs or ARBs on cell proliferation and vascular endothelial growth factor (VEGF) secretion of esophageal squamous cell carcinoma cell lines, CE81T/VGH and TE2, were investigated by 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and Enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Use of ACEI/ARB (p=0.032), pathologic T stage (p<0.001), pathologic N stage (p=0.012), tumor stage (p=0.006), and tumor location (p=0.032) were significantly associated with superior overall survival. In multivariate comparison, use of ACEI/ARB (p=0.006), tumor stage (p=0.002), and tumor location (p=0.014) represented the independent prognosticators of superior overall survival. In cell lines, ACEIs/ARBs inhibit cell proliferation and VEGF secretion in a dose-dependent manner. CONCLUSIONS: ACEIs/ARBs administration is independently associated with superior overall survival in patients with esophageal squamous cell carcinoma receiving esophagectomy. Our data support further investigation of the role of RAS inhibitors as a potential therapy in esophageal squamous cell carcinoma.


Subject(s)
Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Esophageal Neoplasms/drug therapy , Renin-Angiotensin System/drug effects , Adult , Aged , Aged, 80 and over , Angiotensin II Type 1 Receptor Blockers/pharmacology , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Cell Line, Tumor , Cell Proliferation/drug effects , Disease-Free Survival , Esophageal Neoplasms/metabolism , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophageal Squamous Cell Carcinoma , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Prognosis , Risk Factors , Treatment Outcome , Vascular Endothelial Growth Factor A/metabolism
2.
J Formos Med Assoc ; 113(10): 722-6, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24974132

ABSTRACT

BACKGROUND/PURPOSE: Thymectomy may benefit patients with generalized myasthenia gravis (MG) or myasthenia with thymomas. Currently, video-assisted (VA) thoracic surgery is popular and plays an important role in thymectomy. We compared the clinical outcomes of VA thymectomy with conventional transsternal (TS) approach to investigate the effectiveness of VA technology in the current era. METHODS: A retrospective review of our thymectomy results for patients with MG from 1998 to 2011 was conducted. A total of 83 consecutive patients were enrolled. According to the surgeons' and patients' preference, 39 patients received conventional TS thymectomy and 44 were operated on in a VA fashion. The results were categorized and analyzed according to the Myasthenia Gravis Foundation of America (MGFA) postintervention statuses with some modification. RESULTS: No obvious difference between conventional TS thymectomy and VA thymectomy was noted regarding the remission statuses and the clinical outcomes by the modified MGFA score. However, the patients who received VA thymectomy showed shorter intensive care unit (ICU) stays (4.2 ± 3.3 days vs. 2.3 ± 1.5 days, p = 0.001). CONCLUSION: Compared with the conventional TS thymectomy, the VA approach is similarly effective with shorter ICU stays.


Subject(s)
Myasthenia Gravis/surgery , Sternotomy , Thoracic Surgery, Video-Assisted , Thymectomy/methods , Adult , Female , Humans , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Remission Induction/methods , Retrospective Studies , Severity of Illness Index , Treatment Outcome
3.
Ann Thorac Surg ; 90(2): 651-4, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20667374

ABSTRACT

Management of postpneumonectomy empyema has always been a challenging task. Local flaps or free muscle flaps are options for recalcitrant cases when traditional therapeutic attempts fail. This report presents 2 patients with chronic postpneumonectomy empyema who were treated with an anterolateral thigh combined flap consisting of vastus lateralis and rectus femoris muscles. This method showed promising results for reconstruction of large empyema defect.


Subject(s)
Empyema, Pleural/etiology , Empyema, Pleural/surgery , Pneumonectomy/adverse effects , Surgical Flaps , Aged , Chronic Disease , Humans , Male
4.
Radiother Oncol ; 92(2): 270-5, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19195729

ABSTRACT

BACKGROUND AND PURPOSE: We evaluate if C-reactive protein (CRP) is an objective biomarker of esophageal cancer in patients undergoing radiotherapy. MATERIALS AND METHODS: Between November 2002 and July 2007, 123 patients undergoing radiotherapy for newly diagnosed esophageal cancer were enrolled. Serum CRP concentration was measured before the initiation of treatment. The relationship between serum CRP levels and other relevant variables such as body mass index, white blood cell count, platelet count, bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cholesterol, hemoglobin, and albumin levels was also analyzed. RESULTS: Eighty-one patients of the 123 patients enrolled (65.9%) had elevated CRP levels (5mg/L). The 2-year survival for patients with CRP 5mg/L was 7.8% compared to 78.4% for patients with CRP <5mg/L. Hypoalbuminemia (albumin <3.5g/dL) was also related to shorter survival using univariate analysis. Multivariate analysis demonstrated that only higher serum CRP concentration and hypoalbuminemia were independent prognostic indicators for survival of patients with esophageal cancer. CONCLUSIONS: Pretreatment serum levels of CRP and albumin are objective, easily measurable biomarkers which can be used in combination with conventional staging to accurately predict survival in patients with esophageal cancer treated with radiotherapy.


Subject(s)
C-Reactive Protein/analysis , Esophageal Neoplasms/radiotherapy , Hypoalbuminemia/mortality , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/blood , Combined Modality Therapy , Esophageal Neoplasms/blood , Esophageal Neoplasms/mortality , Esophageal Neoplasms/pathology , Female , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Survival Rate
5.
Radiology ; 247(1): 162-9, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18270377

ABSTRACT

PURPOSE: To prospectively assess muscle metabolism in myasthenia gravis (MG) patients before and after thymectomy by using phosphorus 31 (31P) magnetic resonance (MR) spectroscopy. MATERIALS AND METHODS: With institutional review board approval and informed consent, resting and dynamic (31)P MR spectroscopy were performed in 14 healthy volunteers (five men, nine women; mean age, 33 years; range, 23-48 years) and 16 MG patients (six men, 10 women; mean age, 37 years; range 18-50 years) before and after thymectomy. Patients were stratified into groups according to the modified Osserman classification: mild-MG group (classes I-IIA) and moderate-to-severe-MG group (classes IIB-IV). Variables compared among the three groups (Kruskal-Wallis test) included the inorganic phosphate (P(i))-adenosine triphosphate (ATP) (P(i)/ATP) ratio, phosphocreatine (PCr)-ATP (PCr/ATP) ratio, P(i)/PCr ratio, muscle pH at resting and at end-exercise ( 31)P MR spectroscopy, rate constant for PCr recovery (k(PCr)), and maximum oxidative capacity (V(max)). These variables were also compared in MG patients before and after thymectomy (Wilcoxon signed rank test). RESULTS: There were no significant differences in resting P(i)/ATP, PCr/ATP, and P(i)/PCr ratios and resting muscle pH among the three groups (control group, 14; mild-MG group, nine; moderate-to-severe-MG group, seven). Comparison of the control group with the mild-MG group and comparison of the mild-MG group before thymectomy with the mild-MG group after thymectomy showed no significant differences in end-exercise P(i)/ATP, PCr/ATP, and P(i)/PCr ratios; end-exercise muscle pH; k(PCr); and V(max). Compared with the control and mild-MG groups, the moderate-to-severe-MG group had significantly higher end-exercise P(i)/ATP and P(i)/PCr ratios and significantly lower end-exercise muscle pH, k(PCr), and V(max) before thymectomy (P < or = .001), but these values showed significant restoration to normal after thymectomy (P = .018). CONCLUSION: Mild-MG group patients have muscle oxidative metabolism similar to that of healthy control subjects, whereas moderate-to-severe-MG group patients have impaired V(max) during exercise and a noticeable shift to glycolytic metabolism, but these abnormalities are reversible after thymectomy.


Subject(s)
Magnetic Resonance Spectroscopy , Muscle, Skeletal/chemistry , Myasthenia Gravis/metabolism , Thymectomy , Adenosine Triphosphate/analysis , Adolescent , Adult , Female , Humans , Isotonic Contraction , Male , Middle Aged , Myasthenia Gravis/surgery , Phosphates/analysis , Phosphocreatine/analysis
6.
Am J Emerg Med ; 25(9): 1051-6, 2007 Nov.
Article in English | MEDLINE | ID: mdl-18022501

ABSTRACT

OBJECTIVE: To report the clinical and computed tomographic findings of 5 cases of left brachiocephalic vein perforation (LBCVP). METHODS: The clinical and imaging features of 5 patients with LBCVP (1 woman, 4 men; mean age, 57.6 years) encountered over the last 2 decades were reviewed. RESULTS: Etiologies included left jugular central catheter penetration in 2 patients, blunt trauma in 2, and idiopathic in 1. All patients manifested acute chest pain with a widened mediastinum on chest radiographs. Characteristic computed tomographic features included a cord-like hematoma along the course of the left brachiocephalic vein associated with a left upper anterior mediastinal hematoma (AMH). Three clinically stable patients with AMH smaller than 5 cm convalesced after conservative treatment and 2 clinically unstable patients with AMH bigger than 7 cm recovered well after surgery. CONCLUSIONS: Computed tomography is helpful in diagnosing LBCVP. Under close surveillance, patients with stable LBCVP with AMH smaller than 5 cm may be managed conservatively. However, emergency surgery is warranted if there are any signs of instability.


Subject(s)
Brachiocephalic Veins/diagnostic imaging , Brachiocephalic Veins/injuries , Tomography, X-Ray Computed , Vascular Diseases/therapy , Contrast Media , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Retrospective Studies , Vascular Diseases/diagnostic imaging , Vascular Diseases/etiology
8.
J Thorac Cardiovasc Surg ; 132(5): 1092-8, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17059928

ABSTRACT

OBJECTIVE: Congenital heart diseases in pediatric patients are associated with a wide variety of extracardiac thoracic vascular abnormalities. This study analyzed the value of gadolinium-enhanced magnetic resonance angiography during quiet free breathing for assessing extracardiac thoracic vascular abnormalities in young children with congenital heart diseases. METHODS: Fifty-three children with congenital heart diseases (age range, 1 day-40 months; mean, 10.9 months) associated with extracardiac thoracic vascular abnormalities who had undergone both free-breathing, gadolinium-enhanced magnetic resonance angiography and cardiac catheterization, surgical intervention, or both within 2 weeks were reviewed. Diagnostic findings on gadolinium-enhanced magnetic resonance angiography among patients grouped according to 3 major conditions of conotruncal abnormalities (n = 33), aortic or venous abnormalities (n = 11), and pulmonary vascular abnormalities (n = 9), as well as associated extracardiac thoracic vascular abnormality findings, were compared with findings made by using cardiac catheterization, surgical intervention, or both. RESULTS: Extracardiac thoracic vascular abnormality findings on gadolinium-enhanced magnetic resonance angiography were similar to those on catheterization, surgical intervention, or both in patients with conotruncal abnormalities (124 vs 127, P = .083), aortic or venous abnormalities (36 vs 33, P = .083), and pulmonary vascular abnormalities (24 vs 25, P = .317). The overall sensitivity of gadolinium-enhanced magnetic resonance angiography for detection of these lesions identified by means of catheterization, surgical intervention, or both was 97.9%. However, gadolinium-enhanced magnetic resonance angiography revealed 11 additional extracardiac thoracic vascular abnormalities that were not found on cardiac catheterization. The kappa coefficient for the correlation of image quality and diagnostic value of gadolinium-enhanced magnetic resonance angiography by using a 4-point-scale (1 = nondiagnostic to 4 = excellent) assessed by 2 independent reviewers was excellent (mean score = 3.66), with superb interobserver agreement (kappa = 0.727-0.874). CONCLUSIONS: Free-breathing, gadolinium-enhanced magnetic resonance angiography is clinically feasible for detailed anatomic delineation and treatment planning of various extracardiac thoracic vascular abnormalities in young children with congenital heart diseases.


Subject(s)
Heart Defects, Congenital/diagnostic imaging , Magnetic Resonance Angiography , Cardiovascular Abnormalities/diagnostic imaging , Child, Preschool , Feasibility Studies , Female , Gadolinium , Humans , Infant , Infant, Newborn , Male , Radionuclide Imaging , Radiopharmaceuticals
10.
Clin Imaging ; 30(5): 309-14, 2006.
Article in English | MEDLINE | ID: mdl-16919550

ABSTRACT

Seven unusual cases of esophageal bronchogenic cyst (EBC) are presented. Different from mediastinal or pulmonary bronchogenic cysts, EBCs predominately affect young women (six out of seven cases; mean age, 29.9 years), and clinically, such cases were characterized by dysphagia and chest pain, especially during exercise. On radiographs and computed tomographs, EBCs typically appeared as 3- to 4-cm midthoracic cystic masses close abutting to the midthoracic esophagus. Rarely, exophytic lower thoracic EBC may mimic lung nodule. Total cyst excision usually offers satisfactory outcome with no recurrence in long-term follow-up.


Subject(s)
Bronchogenic Cyst/diagnostic imaging , Esophageal Diseases/diagnostic imaging , Adult , Bronchogenic Cyst/surgery , Esophageal Diseases/surgery , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome
11.
AJR Am J Roentgenol ; 185(5): 1268-74, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16247148

ABSTRACT

OBJECTIVE: The purpose of our study was to assess the clinical feasibility of MDCT angiography for evaluating hemodialysis arteriovenous fistulas (AVFs). MATERIALS AND METHODS: MDCT angiography of the complete vascular trees of 36 failing AVFs or AVF-related complications (20 native and 16 polytetrafluoroethylene graft AVFs) was reviewed. The numbers and degrees of stenoses at the anastomoses, graft loops, and draining and central veins and the presence of aneurysms or thrombosis were recorded. Wilcoxon's signed rank test was used to compare the findings of MDCT angiography with those of digital subtraction angiography (DSA) (n = 10), surgery (n = 22), or both (n = 4) performed within 2-6 days. Kappa statistics were used to correlate the clinical feasibility of MDCT angiography assessed by two reviewers. RESULTS: Among the 14 AVFs examined with both MDCT angiography and DSA, no significant difference was seen in the detection and grading (p = 0.317 to > 0.999) of stenoses at various segments of the entire vascular tree. Among the 36 AVFs examined, MDCT angiography also showed no significant difference from DSA or surgery in revealing vascular stenoses, aneurysms, and thromboses from the supplying artery to central veins (p = 0.317 to > 0.999). Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of MDCT angiography in lesion detection were 98.7%, 97.5%, 98.8%, 97.2%, and 98.3%, respectively. High image quality with superb interobserver correlation (kappa = 0.809 to > 0.999) validated the clinical feasibility of MDCT angiography for assessing AVFs. CONCLUSION: MDCT angiography is clinically feasible for evaluating the complete vascular tree of failing AVFs and in showing uncommon complications, including brachial aneurysms and central vein lesions.


Subject(s)
Angiography, Digital Subtraction , Arteriovenous Shunt, Surgical , Graft Occlusion, Vascular/diagnostic imaging , Renal Dialysis , Tomography, X-Ray Computed , Adult , Aged , Feasibility Studies , Female , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Polytetrafluoroethylene , Statistics, Nonparametric
12.
Eur J Cardiothorac Surg ; 28(4): 648-9, 2005 Oct.
Article in English | MEDLINE | ID: mdl-16179196

ABSTRACT

Hydrothorax developing from pleuroperitoneal communication as a complication of peritoneal dialysis was first described in 1967 [Edward SR, Unger AM. Acute hydrothorax-a new complication of peritoneal dialysis. JAMA 1967; 199:853-5. ]. The incidence of hydrothorax is approximately 1.6-2% of continuous ambulatory peritoneal dialysis (CAPD) patients. The key to successful therapy is obliteration of the transdiaphragmatic route of dialysate leakage with video-assisted thoracoscopic surgery (VATS). The method in which air leakage is checked intraoperatively is the preferred choice and better than all other procedures.


Subject(s)
Diaphragm/pathology , Hydrothorax/surgery , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Thoracic Surgery, Video-Assisted/methods , Fistula/surgery , Humans , Hydrothorax/pathology , Peritoneal Cavity , Peritoneal Dialysis, Continuous Ambulatory/methods , Peritoneal Diseases/surgery , Pleural Cavity , Pleural Diseases/surgery , Thoracoscopy/methods
13.
World J Gastroenterol ; 11(20): 3165-6, 2005 May 28.
Article in English | MEDLINE | ID: mdl-15918212

ABSTRACT

A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.


Subject(s)
Esophageal Neoplasms/diagnosis , Thymoma/diagnosis , Thymus Neoplasms/diagnosis , Adult , Deglutition Disorders/etiology , Diagnosis, Differential , Hoarseness/etiology , Humans , Male , Thymoma/therapy , Thymus Neoplasms/therapy
14.
Chang Gung Med J ; 27(8): 614-7, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15553609

ABSTRACT

A sutureless ringed intraluminal graft has been used as a substitute for the diseased aorta with the advantage of decreasing the aortic cross-clamp time and blood loss. Concerns remain about implications of anecdotal accounts of late complications with this graft. We report on the experience of a 68-year-old man, successfully treated for type B aortic dissection using the sutureless technique, who developed a pseudoaneurysm and aortobronchial fistula over the distal anastomosis of the intraluminal graft 12 years after the operation.


Subject(s)
Aneurysm, False/etiology , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Aged , Humans , Male , Suture Techniques
16.
Ann Thorac Surg ; 76(6): 2082-5, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14667651

ABSTRACT

Thymoliposarcoma is an exceedingly rare thymic neoplasm with only five reports in English literature to date. We report another patient, a 36-year-old male, who developed local recurrences 4-years after initial resection. The clinicopathologic features of the present and previously reports were compared with particular emphasis on their morphologic spectrum and differential diagnosis.


Subject(s)
Liposarcoma/diagnosis , Thymus Neoplasms/diagnosis , Adult , Humans , Liposarcoma/pathology , Liposarcoma/surgery , Male , Neoplasm Recurrence, Local , Thymus Neoplasms/pathology , Thymus Neoplasms/surgery
17.
Ren Fail ; 25(5): 871-8, 2003 Sep.
Article in English | MEDLINE | ID: mdl-14575295

ABSTRACT

BACKGROUND: Vascular access failure is a severe and common complication for hemodialysis patients. The possible vascular access sites are limited in dialysis patients. Axillary artery to contralateral axillary vein arteriovenous fistula (AVF) is one of the possibilities. However, the clinical outcome of this procedure is still un-defined. OBJECT: The purpose of this study is to review the clinical outcome of axillary artery to contralateral axillary vein AVF as a hemodialysis vascular access. PATIENTS AND METHODS: We retrospectively reviewed native or graft arteriovenous fistula records for chronic hemodialysis patients at Chang Gung Memorial Hospital in Kaohsiung, Taiwan, from January 1986 to March 2001. Records were reviewed for all chronic hemodialysis patients, with more than 2000 individuals receiving more than 10,000 fistulas. Eight patients received axillary artery to contralateral axillary vein AVF. RESULTS: The mean age for these patients was 61.7 +/- 16.3 year-old at time of surgery. All patients had received multiple native or graft arteriovenous fistula creation. The 2-year and 4-year AVF graft survival is 87.5% and 43.8% respectively. One patients developed brachial plexopathy after operation. Another patient had venous hypertension distal to the AVF site. Both patients were managed conservatively. There is no AVF-related mortality in these patients. CONCLUSION: We conclude that axillary artery to contralateral axillary vein graft fistula may be a feasible alternative choice for chronic hemodialysis access.


Subject(s)
Arteriovenous Shunt, Surgical/methods , Kidney Failure, Chronic/therapy , Renal Dialysis/methods , Adolescent , Aged , Aged, 80 and over , Axillary Artery , Axillary Vein , Female , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
18.
Ann Thorac Surg ; 76(1): 219-24, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12842545

ABSTRACT

BACKGROUND: Castleman disease of the pleura is unusual, and we present our experience with eight surgically proven cases. METHODS: Between 1980 and 2002, 8 patients (7 women and 1 man; age range, 20 to 53 years; mean, 26.5 years) with surgically proven, pleural Castleman disease (six hyaline vascular type, one plasma cell type, and one mixed type) were encountered. Their clinical, imaging, and surgical findings were reviewed. RESULTS: Five patients were asymptomatic, 1 had dyspnea, 1 had cough, and 1 experienced chest discomfort. Chest radiography showed a well-circumscribed interlobar, cardiophrenic, or paraaortic mass in 6 patients, a massive effusion in 1, and a focal diaphragmatic bulge in 1. Six tumors showed varying degrees of contrast enhancement (10 to 95 HU; mean, 46 HU) on computed tomography. Three cases appeared as well-defined, heterogeneously hyperintense pleural masses on magnetic resonance imaging. The masses varied in size from 3 to 10 cm (mean, 5.2 cm). Five masses greater than 5 cm had prominent pleural arterial blood supply and severe adhesions requiring thoracotomy and resection of nearby structures for radical tumor excision. Blood loss from patients varied between 100 and 850 mL (mean, 620 mL). No tumor recurrence was noted during follow-up (range, 1 to 16 years; mean, 6.5 years). CONCLUSIONS: Pleural Castleman disease predominately affects young women and manifests as a well-circumscribed mass with a varying degree of contrast enhancement on computed tomography and heterogeneity on magnetic resonance imaging. Tumors greater than 5 cm have profuse pleural blood supplies and severe adhesion necessitating open thoracotomy and resection of neighboring structures. Radical resection can produce a satisfactory outcome.


Subject(s)
Castleman Disease/diagnosis , Castleman Disease/surgery , Pleural Diseases/diagnosis , Pleural Diseases/surgery , Adult , Biopsy, Needle , Female , Follow-Up Studies , Humans , Immunohistochemistry , Male , Middle Aged , Postoperative Complications/mortality , Rare Diseases , Risk Assessment , Sampling Studies , Thoracic Surgical Procedures/methods , Thoracoscopy/methods , Treatment Outcome
19.
Ann Thorac Surg ; 75(6): 1987-9, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12822661

ABSTRACT

Explantation of a degenerated mitral bioprosthesis with reimplantation of a new bioprosthesis is time-consuming and can be associated with several life-threatening complications. We developed a technique to simplify this procedure and avoid the complications by attaching a new bioprosthesis supported by a pericardium-covered Dacron tube to the intact stent.


Subject(s)
Bioprosthesis , Coated Materials, Biocompatible , Heart Valve Prosthesis , Mitral Valve/surgery , Prosthesis Failure , Stents , Echocardiography, Doppler, Color , Humans , Mitral Valve/diagnostic imaging , Prosthesis Design , Reoperation/methods , Suture Techniques
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