PubMed Health⌕ Search

Biomedical subjects

C C Meng

Publications and source records attributed to C C Meng.

At least 19 recordsLinked to original sources
PubMed2000

Comparison of the one-and-a-half-year results of closure of patent ductus arteriosus by transcatheter coils placement with surgical ligation.

Patent ductus arteriosus (PDA) is a common type of congenital cardiovascular lesion. It usually needs surgical ligation in a full-term baby after 1 year of age. Transcatheter implantation of coils was introduced for the closure of small- to moderate-sized PDA in 1992. From November 1995 to November 1998, the authors closed the PDA in 153 patients by transcatheter implantation of coils and by surgical ligation in 10 patients. One hundred fourteen of them were studied for more than 1(1/2) years. The regular follow-up studies, including physical examination; electrocardiography; and pulsed, continuous-wave, and color Doppler flow mapping, were performed on day one and day 2, and 1 week, 1 month, 3 months, 6 months, and 1 year after the procedure. The results of the closure of PDA by surgical ligation or coil placement were compared and analyzed in all the patients.

Adolescent↗
PubMed2000

Influence of ventricular septal defect type on surgical results in children with tetralogy of Fallot.

BACKGROUND: Tetralogy of Fallot (TOF) with subpulmonary ventricular septal defects (VSD) is relatively more common among Orientals than among Occidentals. This study assessed the influence of type of VSD on surgical results in children with TOF. METHODS: Fifty-one patients with TOF (age range, 14 months to 11 years, mean 40.7 months, median 30 months, 29 boys, 22 girls) who underwent total correction by a single surgeon between January 1992 and December 1995 were retrospectively studied. Of the 51 patients, 17 patients with subpulmonary VSD were classified as group I. The remaining 34 patients with perimembranous VSD were classified as group II. All patients underwent a combined transatrial and transpulmonary surgical approach. Early postoperative results were evaluated 7 to 10 days after surgery and late postoperative results were evaluated 1 year after surgery. RESULTS: There were no statistically significant differences between the two groups in age, sex, body weight, pulmonary to systemic flow ratio, pulmonary to aortic annulus diameter ratio or preceding palliative shunt or balloon pulmonary valvuloplasty. Nevertheless, group I patients had better oxygen saturation preoperatively (84.2 +/- 4.4% vs 80.3 +/- 7.6%, p = 0.037). During surgery, the transannular patch rate was higher in group I (100% vs 73.5%, p = 0.003). The cardiopulmonary bypass time, postoperative stay in the intensive care unit, duration of chest tube placement, early postoperative residual VSD rate, and early and late postoperative residual pulmonary stenosis rate were not significantly different between the groups. However, late postoperative residual VSD rate was 33.3% in group I and 6.45% in group II, which was statistically significant (p = 0.029). There were no significant differences in arrhythmia between the two groups. CONCLUSIONS: Patients with TOF with subpulmonary VSD had a better preoperative oxygenation, higher transannular patch rate during surgery and a higher incidence of late residual VSD than those with TOF with perimembranous VSD.

Cardiac Surgical Procedures↗
PubMed1999

Treatment of pulmonary atresia with intact ventricular septum in early infancy.

BACKGROUND: Early treatment for the neonate with pulmonary atresia and intact ventricular septum (PA-IVS) is important if a high mortality rate is to be avoided. The treatment includes prostaglandin administration, balloon atrial septostomy, pulmonary valvotomy, a shunting procedure and patch repair for the right ventricular outflow tract (RVOT). This study discusses the early treatment and risk factors of this disease that are essential for assessing the risk of surgery and predicting outcome. METHODS: The medical records, echocardiograms, catheterization data and cineangiograms of 29 patients with PA-IVS diagnosed at our institution from 1987 to 1997 were reviewed retrospectively. Clinical manifestations including age, body weight, sex ratio, type of surgery and outcome were analyzed. RESULTS: Three of four patients with a right ventricular volume of less than 1 ml died, and all patients with a right ventricular volume of greater than 2 ml survived. Four of six patients with a tricuspid valvular area of between 0.25 and 0.5 cm2 died, but patients with an area of greater than 0.5 cm2 survived. One case with a monopartite right ventricle died. Patients with a bipartite or tripartite right ventricle had higher survival rates than those with a monopartite right ventricle. Patients with a the right ventricle dependent coronary sinusoid had a higher risk for mortality, even after surgery, than those with normal coronary circulation. CONCLUSIONS: A small right ventricular volume, the presence of a coronary sinusoid involving the right ventricle, a short linear length of the tricuspid valve and a small area of the tricuspid valve were the risk factors associated with a negative outcome in neonates with PA-IVS.

Female↗
PubMed1999

Percutaneous transluminal coronary angioplasty for renovascular hypertension in a child: a case report.

Since its introduction, percutaneous transluminal coronary angioplasty has become an alternative therapeutic modality to surgical and medical treatment for renovascular hypertension. We report the case of a nine-year-old boy who had hypertension caused by renal arterial stenosis. The patient's high blood pressure was 164/100 mmHg, which was discovered incidentally during a physical check-up. A selective renal angiography showed a severe short-segment stenosis with post-stenotic dilatation of the left renal artery. A 4-mm balloon catheter was advanced through the stenotic area and was inflated five times to dilate the stenosis. After the procedure, the selective renal angiography showed a significant increase in the diameter of the left renal artery. Blood pressure decreased to normal immediately after the procedure. During the one-year follow-up period, the patient remained normotensive without the use of antihypertensive drugs.

Angioplasty, Balloon, Coronary↗
PubMed1998

Neonatal myocardial infarction: a case report.

Neonatal myocardial infarction is a rare disorder. It occurs in association with congenital heart disease or coronary artery abnormalities. In the absence of structural heart disease, perinatal asphyxia and coronary artery thromboembolism have been reported as common etiologies. Whether the Coxsackie B viral group has a causal role in adult myocardial infarction remains controversial. We report herein a case of neonatal myocardial infarction without known congenital heart disease, in whom perinatal Coxsackie B viral infection was suspected to be the underlying cause. However, definite evidence indicating a causal relationship between neonatal myocardial infarction and Coxsackie B viral infection was lacking in this case.

Adult↗
PubMed1997

Changes in plasma levels of lipids and lipoprotein composition in patients with Kawasaki disease.

Studies on the response of plasma lipids and lipoproteins to Kawasaki disease are scarce so far. The purpose of this study was to investigate the changes in plasma levels of lipids and apolipoproteins as well as the composition of different lipoproteins in patients during the acute and convalescence phases of Kawasaki disease. The results showed that during the acute phase, the concentrations of plasma high density lipoprotein (HDL)-cholesterol, apolipoprotein A-I (apoA-I) and A-II (apoA-II) were significantly reduced. While the reduction of HDL-cholesterol was mainly related to the lowering of esterified and unesterified cholesterols in HDL2 during the acute stage of Kawasaki disease, most of which recovered during the subsequent convalescence phase. The plasma concentration of triglycerides was 46% higher in patients during the acute phase of Kawasaki disease than in the control subjects, which may be ascribed to the increase of triglycerides in very low density lipoprotein (VLDL), low density lipoprotein (LDL) and HDL2. The variables studied above did not appear to be independent parameters. The level of plasma apoA-I showed a stronger negative association with triglyceride concentration (r = -0.22) than apoA-II (r = -0.11) and HDL-cholesterol (r = -0.07). Furthermore, the levels of cholesterol, apoA-I and apoA-II in HDL2, but not in HDL3, were inversely correlated with the levels of triglyceride. We conclude that the temporary changes of lipid levels associated with Kawasaki disease results predominantly from alterations of lipoprotein composition.

Apolipoproteins↗
PubMed1997

Transcatheter embolization of coronary artery fistula: a case report.

Coronary artery fistula is rare, but it is the most common congenital coronary artery anomaly with hemodynamic significance. It usually causes no symptoms in young patients but may be associated with symptoms and complications in older patients. Surgery has been the traditional treatment. In this report, a 7-year-old girl who had a coronary artery fistula from the left circumflex coronary artery to the right atrium was successfully treated by percutaneous transcatheter technique.

Arterio-Arterial Fistula↗
PubMed1996

A clinical observation of term infants with critical cardiovascular disorders.

BACKGROUND: Cardiovascular disorders are known to be the major causes for infants requiring intensive care. The consequences of the treatment given to these infants suffering from congestive heart failure and/or cyanosis need to be evaluated. METHODS: A total of 210 infants both at term suffering from critical cardiovascular problems were hospitalized in the pediatric and neonatal ICU between July 1990 and December 1993. The etiology, clinical data, emergency procedures and outcomes of infants with or without congestive heart failure or cyanosis were analyzed. RESULTS: Congenital cardiac defects were the most common cause of critical cardiovascular disorders in infancy. These included ventricular septal defect in 42 (20%), Tetralogy of Fallot in 22 (10.5%), Dtransposition of the great arteries in 20 (9.5%) cases, etc. The most common symptoms and signs observed were congestive heart failure in 162 (77.1%) and cyanosis in 137 (65.2%) cases. In spite of aggressive medical and surgical treatments, the outcomes were still unsatisfactory. The mortality rate was found to be the same in infants with or without congestive heart failure, but was significantly higher in infants with cyanosis than in those without cyanosis, after operation (28.5% vs 5.5%, p < 0.05). CONCLUSIONS: Infants suffering from critical cardiovascular disorders need urgent medical and surgical treatments in intensive care units. In spite of treatment, the outcomes are still unsatisfactory.

Female↗
PubMed1995

A quantitative analysis of the structure of right ventricle-pulmonary artery junction for balloon pulmonary valvuloplasty in children.

Percutaneous balloon valvuloplasty (PBVP) was performed in 55 children, aged from four days to twelve years and nine months, with different severity of congenital pulmonary stenosis (PS). To evaluate its efficacy, a quantitative analysis of the structure of right ventricle-pulmonary artery junction was conducted. Significant reductions of peak systolic right ventricular pressure, ratio of peak right-to-left ventricular pressure, and pressure gradients between the right ventricle and pulmonary artery were obtained in 48 children who scored 3 or less (Group I) and 7 children who scored over 3 (Group II) (P < 0.05). After two to forty-six months (M +/- SD = 17.1 +/- 15.5 months) of follow-up study, the residual gradients between right ventricle and pulmonary artery over 36 mmHg were higher in children who scored over 3 than in those who scored 3 or less (71.4% vs 20.8%) (P < 0.01). Repeated percutaneous balloon valvuloplasty was successfully performed in 4 children, 2 each in Group I and Group II. Surgical open pulmonary valvotomy was needed in 1 in Group II because of the dysplastic pulmonary valve and the need for repair of atrial septal defect and in 2 in Group I because of the failure to complete repeated PBVP in the catheterization laboratory or the need for repair of associated atrial septal defect.

Blood Pressure↗
PubMed1995

Percutaneous balloon valvuloplasty in severe pulmonary valvular stenosis.

Percutaneous balloon pulmonary valvuloplasty (PBPV) was achieved successfully in 20 of 22 patients with severe pulmonary valvular stenosis, aged two days to ten years (median four years and two months). The diameters of the balloon for PBPV were 88-125% (mean +/- SD = 109.5 +/- 10.0%) of the pulmonary valve annulus. PBPV failed in 2 patients because of the inability of the cardiac catheters to cross the stenotic valve. A significant reduction of right ventricle-pulmonary artery (RV-PA) pressure gradient occurred in all 20 patients (mean +/- SD = 72.1 +/- 10.3%). The mean RV-PA pressure gradient was reduced from 93.2 +/- 33.1 to 26.3 +/- 15.6 mmHg (P < 0.0001) and the mean right ventricular peak systolic pressure fell from 117.2 +/- 32.4 to 51.6 +/- 17.3 mmHg (P < 0.0001). Five (25%) of 20 patients had an infundibular gradient before PBPV. Two (10%) developed a new infundibular stenosis immediately after PBPV. Four (20%) presented with cyanosis, which disappeared after the successful PBPV. Two patients (10%) who showed a residual RV-PA pressure gradient of more than 40 mmHg had a significant infundibular obstruction initially. Two patients underwent recatheterization fifteen months after PBPV owing to a significant residual RV-PA pressure gradient and had no reductions in right ventricular pressure and RV-PA pressure gradient, but resolution of infundibular obstruction was noted in both. Repeat PBPV was successfully performed on these 2 patients. No significant complications were noted in any patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗
PubMed1995

Palliative treatment for tetralogy of Fallot with percutaneous balloon dilatation of right ventricular outflow tract.

Percutaneous balloon pulmonary dilatation of the right ventricular tract was performed on 16 children with tetralogy of Fallot for palliative purposes after routine cardiac catheterization. Immediate improvement in aortic saturation from 73.4 +/- 6.8 to 84.0 +/- 4.8% (mean +/- SD = 10.6 +/- 2.7%, p < 0.001) and clinical symptoms were achieved in all 16 cases. The pressures in the right ventricle, pulmonary artery, left ventricle and aorta showed no remarkable changes after percutaneous balloon dilatation. The diameters of the proximal end and at the first branching of the right and left pulmonary arteries, pulmonary arterial index and the diameter of the descending aorta at the diaphragm increased significantly after balloon dilatation (p value 0.0004-0.006). One child suffered from repeated cyanotic spells in spite of the immediate improvement of aortic saturation. She received a left side Blalock-Taussig shunt 2 months after the balloon dilatation. None of the children had a significant complication. Eight had follow-up cardiac catheterization one year later and demonstrated much improvement in the diameters of the proximal end and at the first branching of the right and left pulmonary arteries, pulmonary arterial index and the diameter of the descending aorta at the diaphragm (p value 0.005-0.04). All 8 patients had their cardiac lesions successfully corrected. Percutaneous balloon dilatation is an alternative palliative therapy for children with tetralogy of Fallot.

Cardiac Catheterization↗
PubMed1994

Percutaneous balloon valvuloplasty for congenital critical pulmonary stenosis in neonates.

BACKGROUND: Percutaneous balloon valvuloplasty (PBVP) was performed on 6 neonates with severe pulmonary stenosis to evaluate its efficacy. METHODS: The 6 studied neonates were aged from 1 to 30 days and weighed 2.5 to 3.3 kg. Follow-up period ranged 6-21 months with a mean of 11.5 +/- 6.3 months. RESULTS: Dramatic improvement after PBVP was obtained not only on the clinical manifestations but also on the hemodynamic data. After percutaneous balloon valvuloplasty, the aortic O2 saturation increased significantly from 71.3 +/- 14.8% to 83.2 +/- 9.3% (p = 0.001) in 5 neonates who had cyanosis before PBVP. The right to left ventricular peak systolic pressure ratio decreased significantly from 1.65 +/- 0.41 to 0.77 +/- 0.27 (p < 0.001). The peak systolic right ventricular pressure dropped significantly from 104.0 +/- 18.8 to 48.8 +/- 13.6 mmHg (p < 0.001). The peak systolic gradient between right ventricle and main pulmonary artery dropped significantly from 83.2 +/- 16.2 to 24.3 +/- 16.3 mmHg (p < 0.05). CONCLUSIONS: The percutaneous balloon valvuloplasty is safe and effective in treating the neonates with congenital critical pulmonary stenosis.

Catheterization↗
PubMed1992

Importance of spontaneous closure of the ventricular part in atrioventricular septal defect.

The clinical features, hemodynamic changes and prognosis of 21 children with simple atrioventricular septal defect (3 associated with patent ductus arteriosus) were studied during a follow-up period of 1 month to 13 3/12 years (median 3 years). Six patients had spontaneous closure of the ventricular part of the defect within 22.2 +/- 27.7 months (Group I). The symptoms and signs of failure to thrive, frequent respiratory tract infections and congestive heart failure were more common in patients without spontaneous closure of the ventricular part of atrioventricular septal defect (Group II) than in patients in Group I. The Qp/Qs ratio, pulmonary vascular resistance and pulmonary to systemic resistance ratio were also higher in Group II than in Group I. In spite of a higher postoperative mortality rate and a higher incidence of transient complete heart block, the children in Group II also had a significantly higher (p less than 0.005) preoperative mortality rate than those in Group I. In conclusion, if the ventricular part of the atrioventricular septal defect closed or was closing spontaneously, symptoms and signs were less severe and there was a better prognosis.

Child↗
PubMed1992

Surgical repair of ventricular septal defect without ventriculotomy in the first 12 months of life.

Sixty-eight infants with clinical evidence of a large ventricular septal defect (VSD), refractory to conventional medical treatment, underwent surgical closure within the first 12 months of life from August 1987 to June 1991. There were 43 males and 25 females. The ages of the patients ranged from two to 12 months, with a mean age of 6.6 months. The mean body weight of the patients was 5.4 kg (range, 2.3-10 kg). Surgery was performed because of intractable heart failure in 27 infants (39.7%), failure to thrive in 40 (58.8%), repeated pneumonia in 43 (63.2%) and prolonged endotracheal intubation in nine (13.2%). There were 21 patients with a supracristal VSD (30.9%) and 47 patients with perimembranous VSD (69.1%). Nine patients (13.2%) had preoperative cardiac catheterization. Transatrial repair of perimembranous VSDs and transpulmonary repair of supracristal VSDs was used exclusively without ventriculotomy. Surgically induced heart blocks did not occur in any of the patients. Only two patients (2.9%) died during the early postoperative period. Diagnosis in most cases was confirmed by the present advanced integrated color Doppler echocardiographic technology which is widely used by pediatric cardiologists. There was no need to perform cardiac catheterization in most patients with VSDs. The morbidity and mortality were very low. We strongly suggest that for infants with a large VSD, primary repair should be the procedure of choice.

Female↗
PubMed1990

Low sodium content formula for infants with congestive heart failure.

Twenty-two infants of isolated ventricular septal defect with congestive heart failure were fed with lower-sodium content formula-Lonalac (Mead-Johnson) to study the clinical response of treatment for congestive heart failure. There were no significant changes of intake, urinary output, serum sodium, potassium and osmolality before, 2 days and 6 days after Lonalac feeding. The low sodium content formula may feed the infants with congestive heart failure in addition to the traditional anticongestive therapy.

Diet, Sodium-Restricted↗