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Biomedical subjects

C R Hung

Publications and source records attributed to C R Hung.

At least 91 records · Page 5Linked to original sources
PubMed1989

Death due to disruption of sternal fixation wire--a rare complication after open heart surgery through sternotomy: report of a case.

Following sternotomy for open heart surgery, a 57-year-old man had the sternum closed in the usual manner with six No.22 gauge stainless steel wire sutures. Twenty-four days later, sternum disruption occurred with only one wire suture in place, 3 wire sutures cutting through the bone, and 2 wire sutures fractured. A lacerating injury over the anterior surface of the right ventricle was rendered by these 2 fractured wires followed by fatal outcome. To our knowledge, death induced by fractured wires has not been reported. We report in this communication what we believe to be the first case in the literature.

Bone Wires↗
PubMed1989

Reconstruction of right ventricular outflow tract by autologous pericardial tri-semilunar valve with sinus of Valsalva: report of a case with absent pulmonary valve.

The choice of a valved conduit or a valve in the right ventricular outflow tract remains a problem. We propose to reconstruct the pulmonary valve inside the patient's own pulmonary trunk by autologous pericardium in tri-semilunar fashion with concomitant formation of the sinus of Valsalva and commissure. This operation was carried out on a 7-year-old girl suffering from Fallot's tetralogy with an absent pulmonary valve. The ventricular septal defect was repaired and the pulmonary valve reconstructed as above. The postoperative cross-sectional echocardiogram, color Doppler echocardiogram and angiogram showed a pliable tri-semilunar valve across the pulmonary outflow tract without regurgitation. It is concluded that firstly, the sinus of Valsalva is indispensable for a stentless semilunar valve to be competent; secondly, reconstruction of the semilunar valve inside the pulmonary trunk by autologous pericardium is recommended for the absent pulmonary valve syndrome, but the long-term fate of this pericardial valve awaits further evaluation.

Child↗
PubMed1988

Clinical implications of atrial isomerism.

Right atrial isomerism or left atrial isomerism is frequently diagnosed as situs ambiguous without further discrimination of the specific morbid anatomy. Thirty six cases of right atrial isomerism and seven cases of left atrial isomerism were collected from the records and pathological museum at the National Taiwan University Hospital. There was a necropsy report for 18 cases. In all patients one or more of the following conditions was met: (a) isomeric bronchial anatomy, (b) echocardiographic and angiocardiographic evidence of isomerism, and (c) surgical or necropsy evidence of abnormal atrial anatomy. An anomalous pulmonary venous connection was present in 55% of patients with right atrial isomerism; in left atrial isomerism one case (14%) had a partial anomalous pulmonary venous connection. Forty per cent of cases of anomalous pulmonary venous connection with right atrial isomerism had obstruction. Six (86%) of seven cases with left atrial isomerism had an ambiguous biventricular atrioventricular connection. In contrast, univentricular atrioventricular connection (26 of 36, 72%) was significantly more common in right atrial isomerism. A common atrioventricular valve was the most frequent mode of connection in both forms. Two discrete atrioventricular valves were significantly more common in left atrial isomerism. Atrioventricular valve regurgitation was detected in 14 cases. Double outlet right ventricle was the most common type of ventriculoarterial connection. The most commonly cited causes of death after either palliative or definitive operation were undetected anomalous pulmonary venous connection, pulmonary venous stricture, and uncorrected atrioventricular valve or aortic regurgitation complicated by abnormal coagulation. Although the prognosis is poor, successful operation depends on knowledge of the precise anatomical arrangement associated with atrial isomerism.

Abnormalities, Multiple↗
PubMed1988

Growth of the aortic anastomosis in pigs. Comparison of continuous absorbable suture with nonabsorbable suture.

Growth at the anastomotic site after continuous vascular anastomosis in the pediatric patient remains a problem. Primary end-to-end anastomosis of the infrarenal aorta was performed with absorbable Maxon suture or nonabsorbable Prolene suture in 20 piglets. Ten of the Maxon suture group and nine of the Prolene suture group survived; one pig died of infection. The animals were put to death 6 months after the operation. Each abdominal aorta was removed and a roentgenogram was obtained. The aorta was then burst-tested to 300 mm Hg, measured, and examined both grossly and histologically. All anastomoses were patent and no burst failures were observed in either group. However, Prolene sutures protruded into lumen and were partially embedded in the aortic wall in all animals in the Prolene suture group. Thrombus adhered to the intraluminal Prolene suture in six of nine animals. The growth of the anastomotic area was wider in the Maxon suture group (446.4% +/- 131.8% versus 317.6% +/- 121.5%, p less than 0.05). Stenosis was more common in the Prolene suture group (7/9) than in the Maxon suture group (1/10) (p less than 0.01), but the distal segment was widely patent in both groups. Dilatation at the anastomotic site was present in eight of 10 pigs in the Maxon suture group and in two of nine in the Prolene suture group. Histologic study showed that the area of tissue reaction was more prominent in the Prolene suture group. No sutures were observed in the Maxon suture group. We therefore recommend the use of absorbable Maxon sutures for anastomoses in which the suture line must be able to grow.

Absorption↗
PubMed1986

Frequency of various congenital heart diseases in Chinese adults: analysis of 926 consecutive patients over 13 years of age.

A retrospective analysis was performed in 926 consecutive Chinese persons, aged 14 to 68 years, in whom congenital heart disease had been diagnosed and catheterization had been performed over the past 24 years. The incidence of various congenital cardiac malformations was compared with that in other series reported world-wide. About 60% of the 926 patients underwent surgery, and anatomic details of the malformations were examined. Congenital aortic valvular stenosis and coarctation of the aorta were uncommon (2.4% and 1.2%, respectively) among the Chinese adults, and the ethnic differences with Western countries in the incidence of these 2 defects were apparent and real. In contrast, aneurysm of the sinus of Valsalva, either ruptured or nonruptured, was more common (4.3%) and the incidence of outlet muscular type (or type 1) of ventricular septal defect was 4 to 9 times as common as has been reported in the West. Genetic differences rather than environmental factors or dietary habits may explain these special features.

Adolescent↗
PubMed1986

Ventricular septal defect in Chinese with aortic valve prolapse and aortic regurgitation.

The incidence of aortic valve prolapse and aortic regurgitation (AR) among Chinese with ventricular septal defect (VSD) has not been studied, and controversies still exist regarding optimal surgical treatment and timing of operation for this condition. A prospective study of 332 consecutive patients with VSD showed that aortic valve prolapse and AR occurred in 43 (11.9%) patients. Valve lesions occurred more commonly among patients with subpulmonic VSD (28.0%) than with subaortic VSD (8.8%) (P less than 0.005). A retrospective study of another 306 patients revealed that 37 (12.1%) had valve complications. Of the 80 patients with valve lesions, 60 were males and 20 were females. The youngest ages of prolapse and AR in subpulmonic VSD were 7 months and 3 years 8 months, respectively; those in subaortic VSD were 2 years and 3 years 6 months, respectively. Valve prolapse occurred mostly before the age of 6-10 years, leading progressively to AR. The coronary cusps prolapsed in subpulmonic VSD were limited to the right cusp; and those in subaortic VSD were the right cusp, noncoronary cusp, or both. The magnitude of left-to-right shunts was small and the pulmonary artery pressure was normal in the majority of patients. Seventy-two patients underwent open-heart closure of the VSD, with additional valvuloplasty in 15 and valve replacement in three patients. It is concluded that Chinese with VSD are prone to develop aortic valve complications. Surgical closure of the subpulmonic VSD may restore the prolapsed valve to normal. Closure of the subaortic VSD has little effect. Valvuloplasty in subaortic VSD may palliate AR, but in all probability cannot restore valve competency.

Adolescent↗