Biomedical subjects

J C Yuen

Publications and source records attributed to J C Yuen.

24 records · Page 2Linked to original sources

PubMed1995

Long-term sequelae following median sternotomy wound infection and flap reconstruction.

Use of muscle and omental flaps has been shown to provide reliable reconstruction of infected median sternotomy wounds; however, few reports emphasize the long-term sequelae of the complication and its treatment. This study was performed to evaluate the long-term problems, including patient satisfaction and survival rate, in 88 patients with median sternotomy infections treated with muscle or omental flaps. Forty-two patients were available for long-term follow-up by telephone interview, with an average length of follow-up of 42 months. Forty-three percent complained of chronic chest wall pain or discomfort, and 45% complained of sternal instability. After pectoralis major muscle flap reconstruction in 32 patients, 25% complained of upper extremity weakness, and 56% complained of chest contour deformity. Delayed septic costochondritis or osteomyelitis occurred in 8%. Despite these unfavorable consequences, 72% and 83% of patients were satisfied with the cosmesis of the operation and the overall result, respectively. Furthermore, after hospital discharge, these patients seem to enjoy satisfactory longevity. By emphasizing the potential sequelae, further research interest may be stimulated in delineating their causes and in refining techniques of reconstruction.

Adult↗

PubMed1991

Immediate muscle flap coverage for repair of cardiac rupture associated with mediastinitis.

Sternal wound infection with mediastinitis is a dreaded complication of cardiac surgery. Even more devastating is perforation of the heart or great vessels secondary to advanced mediastinitis. The exsanguinating hemorrhage and presence of extensive infection usually lead to a poor salvage rate in these patients. Citations in the English literature of successful management of cardiac rupture associated with mediastinitis are, as expected, scare. Recently, the capability for immediate muscle flap coverage in the repair of associated rupture of the heart secondary to active mediastinal infection has been discussed in two reports. This article presents another report, in which bilateral pectoralis major muscle flaps were used successfully in salvage of a patient who sustained rupture of the right ventricle after debridement of an extensively purulent sternal wound and mediastinum.

Aged↗

PubMed1991

Percutaneous intra-aortic balloon pump: emphasis on complications.

In a review of our 5-year experience with intra-aortic balloon pump (IABP) insertion I examined the complications of percutaneous IABP placement in 93 patients, and compared them with those reported in other studies in the literature. I analyzed several variables that may affect the complication rate. Of 78 patients in our series who had percutaneous IABP cardiac assist, 15 (19%) had complications, which falls into the acceptable range reported by others. Among 15 patients who had surgical placement of an IABP, the complication rate was similar at 20%. The complication rate after IABP insertions done by surgeons primarily in the operating room was compared with that from insertions done by cardiologists in the catheterization laboratory. The overall complication rate was found to be higher in the second group, 28.0% compared with 12.8%. The application of the IABP in cardiogenic shock was associated with a high complication rate (46%). On the other hand, its insertion before cardiac surgery was associated with a relatively low complication rate (9.5%).

Academic Medical Centers↗

PubMed1991

Aortoiliac dissection after percutaneous insertion of an intra-aortic balloon pump.

Aortic or aortoiliac dissection may complicate percutaneous intra-aortic balloon pump insertion in various ways. Thrombosis can escape clinical recognition if no major obstruction develops. Death due to perforation after dissection is not uncommon. In this case study, aortoiliac dissection led to bilateral iliac artery stenosis, an unusual complication of percutaneous femoral cannulation for insertion of a balloon pump.

Aorta, Thoracic↗

PubMed1991

Exclusion bypass of a difficult abdominal aortic aneurysm.

Aortic repair by graft replacement is currently the most generally accepted and widely used technique in the treatment of infrarenal abdominal aortic aneurysm. Many alternative approaches have been considered in order to limit the physiological stress of surgery. A recently described technique involves an extraperitoneal approach to the abdominal aorta, whereby the aneurysm is left in situ, excluded from arterial pressure, and an infrarenal aortic bypass is performed. In this case report, this exclusion bypass technique was safely applied through a transperitoneal approach to manage a very large, tortuous and displaced infrarenal abdominal aortic aneurysm which was densely adherent to the left kidney and ureter.

Aged↗

PubMed1989

Distal colonic impaction requiring laparotomy in an adult with cystic fibrosis.

A sigmoid fecal impaction leading to colonic obstruction in an adult with cystic fibrosis was evacuated at laparotomy by manual compression of the inspissated stool through the rectum. In cystic fibrosis beyond infancy, constipation is a common management problem. Intestinal obstruction caused by inspissated stool in the terminal ileum and cecum has been well documented; however, distal colonic obstruction requiring operation has not been previously reported.

Adult↗