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Biomedical subjects

Jen-Ping Chang

Publications and source records attributed to Jen-Ping Chang.

17 recordsLinked to original sources
PubMed2003

Idiopathic calcific constrictive pericarditis causing pulmonary stenosis associated with a ventricular septal defect mimicking tetralogy of Fallot.

We describe an unusual case of pulmonary stenosis caused by calcific constrictive pericarditis associated with a congenital ventricular septal defect in a 16-year-old boy who had a 2-week history of progressive dyspnea, cyanosis, fatigue, and bilateral leg edema. Echocardiographic findings led to an initial diagnosis of tetralogy of Fallot; however, findings on chest radiography and CT were suggestive of calcific constrictive pericarditis with pulmonary stenosis, which was then confirmed on cardiac catheterization. Total pericardiectomy and repair of the ventricular septal defect resulted in a satisfactory outcome. Follow-up examinations at 6 and 20 months showed that the patient was asymptomatic and considered to have class I New York Heart Association functional status. To our knowledge, this is the first reported case of calcific constrictive pericarditis with pulmonary stenosis associated with a ventricular septal defect.

Adolescent↗
PubMed2003

Conduit-on-valve replacement of a degenerated mitral bioprosthesis with a bioprosthesis.

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.

Bioprosthesis↗
PubMed2003

Mitral valve repair in uremic congestive cardiomyopathy.

BACKGROUND: There is limited reported experience on mitral valve repair in patients with chronic renal failure. This study was designed to evaluate the outcomes of mitral valve repair in patients suffering from congestive heart failure as a result of uremic cardiomyopathy and severe mitral regurgitation requiring chronic hemodialysis. METHODS: From 1995 to 2002, 5 women, ages 41 to 64 years (53 +/- 8 years), with uremic congestive cardiomyopathy and end-stage renal disease on chronic hemodialysis who underwent mitral valve repair for severe mitral regurgitation were identified retrospectively and followed for clinical and echocardiographic outcomes. The preoperative New York Heart Association functional class was 3.8 +/- 0.45. RESULTS: All patients had good results immediately after surgical mitral valve repair with no more than mild mitral regurgitation. During the follow-up at an average of 22.4 +/- 14.9 months (range, 3 to 41 months) postoperatively, all patients returned to New York Heart Association functional class I. Neither mitral calcification nor increasing peak transmitral gradient (or decreasing mitral valve orifice area) was notable by two-dimensional echocardiography. No reoperation was required. CONCLUSIONS: Although accelerated calcification of the repaired mitral valve and high incidence of failure of the reconstruction had been reported in patients with end-stage renal disease, based on our experience we advocate mitral valve repair when this can be safely performed, especially in patients with uremic congestive cardiomyopathy, in view of the added advantage of retaining the native valve in such patients.

Adult↗
PubMed2003

Large extracranial vertebral aneurysm with absent contralateral vertebral artery.

The extracranial segment of the vertebral artery is well protected, and the rate of occurrence of extracranial vertebral aneurysms is very low. We describe the case of a 40-year-old woman who presented with a large aneurysm of the left vertebral artery in the angiographic absence of a right vertebral artery. Her medical history included a motorcycle accident at the age of 20, at which time a neck sprain had been diagnosed. Computed tomography of the chest and neck revealed a 6- x 4-cm aneurysm with mural thrombus in the left thoracic outlet and in the first portion of the left vertebral artery before the entrance of the transverse foramen of the 6th cervical vertebra. Angiography of the arch vessels confirmed both the presence of an aneurysm of the left vertebral artery and the absence of a right vertebral artery. Due to the lack of contralateral vertebral flow, we planned to perform a graft interposition under deep hypothermic circulatory arrest, for cerebral protection. Unfortunately, the patient refused the operation and was lost to follow-up. To our knowledge, there has been no previous report of an extracranial vertebral artery aneurysm in the absence of a contralateral vertebral artery. We believe that deep hypothermic circulatory arrest with graft interposition is the best treatment strategy, although we did not, in this case, have opportunity to treat the patient.

Adult↗
PubMed2003

Perigraft-to-right atrial shunt for aortic root hemostasis.

We have modified the technique of perigraft-to-right atrial shunt to control hemorrhage after aortic root replacement. We have performed this operation in 2 patients, including one who had acute aortic dissection and another who underwent aortic root replacement and single-vessel coronary artery bypass. Neither patient required re-exploration for bleeding, and both shunts closed spontaneously during the follow-up period without any related complications. With this modification, even in the presence of concomitant coronary artery bypass grafting, hemostasis was achieved with preservation of the proximal vein graft.

Adult↗
PubMed2003

Aortic graft pseudoaneurysm secondary to fracture of sternal wires.

A 74-year-old man with a previously placed ascending aortic graft was admitted to our hospital with a pulsating sternal mass, 2 days after an episode of severe coughing. Six months earlier, computed tomographic scanning had shown an intact aortic graft and no sternal wire fracture, but the wires had cut through the sternum. Computed tomographic scans at the current admission showed the patient to have 2 perforations of the ascending aortic graft, which led to 2 pseudoaneurysms and a large subcutaneous hematoma. In another view, a fractured sternal wire could be seen leading to one of the pseudoaneurysms. We performed emergent surgery and found sternal separation, as well as 2 holes in the graft that coincided with the location of the fractured sternal wires. We successfully patched the graft; however, the patient had a cerebral ischemic stroke and died 2 weeks postoperatively. This case emphasizes the importance of early removal of loosening sternal wires.

Aged↗
PubMed2002

Brown tumor of the sternum.

The skeletal changes of severe hyperparathyroidism, known as osteitis fibrosa cystica, are now rarely encountered, because hyperparathyroidism is currently being diagnosed and treated at an early stage. Herein, a case of brown tumor of the sternum is reported; our report adds histologic data on this type of tumor to the literature.

Adenoma↗
PubMed2002

Double-switch Ross procedure.

Aortic root replacement with pulmonary autograft (Ross procedure) is a valuable technique. However, the best material for right ventricular outflow tract reconstruction remains controversial. We report on the experience with use of an aortic autograft with reimplantation of the diseased aortic valve for right ventricular outflow tract reconstruction in 3 patients with satisfactory result.

Adolescent↗
PubMed2002

Pseudoaneurysm of the popliteal artery: a rare sequela of acupuncture.

Acupuncture is an ancient Chinese treatment that has proved effective in relieving pain of various origins. Pseudoaneurysm resulting from acupuncture is an extremely rare event. Only 4 patients treated surgically for such a condition have previously been reported in the world medical literature. We present the case of a patient who had a pseudoaneurysm of the popliteal artery that resulted from acupuncture therapy for osteoarthritis of the knee. The patient was successfully treated by direct repair of the pseudoaneurysm.

Acupuncture Therapy↗