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Chun-an Chen - One of the best experts on this subject based on the ideXlab platform.
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device deformation and Left Pulmonary Artery obstruction after transcatheter patent ductus arteriosus closure in preterm infants
International Journal of Cardiology, 2020Co-Authors: Yuhsuan Chien, Joukou Wang, Mingtai Lin, Hsuanhui Wang, Hsinchia Lin, Shuennnan Chiu, Chun-an ChenAbstract:Abstract Background Transcatheter closure of patent ductus arteriosus (PDA) is an effective alternative to surgical ligation in preterm infants. However, data on device deformation and risk of Left Pulmonary Artery (LPA) obstruction remain scant. This study describes the outcomes and complications of transcatheter closure of PDA in preterm infants weighing Methods Amplatzer Piccolo Occluder and Amplatzer Vascular Plug were used. Echocardiography was repeated at prespecified intervals. The device waist and length were assessed through lateral fluoroscopy immediately and at least 3 months after deployment. Results Fourteen infants were prospectively enrolled (mean procedural weight 1335 g, procedural age 24 days), and all procedures were successful. There was no obstruction of adjacent vessels immediately after deployment. At follow-up, three infants developed aortic coarctation, all of which resolved gradually. Obstruction of the LPA occurred in eight infants, with five being severe cases. Compared with the shape immediately after deployment, the devices became significantly more flattened and lengthened at follow-up in patients with LPA obstruction. This deformation was nonsignificant in infants without any LPA obstruction. The ratio of the device waist after deployment to the nominal waist ( Conclusions Device deformation occurring late at follow-up is common and may be associated with LPA obstruction in preterm infants after transcatheter PDA closure. Meticulous device selection and implantation technique are crucial for minimizing the associated risks.
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Repair of Complex Tracheobronchial Stenosis With Left Pulmonary Artery Sling and Bridging Bronchus
The Annals of Thoracic Surgery, 2010Co-Authors: Shu-chien Huang, Ching-chia Wang, Chun-an Chen, Chien-yi Chen, Shyhjye ChenAbstract:Slide tracheoplasty with reimplantation of the Left Pulmonary Artery is one of the preferred techniques for repair of long-segment congenital tracheal stenosis in association with a Pulmonary Artery sling. Left Pulmonary Artery sling associated with a right upper bronchus from the trachea (tracheal bronchus) and stenosis of the bridging bronchus is a more complicated situation. We present an infant with Left Pulmonary Artery sling, and stenosis of the bridging bronchus, carina, and both right and Left main bronchi. His condition was successfully repaired using the combination of slide tracheoplasty and tracheal autograft techniques.
Shyhjye Chen - One of the best experts on this subject based on the ideXlab platform.
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Repair of Complex Tracheobronchial Stenosis With Left Pulmonary Artery Sling and Bridging Bronchus
The Annals of Thoracic Surgery, 2010Co-Authors: Shu-chien Huang, Ching-chia Wang, Chun-an Chen, Chien-yi Chen, Shyhjye ChenAbstract:Slide tracheoplasty with reimplantation of the Left Pulmonary Artery is one of the preferred techniques for repair of long-segment congenital tracheal stenosis in association with a Pulmonary Artery sling. Left Pulmonary Artery sling associated with a right upper bronchus from the trachea (tracheal bronchus) and stenosis of the bridging bronchus is a more complicated situation. We present an infant with Left Pulmonary Artery sling, and stenosis of the bridging bronchus, carina, and both right and Left main bronchi. His condition was successfully repaired using the combination of slide tracheoplasty and tracheal autograft techniques.
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Left Pulmonary Artery sling complex computed tomography and hypothesis of embryogenesis
The Annals of Thoracic Surgery, 2007Co-Authors: Shyhjye Chen, Joukou Wang, Wenjeng Lee, Mingtai Lin, Chungi Chang, Ingsh ChiuAbstract:Background We retrospectively reviewed cases of Left Pulmonary Artery (LPA) sling complex with computed tomography to explore its possible meaning in embryogenesis. Methods Eighteen children (6 girls and 12 boys aged 5 days to 17.5 years; mean, 1.5 years) were identified as having LPA sling during the period of October 1996 to March 2006. Another 2,364 cardiac computed tomography scans that had no LPA sling were included as control. The associated bronchoPulmonary and vascular anomalies were identified. Chi-square tests were used to compare the probabilities of coexistence of these anomalies, with or without LPA sling. Results All patients with LPA sling presented with tracheal stenosis (100%), and there was a high incidence of combined right tracheal bronchus (22%), underdeveloped right lung (22%), persistent Left superior vena cava (22%), and Left patent ductus arteriosus (39%). These associated anomalies were more highly associated with subjects who had LPA sling than with those who did not ( p Conclusions Owing to the spatial coexistence of LPA sling with the associated anomalies in the embryonic foregut mesoderm, we propose that a "space available" hypothesis in the local environment appears to be important in the embryogenesis of an LPA sling complex.
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right lung agenesis with Left Pulmonary Artery sling
Pediatric Pulmonology, 2000Co-Authors: Shyhjye Chen, Joukou Wang, Meihwan Wu, Yiuwah LiAbstract:We report on a 2-month-old infant girl who had right Pulmonary agenesis and an unusual course of the Left Pulmonary Artery. Computed tomography and cardiac catheterization showed that the Left Pulmonary Artery arose from the main Pulmonary Artery, crossing the midline, and reaching the Left lung via an aberrant course between the esophagus and trachea. The coexistence of right Pulmonary agenesis and Left Pulmonary sling is extremely rare. Unlike in other reports, our patient remained symptom-free and in good health, with normal growth and development until age 2 years, when she died from complications during an attack of bronchiolitis caused by respiratory syncytial virus.
Joukou Wang - One of the best experts on this subject based on the ideXlab platform.
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device deformation and Left Pulmonary Artery obstruction after transcatheter patent ductus arteriosus closure in preterm infants
International Journal of Cardiology, 2020Co-Authors: Yuhsuan Chien, Joukou Wang, Mingtai Lin, Hsuanhui Wang, Hsinchia Lin, Shuennnan Chiu, Chun-an ChenAbstract:Abstract Background Transcatheter closure of patent ductus arteriosus (PDA) is an effective alternative to surgical ligation in preterm infants. However, data on device deformation and risk of Left Pulmonary Artery (LPA) obstruction remain scant. This study describes the outcomes and complications of transcatheter closure of PDA in preterm infants weighing Methods Amplatzer Piccolo Occluder and Amplatzer Vascular Plug were used. Echocardiography was repeated at prespecified intervals. The device waist and length were assessed through lateral fluoroscopy immediately and at least 3 months after deployment. Results Fourteen infants were prospectively enrolled (mean procedural weight 1335 g, procedural age 24 days), and all procedures were successful. There was no obstruction of adjacent vessels immediately after deployment. At follow-up, three infants developed aortic coarctation, all of which resolved gradually. Obstruction of the LPA occurred in eight infants, with five being severe cases. Compared with the shape immediately after deployment, the devices became significantly more flattened and lengthened at follow-up in patients with LPA obstruction. This deformation was nonsignificant in infants without any LPA obstruction. The ratio of the device waist after deployment to the nominal waist ( Conclusions Device deformation occurring late at follow-up is common and may be associated with LPA obstruction in preterm infants after transcatheter PDA closure. Meticulous device selection and implantation technique are crucial for minimizing the associated risks.
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Left Pulmonary Artery sling complex computed tomography and hypothesis of embryogenesis
The Annals of Thoracic Surgery, 2007Co-Authors: Shyhjye Chen, Joukou Wang, Wenjeng Lee, Mingtai Lin, Chungi Chang, Ingsh ChiuAbstract:Background We retrospectively reviewed cases of Left Pulmonary Artery (LPA) sling complex with computed tomography to explore its possible meaning in embryogenesis. Methods Eighteen children (6 girls and 12 boys aged 5 days to 17.5 years; mean, 1.5 years) were identified as having LPA sling during the period of October 1996 to March 2006. Another 2,364 cardiac computed tomography scans that had no LPA sling were included as control. The associated bronchoPulmonary and vascular anomalies were identified. Chi-square tests were used to compare the probabilities of coexistence of these anomalies, with or without LPA sling. Results All patients with LPA sling presented with tracheal stenosis (100%), and there was a high incidence of combined right tracheal bronchus (22%), underdeveloped right lung (22%), persistent Left superior vena cava (22%), and Left patent ductus arteriosus (39%). These associated anomalies were more highly associated with subjects who had LPA sling than with those who did not ( p Conclusions Owing to the spatial coexistence of LPA sling with the associated anomalies in the embryonic foregut mesoderm, we propose that a "space available" hypothesis in the local environment appears to be important in the embryogenesis of an LPA sling complex.
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right lung agenesis with Left Pulmonary Artery sling
Pediatric Pulmonology, 2000Co-Authors: Shyhjye Chen, Joukou Wang, Meihwan Wu, Yiuwah LiAbstract:We report on a 2-month-old infant girl who had right Pulmonary agenesis and an unusual course of the Left Pulmonary Artery. Computed tomography and cardiac catheterization showed that the Left Pulmonary Artery arose from the main Pulmonary Artery, crossing the midline, and reaching the Left lung via an aberrant course between the esophagus and trachea. The coexistence of right Pulmonary agenesis and Left Pulmonary sling is extremely rare. Unlike in other reports, our patient remained symptom-free and in good health, with normal growth and development until age 2 years, when she died from complications during an attack of bronchiolitis caused by respiratory syncytial virus.
Michael Weyand - One of the best experts on this subject based on the ideXlab platform.
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first successful implantation of a biodegradable metal stent into the Left Pulmonary Artery of a preterm baby
Catheterization and Cardiovascular Interventions, 2005Co-Authors: Peter Zartner, H Singer, R Cesnjevar, Michael WeyandAbstract:Stent implantation in the youngest patients with a congenital heart disease implicates limitations concerning further vessel growth, the need of staged redilation, and later surgical removal. The search to overcome these restrictions led to open stent designs, with a wide adaptability to the vessel growth and recently to the development of bioabsorbable stent materials. A preterm baby born at 26 weeks of gestation was referred to our clinic following inadvertent ligation of the Left Pulmonary Artery. Despite efficient debanding, the Left lung perfusion was absent. Implantation of a biodegradable 3 mm magnesium stent was performed in a hybrid procedure when the baby weighed 1.7 kg. Reperfusion of the Left lung was established and persisted throughout the 4-month follow-up period during which the gradual degradation process of the stent completed. Additional interventions, should they become necessary, seem not to be limited. Despite the small size of the baby, the degradation process was clinically well tolerated. The mechanical and degradation characteristics of the magnesium stent proved to be adequate to secure reperfusion of the previously occluded Left Pulmonary Artery. Bioabsorbable stents with different diameters may help develop new strategies in the therapy of vessel stenosis in pediatric patients.
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first successful implantation of a biodegradable metal stent into the Left Pulmonary Artery of a preterm baby
Catheterization and Cardiovascular Interventions, 2005Co-Authors: Peter Zartner, H Singer, R Cesnjevar, Michael WeyandAbstract:Stent implantation in the youngest patients with a congenital heart disease implicates limitations concerning further vessel growth, the need of staged redilation, and later surgical removal. The search to overcome these restrictions led to open stent designs, with a wide adaptability to the vessel growth and recently to the development of bioabsorbable stent materials. A preterm baby born at 26 weeks of gestation was referred to our clinic following inadvertent ligation of the Left Pulmonary Artery. Despite efficient debanding, the Left lung perfusion was absent. Implantation of a biodegradable 3 mm magnesium stent was performed in a hybrid procedure when the baby weighed 1.7 kg. Reperfusion of the Left lung was established and persisted throughout the 4-month follow-up period during which the gradual degradation process of the stent completed. Additional interventions, should they become necessary, seem not to be limited. Despite the small size of the baby, the degradation process was clinically well tolerated. The mechanical and degradation characteristics of the magnesium stent proved to be adequate to secure reperfusion of the previously occluded Left Pulmonary Artery. Bioabsorbable stents with different diameters may help develop new strategies in the therapy of vessel stenosis in pediatric patients. © 2005 Wiley-Liss, Inc.
Constantine Mavroudis - One of the best experts on this subject based on the ideXlab platform.
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right aortic arch right ligamentum absent Left Pulmonary Artery a rare vascular ring
The Annals of Thoracic Surgery, 1999Co-Authors: Ali Dodgekhatami, Carl L Backer, Michael E Dunham, Constantine MavroudisAbstract:A 5-month-old infant presented with respiratory failure secondary to severe right bronchial compression. Diagnostic imaging revealed a right aortic arch and absent Left Pulmonary Artery. Surgical relief was obtained via median sternotomy by dividing a right ligamentum and pexing the enlarged right Pulmonary Artery to the ascending aorta.