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Shoei-shen Wang - One of the best experts on this subject based on the ideXlab platform.

  • surgical management of pulmonary artery sling Trachea diameter and outcomes with or without tracheoplasty
    Pediatric Pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea <3 mm is associated with the use of tracheoplasty or poor outcomes. Slide tracheoplasty provided acceptable good results. Pediatr Pulmonol. 2012. 47:903–908. © 2012 Wiley Periodicals, Inc.

  • Surgical management of pulmonary artery sling: Trachea diameter and outcomes with or without tracheoplasty.
    Pediatric pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea

Shu-chien Huang - One of the best experts on this subject based on the ideXlab platform.

  • Management of long-segment Tracheal Stenosis: a continuing surgical challenge.
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014
    Co-Authors: Shu-chien Huang, Ching-chia Wang
    Abstract:

    Yazdanbakhsh et al. [1] report a surgical technique using autologous pericardial patch and strips of costal cartilage for relieving severe Tracheal Stenosis. Over nearly two decades of experience, 21 patients were treated, with 3 (14%) suffering late postoperative mortality. Seven patients underwent bronchoscopic reintervention and 8 underwent surgical intervention, including 3 sliding tracheoplasty and 5 patch and strip techniques. This paper presents good results with a detailed long-term follow-up. I believe it is worth a careful read for its appraisals of various tracheoplasty techniques. The patch and strip technique has benefits for both pericardial patch and costal cartilage. Pericardial patch is too flaccid and results in tracheomalacia after reconstruction, and costal cartilage is too rigid making it difficult to achieve air-tight anastomosis. Combining both materials can reconstruct an enlarged Trachea with good external support. However, a major drawback is potential leakage and granulation tissue formation. The authors reported on a follow-up period of over 10 years, showing that Trachea growth was evident with this technique. Currently, many centres, including our own, favour slide tracheoplasty for long-segment Tracheal Stenosis [2, 3]. This technique reconstructs a widened Trachea lumen with native respiratory epithelium, and has also shown growth potential in animal experiments [4] and in clinical observation. The authors worried about blood supply issues after dissection around the Trachea, so they favoured a patch and strip technique. However, we did not encounter this issue in our personal experience or in the literature. Nonetheless, it should be kept in mind that dissection around the Trachea needs to be meticulous. Congenital Trachea Stenosis is a rare condition, but often presents in combination with congenital heart defect and vascular ring-sling complex [5, 6]. Both relief of external compression and correction of intrinsic Stenosis (complete Trachea cartilage rings) are important. As in the report, 3 patients with persistent compression of the Trachea by the right aortic arch and 1 patient with agenesis of right lung required reoperation. Treating these patients required thorough consideration of the entire airway and cardiovascular structures, and their inter-relationship, to optimize the final results. Despite the improved survival rate, there was still considerable mortality, morbidity and Trachea cannula placement. Management of Tracheal Stenosis as well as tracheobronchial malacia and cardiovascular abnormality (frequently seen in combination) still have much room for improvement. A multidisciplinary approach and a choice of the optimal surgical technique for each individual condition are important to improve long-term results. This paper provides a detailed description on the benefits, complications and recent results, and I recommend it be read by surgeons who are interested in this topic.

  • surgical management of pulmonary artery sling Trachea diameter and outcomes with or without tracheoplasty
    Pediatric Pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea <3 mm is associated with the use of tracheoplasty or poor outcomes. Slide tracheoplasty provided acceptable good results. Pediatr Pulmonol. 2012. 47:903–908. © 2012 Wiley Periodicals, Inc.

  • Surgical management of pulmonary artery sling: Trachea diameter and outcomes with or without tracheoplasty.
    Pediatric pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea

Ching-chia Wang - One of the best experts on this subject based on the ideXlab platform.

  • Management of long-segment Tracheal Stenosis: a continuing surgical challenge.
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014
    Co-Authors: Shu-chien Huang, Ching-chia Wang
    Abstract:

    Yazdanbakhsh et al. [1] report a surgical technique using autologous pericardial patch and strips of costal cartilage for relieving severe Tracheal Stenosis. Over nearly two decades of experience, 21 patients were treated, with 3 (14%) suffering late postoperative mortality. Seven patients underwent bronchoscopic reintervention and 8 underwent surgical intervention, including 3 sliding tracheoplasty and 5 patch and strip techniques. This paper presents good results with a detailed long-term follow-up. I believe it is worth a careful read for its appraisals of various tracheoplasty techniques. The patch and strip technique has benefits for both pericardial patch and costal cartilage. Pericardial patch is too flaccid and results in tracheomalacia after reconstruction, and costal cartilage is too rigid making it difficult to achieve air-tight anastomosis. Combining both materials can reconstruct an enlarged Trachea with good external support. However, a major drawback is potential leakage and granulation tissue formation. The authors reported on a follow-up period of over 10 years, showing that Trachea growth was evident with this technique. Currently, many centres, including our own, favour slide tracheoplasty for long-segment Tracheal Stenosis [2, 3]. This technique reconstructs a widened Trachea lumen with native respiratory epithelium, and has also shown growth potential in animal experiments [4] and in clinical observation. The authors worried about blood supply issues after dissection around the Trachea, so they favoured a patch and strip technique. However, we did not encounter this issue in our personal experience or in the literature. Nonetheless, it should be kept in mind that dissection around the Trachea needs to be meticulous. Congenital Trachea Stenosis is a rare condition, but often presents in combination with congenital heart defect and vascular ring-sling complex [5, 6]. Both relief of external compression and correction of intrinsic Stenosis (complete Trachea cartilage rings) are important. As in the report, 3 patients with persistent compression of the Trachea by the right aortic arch and 1 patient with agenesis of right lung required reoperation. Treating these patients required thorough consideration of the entire airway and cardiovascular structures, and their inter-relationship, to optimize the final results. Despite the improved survival rate, there was still considerable mortality, morbidity and Trachea cannula placement. Management of Tracheal Stenosis as well as tracheobronchial malacia and cardiovascular abnormality (frequently seen in combination) still have much room for improvement. A multidisciplinary approach and a choice of the optimal surgical technique for each individual condition are important to improve long-term results. This paper provides a detailed description on the benefits, complications and recent results, and I recommend it be read by surgeons who are interested in this topic.

  • surgical management of pulmonary artery sling Trachea diameter and outcomes with or without tracheoplasty
    Pediatric Pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea <3 mm is associated with the use of tracheoplasty or poor outcomes. Slide tracheoplasty provided acceptable good results. Pediatr Pulmonol. 2012. 47:903–908. © 2012 Wiley Periodicals, Inc.

  • Surgical management of pulmonary artery sling: Trachea diameter and outcomes with or without tracheoplasty.
    Pediatric pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea

Ing-sh Chiu - One of the best experts on this subject based on the ideXlab platform.

  • surgical management of pulmonary artery sling Trachea diameter and outcomes with or without tracheoplasty
    Pediatric Pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea <3 mm is associated with the use of tracheoplasty or poor outcomes. Slide tracheoplasty provided acceptable good results. Pediatr Pulmonol. 2012. 47:903–908. © 2012 Wiley Periodicals, Inc.

  • Surgical management of pulmonary artery sling: Trachea diameter and outcomes with or without tracheoplasty.
    Pediatric pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea

Chung-i Chang - One of the best experts on this subject based on the ideXlab platform.

  • surgical management of pulmonary artery sling Trachea diameter and outcomes with or without tracheoplasty
    Pediatric Pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea <3 mm is associated with the use of tracheoplasty or poor outcomes. Slide tracheoplasty provided acceptable good results. Pediatr Pulmonol. 2012. 47:903–908. © 2012 Wiley Periodicals, Inc.

  • Surgical management of pulmonary artery sling: Trachea diameter and outcomes with or without tracheoplasty.
    Pediatric pulmonology, 2012
    Co-Authors: Shu-chien Huang, Ching-chia Wang, Shyh-jye Chen, Yih-sharng Chen, Chung-i Chang, Ing-sh Chiu, Shoei-shen Wang
    Abstract:

    Objectives Pulmonary artery sling is frequently associated with Tracheal and/or bronchial Stenosis. A number of patients receive only re-implantation or relocation of the left pulmonary artery (LPA) while other patients may require tracheoplasty for Stenosis of the airway. This study used computer tomography (CT) scans for the evaluation of airways and to evaluate the Trachea diameter and the clinical outcomes with or without tracheoplasty. Methods A total of 15 patients with PA sling who received CT scans were included in this study. We reviewed the clinical outcomes and the severity of Trachea Stenosis, and evaluated various surgical strategies. Results Among the 15 patients, one received only conservative treatment, 14 (93%) patients received LPA re-implantation, and eight (53%) received tracheoplasty. For the eight patients that received LPA reimplantation and tracheoplasty, five received slide tracheoplasty and all survived, two patients had pericardial patch augmentation and both died, and one patient received a resection and end-to-end anastomosis and survived. The diameter of the Trachea in survivors without tracheoplasty was significantly larger than those who died or received tracheoplasty (3.2 ± 0.3 mm vs. 2.2 ± 0.4 mm, P = 0.003). Establishing 3.0 mm as the threshold, the positive predictive value for tracheoplasty or mortality was 89% and the negative predictive value was 83%. Conclusions In this study cohort, approximately 60% of the patients with PA sling received tracheoplasty. A diameter of the Trachea