1.Open surgical insertion of Tenkchoff straight catheter without guide wire.
Shi-feng YANG ; Wu-jun XUE ; Ai-ping YIN ; Li-yi XIE ; Wan-hong LU
Chinese Medical Sciences Journal 2013;28(2):117-121
OBJECTIVETo compare the clinical outcomes of open surgical peritoneal dialysis catheter (PDC) insertion with guide wire and the outcomes of PDC insertion without guide wire.
METHODSData of the patients receiving open surgical Tenkchoff straight catheter insertion in our department from January 2005 to January 2011 were retrospectively analyzed. The 117 patients in whom PDC insertion was conducted with the guidance of guide wire were enrolled into group A, and the 121 cases receiving PDC insertion without guide wire were enrolled into group B. The incidences of post-operative complications (catheter obstruction, catheter displacement, bloody dialysate, and dialysate leakage), catheter survival, and patient survival rates were compared between the 2 groups.
RESULTSThe baseline characteristics (gender, age, body mass index, prothrombin time, activated partial thromboplastin time, platelet count, serum creatinine, follow-up time, primary diseases, and outcomes) of the 2 groups were comparable (all P>0.05). In post-operative complications, only the incidence of early bloody dialysate showed significant difference, being 16.2% in group A and 7.4% in group B (P=0.04). Catheter and patient survival rates were not significantly different between the two groups. Overweight patients showed a higher incidence of catheter obstruction compared with normal weight patients [16.0% (4/25) vs.3.3% (7/213), P=0.02], but no differences in post-operative complications were found among overweight patients between the 2 groups.
CONCLUSIONSOpen surgical Tenkchoff straight catheter insertion without guide wire does not lead to higher risk of post-operative complications and catheter removal. It may be an alternative option when guide wire is not available.
Adult ; Aged ; Catheterization ; adverse effects ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Peritoneal Dialysis ; instrumentation ; mortality ; Postoperative Complications ; etiology
2.Different Strategies for Transpancreatic Septotomy and Needle Knife Infundibulotomy Due to the Presence of Unintended Pancreatic Cannulation in Difficult Biliary Cannulation.
Yoon Jung LEE ; Yun Kyung PARK ; Min Ji LEE ; Kyu Taek LEE ; Kwang Hyuck LEE ; Jong Kyun LEE
Gut and Liver 2015;9(4):534-539
BACKGROUND/AIMS: Several precut techniques have been used to gain biliary access for difficult cases. The aim of this study was to evaluate the success and complication rates of two precut techniques, transpancreatic septotomy (TPS) and needle knife infundibulotomy (NKI), in difficult biliary cannulation due to the presence of unintended pancreatic cannulation. METHODS: Eighty-six patients who failed standard biliary cannulation were included. TPS was performed when we failed to achieve biliary access despite 5 minutes of attempted cannulation or when more than three attempted unintended pancreatic cannulations occurred. If deep cannulation was not achieved within 5 minutes for any duct, NKI was performed. If this failed, we crossed over to the other technique in the second attempt. RESULTS: The initial total success rate of biliary cannulation was 88.4% (86.6% for the TPS group and 94.7% for the NKI group, p=0.447). After crossover of the techniques, the final success rate was 95.3%. The complication rate was 20.9% in patients with TPS and 15.8% in patients with NKI (p=0.753). CONCLUSIONS: The use of different strategies based on the presence of unintended pancreatic cannulation may help increase the success rate for difficult biliary cannulation without increasing complication rates.
Aged
;
Bile Ducts/surgery
;
Biliary Tract Diseases/*surgery
;
Catheterization/adverse effects/instrumentation/*methods
;
Cholangiopancreatography, Endoscopic Retrograde/adverse effects/*methods
;
Female
;
Humans
;
Male
;
Middle Aged
;
Pancreas/surgery
;
Prospective Studies
;
Retrospective Studies
;
Sphincterotomy, Endoscopic/adverse effects/instrumentation/*methods
;
Surgical Instruments
;
Treatment Outcome
3.Preliminary study of a new heart valve prostheses implanted with minimally invasive techniques: pulsatile-flow testing in vitro.
Jinglong TANG ; Shuo WANG ; Li LIU ; Jian WANG ; Chunren WANG
Journal of Biomedical Engineering 2013;30(1):166-169
The aim of this study was to investigate the pulsatile-flow performance in vitro of a new heart valve prostheses implanted with minimally invasive techniques (HVPMIT). Three HVPMITs were tested valves and another three original biological heart valve prostheses acted as reference valves. The pulsatile-flow parameters (including mean pressure drop, regurgitant percentage of stroke volume, and effective orifice area) were tested in a pulse duplicator according to the methods listed in ISO5840-2005 and GB 12279-2008. The results demonstrated that the regurgitant percentage of stroke volume of tested valves was up to 13%. It was significantly higher than that of the reference valves. This result suggested that paravalvular leakage had occurred in the tested valves. It was found in the further analysis that because HVPMIT was not sewn into the heart tissue when the HVPMIT was implanted in vivo and there was not a sewing ring in the HVPMIT, when tested valves were fixed in the pulse duplicator, some gaps might exist between the stent of HVPMIT and the fix gasket, and the paravalvular leakage could therefore take place through these gaps. This study demonstrated that there are significant differences in the shape, structure, fixation in vivo and clinical operational methods between HVPMIT and original biological heart valve prostheses. It is necessary to establish new test methods which adapt for HVPMIT to evaluate its pulsatile-flow performance according to its own features.
Animals
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Cardiac Catheterization
;
Heart Valve Prosthesis
;
Heart Valve Prosthesis Implantation
;
adverse effects
;
instrumentation
;
methods
;
Minimally Invasive Surgical Procedures
;
methods
;
Prosthesis Design
;
Pulsatile Flow
4.Noninfectious Complications of Peritoneal Dialysis in Korean Children: A 26-Year Single-Center Study.
Ji Eun KIM ; Se Jin PARK ; Ji Young OH ; Ji Hong KIM ; Jae Seung LEE ; Pyung Kil KIM ; Jae Il SHIN
Yonsei Medical Journal 2015;56(5):1359-1364
PURPOSE: The aim of this study was to investigate noninfectious complications of peritoneal dialysis (PD), including mechanical and metabolic complications, at a single center in Korea. MATERIALS AND METHODS: We analyzed data from 60 PD patients aged < or =18 years (40 boys and 20 girls) during the period between 1986 and 2012. The collected data included gender, age, causes of PD, incidence of noninfectious complications, and treatment for the complications. RESULTS: The mean duration of PD therapy was 28.7+/-42.1 months (range 1-240 months). The most common cause of end-stage renal disease was glomerular disease (43.3%). There were no statistically significant differences between patients with and without mechanical complications regarding gender, age at the start of PD, and total duration of PD. Outflow failure was the most common catheter-related complication (14.3%), followed by leakage (10.0%) and hernia (8.6%). Metabolic complications, such as hyperglycemia and hypokalemia, were observed in three of 16 patients. The frequency of noninfectious complications of PD in our study was comparable with those in previous pediatric studies. PD was switched to hemodialysis (HD) in only three patients. CONCLUSION: Our results indicate that noninfectious complications of PD are common, though they hardly lead to catheter removal or HD in pediatric patients on PD.
Adolescent
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Asian Continental Ancestry Group
;
Catheterization/*adverse effects
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Child
;
Child, Preschool
;
Device Removal
;
Female
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Humans
;
Incidence
;
Kidney Failure, Chronic/*therapy
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Male
;
*Outcome and Process Assessment (Health Care)
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Peritoneal Dialysis/*adverse effects/instrumentation/*methods
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Renal Dialysis/adverse effects
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Republic of Korea
;
Treatment Outcome
5.Successful transcatheter bioprosthetic heart valve paravalvular leak closure: the role of 3-dimensional transesophageal echocardiography.
Edgar L W TAY ; Swee Chong SEOW ; Wai Sun CHOO ; Lieng Hsi LING ; James W L YIP
Annals of the Academy of Medicine, Singapore 2011;40(3):145-146
Cardiac Catheterization
;
instrumentation
;
methods
;
Echocardiography, Three-Dimensional
;
instrumentation
;
methods
;
Heart Valve Prosthesis
;
adverse effects
;
Hemodynamics
;
Humans
;
Hypertension, Pulmonary
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Male
;
Middle Aged
;
Mitral Valve
;
pathology
;
Mitral Valve Insufficiency
;
pathology
;
therapy
6.Inadvertent fracture during the attempted removal of entrapped Swan-Ganz catheter.
Mustafa SEZEN ; Senol YAVUZ ; Tugrul GONCU ; Cuneyt ERIS
Annals of the Academy of Medicine, Singapore 2008;37(11):984-985
Adult
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Angiography
;
Catheterization, Swan-Ganz
;
instrumentation
;
Device Removal
;
adverse effects
;
methods
;
Diagnosis, Differential
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Equipment Failure
;
Foreign-Body Migration
;
diagnostic imaging
;
etiology
;
surgery
;
Heart Atria
;
injuries
;
Humans
;
Male
;
Radiography, Thoracic
;
Thoracic Surgical Procedures
;
methods
7.Therapeutic effect and safety of transcatheter occlusion of ventricular septal defects in 50 patients.
Da-Jun HU ; Chuan-Chang LI ; Xiao-Qun PU ; Zhao-Fen ZHENG ; Yang-Cheng ZHAO ; Tian-Lun YANG
Journal of Central South University(Medical Sciences) 2005;30(5):587-589
OBJECTIVE:
To determine the therapeutic effect and safety of transcatheter closure of ventricular septal defects (VSD) in 50 patients.
METHODS:
Fifty patients were diagnosed by transthoracic echocardiography. To perform the operation, transthoracic echocardiography and X ray were used continuously to monitor the procedure. Transthoracic echocardiography and ECG were performed at 1, 3, and 6 months after the operation to evaluate the therapeutic effect.
RESULTS:
The VSD diameter ranged from 1.8 to 13.4 (5.54 +/- 2. 75) mm. The successful rate of the operation was 96.0%, and the complication rate of the operation was 16.7%. A 3 month follow-up was completed in 20 patients, and the median left ventricle end-diastolic dimension significantly decreased from (40.20 +/- 8.80) mm to (32.90 +/- 8.36) mm (P < 0.001).
CONCLUSION
Transcatheter closure of ventricular septal defects is a good method with a high success rate of placement, fewer complications, and a good occlusion effect.
Adolescent
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Adult
;
Balloon Occlusion
;
adverse effects
;
instrumentation
;
methods
;
Cardiac Catheterization
;
methods
;
Child
;
Child, Preschool
;
Echocardiography
;
Female
;
Heart Septal Defects, Ventricular
;
diagnostic imaging
;
therapy
;
Humans
;
Male
;
Prostheses and Implants
;
Treatment Outcome
8.Echocardiography in Transcatheter Aortic Valve Implantation and Mitral Valve Clip.
The Korean Journal of Internal Medicine 2012;27(3):245-261
Transcatheter aortic valve implantation and transcatheter mitral valve repair (MitraClip) procedures have been performed worldwide. In this paper, we review the use of two-dimensional and three-dimensional transesophageal echo for guiding transcatheter aortic valve replacement and mitral valve repair.
Aged
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Aged, 80 and over
;
Aortic Valve Stenosis/*therapy/*ultrasonography
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Balloon Valvuloplasty
;
Bioprosthesis
;
*Cardiac Catheterization/adverse effects/instrumentation
;
*Echocardiography
;
Echocardiography, Doppler, Color
;
Echocardiography, Three-Dimensional
;
Echocardiography, Transesophageal
;
Heart Valve Prosthesis
;
Heart Valve Prosthesis Implantation/adverse effects/instrumentation/*methods
;
Humans
;
Mitral Valve Insufficiency/*therapy/*ultrasonography
;
Predictive Value of Tests
;
Prosthesis Design
;
Severity of Illness Index
;
Surgical Instruments
;
Ultrasonography, Interventional/*methods
9.Application of double-balloon push enteroscopy in diagnosis of small bowel disease in children.
Chun-di XU ; Chao-hui DENG ; Jie ZHONG ; Chen-li ZHANG
Chinese Journal of Pediatrics 2006;44(2):90-92
OBJECTIVEDouble-balloon enteroscopy is a new method that allows complete visualization of the lumen of small bowel. This study was conducted to evaluate safety, extent of observation and clinical efficacy of double-balloon push enteroscopy in diagnosis of patients with small bowel disease in children.
METHODSFourteen cases suspected of small bowel diseases with negative findings on examinations with various routine diagnostic modalities underwent double-balloon push enteroscopy from June, 2003 to May, 2005. Of the 14 cases, 13 had gastrointestinal bleeding and iron deficient anemia and 1 case had chronic diarrhea, the causes of these conditions were unknown.
RESULTSThe enteroscopy reached jejunal-ileum transitional area, middle or lower portion of ileum and terminal ileum in 2, 10 and 2 cases, and the examination time was 40-50 min, 55-70 min and 78-89 min, respectively. Lesions were detected in 12 of 14 the cases. The positive diagnostic rate was 85.7%. There were no relevant technical problems or severe complications.
CONCLUSIONDouble-balloon push enteroscopy is a safe, reliable diagnostic modality of high clinical value for small bowel diseases in children.
Adolescent ; Anemia, Iron-Deficiency ; diagnosis ; etiology ; Catheterization ; instrumentation ; methods ; Child ; Child, Preschool ; Diagnosis, Differential ; Diarrhea ; etiology ; Endoscopes, Gastrointestinal ; adverse effects ; Endoscopy, Gastrointestinal ; adverse effects ; methods ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Humans ; Intestinal Diseases ; complications ; diagnosis ; etiology ; pathology ; Intestine, Small ; pathology ; Male
10.A follow-up study on transcatheter closure of patent ductus arteriosus with Amplatzer duct occluder in children.
Jun-jie LI ; Yu-fen LI ; Zhi-wei ZHANG ; Ming-yang QIAN ; Hui-shen WANG
Chinese Journal of Pediatrics 2005;43(8):608-611
OBJECTIVETo document the five-year follow-up results of transcatheter Amplatzer duct occluder (ADO) occlusion of patent ductus arteriosus (PDA) in children and to assess the safety and effectiveness of this method for PDA closure.
METHODSA retrospective cohort study was completed in patients with PDA underwent transcatheter closure by the ADO in Guangdong Cardiovascular Institute from April 1998 to December 2003.
RESULTSTranscatheter closure of PDA with ADO was attempted in 250 children patients. The median age was 5.3 years and median weight was 15.1 kg. The PDAs were from 1.8 mm to 11.0 mm (median 4.2 mm) in the narrowest diameter, of which 52 were larger than 5 mm (20.0%). All PDAs were occluded with 4 approximately 14 mm ADO through 6F (n = 205) or 7F (n = 45) sheaths. Devices were successfully implanted in 245 patients (98.0%). The Qp/Qs decreased from 1.90 +/- 0.60 to 1.03 +/- 0.21 (P < 0.05). All shapes of the PDA could be closed. Late complication occurred in five patients, including hemolysis in three patients and the los of the pulse of femoral artery in two patients. Follow-up after device implantation was accomplished in 205 patients (82.0%). The incidence of residual shunt at follow-up periods of 1 d, 1 m, 6 m, 12 m, 24 m, 36 m, 48m and 60 m after device occlusion was 9.2%, 2.8%, 1.2%, 0.8%, 0, 0, 0 and 0, respectively. Five patients (2.0%) required re-intervention to treat residual shunt with or without hemolysis. Event-free rates were 98.0% at one year and five years.
CONCLUSIONThis long-term follow-up result confirmed the safety and effectiveness of ADO closure of PDAs in children.
Adolescent ; Balloon Occlusion ; adverse effects ; instrumentation ; methods ; Cardiac Catheterization ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; diagnostic imaging ; therapy ; Echocardiography, Doppler, Color ; Embolization, Therapeutic ; adverse effects ; methods ; Female ; Follow-Up Studies ; Hemolysis ; Humans ; Infant ; Male ; Radiography, Interventional ; Retrospective Studies ; Time Factors ; Treatment Outcome