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Article ; Online: Tracheal Bronchus in Children.

Yuan, Shi-Min

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2023 Volume 33, Issue 6, Page(s) 684–690

Abstract: Tracheal bronchus is an uncommon congenital anomaly. It is often of important significance during endotracheal intubation. In paediatrics with tracheal bronchus, stenosis of trachea and (or) bronchus and the management strategies remain to be further ... ...

Abstract	Tracheal bronchus is an uncommon congenital anomaly. It is often of important significance during endotracheal intubation. In paediatrics with tracheal bronchus, stenosis of trachea and (or) bronchus and the management strategies remain to be further clarified. A comprehensive retrieval of literature since 2000 revealed 43 articles with 334 paediatric patients with tracheal bronchus. The delayed diagnosis rate is 4.1%. Paediatric patients with tracheal bronchus most often present with recurrent pneumonia and atelectasis. In less than one-third of the patients, there was an intrinsic or extrinsic stenosis of the trachea, which warrant a conservative or a surgical treatment. A surgical treatment was performed in 15.3% of the patients, in most of which the operations were for relieving the tracheal stenosis. The surgical outcomes were satisfactory. Paediatric patients with tracheal bronchus with tracheal stenosis and recurrent pneumonia and persistent atelectasis warrant active treatments, and surgical treatments are preferred. No treatment is needed in those with no tracheal stenosis or those with no or mild symptoms. Key Words: Abnormality, Congenital, Thoracic surgery, Tracheal stenosis.
MeSH term(s)	Humans ; Child ; Constriction, Pathologic ; Trachea/surgery ; Bronchi/diagnostic imaging ; Bronchi/surgery ; Tracheal Stenosis/diagnosis ; Tracheal Stenosis/etiology ; Tracheal Stenosis/surgery ; Pulmonary Atelectasis/etiology ; Pulmonary Atelectasis/surgery ; Pneumonia
Language	English
Publishing date	2023-05-28
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2023.06.684
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Article ; Online: Right Atrial Tumour Thrombus in Advanced Hepatocellular Carcinoma: Surgical Techniques and Prognosis.

Yuan, Shi-Min

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2023 Volume 33, Issue 4, Page(s) 443–448

Abstract: Hepatocellular carcinoma (HCC) with right atrium (RA) tumour thrombus is a rare condition but the treatment always poses challenges. Debates remain with regard to the use of cardiopulmonary bypass (CPB) in the surgical procedures. The aim of the present ... ...

Abstract	Hepatocellular carcinoma (HCC) with right atrium (RA) tumour thrombus is a rare condition but the treatment always poses challenges. Debates remain with regard to the use of cardiopulmonary bypass (CPB) in the surgical procedures. The aim of the present review was to summarise the surgical procedures of RA tumour thrombus removal and to discuss the pertinent indications. Twenty-three articles involving 35 patients were collected and recruited into this study. Surgical operation for HCC was performed in 29 (82.9%) patients and non-surgical operation in 6 (17.1%) patients. RA tumour thrombus removal was performed with the aid of CPB in 25 (71.4%), venovenous bypass in 3 (8.6%), and without CPB in 7 (20%) patients. After tumour thrombus removal, RA or vessel wall reconstruction with a graft was required in 7 (20%) patients. The overall median survival time of this patient cohort was 30.8 months. The median survival time of patients who received a hepatectomy was 30.5 months, in comparison to 6.0 months for those who did not receive a hepatectomy. Aggressive surgical treatment prolongs survival of selective patients with HCC with RA tumour thrombus. CPB is helpful for complete removal of the tumour thrombus from the RA. In patients with tumour thrombus invading the RA or vessel walls, a graft repair is warranted. Key Words: Hepatocellular carcinoma, Inferior vena cava, Right atrium, Tumour thrombus.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/therapy ; Atrial Fibrillation ; Thrombosis/etiology ; Thrombosis/surgery ; Prognosis ; Vena Cava, Inferior/surgery ; Vena Cava, Inferior/pathology ; Heart Atria/surgery
Language	English
Publishing date	2023-05-16
Publishing country	Pakistan
Document type	Review ; Journal Article
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2023.04.443
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Article: Pulmonary artery pathologies in Alagille syndrome: a meta-analysis.

Yuan, Shi-Min

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

2022 Volume 18, Issue 2, Page(s) 111–117

Abstract: Alagille syndrome, caused by mutations in the gene ... ...

Abstract	Alagille syndrome, caused by mutations in the gene encoding
Language	English
Publishing date	2022-08-19
Publishing country	Poland
Document type	Journal Article ; Review
ISSN	1734-9338
ISSN	1734-9338
DOI	10.5114/aic.2022.118526
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Article: Percutaneous closure of left ventricular pseudoaneurysm.

Yuan, Shi-Min

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

2022 Volume 18, Issue 2, Page(s) 101–110

Abstract: The aim of the present study is to describe the indications, treatment effects, and patient outcomes of percutaneous management of left ventricular pseudoaneurysm (LVPA). The study materials were based on comprehensive literature retrieval since 2004. ... ...

Abstract	The aim of the present study is to describe the indications, treatment effects, and patient outcomes of percutaneous management of left ventricular pseudoaneurysm (LVPA). The study materials were based on comprehensive literature retrieval since 2004. The mechanisms of LVPA formation can be divided into surgical, percutaneous, and medial disease related. Of the surgical mechanisms, coronary artery bypass grafting prevailed. The formation time was the longest in medical disease-related LVPAs up to 44.4 months. The percutaneous procedures succeeded on the first try in 79 (84.9%) patients, whereas failures were encountered during the percutaneous manoeuvres in 14 (15.1%) patients. Percutaneous closure of LVPA was especially indicated for patients carrying a high surgical risk. The iatrogenic traumas, such as left ventricular venting, should be avoided to prevent this complication. The preliminary cut-off valves of oversize 3.3 mm and oversize ratio 1.6 should be followed for reference for device choice.
Language	English
Publishing date	2022-08-20
Publishing country	Poland
Document type	Journal Article ; Review
ISSN	1734-9338
ISSN	1734-9338
DOI	10.5114/aic.2022.118525
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Catheter ablation for tachyarrhythmias during pregnancy.

Yuan, Shi-Min

Postepy w kardiologii interwencyjnej = Advances in interventional cardiology

2022 Volume 18, Issue 3, Page(s) 206–216

Abstract: Introduction: Refractory arrhythmias during pregnancy pose challenges to physicians.: Aim: To give an overview of catheter ablation for tachyarrhythmias during pregnancy, and to discuss the indications of the procedure and the outcomes of both mother ...

Abstract	Introduction: Refractory arrhythmias during pregnancy pose challenges to physicians. Aim: To give an overview of catheter ablation for tachyarrhythmias during pregnancy, and to discuss the indications of the procedure and the outcomes of both mother and fetus. Material and methods: The study materials were based on comprehensive literature retrieval of the pertinent articles published since 2000. Results: The indications for catheter ablation were refractory arrhythmias unresponsive to drug therapy in most of the cases followed by requirement of cardioversion. Atrioventricular nodal reentrant tachycardia was the most common arrhythmia developed during pregnancy. Pregnancy complications were present in 2.4% of the cases. There was no mortality among the pregnant patients. Fetal adverse events occurred in 3.1% of the cases, more in the fluoroscopy than in the zero-fluoroscopy group. The patient cohort with a radiation dose of > 50 mGy in one-third of the cases had a 14.3% fetal adverse event rate. Fetal adverse events occurred only in the second trimester, not in the other two trimesters. Conclusions: Drug-refractory and poorly tolerated tachycardias in pregnant patients warrant catheter ablation. Zero-fluoroscopy technique under guidance with three-dimensional mapping systems is preferred and strict minimal fluoroscopy is only used in extreme necessity. As ablation in the second trimester was associated with a probable higher fetal adverse event rate, it is suggested that ablation is preferably performed in the third trimester.
Language	English
Publishing date	2022-12-17
Publishing country	Poland
Document type	Journal Article ; Review
ISSN	1734-9338
ISSN	1734-9338
DOI	10.5114/aic.2022.122032
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Surgical treatment of renal cell carcinoma with inferior vena cava tumor thrombus.

Yuan, Shi-Min

Surgery today

2022 Volume 52, Issue 8, Page(s) 1125–1133

Abstract: Purpose: The present report discusses the indications of cardiopulmonary bypass (CPB) in open nephrectomy and surgical outcomes of conventional and minimally invasive surgical techniques for treating advanced renal cell carcinoma with inferior vena cava ...

Abstract	Purpose: The present report discusses the indications of cardiopulmonary bypass (CPB) in open nephrectomy and surgical outcomes of conventional and minimally invasive surgical techniques for treating advanced renal cell carcinoma with inferior vena cava tumor thrombus. Methods: The present study involved a comprehensive retrieval of pertinent literature from the most recent two decades. Results: Comparisons between radical nephrectomy procedures in terms of open, laparoscopic and robotic-assisted surgeries revealed that open surgery had more blood loss, a longer operation time and higher mortality rates than laparoscopic and robotic-assisted surgeries. Furthermore, surgery with CPB was associated with more blood loss than non-CPB surgery. Rates of early and late deaths were much higher in patients with CPB than in those without CPB. Conclusions: Different surgical techniques had different indications in terms of levels of inferior vena cava tumor thrombus. The laparoscopic, robotic-assisted, open surgical techniques and CPB with deep hypothermic circulatory arrest were indicated for Levels I, II, III and III-IV inferior vena cava tumor thrombus, respectively. Laparoscopic and robotic-assisted surgeries cause less trauma than open surgery but require more complicated equipments to support the procedure. CPB should be avoided in radical nephrectomy whenever possible. The increased application of laparoscopic and robotic techniques in the future is anticipated.
MeSH term(s)	Carcinoma, Renal Cell/complications ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/surgery ; Humans ; Kidney Neoplasms/surgery ; Neoplastic Cells, Circulating/pathology ; Nephrectomy/adverse effects ; Nephrectomy/methods ; Thrombectomy/methods ; Vena Cava, Inferior/pathology ; Vena Cava, Inferior/surgery ; Venous Thrombosis/complications ; Venous Thrombosis/surgery
Language	English
Publishing date	2022-01-03
Publishing country	Japan
Document type	Journal Article ; Review
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-021-02429-9
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Article ; Online: Sternal Fractures due to Blunt Chest Trauma.

Yuan, Shi-Min

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2022 Volume 32, Issue 12, Page(s) 1591–1596

Abstract: The present article aimed to give an overview of sternal fractures and discuss their management and prognoses. The retrieved pertinent publications of 2011-2021 constituted the materials of the present study. The misdiagnosis rate of X-ray was 5.5% and ... ...

Abstract	The present article aimed to give an overview of sternal fractures and discuss their management and prognoses. The retrieved pertinent publications of 2011-2021 constituted the materials of the present study. The misdiagnosis rate of X-ray was 5.5% and that of sonography was 6.3% for diagnosing the sternal fractures. There were more patients with complicated than with isolated sternal fractures (98.8% vs. 1.2%, p<0.001). Sternal fractures were treated surgically in 59.5%, conservatively in 39.7%, and staged conservatively and surgically in 0.8% of patients. Extremity fractures, brain injury, lung contusion, and intraabdominal/intraperitoneal injuries were the most common associated injuries to sternal fractures. A small number of patients with sternal fractures have fracture-related delayed complications, most of which require surgical treatments with good outcomes. For solitary sternal fractures, short-term pain relief is sufficient. Most complicated sternal fractures require surgical treatment by sternal fixation. Intrathoracic injuries, especially life-threatening cardiopulmonary injuries that are complicated to sternal fractures warrant resuscitation and corresponding active treatment. The causes of patients' death with sternal fractures were usually not related to the sternum fracture itself, but mostly to the associated injuries. Key Words: Fracture, Sternum, Trauma.
MeSH term(s)	Humans ; Thoracic Injuries/complications ; Thoracic Injuries/surgery ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/surgery
Language	English
Publishing date	2022-11-29
Publishing country	Pakistan
Document type	Journal Article ; Review
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2022.12.1591
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Article ; Online: Percutaneous closure of left ventricular pseudoaneurysm

Shi-Min Yuan

Advances in Interventional Cardiology, Vol 18, Iss 2, Pp 101-

2022 Volume 110

Abstract	The aim of the present study is to describe the indications, treatment effects, and patient outcomes of percutaneous management of left ventricular pseudoaneurysm (LVPA). The study materials were based on comprehensive literature retrieval since 2004. The mechanisms of LVPA formation can be divided into surgical, percutaneous, and medial disease related. Of the surgical mechanisms, coronary artery bypass grafting prevailed. The formation time was the longest in medical disease-related LVPAs up to 44.4 months. The percutaneous procedures succeeded on the first try in 79 (84.9%) patients, whereas failures were encountered during the percutaneous manoeuvres in 14 (15.1%) patients. Percutaneous closure of LVPA was especially indicated for patients carrying a high surgical risk. The iatrogenic traumas, such as left ventricular venting, should be avoided to prevent this complication. The preliminary cut-off valves of oversize 3.3 mm and oversize ratio 1.6 should be followed for reference for device choice.
Keywords	cardiac surgical procedures ; left ventricular pseudoaneurysm ; transcatheter therapy ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pulmonary artery pathologies in Alagille syndrome

Shi-Min Yuan

Advances in Interventional Cardiology, Vol 18, Iss 2, Pp 111-

a meta-analysis

2022 Volume 117

Abstract: Alagille syndrome, caused by mutations in the gene encoding Jagged1 (JAG1), a ligand in the Notch signaling pathway, is an autosomal dominant disorder with developmental abnormalities affecting the liver, heart, eyes, face and skeleton. The aim of the ... ...

Abstract	Alagille syndrome, caused by mutations in the gene encoding Jagged1 (JAG1), a ligand in the Notch signaling pathway, is an autosomal dominant disorder with developmental abnormalities affecting the liver, heart, eyes, face and skeleton. The aim of the present study is try to disclose the clinical features, management and outcomes of pulmonary artery stenosis associated with Alagille syndrome. By comprehensive literature retrieval, 38 articles involving 401 patients were recruited for this study. The pertinent variables closely related to pulmonary artery stenosis in patients with Alagille syndrome were comprehensively analyzed by following the PRISMA guidelines. The management of pulmonary artery pathologies, especially a severe type of pulmonary artery stenosis in Alagille syndrome, is a concerned matter. Publications of literature retrieval of recent 3 decades were the study material of this article. The pulmonary artery pathologies, especially the severe type of pulmonary artery stenosis in Alagille syndrome, warrant surgical or interventional treatments. After the procedures, the right ventricular to left ventricular pressure ratio was reduced by 25%. There were no intergroup differences in terms of recovery, reintervention and mortality rates between interventionally and surgically treated patients. Transcatheter treatment is preferable due to less trauma. Surgical treatment of pulmonary artery stenosis can be performed currently with intracardiac defect repair.
Keywords	alagille syndrome ; cardiac surgical procedures ; pulmonary artery stenosis ; stents ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Post-Myocardial Infarction Left Ventricular Pseudoaneurysm

Shi-Min Yuan

Liaquat National Journal of Primary Care, Vol 4, Iss 1, Pp 38-

A Meta-Analysis

2022 Volume 48

Abstract: Left ventricular pseudoaneurysm (LVPA) is a rare complication of myocardial infarction. The clinical characteristics and treatment of choice in the current era remain to be elaborated. The present article aims to give an overview of post-infarct LVPA and ...

Abstract	Left ventricular pseudoaneurysm (LVPA) is a rare complication of myocardial infarction. The clinical characteristics and treatment of choice in the current era remain to be elaborated. The present article aims to give an overview of post-infarct LVPA and discuss the management strategy and outcomes. The study was based on comprehensive retrieval of literature of the recent 10 years. Myocardial infarctions as the underlying causes of LVPAs were mostly acute myocardial infarctions. The mean time for LVPA formation was 51.7 months after myocardial infarction. Postoperative and follow-up ejection fraction values were significantly higher than preoperative. In the interventional group patients, the oversize ratio of patients in whom devices remained in position was a little larger than that of those with a migrated one, but lack of a statistical significance (1.32±0.25 vs. 1.25±0.21, p=0.707). The mortality rate was significantly higher in the conservative group than in the surgical and interventional groups. Post-infarct LVPAs are curable to surgical aneurysmectomy and left ventricular reconstruction, thereby avoiding unexpected LVPA ruptures and other fatal complications. Elderly patients and patients at a high operative risk may resort to interventional therapy. The conservatively treated patients inevitably carry a considerable risk of death. An oversize ration of >1.3 might be a reference value for preventing device migration in the interventional group patients.
Keywords	aneurysm ; false ; heart ventricles ; cardiac surgical procedures ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Liaquat National Hospital and Medical College
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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