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Biomedical subjects

C H Chang

Publications and source records attributed to C H Chang.

795 records · Page 45Linked to original sources

Femoro-arterial bypass using Gott shunt in liver transplantation following severe hepatic trauma.

The heparinized-coated tube is widely used for arterial bypass, mainly in patients with aneurysms or trauma of the thoracic aorta. Its application in venous bypass was less frequent. We report a 26-year-old woman who sustained blunt abdominal injury which resulted in complete severance of the suprahepatic hepatic vein and multiple partial lacerations of the inferior vena cava. For hemostasis, total hepatectomy with interruption of the inferior vena cava was performed. During the anhepatic phase, end-to-end portocaval anastomosis and a bypass shunt using 9 mm Gott tube from the right femoral vein to the right atrium were set up for veno-venous bypass. Orthotopic liver transplantation was performed later. Gott tube was placed for 18 hours with good venous return. We concluded that heparinized-coated tube is good for veno-venous bypass with the following advantages: 1) simple operative procedure, 2) enough flexibility to be kept out of the operative field, 3) no anticoagulant is necessary, consequently less bleeding resulted.

Adult↗

[Congenital esophageal stenosis with submucosal fibrosis: report of one case].

Esophageal stenosis due to an intrinsic congenital factor is uncommon in infancy. We report a case of a male newborn infant, who was well at birth and presented with foamy sputum from the third day of life and vomiting at 18 days of age. Esophagogram revealed a narrowed segment, about 1 cm in length, at the level of the seventh and eighth cervical vertebral bodies, with proximal dilatation. There was no sign of gastroesophageal reflux. Operative findings: There was no external compression, foreign body or fistula, but a 1 cm length of esophageal stenosis was found. The stenosed segment was hard on palpation. Segmental resection of the stenosed region, with direct anastomosis of the esophagus was performed. Pathological examination of the narrowed segment revealed fibrosis of the submucosa without any tracheobronchial remnent components.

Esophageal Stenosis↗

Arterial switch operation in a neonate with simple transposition of great arteries.

Transposition of the great arteries (TGA) is characterized by severe and life-threatening hypoxemia during a newborn period. Without treatment, most of the patients die during early infancy. We reported a 20-day-old male newborn who was referred to our hospital due to severe cyanosis and respiratory distress. Echocardiograms revealed D-TGA with an intact ventricular septum. There was no pulmonary stenosis or other major cardiac anomalies. The cardiac catheterization and angiographic findings which were performed 4 days later were consistent with the diagnosis of echocardiography. The systolic left and right ventricular pressures were 65 and 69 mmHg respectively. Arterial switch operation was performed at the age of 28 days. Postoperative course was uneventful. The cardiac recatheterization and angiographic study performed 6 months after operation, and the latest non-invasive examination including chest X-ray, electrocardiogram and echocardiographic assessment revealed good ventricular performance and normal semilunar valve function. There was no obstruction at the anastomotic site. The patient has been doing well with regular follow-up at our clinic for 2 years and 6 months without medication.

Arteries↗