Search PubMed⌕ Search

Biomedical subjects

Z C Weng

Publications and source records attributed to Z C Weng.

24 records · Page 2Linked to original sources

Simulated left ventricular aneurysm and aneurysm repair in swine.

Patch reconstruction of left ventricular aneurysm may be superior to linear closure, but this hypothesis has not been tested experimentally. Accordingly, six anesthetized domestic pigs were instrumented to measure regional left ventricular wall thickening, stroke volume, systolic left ventricular pressure, and myocardial oxygen consumption. With total bypass and cardioplegia, a 6 by 8 cm Dacron patch was inserted into the anteroapical left ventricle. Simulations were as follows: left ventricular aneurysm, patch open; patch reconstruction, 50% patch plication; standard repair, ventriculotomy edges approximated. Global function, from stroke work (stroke volume x integral of left ventricular pressure)-left ventricular end-diastolic pressure curves, was depressed in all three simulations compared with control. A tendency for stroke work to be greater for standard repair than for left ventricular aneurysm and patch reconstruction at higher preloads was not statistically significant. Mechanical efficiency, from stroke work/myocardial oxygen consumption (joules per milliliter oxygen per beat), was 2.43 +/- 0.52 (mean +/- standard error of the mean) (control), 2.22 +/- 0.94 (standard repair), 1.27 +/- 0.39 (patch reconstruction), and 1.09 +/- 0.37 (left ventricular aneurysm) (no significant differences). Regional work was calculated as regional left ventricular wall thickening x integral of left ventricular pressure. The slope of the regional work-end-diastolic wall thickness relation decreased in the posterior wall 14.0 +/- 2.9 (control) versus 8.4 +/- 2.0 (left ventricular aneurysm), 6.9 +/- 1.4 (patch reconstruction), and 7.4 +/- 1.4 (standard repair) (p less than 0.05). In the anterior wall, contractility did not change significantly (7.4 +/- 1.2, control; 7.8 +/- 2.7, left ventricular aneurysm; 5.0 +/- 0.4, patch reconstruction; and 5.3 +/- 0.4, standard repair). Decreased end-diastolic wall thinning anteriorly suggested tethering. These results in the normal left ventricle suggest that patch ventriculoplasty is of no greater benefit than linear repair. Either repair may impede function of adjacent myocardium through restriction of regional diastolic lengthening.

Animals↗

[Results of vascular reconstruction in lower limbs ischemia: a six-year clinical experience].

During the period between Dec. 1982 to Nov. 1988, a total of 412 patients with 471 limbs at risk of peripheral arterial occlusive disease underwent vascular surgical treatment at the Veterans General Hospital. There were 382 men and 30 women, who ranged in age from 20 to 84 years (mean 63.17 +/- 11.85 years). 95 cases were isolated aortoiliac occlusive disease, 94 cases were combined aortoiliac and femoropopliteal disease, 169 cases were femoropopliteal occlusive disease and 54 cases were femorotibialperoneal occlusive disease. Various reconstructive procedures were performed in the these patients. The cumulative limb salvage rate (LSR) exceeded cumulative patency rate (CPR) in all categories and the result of LSR and CPR were 97.6% and 91% for aortoiliac reconstructive surgery in six years, 96% and 77% for above-knee femoropopliteal saphenous vein bypass (SVB) in six years, 79% and 74% for below-knee femoropopliteal SBV and 63% and 34% for femoro-distal SVB in five years. 88% and 76% for above-knee femoropopliteal human umbilical vein (HUV) bypass in four years. 67% and 45% for femoro-distal HUV bypass in three years follow-up period individually. The immediate good symptomatic results of the vascular reconstruction was 88% encountered in isolated aortoiliac disease, 63% in combined aortoiliac and femoropopliteal disease, 70.4% in isolated femoropopliteal disease and only 26% in femorotibial-peroneal disease (FTP). No change symptoms was still higher (33%) in FTP than the other vascular reconstruction due to poor distal runoff in this series. The early postoperative mortality rate was 1.6%, the late mortality rate was 2.7%, the incidence of postoperative complication rate was 13.6%. The major lower limb amputation rate was low as 7% in our series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Transcatheter stent treatment for congenital peripheral pulmonary arterial stenosis.

A total of 5 Johnson and Johnson stents were implanted in two patients with significant residual peripheral pulmonary arterial stenosis. These were a 15-year-old boy with post-open heart surgery for tetralogy of Fallot and a 3 8/12 year-old boy with D-transposition of great vessels. Immediately after balloon dilatation and implantation of the stents, the diameter of the narrowing pulmonary arteries increased significantly from 6.0 +/- 0.8 mm to 13.5 +/- 1.7 mm (P < 0.001) and the systolic pressure gradients across the stenosis of peripheral pulmonary artery dropped significantly from 33.0 +/- 16.0 mmHg to 10.2 +/- 4.4 mmHg (P < 0.01). One year later, repeated cardiac catheterization was performed on both patients. In the patient with tetralogy of Fallot, a 20 mmHg pressure gradient was found between the main and left pulmonary artery. This patient then received another stent implantation to release the residual stenosis. The boy with D-transposition of great vessels had only 9 mmHg gradient between main and right pulmonary artery. Transcatheter placement of the stent is a feasible and effective method to treat certain patients with significant pulmonary arterial stenosis if surgical correction can not be performed.

Adolescent↗