• Clinical and Experimental Pediatrics
• /
• v.53 no.12
• /
• pp.1012-1017
• /
• 2010

Purpose: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. Methods: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable $Coil^{(R)}$, PFM Nit-$Occlud^{(R)}$, or Amplatzer duct $occluder^{(R)}$. A retrospective review of the treatment results and complications was performed. Results: The mean age of patients was $9.1{\pm}5.9$ months (median, 8 months), and mean weight was $7.6{\pm}1.8kg$ (median, 7.8 kg). The mean diameter of PDA was $3.2{\pm}1.4mm$ (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was $3.0{\pm}3.3$ days, and mean follow-up duration was $21.0{\pm}19.6$ months. There were no major complications in any of the patients. Conclusion: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

• Journal of Chest Surgery
• /
• v.54 no.6
• /
• pp.449-453
• /
• 2021

The 2020 American College of Cardiology focused update on the mitral regurgitation (MR) pathway provides an excellent summary of the decision-making trees in the treatment of severe MR, in which 2 main branches of the flowchart are suggested depending on whether MR is primary or secondary. Surgery is suggested as preferable over transcatheter edge-to-edge repair (TEER) in primary MR that needs intervention. The decision-making for secondary MR generally prioritizes TEER over surgery according to the guidelines, but further stratification is necessary based on the pathophysiologic mechanisms of MR. TEER is probably the more suitable option in secondary MR caused by left ventricular dysfunction or dilatation, given the high perceived surgical risks, despite the lack of sufficient evidence in support of overt clinical benefits from surgical therapy in these patients. In atrial functional MR associated with atrial fibrillation (AF), however, concomitant ablation of AF seems to be a desirable option, as it has been demonstrated to be a key factor leading to improved survival, reduced stroke risk, and more durable mitral and tricuspid function in patients undergoing mitral surgery. Therefore, atrial functional MR requiring intervention may be best treated by surgical therapy that combines mitral repair and AF ablation in the majority of patients. This particular issue, however, needs further research to obtain scientific evidence to guide optimal management strategies.

• Clinical and Experimental Pediatrics
• /
• v.49 no.9
• /
• pp.930-936
• /
• 2006

Although antiarrhythmic medication has been the main treatment modality for arrhythmia in children, in recent decades technological development and computerization have made great advances in nonpharmacological therapy. This article reviews the transcatheter radiofrequency ablation for tachycardia in children, recent advances of device therapy for bradycardia, antitachycardia pacing, implantable cardioverter defibrillator. As a new field of device therapy, cardiac resynchronization therapy for congestive heart failure is also mentioned.

• Journal of Yeungnam Medical Science
• /
• v.41 no.2
• /
• pp.96-102
• /
• 2024

Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.12
• /
• pp.6257-6261
• /
• 2012

Objective: To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE), combined with portal vein embolization (PVE), and high intensity focused ultrasound (HIFU) sequential therapy in treating patients with hepatocellular carcinoma (HCC). Methods: Patients with inoperative HCC were treated by two methods: in the study group with TACE first, then PVE a week later, and then TACE+PVE every two months as a cycle, after 2~3 cycles finally HIFU was given; in the control group only TACE+PVE was given. Response (CR+PR), and disease control rate (CR+PR+SD), side effects, overall survival and time to progress were calculated. Results: Main side effects of both groups were nausea and vomiting. No treatment related death occurred. In the study group, 32 patients received TACE for overall 67 times, PVE 64 times, and HIFU 99 times; on average 2.1, 2 and 3.1 times for each patient, respectively. In the control group, 36 patients were given TACE 78 times and PVE 74 times, averaging 2.2 and 2.1 times per patient. Effective rate: 25.0% in study group and 8.3% in control group (p>0.05). Disease control rates were 71.9% and 44.4%, respectively (p<0.05). In patients with portal vein tumor thrombus, the rate reduced over 1/2 after treatment was 69.2%(9/13) in the study and 21.4%(3/14) in the control group (p<0.05). Rate of AFP reversion or decrease over 1/2 was 66.7%(16/24) in study and 37%(10/27) (p<0.05) in control group. Median survival time: 16 months in study and 10 months in control group. PFS was 7months in study and 3 months in control group. Log-rank test suggested that statistically significant difference exists between two groups (p=0.024). 1-, 2- and 3-year survival rates were 56.3%, 18.8% and 9.3% in study, while 30.6%, 5.6% and 0 in control group, respectively, with statistically significant difference between two groups (by Log-rank, p = 0.014). Conclusions: The treatment of TACE+PVE+HIFU sequential therapy for HCC increases response rate, prolong survival, and could thus be a safe and effective treatment for advanced cases.

• Clinical and Experimental Pediatrics
• /
• v.51 no.4
• /
• pp.401-408
• /
• 2008

Purpose : Transcatheter closure of atrial septal defects (ASD) is currently established therapy as an alternative to surgery. But rarely, complications are reported in some studies. We report early and intermediate term complications associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder (ASO). Methods : From June 2003 to May 2006, 64 patients underwent transcatheter closure of secundum ASD or patent foramen ovale using the ASO. The ratio of male to female was 1:2.4, the median age was 17 years (range: 2.6-64 years) and their median weight was 47.5 kg (range: 2.6-64 kg). Results : The median diameter of ASD measured with transthoracic or transesophageal echocardiography was 15 mm (range: 6-28 mm), the median balloon stretched diameter was 18 mm (range: 6.5-34 mm), and the median size of device was 19.5 mm (range: 6-36 mm), was little difference with balloon stretched diameter. There were 10 cases of complications: arrhythmia (2), device malformation (2), aorta to right atrial fistula (1), hemolytic anemia (1), mitral valve encroachment (1), malposition (1), residual shunt (1), and inferior vena cava perforation (1). Conclusion : Transcatheter closure of ASD using ASO is effective and safe therapy. However, significant complications such as aorta to atrial fistula, atrial erosion, or device embolization can happen, so an appropriate selection of patient and device in relevance to size and anatomy of ASD is important for successful closure.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.2057-2060
• /
• 2014

Purpose: To assess the effect and safety of lobaplatin combinated floxuridine /pirarubicin in transcatheter hepatic arterial chemoembolization(TACE) of unresectable primary liver cancer. Patients and Methods: TACE combined with the chemotherapy regimen was used to treat 34 unresectable primary liver cancer patients. DSA/MRI/CT/blood routine examinations were used to evaluate short term activity and toxicity after 4-5 weeks, the process being repeated if necessary. Results: Among the 34 cases, 1 (2.9%) showed a complete response, 21 (61.7%) a partial response, 8 (23.5%) stable disease, and 4 progressive disease, with a total effective rate of 67.6%. The content of alpha fetoprotein dropped by over 50% in 20 cases (58.8%). The rate of recovery was hepatalgia (88.2%), ascites (47.1%), appetite (55.9%), Performance Status(30.4%). The median follow-up time (MFT) was 281 days (63-558 days), and median progression-free survival was 118.5 days (95%, CI:88.8-148.2days). Adverse reactions (III-IV grade) were not common, with only 4 cases of vomiting and 2 cases of thrombocytopenia (III grade). Conclusions: Lobaplatin-based TACE is an effective and safe treatment for primary liver cancer.

• Journal of the Korean Society of Radiology
• /
• v.81 no.6
• /
• pp.1453-1458
• /
• 2020

Retroperitoneal hemorrhage is a potentially lethal complication in patients on anticoagulant therapy and can be caused by ovarian artery bleeding, regardless of the patients' age and obstetric history. This case illustrates the clinical presentation of ovarian artery bleeding in a postmenopausal female on anticoagulant therapy, the diagnostic utility of transcatheter angiography, and successful embolization.

• Korean Journal of Adult Nursing
• /
• v.15 no.1
• /
• pp.116-125
• /
• 2003

Purpose: This study was to evaluate the importance of liver cancer patient's diet and to provide guideline materials for proper nursing intervention. Method: The hermeneutic phenomenological method of van Manen was applied for the in-depth interview of liver cancer patients and the cultural background studies including linguistic, literary and art works to enhance the insight and understanding, from which the meaning of the cognition and lesson of the experiences were extracted. The participants for this study were five male patients, who had been diagnosed with liver cancer, 5-15 years ago and had been treated with Transcatheter Arterial Embolization without chemotherapy. The repeated interview and close observation were carried out for nine months starting from January 2001 in Seoul, Korea. Result: Eight essential themes were emerged ; (1) confliction(frustration) with hospital treatment (2) trial of every possible remedies (3) liking unpolluted natural foods(4) faithful tolerance (5) experiencing diet effectiveness (6) discovering personal control methods (7) deepen their faith in God (8) searching for healthy new life. Conclusion: The alternative diet therapy influenced their life beyond the physical overcoming of cancer toward psychological and spiritual healing. The study evidenced the necessity for scientific research and education on the effectiveness and application of complementary and alternative diet therapy for the treatment of cancer in hospital practices.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.4
• /
• pp.2491-2494
• /
• 2013

Background: To evaluate the relative effectiveness of different treatments of hepatocellular carcinoma (HCC) via the hepatic artery. Materials and Methods: The study sample group consisted of 418 patients who were randomly selected from 2008 to 2012 with a first diagnosis of HCC and treated with transcatheter arterial chemoembolization (TACE) or without (TAE) chemotherapy or transcatheter arterial infusion (TAI). We collected data including tumor size preoperative and one month thereafter to compare change in areas across the three groups, along with various laboratory indexes for comparison. Results: The overall average change of areas was $240.8{\pm}72.1mm^2$. In the three groups it was $265.0{\pm}58.0mm^2$ vs. $250.5{\pm}51.9mm^2$ vs. $123.7{\pm}26.2mm^2$. In groups TACE and TAE values were larger than in group TAI (p<0.01), but the difference between the two was not statistically significant (p= 0.191). Additionally, U/L change of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in groups TACE and TAE was greater than in the TAI cases ($24.0{\pm}13.5$ vs. $20.9{\pm}12.1$ vs. $5.47{\pm}8.20$ and $25.6{\pm}13.5$ vs.$23.2{\pm}12.28$ vs.$5.48{\pm}14.3$) on the preoperative day and two days thereafter (p<0.01). Between the two groups there was no significant cariation (p= 0.320 and p= 0.609). However, the AST and ALT recovered to normal levels one month later on therapy with liver protecting drugs. Conclusion: The groups TACE and TAE demonstrated more effective reduction of tumor size than group TAI. While lipiodol caused acute liver function damage, this proved reversible.