MyMedR

Displaying publications 61 - 69 of 69 in total

Abstract:

Sort:

Is it worth repairing rheumatic mitral valve disease in children? Long-term outcomes of an aggressive approach to rheumatic mitral valve repair compared to replacement in young patients

Krishna Moorthy PS, Sivalingam S, Dillon J, Kong PK, Yakub MA

Interact Cardiovasc Thorac Surg, 2019 02 01;28(2):191-198.
PMID: 30085022 DOI: 10.1093/icvts/ivy234

OBJECTIVES: Contemporary experience in mitral valve (MV) repair for children with rheumatic heart disease (RHD) is limited, despite the potential advantages of repair over replacement. We reviewed our long-term outcomes of rheumatic MV repair and compared them with the outcomes of MV replacement in children with RHD.
METHODS: This study is a review of 419 children (≤18 years) with RHD who underwent primary isolated MV surgery between 1992 and 2015, which comprised MV repair (336 patients; 80.2%) and MV replacement (83 patients; 19.8%). The replacement group included mechanical MV replacements (MMVRs) (n = 69 patients; 16.5%) and bioprosthetic MV replacements (n = 14 patients; 3.3%). The mean age with standard deviation at the time of operation was 12.5 ± 3.5 (2-18) years. Mitral regurgitation (MR) was predominant in 390 (93.1%) patients, and 341 (81.4%) patients showed ≥3+ MR. The modified Carpentier reconstructive techniques were used for MV repair.
RESULTS: Overall early mortality was 1.7% (7 patients). The mean follow-up was 5.6 years (range 0-22.3 years; 94.7% complete). Survival of patients who underwent repair was 93.9% both at 10 and 20 years, which was superior than that of replacement (P

Matched MeSH terms: Heart Valve Prosthesis Implantation/methods*
Outcome of expandable endoprosthesis: A single centre retrospective review

Ajit Singh V, Earnest Kunasingh D, Haseeb A, Yasin NF

J Orthop Surg (Hong Kong), 2019 5 30;27(2):2309499019850313.
PMID: 31138060 DOI: 10.1177/2309499019850313

PURPOSE: Expandable endoprosthesis allows limb salvage in children with an option to leading a better life. However, the revision rate and implant-related complications impose as a limitation in the skeletal immature. This study investigates the functional outcomes and complications related to expandable endoprosthesis in our centre.
MATERIALS AND METHODS: Twenty surviving patients with expandable endoprosthesis from 2006 till 2015 were scored using Musculoskeletal Tumour Society (MSTS) outcomes instrument and reviewed retrospectively for range of motion of respected joints, limb length discrepancy, number of surgeries performed, complications and oncological outcomes. Patients with less than 2 years of follow-up were excluded from this study.
RESULTS: Forty-five percentage patients reached skeletal maturity with initial growing endoprosthesis and 25% of patients were revised to adult modular prosthesis. One hundred fifty-seven surgeries were performed over the 9-year period. The average MSTS score was 90.83%. The mortality rate was 10% within 5 years due to advanced disease. Infection and implant failure rate was 15% each. The event-free survival was 50% and overall survival rate was 90%.
CONCLUSION: There is no single best option for reconstruction in skeletally immature. This study demonstrates a favourable functional and survival outcome of paediatric patients with expandable endoprosthesis. The excellent MSTS functional scores reflect that patients were satisfied and adjusted well to activities of daily living following surgery despite the complications.

Matched MeSH terms: Prosthesis Implantation/methods*
Fulltext Passive Fit in Screw Retained Multi-unit Implant Prosthesis Understanding and Achieving: A Review of the Literature

Buzayan MM, Yunus NB

J Indian Prosthodont Soc, 2014 Mar;14(1):16-23.
PMID: 24604993 DOI: 10.1007/s13191-013-0343-x

One of the considerable challenges for screw-retained multi-unit implant prosthesis is achieving a passive fit of the prosthesis' superstructure to the implants. This passive fit is supposed to be one of the most vital requirements for the maintenance of the osseointegration. On the other hand, the misfit of the implant supported superstructure may lead to unfavourable complications, which can be mechanical or biological in nature. The manifestations of these complications may range from fracture of various components in the implant system, pain, marginal bone loss, and even loss of osseointegration. Thus, minimizing the misfit and optimizing the passive fit should be a prerequisite for implant survival and success. The purpose of this article is to present and summarize some aspects of the passive fit achieving and improving methods. The literature review was performed through Science Direct, Pubmed, and Google database. They were searched in English using the following combinations of keywords: passive fit, implant misfit and framework misfit. Articles were selected on the basis of whether they had sufficient information related to framework misfit's related factors, passive fit and its achievement techniques, marginal bone changes relation with the misfit, implant impression techniques and splinting concept. The related references were selected in order to emphasize the importance of the passive fit achievement and the misfit minimizing. Despite the fact that the literature presents considerable information regarding the framework's misfit, there was not consistency in literature on a specified number or even a range to be the acceptable level of misfit. On the other hand, a review of the literature revealed that the complete passive fit still remains a tricky goal to be achieved by the prosthodontist.

Matched MeSH terms: Prosthesis Implantation
Fulltext Thoracic Endovascular Aortic Repair (TEVAR) in traumatic high-velocity blunt injury to thoracic aorta

Nor Elina NS, Naresh G, Hanif H, Zainal AA

Med J Malaysia, 2013 Jun;68(3):239-44.
PMID: 23749014 MyJurnal
Matched MeSH terms: Blood Vessel Prosthesis Implantation*
Fulltext Endovascular stent graft repair of aorto-iliac pseudoaneurysms - Hospital Kuala Lumpur experience

Khang NC, Zainal AA

Med J Malaysia, 2016 02;71(1):17-22.
PMID: 27130738

BACKGROUND: This is a single institutional review of aortoiliac pseudoaneurysm of various aetiologies managed with endovascular stent graft repair.

METHODS: From 2009 to 2014, 16 patients had endovascular stent graft inserted for pseudoaneurysm of the thoracic aorta, abdominal aorta and iliac arteries in Hospital Kuala Lumpur. Co-morbidity, causative agents, in-hospital mortality, complications and outcomes were examined.

RESULTS: The average age was 59.1 years (range 36-77). Comorbidities include hypertension, diabetes mellitus, tuberculosis, prior infection and previous open aneurysmal repair. All patients had raised WBC (>10.0x10(9) /L), ESR or Creactive protein on admission while 50% of patients had fever. Blood cultures were positive in 4 patients. All patients were given antibiotics. Only one in-hospital mortality was noted at day-47 post-procedure. Two patients died of aortoenteric fistula at district hospital eight and 16 months later. One patient died of chronic graft infection two years later. One died of unrelated cause. One patient developed type IB endoleak from internal iliac artery two years later and surgical ligation was performed. The average follow up was 15.8 months.

CONCLUSION: Endovascular stent graft repair for pseudoaneurysm is a viable option compared to open surgery. It is less invasive, has lower operative morbidity and fair outcomes. However, some cases may be due to inflammatory aortitis instead of infective pseudoaneurysm, given the frequent culture-negative results. In order to obtain high yield of bacteria culture for infected pseudoaneurysm, open repair with tissue culture is still the main mode of treatment especially for patients with low comorbidity.

Matched MeSH terms: Blood Vessel Prosthesis Implantation*
Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent

Inn FX, Ahmed N, Hou LG, Abidin ZAZ, Yi LL, Zainuddin ZM

Int Urol Nephrol, 2019 Nov;51(11):1949-1953.
PMID: 31441009 DOI: 10.1007/s11255-019-02262-7

PURPOSE: The internal drainage provided by a ureteral stent helps with the relief and prevention of ureteral obstruction. By definition, correct stent placement is one with a complete loop in both the renal pelvis and bladder. This prevents stent migration proximally or distally despite urinary flow, patient movement, and ureteral peristalsis.
METHODS: We performed a comparative prospective cross-sectional study assessing the impact of intravesical stent position on the quality of life in 46 patients with a ureteral stent. This is done using the Ureteral Stent Symptom Questionnaire (USSQ).
RESULTS: 52.5% of patients had an ipsilateral positioned intravesical stent, while the remaining had their stent positioned contralaterally. Intravesical stent position significantly influenced the quality of life. The USSQ score was worse for the contralateral group. Subscore analysis found that urinary symptoms and body pain index contribute significantly to the morbidity. Majority of patients in the ipsilateral group reported no discomfort as compared to the contralateral group.
CONCLUSIONS: To the best of our knowledge, this is the first study assessing the impact of intravesical stent position on the quality of life in the Asian population. Intravesical stent position has a significant influence on patient's morbidity and quality of life in particular towards their urinary irritative symptoms and body pain. It is imperative to ensure correct distal placement of ureteric stent that does not cross the midline to the contralateral site. We believe that the USSQ should be used in daily clinical practice in assessing the symptoms related to indwelling ureteric stents.

Matched MeSH terms: Prosthesis Implantation
Fulltext Tracheobronchial stenting is safe and effective in relieving upper airway obstruction

Pang YK, Liam CK, Leow CH, Shyamala P, Zal AR

Med J Malaysia, 2006 Jun;61(2):147-50.
PMID: 16898303 MyJurnal

Many studies have shown that tracheobronchial stenting is effective in relieving respiratory distress secondary to major airway obstruction due to lung or oesophageal cancer. A retrospective review on the benefits and complications of self-expandable metallic stent (SEMS) insertion through flexible bronchoscopy for the palliative treatment of upper airway obstruction in University Malaya Medical Centre was performed. Ten patients underwent this procedure. Relief of dyspnoea was immediate following stent insertion in all patients. Stent migration occurred in one patient and three patients had restenosis of the central airway. We conclude that tracheobronchial stenting via flexible bronchoscopy is feasible and safe.

Matched MeSH terms: Prosthesis Implantation/instrumentation*
Fulltext Update on the management of peripheral arterial disease (PAD)

Liew NC, Moissinac K, Lee L, Gee T, Zezeman RB

Med J Malaysia, 2011 Oct;66(4):386-8; quiz 389.
PMID: 22299571 MyJurnal

There has been much progress made in the management of peripheral arterial disease (PAD) in the past two decades. Progress in the understanding of the endothelial-platelet interaction during health and disease state have resulted in better antiplatelet drugs that can prevent platelet aggregation, activation and thrombosis during angioplasty and stenting. Collaborative effort by different international societies has resulted in a consensus guideline that recommends the modality of intervention in certain disease states. Progress in perioperative care has reduced the morbidity and mortality associated with peripheral vascular reconstruction surgery. Nevertheless, the advances in percutaneous peripheral intervention (PPI) have made a paradigm shift in the current management of patients. The procedure is safe and effective and is emerging as the first choice revascularization procedure.

Matched MeSH terms: Blood Vessel Prosthesis Implantation
Fulltext Management of extensive surgical wounds of the extremity after tumour resections using two simultaneous composite flaps: two case reports

Faisal, A., Ahmad, S.H., Zulmi, W.

Journal of Surgical Academia, 2011;1(1):42-45.
MyJurnal

Tumour surgery for locally extensive malignant neoplasms of the extremity will sometimes result in extensive composite soft tissue defect. Local flaps are usually inadequate to cover these large defects. More than one tissue flap might be required to cover any exposed neurovascular structures, bone or prosthesis. We present two cases where two composite flaps were simultaneously used to cover extensive surgical defects after ablative tumour resections in the extremity. These resulted in uncomplicated wound healing and limb salvage.

Matched MeSH terms: Prosthesis Implantation