Journal of Yeungnam Medical Science

Original article

Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study: Chul Ho Lee, Jae Seok Jang, Jun Woo Cho; J Yeungnam Med Sci. 2022;39(4):294-299. Published online February 10, 2022; DOI: https://doi.org/10.12701/jyms.2021.01690

3,321 View
60 Download

Abstract PDF: Background
Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD.
Methods
We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into long-term ICU stay (LIS) and short-term ICU stay (SIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared.
Results
Fifty-five patients were treated for uncomplicated ATBAD (n=26 for LIS and n=29 for SIS). The incidence of pneumonia (7.7% vs. 3.6%) and delirium (34.6% vs. 14.3%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (LIS: 96.2%, 88.0%, and 54.2% vs. SIS: 96.4%, 92.2%, and 75.5%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events.
Conclusion
Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Original Articles

Investigation of right ventricle function in patients with tetralogy of Fallot after total correction using cardiac magnetic resonance imaging: Woo Sung Jang, Hee Joung Choi, Jong Min Lee, Jae Bum Kim, Jae Hyun Kim, Jae Seok Jang; Yeungnam Univ J Med. 2017;34(2):238-241. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.238

2,118 View
6 Download

Abstract PDF: BACKGROUND
We investigated the difference in right ventricle (RV) volume and ejection fraction (EF) according to the pulmonary valve (PV) annular extension technique during Tetralogy of Fallot (TOF) total correction. METHODS: We divided patients who underwent the procedure from 1993 to 2003 into two groups according to PV extension technique (group I: PV annular extension, group II: no PV annular extension) during TOF total correction. We then analyzed the three segmental (RV inlet, trabecular and outlet) and whole RV volume and EF by cardiac magnetic resonance imaging (MRI). RESULTS: Fourteen patients were included in this study (group I: 10 patients, group II: four patients; male: nine patients, female: five patients). Cardiac MRI was conducted after a 16.1 years TOF total correction follow-up period. There was no statistical difference in RV segmental volume index or EF between groups (all p>0.05). Moreover, the total RV volume index and EF did not differ significantly between groups (all p>0.05). CONCLUSION: The RV volume and EF of the PV annular extension group did not differ from that of the PV annular extension group. Thus, PV annular preservation technique did not show the surgical advantage compared to PV annular extension technique in this study.

Comparison of symptomatic and asymptomatic pulmonary embolism in proximal deep vein thrombosis: Dong Hun Kim, Young Woo Seo, Gyun Moo Kim, Seung Hyun Ko, Jae Seok Jang, Tae Chang Jang; Yeungnam Univ J Med. 2017;34(2):231-237. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.231

2,581 View
13 Download

Abstract PDF: BACKGROUND
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are conditions with significant morbidity and mortality. Proximal DVT has a significant association with PE and possible fatal outcomes. Traditionally, PE is subdivided into symptomatic PE and asymptomatic PE, which have different treatments, preventions and prognoses. The growing utilization of computed tomography pulmonary angiography has led to increased detection of PE in DVT patients. This study examined the clinical characteristics and compared symptomatic PE and asymptomatic PE following proximal DVT. METHODS: The medical records of 258 DVT inpatients from July, 2012 to June, 2015 were reviewed retrospectively. After excluding the patients who did not performed PE evaluation and were not diagnosed with PE, 95 patients diagnosed with PE following proximal DVT were enrolled in this study. They were divided into the symptomatic PE group and asymptomatic PE group. RESULTS: The body weight, body mass index, thrombus size, thrombus length and location were similar in the two groups. The symptomatic PE following proximal DVT group showed an older age, higher incidence of emergency department access (85.0% vs. 38.7%, p < 0.001) and preceding infection (25.0% vs. 1.3%, p < 0.001) as well as a higher incidence of immobilization (45.0% vs 13.3%, p=0.016). In the multivariate logistic regression study, preceding infection and emergency department access showed significant association with symptomatic PE. CONCLUSION: In proximal DVT inpatients, symptomatic PE was associated with emergency department access and preceding infection. The possibility of a symptomatic PE event should be considered in proximal DVT patients, especially those who were admitted through the emergency department and had preceding infection.

First
Prev
Page of 1
Next
Last

Search