Ming-Huei Sheu

National Yang Ming University, T’ai-pei, Taipei, Taiwan

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Publications (36)82.7 Total impact

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    ABSTRACT: Management of diseases of the descending thoracic aorta is trending from open surgery toward thoracic endovascular aortic repair (TEVAR), because TEVAR is reportedly associated with less perioperative mortality. However, comparisons between TEVAR and open surgery, adjusting for patient comorbidities, have not been well studied. In this nationwide population-based study, we compared the outcomes between TEVAR and open surgery in type B aortic dissection. From 2003 to 2009, data on patients with type B aortic dissection who underwent either open surgery or TEVAR were obtained from the National Health Insurance Research Database. Survival, length of stay, and complications were compared between TEVAR and open repair. To minimize possible bias, we performed an additional analysis after matching patients by age, sex, and propensity score. A total of 1661 patients were identified, of whom 1542 underwent open repair and 119 TEVAR. Patients in the TEVAR group were older (63.0 ± 15.4 years vs. 58.1 ± 13.1 years; p = 0.001), included more males, and had more preoperative comorbidities. Thirty-day mortality in the TEVAR group was significantly lower than that in the open repair group (4.2% vs. 17.8%; p < 0.001). The midterm survival rates in the unmatched cohort between the open surgery and TEVAR groups at 1 year, 2 years, 3 years, and 4 years were 76%, 73%, 71%, and 68% vs. 92%, 86%, 82%, and 79%, respectively. The length of stay in the TEVAR group was shorter than that in the open repair group (p = 0.001). The TEVAR group had less respiratory failure (p = 0.022) and fewer wound complications than the open repair group (p = 0.008). The matched cohort showed similar results. TEVAR for type B aortic dissection repair has less perioperative mortality, a shorter length of hospitalization, a higher midterm survival rate, less postoperative respiratory failure, and fewer wound complications than open surgery. Copyright © 2015. Published by Elsevier Taiwan.
    No preview · Article · Feb 2015 · Journal of the Chinese Medical Association
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    ABSTRACT: To retrospectively analyze the efficacy and short- to mid-term survival rate of cryoablation for malignant lung tumors METHODS: Percutaneous CT-guided cryoablation for 45 malignant lung tumors in 26 patients during 41 sessions from 2009-2013 were performed. Follow up CT-scan were used to determine local tumor progression. Survival rate, local tumor control rate and associated risk factors were analyzed. The immediate during and short-term complications with CTCAE grade 2 or upper include pneumothorax (15%), pleural effusion (20%), pulmonary hemorrhage (24%), pneumonitis (15%), hemothorax (15%), hemoptysis (10%), pain (20%), bronchopleural fistula (n=1), and empyema (n=2). Life-threatening bleeding or hemodynamic instability was not observed. There was no procedural-related mortality. Overall survival rate of 1, 2, 3 years are 96%, 88%, 88%. For curative intent, local tumor control (LTC) rate of 1, 2, 3 years are 75%, 72%, 72%. Cryoablation for malignant lung tumors is effective and feasible in local control of tumor growth, with good short- to mid-term survival rate, as an alternative option for inoperable patients. Copyright © 2014. Published by Elsevier Inc.
    No preview · Article · Dec 2014 · Cryobiology
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    ABSTRACT: Background Context CT scans of the lumbar spine (CTLS) have demonstrated a higher level of accuracy than plain film, and have been used to assess patients with spinal disorder when MR is not available. Nevertheless, radiation exposure remains a serious safety concern. Iterative reconstruction (IR) decreases the CT radiation dose for diagnostic imaging. However, the feasibility of using IR in CTLS is unclear. Purpose To evaluate the imaging quality and diagnostic reliability of CTLS with IR. Study Design/Setting A prospective study. Patient Sample All patients from out-patient departments who suffered from spinal disorders and were referred for CTLS Outcome Measures In acquired CT images, the signal-to-noise ratio (SNR) of the dural sac (DS), intervertebral disc (IVD), psoas muscle (PM), and L5 vertebral body (BM), the contrast-to-noise ratio between the dural sac and the intervertebral disc (D-D CNR), and the subjective imaging qualities were compared across groups. Inter-observer agreement was evaluated with Kappa values. The study was supported by a grant from our institution. Methods Patients receiving low radiation CTLS were divided into three groups. A 150 mAs tube current with 120 kVp tube voltage was used with group A and a 230 mAs tube current with 100 kVp tube voltage with group B. Intended end radiation exposure was 50% less than that of the control group. Tube modulation was active for all groups. The images of the two low-radiation groups were reconstructed by IR; those of the control group by filtered back projection. Results The SNRs of the DS, IVD, PM, BM, and D-D CNR of group A were not inferior to those of the control group. All SNRs and D-D CNRs for group B were inferior to those of the control group. Except for that of the facet joint, all subjective imaging ratings for anatomic regions were equivalent between groups A and B. Inter-observer agreement was highest for the control group (0.72-0.88), followed by group A (0.69-0.83) and group B (0.55-0.83). Conclusions Fifty percent tube current reduction combined with IR provides equivalent diagnostic accuracy and improved patient safety when compared with conventional CTLS. Our results support its use as a screening tool. With the tube modulation technique, further adjustments in weighting IR and FBP algorithms based on BMI become unnecessary.
    Full-text · Article · Nov 2014 · The spine journal: official journal of the North American Spine Society
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    ABSTRACT: In this study, we assessed the association between the tortuosity of the thoracic aorta as measured by the reporting standards for thoracic endovascular aortic repair (TEVAR), described by the Society for Vascular Surgery, and midterm outcomes after TEVAR for atherosclerotic aneurysms. We analyzed 77 consecutive patients who underwent TEVAR for atherosclerotic aneurysms from November 2006 through May 2013 in a single institution. The preoperative aortic tortuosity index (TI) was calculated by computed tomography aortography, and patients were divided into low-tortuosity (TI ≤ 1.29) and high-tortuosity (TI > 1.29) groups. The relationships between TI and the occurrence of endoleaks, complications, and survival were analyzed. The mean follow-up period was 29 ± 26 months. During this period, endoleaks occurred in 19 patients. Patients in the high-tortuosity group were at greater risk for endoleaks (odds ratio, 9.95; 95% confidence interval, 2.06-48.1; P = .004) and stroke (odds ratio, 13.2; 95% confidence interval, 1.03-169; P = .047) than those in the low-tortuosity group. The overall survival at 1, 3, and 5 years was 73%, 69%, and 63%, respectively, for the high-tortuosity group and 92%, 92%, and 86%, respectively, for the low tortuosity group. Our findings demonstrated that high tortuosity of the thoracic aorta is associated with higher rates of endoleaks and lower survival in patients undergoing TEVAR for atherosclerotic aneurysms. Patients with aneurysms in a highly tortuous aorta may therefore need greater attention in preoperative planning, perioperative procedures, and follow-up examinations.
    No preview · Article · May 2014 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
  • Chun-Ku Chen · Hsiao-Ping Chou · Ming-Huei Sheu
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    ABSTRACT: Image-guided tumor ablation for lung malignancies has emerged as a treatment modality for medically inoperable patients. Overall, image-guided lung tumor ablation is a minimally invasive procedure that has an acceptable safety profile and less impact on lung function. This is important for patients with poor pulmonary and/or cardiac functions or with multiple comorbidities, which prevent them from undergoing surgery, chemotherapy, and radiation therapy. Herein, we review the principle, techniques, clinical application, and patient outcomes of image-guided lung tumor ablation.
    No preview · Article · Apr 2013 · Journal of the Chinese Medical Association
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    ABSTRACT: Small bowel angioedema is a rare adverse effect of iodinated contrast medium. Here, we report the first case of contrast medium-induced small bowel angioedema with concurrent respiratory tract symptoms. A patient with colon cancer underwent CT scanning for preoperative staging. After injection of the contrast medium, a persistent cough developed and CT images showed that the small bowel wall was abnormally thickened. It returned to normal by the follow-up. The persistent coughing that developed right after the CT and small bowel wall thickening on the contrast-enhanced CT suggested the diagnosis of small bowel angioedema induced by the contrast medium.
    No preview · Article · Jul 2012 · Clinical imaging
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    ABSTRACT: Analysis of the coronary artery calcium levels usually provides important information that can be used in patient prognosis and stratification of treatment when coronary artery disease is suspected. However, plaques, with or without significant stenosis, have been reported in patients without coronary artery calcium. The aim of this study was to determine the frequency and risk factors of the development of coronary artery plaques in individuals with a zero calcium score. Analysis of coronary artery calcium levels and coronary computed tomography angiography (CTA) were performed using 64-slice computed tomography (CT). The demographic data, clinical risk factors, and imaging features of 519 consecutive patients (54 ± 10 years, male:female ratio of 56:44) were retrospectively analyzed. The presence of plaques and the degree of the resulting stenosis were recorded. Descriptive, univariate, and multivariate analyses were carried out to identify the frequency and risk factors associated with the presence of coronary artery plaques. Among 66 patients, 82 coronary arteries were found to have plaques, and six coronary arteries showed significant stenosis. Univariate analysis showed that an age greater than 55 years, male gender, a body mass index (BMI) of more than 27, hypertension, and diabetes mellitus are significant factors associated with the development of coronary artery plaques. Multivariate logistic regression analysis showed that an age over 55 years (p = 0.012, OR = 2.13, 95% C.I. = 1.18-3.84) and BMI greater than 27 (p = 0.026, OR = 2.01, 95% C.I. = 1.09-3.72) are independent factors associated with the presence of plaques in patients with a zero calcium score. The results of this study show that plaques are present in a significant proportion of individuals with a zero coronary artery calcium score. In addition, advanced age and obesity are risk factors associated with the development of plaques.
    Preview · Article · Jan 2012 · Journal of the Chinese Medical Association
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    ABSTRACT: Aberrant systemic arteries supplying the intralobar pulmonary sequestration can become dilated and have atherosclerotic change. Computed tomography is very useful in demonstrating the aberrant artery. We report a case of intralobar pulmonary sequestration with giant branching aneurysmal aberrant artery, and demonstrated the discontinuity of the bronchus by 64-slice computed tomography, which has not previously been described.
    Preview · Article · Aug 2011 · Journal of the Chinese Medical Association
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    ABSTRACT: Myocardial bridging (MB) is a congenital structural variant in which a segment of the epicardial coronary artery tunnels into and is surrounded by the myocardium. MB has been correlated to some clinical complications of cardiovascular disease (CVD). The depiction rate of MB varies significantly between catheter coronary angiography and autopsy studies. This study aimed to assess the depiction rate of MB among Taiwanese by coronary computed tomographyic angiography (CCTA), to determine the anatomical features of the tunneling vessels, and to evaluate the outcome of patients having MB.
    Preview · Article · Apr 2011 · Journal of the Chinese Medical Association
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    ABSTRACT: Epicardial adipose tissue (EAT) contains ganglionated plexuses and adipocytes that can affect the pathogenesis of atrial fibrillation (AF). The aim of this study was to quantify the EAT surrounding the left atrium (LA) and correlate it with occurrence of AF and outcome after catheter ablation. EAT was evaluated using 64-slice multidetector computed tomography in 68 patients with AF and 34 controls. EAT volume was acquired by semiautomatically tracing axial images from the pulmonary artery to the coronary sinus. Topographic distribution of EAT was assessed by dividing the periatrial space into 8 equal regions. EAT volume significantly increased in patients with AF than in controls (29.9 ± 12.1 vs 20.2 ± 6.5 cm(3), p <0.001). Most EAT was located in regions (1) within the superior vena cava, right pulmonary artery, and right-sided roof of the LA (29.8%), (2) within the aortic root, pulmonary trunk, and left atrial appendage (26.5%), and (3) between the left inferior pulmonary vein and left atrioventricular groove (18.1%). Baseline variables were analyzed in patients with (n = 24) and without (n = 44) AF recurrence after ablation. The recurrent group showed significantly increased EAT (35.2 ± 12.5 vs 26.8 ± 11.1 cm(3), p = 0.007). Multivariate analysis revealed that EAT was an independent predictor of AF recurrence after ablation (p = 0.038). In conclusion, EAT of LA was increased in patients with AF. Large clusters of EAT were observed adjacent to the anterior roof, left atrial appendage, and lateral mitral isthmus. Abundance of EAT was independently related to AF recurrence after ablation.
    No preview · Article · Mar 2011 · The American journal of cardiology
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    Hsiao-Ping Chou · Chun-Ku Chen · Ming-Huei Sheu · Mei-Han Wu

    Preview · Article · Mar 2011 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery
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    ABSTRACT: Understanding pulmonary vein (PV) function before and after catheter ablation can validate the benefit of the treatment and provide mechanistic insight into atrial fibrillation (AF). This study was aimed to investigate the functional remodeling process of PVs by multi-detector computed tomography (MDCT). We assessed the dynamic function of four PVs by MDCT at systolic and diastolic phases. Twelve points around each PV ostium were used to assess the magnitude and abnormalities of the regional wall motion. The axis of PV shifting during cardiac cycle was also determined. Seventy-four paroxysmal AF patients and 29 controls were enrolled. In those of AF, the superior PVs had poorer contractile function (ejection fraction: P = 0.01 for left; P = 0.009 for right; magnitude of the motion: P = 0.01 for left; P = 0.02 for right) which mainly resulted from the decreased movement of the posterior wall. In contrast, the function of inferior PVs was similar between two groups. After a mean follow-up of 158 ± 95 days, the PV motion improved in the patients without any AF recurrence. In addition, analysis of the pre-ablation PV function showed that the angles, which shifted during cardiac cycle of left (P = 0.035) and right (P = 0.014) inferior PV, were significantly decreased in recurrent patients. The contractile function of the superior PVs was impaired in paroxysmal AF patients. This was attributed to the hypokinesia of the posterior wall of PVs and improved after circumferential ablation in the patients without recurrence. MDCT images can effectively delineate the functional characteristics of PVs.
    No preview · Article · Nov 2010 · The international journal of cardiovascular imaging
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    ABSTRACT: Elucidating the functional properties and remodeling process of the entire left atrium (LA) is important not only for offering the mechanistic insight into atrial fibrillation (AF) but also for assessing the effectiveness of catheter ablation. We included 65 patients with paroxysmal AF and 29 controls. Baseline multidetector computed tomography (MDCT) was acquired in all subjects and a follow-up MDCT was available in 48 patients after pulmonary vein and LA ablation. The 3-dimensional images at atrial end-diastole (ED) and end-systole (ES) were analyzed. The LA volume (ED: 61.11 +/- 15.94 vs 54.12 +/- 8.94 mL/m(2), P = 0.03; ES: 45.29 +/- 17.64 vs 33.38 +/- 7.78 mL/m(2), P < 0.001) was increased, and ejection fraction (EF) (26.93 +/- 13.40 vs 38.09 +/- 11.62%, P < 0.001) decreased in AF patients as compared to controls. After ablation, the ES LA volume (44.73 +/- 14.93 vs 38.04 +/- 11.51 mL/m(2), P = 0.04) decreased and the LA EF (25.04 +/- 13.13 vs 30.82 +/- 7.85%, P = 0.03) increased in patients without any AF recurrence. The wall motion (WM) analysis of the 18 segments of LA revealed increased motional magnitudes of entire LA except for the anterior roof. In contrast, the volume, EF, and WM of LA remained similar in patients with recurrence. Dilated LA with global hypokinesia was noted in AF patients. Improved LA transport function was demonstrated in patients without any recurrence after ablation. However, the anatomic and functional reverse remodeling was not significant in patients with AF recurrence.
    No preview · Article · Oct 2009 · Journal of Cardiovascular Electrophysiology
  • Yu-Dong Chen · Mei-Han Wu · Ming-Huei Sheu · Cheng-Yen Chang
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    ABSTRACT: Myocardial bridging (MB) is a condition in which a segment of the major epicardial coronary artery is tunneled within and surrounded by the myocardium. This condition has been linked to severe complications. The aim of this study was to evaluate the incidence of MB in Taiwanese subjects examined with electrocardiogram-gated, 16-slice, multidetector computed tomography (MDCT) coronary angiography, as well as to determine the location, depth, and length of the bridged segments and the concomitant atherosclerosis of MB. From August 2004 to May 2005, 276 consecutive subjects referred to our department for MDCT coronary angiography were enrolled in the study after written informed consent was obtained from each participant. Twenty-four subjects (8.7%) had at least one coronary segment that was completely surrounded by myocardium. Patients ranged in age from 27 to 76 years, with an average of 54 +/- 12 years. Thirty coronary segments were found to have MB. The most common location of MB was in segment 7, which accounted for 14 coronary segments (46.7%) of the total number of bridged segments; left anterior descending artery (LAD) segments accounted for 23 (76.7%); and right coronary artery and left circumflex artery segments accounted for three (10%) and two (6.7%), respectively. The length of bridged segments ranged from 5.2 to 50.6 mm, with an average length of 24.6 +/- 11.8 mm, and the depth of the bridged segments ranged from 0.5 to 9.1 mm, with an average depth of 3.65 +/- 1.89 mm. Two bridged segments (6.7%) had concomitant atherosclerosis; these were located in segment 7 (24.0 mm long and 6.10 mm deep) and segment 8 (27.1 mm long and 7.0 mm deep). Bridged segments with concomitant atherosclerosis were deeper, but not longer, compared with bridged segments without concomitant atherosclerosis (p < 0.05). Electrocardiogram-gated MDCT is an effective noninvasive tool for evaluating MB in a clinical setting. The most common location of MB was in the LAD, especially in segment 7. Bridged segments with concomitant atherosclerosis were deeper, but not longer, compared with bridged segments without concomitant atherosclerosis.
    No preview · Article · Jun 2009 · Journal of the Formosan Medical Association
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    ABSTRACT: PURPOSE To evaluate the impact of gender, age, body weight, heart rate, contrast volume, contrast concentration, contrast injection flow rate, bolus tracking threshold and coronary calcium score on the enhancement quality of coronary arteries during coronary CTA. METHOD AND MATERIALS From September 2007 to November 2007, 135 patients (91 men and 44 women) received coronary CTA by a 64-detector row scanner in this institute. Coronary CTA was performed using retrospective ECG-gating and automated bolus triggering with biphasic injection of iodinated contrast agent followed by saline chaser. The enhancement quality of coronary arteries, measured by Hounsfield uint, in segment 1, 2, 5, 6, 7, 11 and 13 (according to AHA classification) was check. Gender, age, body weight, heart rate, contrast volume, contrast concentration, contrast flow rate, bolus tracking threshold and coronary calcium score in each case were recorded. Regression analysis was used to check the correlation between each independent variables and coronary artery enhancement. RESULTS Of the 135 patients, their mean age was 58.2±15.5 years, body weight 68.5±113.3 kg, heart rate 56.5±6.6 bpm, contrast injection flow rate 4.9±0.4 ml/sec, total contrast volume 58.8±7.9 ml, contrast concentration 362.4±9.7 mgI/mL, coronary calcium score(by Agatston method) 256.9±521.7, and bolus tracking threshold 142.3±9.5 HU. Image quality was assessable in all studies. Regression test revealed gender, age, body weight, bolus tracking threshold, and calcium score had significant influence in the enhancement quality of coronary arteries in each segment(p<0.05). Contrast flow rate had no interference with coronary artery enhancement(p>0.05). Contrast concentration had borderline significance in LCX-p(p=0.0456). Contrast volume had significant influence in all segments(p<0.01), except in LCX-m and LAD-m. Heart rate had significant influence in all segments(p<0.01), except in LAD-p. CONCLUSION Man, younger age, lower body weight and lower heart rate, lower calcium score correlated with better coronary artery enhancement, and so did the application of lower bolus tracking threshold, fewer contrast volume and higher contrast concentration. CLINICAL RELEVANCE/APPLICATION Using lower bolus tracking threshold, low-volume and high-concentration of contrast and keeping patient in lower heart rate can get better coronary artery enhancement.
    No preview · Conference Paper · Dec 2008
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    Ming-Huei Sheu

    Preview · Article · Jun 2008 · Journal of the Chinese Medical Association
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    ABSTRACT: We sought to investigate the imaging of the left atrial (LA) muscular bundle and the relationship between the bundle and inducibility of tachyarrhythmia after pulmonary vein isolation (PVI). Noninducibility is used as a clinical end point of atrial substrate ablation after PVI. However, little is known about the role of the LA muscular bundles in tachyarrhythmia after PVI. Forty-three consecutive patients with paroxysmal atrial fibrillation who underwent catheter ablation were included. Bi-atrial isochronal mapping was performed with the NavX system (St. Jude Medical Inc., St. Paul, Minnesota) during sinus rhythm. After 4 PVI, inducible organized LA flutter with or without transforming to atrial fibrillation (AF) (LA flutter/AF) was ablated with additional lines at the roof and/or mitral isthmus. The existence of bilateral muscular bundles was an independent predictor of LA flutter/AF after PVI (p = 0.02). Patients with LA flutter/AF after PVI had a greater index of the double potentials (5.4 +/- 3.4% vs. 2.8 +/- 1.8%, p = 0.006) and interpotential interval (33 +/- 5 ms vs. 29 +/- 4 ms, p = 0.02) than without LA flutter/AF. The muscular bundles were identified in 28% patients using 16-slice multidetector computed tomography, which were identical to the isochrone map. Patients with noninducible LA flutter/AF after PVI plus the additional linear ablation had a lower recurrence rate as compared with the patients without it (19% vs. 75%, p = 0.02). Left atrial muscular bundles may provide a conduction block line and barrier, which is important for the formation of LA flutter/AF after PVI. The noninducibility of LA flutter/AF achieved after additional linear ablation may contribute to a better outcome in RF ablation of paroxysmal atrial fibrillation.
    Preview · Article · Oct 2007 · Journal of the American College of Cardiology
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    ABSTRACT: Atrio-bronchial fistula (ABF) can be a rare but potentially lethal complication following the catheter ablation of atrial fibrillation (AF). Understanding the extent of the contact between the bronchial tree and pulmonary veins (PVs) is critical to avoid this complication. We investigated the anatomic relationship between the four PVs and bronchial tree using multi-detector computed tomography (MDCT) images. Seventy patients with drug refractory AF were included. They underwent 16-slice MDCT before the ablation. The spatial relationship between the bronchus and PVs was demonstrated by the multi-planar images. The bronchus was in direct contact with four PVs in the vast majority of patients. The mean distances between the bronchus and the ostia of right superior, left superior, right inferior, and left inferior PV were 7.1 +/- 5.5, 3.5 +/- 4.8, 12.3 +/- 5.6, and 17.9 +/- 6.8 mm, respectively. Patients were categorized into two groups: Group I: proximal contact (<5 mm from the PV ostium) and Group II: distal contact (>5 mm from the PV ostium). For the right superior pulmonary vein (RSPV), the Group I patients were associated with thinner connective tissue between them (P = 0.001), a larger RSPV (17.2 +/- 2.2 vs 15.5 +/- 2.1 mm, P < 0.001), and right inferior pulmonary vein (RIPV) diameter (15.9 +/- 1.9 vs 14.6 +/- 1.6 mm, P < 0.01). For the left superior pulmonary vein (LSPV), the Group I patients were associated with an older age (P = 0.02). Isolation of the superior PVs may carry the potential risk of bronchial damage. The clinical or anatomic characteristics associated with the proximal contact between the bronchi and superior PVs can provide useful information to prevent this complication.
    No preview · Article · Sep 2007 · Journal of Cardiovascular Electrophysiology
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    ABSTRACT: The left atrial appendage (LAA) has been proven to be the most important site of thrombus formation in patients with atrial fibrillation (AF). However, the information regarding the morphometric alteration of the LAA related to the outcome of AF ablation is still lacking. Thus, we evaluated the long-term changes of the LAA morphology in patients undergoing catheter ablation of AF using magnetic resonance angiography (MRA). Group 1 included 15 controls without any AF history. Group 2 included 40 patients with drug-refractory paroxysmal AF. They were divided into two subgroups: group 2a included 30 patients without AF recurrence after pulmonary vein (PV) ablation. Group 2b included 10 patients with late recurrence of AF. The LAA morphology before and after (20 +/- 11 months) ablation was evaluated by three-dimensional MRA. The group 2 patients had a larger baseline LAA size (including the LAA orifice, neck, and length) and less eccentric LAA orifice and neck. After the AF ablation, there was a significant reduction in the LAA size in the group 2a patients, and the morphology of the LAA neck became more eccentric during the follow-up period. In group 2b, the LAA size increased and no significant change in the eccentricity of the orifice and neck could be noted. The morphometric remodeling of the LAA in the AF patients could be reversed after a successful ablation of the AF. Progressive dilation of the LAA was noted in the patients with AF recurrence. These structural changes in the LAA may play a role in reducing the potential risk of cerebrovascular accidents.
    No preview · Article · Feb 2007 · Journal of Cardiovascular Electrophysiology
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    ABSTRACT: The left atrium (LA) ablation in different regions, including LA appendage (LAA), LA roof, and LA septum, has recently been proposed to improve the success rate of treating patients with atrial fibrillation (AF). The purpose of this study was to investigate the anatomy of LAA, LA roof, and LA septum, using computed tomography (CT). Multidetector CT scan was used to depict the LA in 47 patients with drug-refractory paroxysmal AF (39 males, age = 50 +/- 12 years) and 49 control subjects (34 males, age = 54 +/- 11 years). The area of LAA orifice, neck, and the length of roof line were greater in AF group than in control subjects. Three types of LAA locations and two types of LAA ridges were observed. Higher incidence of inferior LAA was noted in AF patients. The different morphologies of LA roof were described. Roof pouches were revealed in 15% of AF and 14% of controls. Moreover, we found septal ridge in 32% of AF and 23% of controls. Considerable variations of LAA and LA roof morphologies were demonstrated. Peculiar structures, including roof pouches and septal ridges, were delineated by CT imaging. These findings were important for determining the strategy of AF ablation and avoiding the procedure-related complications.
    No preview · Article · Oct 2006 · Journal of Cardiovascular Electrophysiology

Publication Stats

360 Citations
82.70 Total Impact Points

Institutions

  • 2000-2015
    • National Yang Ming University
      • • Faculty of Medicine
      • • School of Medicine
      T’ai-pei, Taipei, Taiwan
  • 1997-2011
    • Taipei Veterans General Hospital
      • • Division of Radiology
      • • Department of Obstetrics and Gynecology
      T’ai-pei, Taipei, Taiwan
  • 2003-2005
    • Far Eastern Memorial Hospital
      T’ai-pei, Taipei, Taiwan