• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.445-447
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• 2007

Occlusion of a coronary artery ostium and especially occlusion of the right by an aortic cusp is a rare condition. We experienced an adult patient with occlusion of the right coronary ostium that was due to fusion of the right coronary cusp to the aortic wall along with underlying rheumatic aortic valve stenosis. During the operation, the adherent right coronary cusp was excised. After confirming that the right coronary ostium was patent, the other cusps were removed, and this followed by replacement of the aortic valve with a mechanical valve. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.308-311
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• 2010

Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.

• Proceedings of the KTCVS Conference
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• 1996.10a
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• pp.49-49
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• 1996

• Journal of Chest Surgery
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• v.23 no.3
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• pp.527-531
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• 1990

A 11 year-old girl with quadricuspid aortic avlve associated with regurgitation left superior vena cava and chromosomal anomaly is presented. The quadricuspid valve was unexpectedly found during operation for aortic valve replacement. The aortic valve consisted of 4 equal-sized cusps and retrospective review of the aortogram revealed the aortic valve to have 4 cusps also. To the best of our knowledge, this combination of anomalies has not been reported in Korea previously.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.119-123
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• 1999

Background: From January 1989 to December 1996, we analyzed 22 cases of ventricular septal defect associated(VSD) with aortic valvular prolapse. Material and Method: The mean age of the patients was 7 years with a range of 6 months to 22 years . Thirteen patients were male and 9 were female. The types of VSD were Kirklin type I in 13 , Kirklin type II in 8 and Kirklin type I+II in one. Result: The preoperative echocardiographic findings were aortic valvular prolapse in 10 patients, aortic valvular prolapse associated with aortic regurgitation in 6, and only aortic regurgitation in 2. Aortic valvular prolapse were found in operation field in 4 that was not be in preoperative echcardiography. Preoperative mean Qp/Qs, systolic PAP, systolic RVP were 1.48${\pm}$0.42, 27.9${\pm}$9.87, 32.9${\pm}$10.87 mmHg, respectively. Twenty patients underwent patch closure of VSD, and two patients with moderate aortic regurgitation and prolapsed of the aortic valve underwent patch closure of VSD and aortic valvuloplasty. Short and long term echocardiographic follow-up in 8 patients who had preoperative aortic regurgitation were found to have improved or not aggravated by performing VSD patch closure only and patch closure with valvuloplasty in 2. Twelve patients who had only preoperative aortic valvular prolapse had no change in prolapsed valve in postoperative echocardiography. Conclusion: Early closure of VSD with patch is necessary in VSD with aortic valvular prolapse even in associated with mild regurgitation. But in moderate regurgitation, VSD closure with valvuloplasty is recommended.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.600-606
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• 2007

Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.822-827
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• 1996

Ross procedure is an ideal operative modality for diseased aortic valve especially in children, but homogrart for right ventricular outflow tract(RVOT) reconstruction is not easily available in Korea. We tried to perform REV procedure for RVOT reconstruction in 10 young piglets(15.3 $\pm$ 1.3 kg) In an attempt to e clude the use of homograft in Ross operation. 3 of them survived after operation and raised till adult pig(about 70 kg), then examined their pulmonary arteries and hearts. Without any stenotic residues in the great arteries, we only found the deformed monocusp patch with severe calcification, which deprived the adequate valve function, but kept the pig growing normally We are sure that this operative modality (REV + Ross procedure) could be extendedly applied to the diseased human aortic valve, but we need to develope the anti-calcification method for the heterograft patch.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.939-942
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• 2006

Acute mesenteric ischemia after cardiac surgery is a serious complication associated with high mortality. Superior mesenteric artery is most commonly affected artery. Acute obstruction of mesenteric artery generally has an unfavorable prognosis because of late diagnosis. The keys to a successful outcome are early diagnosis and appropriate operative intervention. We successfully treated a patient with acute mesenteric ischemia after aortic valve replacement. Therefore, we report a case with a review of articles.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.815-818
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• 1997

Prosthetic valve endocarditis(PVE), although uncommon, is associated with significant mortality if the infection spreads into the paravavular structures with later abscess formation. However, combined antibiotic and surgical treatment is often successful. Accurate diagnosis by on echocardiography, effective myocardial protection during operation and increased surgical experience have improved the short-term and long-term outcomes for patients with PVE. A 35-year-old male had a history of replacement of aortic and mitral valve, and tricuspid annuloplasty on August 1994, was admitted due to sudden onset of aphasia, leftward deviation of both eyeballs and spiking fever and diagnosed of having PVE by echocardiography. Reoperation was done after 6weeks of antibiotic treatment. On the operative field, we could notice circumferential vegetation along aortic valve annulus, paravalvular leakage and abscess pocket. The mitral valve amlulus was healthy. The patient underwent redo aortic valve replacement using cryopreserved aortic homograft after radical debridement of infected issue. During the follow up of 7 months period the homograft was well functioning without recurrence of symptoms.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.92-96
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• 1997

The prognosis of Behfet's disease characterized by recurrent orogenltal ulcers and ocular and skin lesions depends upon the complications in the central nervous system, the gastrointestinal tract And the vascular system. Cardiac involvement, especially aortic regurgitation, is quite uncommon and hemodynamic instability is usually treated with ope heart surgery. But serious postoperative complications had been reported in many cases, which are prosthetic valve detachment, paravalvular leakage, conduction disturbance, and false aneurysm. Many efforts to prevent the complications have been made such as application of cryopreseved homograft. We have described an experience of root replacement with homograft in d 39 year-old male patient for prosthetic valve detachment because of Behfet's aorlitis with a review of the literatures regarding treatment, complication, and prognosis.