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Clinical Study of Composite Valve Graft Replacement of the Aortic Root (대동맥 근부 복합 인공 판막 도관 치환술에 관한 임상적 고찰)

  • Park, Kwon-Jae;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Jeong, Sang-Seok
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.260-265
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    • 2010
  • Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

Aortic Valvuloplasty Using Triangular Resection lechniolue (설상절제술(triangular resection)을 사용한 대동맥판막 성형술의 단기 성적)

  • 김욱성;정철현;허재학;백만종;이석기;박영관;김종환;장우익;장지민
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.113-117
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    • 2002
  • With an increasing awareness of the limitations of both mechanical prostheses and bioprostheses, aortic valvuloplasty has gained attention as an alternative procedure for aortic valve disease. Material and Method: Eight consecutive patients underwent aortic valvuloplasty caused by leaflet prolapse between June 1799 to June 2000. Mean age of the patients was 18.4$\pm$12.6 year. Four paitents(50%) were male. Six patients had tricuspid valves and ventricular septal defect and two patients had bicuspid valves. The extent of aortic insufficiency was 3.5$\pm$0.5 by preoperative Doppler echocardiography. The technique involved triangular resection of the free edge of the prolapsed leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. Result: There was no in-hospital mortality or morbidity. Mean follow-up was complete at 11.973.6months. There was no late mortality or morbidity. The amount of the severity of aortic insufficiency, as assessed by echocardiography preoperatively, postoperatively and at late follow-up was 3.5$\pm$0.5, 0.6$\pm$0.5 and 0.8$\pm$0.6, respectively(p value : 0.01). There was one patient with grade 2/4 aortic insufficiency and in the other patients, grade 1/2 or trivial aortic insufficiency were detected with late echocardiograms. Conclusion: Triangular resection in the patients with aortic leaflet prolapse offers a good early clinical result, but long-term follow-up is necessary.

Comparison of Stress-rest and Rest-stress One Day Myocardial Perfusion Scintigraphies in Detecting Coronary Artery Diseases (부하-휴식과 휴식-부하 1일 심근관류영상법의 관동맥질환 진단율 비교)

  • Bom, Hee-Seung;Min, Jung-Jun;Song, Ho-Cheon;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.30-35
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    • 1997
  • It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age $57{\pm}9$ years) and 120 patients (79 males, 41 females, mean age $59{\pm}10$ years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively. All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by ${\geq} 50%$. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35% and 68%, respectively. Those of rest-stress protocol were 96%, 47% and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using $^{99m}Tc$ agents were comparable and were very sensitive tests in detecting coronary artery diseases.

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Comparison of $^{99m}Tc$-tetrofosmin and $^{99m}Tc$-sestamibi Myocardial Perfusion SPECT in Detecting Coronary Artery Fisease (부하-휴식 1일 영상법을 이용한 심근관류 SPECT에서 $^{99m}Tc$-tetrofosmin과 $^{99m}Tc$-MIBI의 관동맥질환 진단율 비교)

  • Min, Jung-Jun;Bom, Hee-Seung;Song, Ho-Cheon;Jeoung, Hwan-Jeoung;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.137-142
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    • 1998
  • Purpose: $^{99m}Tc$-tetrofosmin(TF) is a recently proposed myocardial imaging agent which has similar biokinetic characteristics to $^{99m}Tc$-sestamibi(MIBI). The aim of this study was to compare TF and MIBI myocardial perfusion SPECTs in detecting coronary artery disease. Materials and Methods: One hundred and sixty patients(101 males, 59 females, mean age $57{\pm}9yr$) who had undergone both myocardial perfusion SPECT(M-SPECT) and coronary angiography within 1 month were studied. M-SPECT was performed using TF in 115 patients and MIBI in 45 patients. Stress-rest one day protocol was used in all patients. A coronary stenosis was considered significant when the luminal diameter ${\geq}$50% was compromised. The chi square test was used to compare differences in sensitivity and specificity between the two groups. Results: There was no difference in age and diseased coronary artery branches between the two groups. There were more male patients in TF group: Male-to-female ratios of TF and MIBI groups were 78:37 and 23:22, respectively(p<0.05). The overall sensitivity of TF study was 92% and specificity 36%. The overall sensitivity and specificity of MIBI study were 93% and 30%, respectively. There was no difference between TF and MIBI groups in identifying individual diseased coronary artery branches. Conclusion: One day stress-rest myocardial SPECT using either TF or MIBI was comparable and was a very sensitive test in detecting coronary artery disease.

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Clamp and Sew Technique without Distal Perfusion for the Management of Traumatic Descending Thoracic Aortic Rupture (외상성 흉부 하행 대동맥 파열에서 원위부 관류 없이 시행한 겸자 봉합술)

  • Seok, Yang-Ki;Lee, Jong-Tae;Kim, Gun-Jik;Park, Il;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.558-563
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    • 2007
  • Background: Traumatic aortic rupture is a highly fatal condition in which a patient's outcome is strongly affected by other associated injuries. Selection of the appropriate surgical timing and the management plan is important. Material and Method: The medical records of the 15 traumatic descending thoracic aortic rupture patients who underwent the clamp & sew technique were retrospectively reviewed and checked for the presence of associated injuries and the postoperative course. Result: The hospital mortality was 6.07% (one patient). This patient died intra-operatively and the cause of the death was delayed hemoperitoneum. The mean operative time and aortic clamp time were $231{\pm}53.1$ and $13.1{\pm}5.3$ minutes, respectively. One patient complained the bowel obstructive symptoms at postoperative 10 days. We found the mechanical bowel obstruction on computed tomography of the abdomen, and segmental bowel resection was done. Conclusion: Although several surgical strategies may be appropriate for managing traumatic aortic rupture, the clamp & sew technique is a safe and effective method for the treatment of traumatic aortic injury.

Intra-aortic Balloon Pump Therapy for Hemodynamic Instability during Off-pump Coronary Artery Bypass Surgery (심폐바이패스를 사용하지 않는 관상동맥우회술 중 발생한 혈역학적 불안정에 대한 대동맥내 풍선펌프 치료)

  • Jeong, Dong-Seop;Kim, Ki-Bong;Choi, Eun-Seok
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.704-709
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    • 2009
  • Background: We assessed the efficacy of intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery. Material and Method: We studied seven hundred ninety-six patients who underwent off-pump coronary artery bypass between January 2000 and December 2006. The patient were divided into group I (n=39), which received intraoperative intra-aortic balloon pump therapy, and group II (n=757), which did not receive intraoperative intra-aortic balloon pump therapy. Result: There were no differences in the operative mortalities (2.6%, 1/39 vs 0.8%, 6/757; p=0.195) and morbidities such as atrial fibrillation (p=0.691), stroke (p=0.908) and mediastinitis (p=0.781) between the 2 groups, although the ventilator support time, the length of the intensive care unit stay and the length of the hospital stay were longer in group I than in group II (p<0.05). Multivariate analysis failed to prove that group I was a high risk group for operative mortality (p=0.549). There were 3 intraoperative intra-aortic balloon pump-related complications in group I (7.9%). However, no longer complications occurred after 2003, when the surgeons began using a smaller sized 8 F catheter that was inserted using a sheathless technique. Conclusion: Intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery can be performed safely and it showed comparable clinical results to that of not using intraoperative intra-aortic balloon pump therapy.

Analysis of Changes in Carotid Intima-media Thicknesses according to Metabolic Syndrome-inducing Factors (대사증후군 유발 인자에 따른 경동맥 내중막 두께의 변화 분석)

  • Nan-Hee An;Tae-Jeong Ji;Hyeon-Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.597-606
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    • 2023
  • This study retrospectively analyzed the test results of 235 patients who visited a medical institution in Busan from May 2022 and February 2023 and conducted both carotid ultrasonography and blood tests. The purpose of this study was to investigate the effect on intima-media thickness and blood flow velocity by measuring the intima-media thickness and blood flow velocity through carotid ultrasonography and analyzing the factors influencing the subject's body mass index and metabolic syndrome. Correlation analysis between carotid intima-media thickness and body mass showed (p=0.000) confirming that there is a correlation. As a result Correlation analysis between blood flow velocity and body mass index (p=0.015) was found, comfirming that there was a correlation. Age (p= 0.000), fasting blood glucose (p=0.002) and alcohol consumption (p=0.006) were found to be correlated with carotid intima-media thickness. An increase in Carotid intima-media thicknesses causes an increase in events caused by cardiovascular disease. Therefore, efforts must be made to exclude factors that increase Carotid intima-media thicknesses, and it will be most important to prevent cardiovascular disease through research on various prediction methods and regular checkups.

Studies on the Morphological Characteristics of Barley Internode (대맥절간의 형태적 특성에 관한 연구)

  • Kim, Bong-Ku;Cho, Chang-Hwan;Kim, Ki-Joon;Lee, Dong-Jin;Yang, Seung-Gyun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.31 no.2
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    • pp.162-166
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    • 1986
  • Experiments were carried out to find the varietal differences in histological structure and outer characteristics, and its relationships between each characters in the internodes of 15 barley varieties (5 covered barley, 5 naked barley and 5 malting barley). The length of 1st-3th internodes from the top was longer in malting barley varieties, covered barley varieties and naked barley varieties in the order, but of 4th-5th internodes was longer in naked barley varieties, covered barley varieties, and malting barley varieties in the order. The diameter of naked barley varieties internodes was much thicker that of malting barley varieties. The thickness of culm wall in 1st-3rd internodes was thicker naked barley varieties, covered barley varieties, and malting barley varieties in sequence and in 4th-5th inter-nodes was covered barley varieties, malting barley varieties, and naked barley varieties in the order. The number of large vascular bundles in covered barley varieties had more than that of naked barley varieties and malting barley varieties in 1st internodes. The size of large vascular bundles in covered barley varieties and naked barley varieties was larger than that of malting barley varieties. The size of large vascular bundles had significant positive correlation with thickness of culm wall and the diameter of internodes. The thickness of culm wall was negatively correlated with the length of internodes and culm, but positively correlated with the diameter of internodes.

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CNN Model-based Arrhythmia Classification using Image-typed ECG Data (이미지 타입의 ECG 데이터를 사용한 CNN 모델 기반 부정맥 분류)

  • Yeon-Suk Bang;Myung-Soo Jang;Yousik Hong;Sang-Suk Lee;Jun-Sang Yu;Woo-Beom Lee
    • Journal of the Institute of Convergence Signal Processing
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    • v.24 no.4
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    • pp.205-212
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    • 2023
  • Among cardiac diseases, arrhythmias can lead to serious complications such as stroke, heart attack, and heart failure if left untreated, so continuous and accurate ECG monitoring is crucial for clinical care. However, the accurate interpretation of electrocardiogram (ECG) data is entirely dependent on medical doctors, which requires additional time and cost. Therefore, this paper proposes an arrhythmia recognition module for the purpose of developing a medical platform through the analysis of abnormal pulse waveforms based on Lifelogs. The proposed method is to convert ECG data into image format instead of time series data, apply visual pattern recognition technology, and then detect arrhythmia using CNN model. In order to validate the arrhythmia classification of the CNN model by image type conversion of ECG data proposed in this paper, the MIT-BIH arrhythmia dataset was used, and the result showed an accuracy of 97%.

Early Results of Aortic Valve-sparing Procedures in Patients with Annuloaortic Ectasia (대동맥륜대동맥확장(Annuloaortic Ectasia) 환자에서 대동맥판막을 보존하면서 시행된 대동맥근부 및 상행대동맥 치환술의 단기 성적)

  • Sung Kiick;Park Kay-Hyun;Lee Young Tak;Jun Tae-Gook;Yang Ji-Hyuk;Kim Su Wan;Kim Jin Sun;Cho Sung Woo;Kim Si Wook;Choi Jin Ho;Park Pyo Won
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.483-488
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    • 2005
  • Aortic valve-sparing procedures could reduce valve-related morbidity, but may increase operative risks; therefore, these procedures could not be performed routinely. We attempted to find out the early results while focusing on the operative risks associated with these procedures in our hospital. Material and Method: From May 1996 to July 2003, 26 patients underwent these procedures including 15 patients with Marfan syndrome and 1 patient with Behcet disease. There were 17 men and 9 women with mean age of $37.9\pm19.2$ years (range: 6 months-74 years). Ten patients had ascending aortic dissection, 18 patients had more than moderate degree of aortic valve insufficiency (AI). Two types of valve-sparing procedures were performed: valve reimplantation in 14 and root remodeling in 12 patients. Associated procedures were performed as follows: aortic valve plasty in 6, mitral valve plasty in 5, hemi-arch replacement in 4, total arch replacement in 2, coronary artery bypass surgery in 1 and Maze procedure in 1 patient(s). Result: In four patients, valve-sparing procedures were converted to Bentall procedures during operation. Including these patients, there was no operative deaths, 3 patients underwent re-operation due to bleeding, 1 patient had permanent pacemaker. The median duration of ICU stay was 45.5 hours, the median duration of hospital stay was 10.5 days. In 22 patients excluding 4 converted patients, intraoperative transesophageal echocardiogram (TEE) showed less than mild degree of AI in all except one who had not received intra-operative TEE in the beginning and showed moderate degree of AI at discharge. The mean duration of follow-up was $21.2\pm27.4$ months. All patients were alive except one who died during other departmental surgery. In 3 patients, more than moderate degree of AI was recurred, but there were no reoperation. Conclusion: Aortic valve-sparing procedures could be performed relatively safely in selected patients who had annuloaortic ectasia.