• Title/Summary/Keyword: 인공 혈관

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Surgical Treatment of Multivalvular Endocarditis with Ventricular Septal Defect (심실중격결손과 동반한 다중판막 감염성 심내막염의 수술적 치료)

  • Kim, Seon-Hee;Je, Hyoung-Gon;Lee, Sang-Kwon;Kim, Sang-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.417-420
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    • 2010
  • As higher mortality rate and frequent incidence of morbidity, early surgical treatment is generally recommended for the multivalvular endocarditis. A 46-year-old female presented with high fever. Echocardiography showed the vegetation on pulmonic valve, tricuspid valve and mitral valve with a ventricular septal defect. Emergency operation was conducted due to uncontrolled infection. We present a clinical success of this rare case with review of the medical literature.

Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma (외상성 좌측주기관지 절단환자의 지연수술 치험)

  • 김명천;이재영;조규식;박주철;유세영
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.182-185
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    • 1998
  • Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

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Clinical Study of the Effect of Aprotinin for Hemostasis in Open Heart Surgery (개심술시 Aprotinin의 지혈효과에 관한 임상적 고찰)

  • 정성운;김종원
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.364-367
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    • 1999
  • Background: The efficacy of the hemostasis of prophylactic aprotinin after cardiac valve replacement was evaluated from January 1994 to December 1996 at Pusan National University Hospital. Material and Method: In a randomized study, 20 patients received aprotinin(2${\times}$106 KIU as a loading dose for 30 minutes after anesthesia, 1${\times}$106 KIU for priming and 5${\times}$105 KIU/hr as a maintenance dose from the completion of loading dose till skin closure) and another 20 untreated patients served as controls. Result: Aprotinin produced a significant reduction in postoperative blood loss compared with controls and significantly decreased total exposure to allogenic blood products compared with the control group(p<0.05). Conclusion: We conclude that aprotinin effectively reduces postoperative blood loss and trasfusion in patient undergoing cardiac valve replacement.

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Cardiac Valve Replacement: A Report of 145 Cases (인공심장판막에 의한 심장질환수술에 관한 연구)

  • 이영균
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.501-515
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    • 1978
  • The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

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Ten-year Clinical Experience with CarboMedics Valve (CarboMedics 판막의 10년 임상 성적)

  • 김근직;이응배;조준용;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.643-647
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    • 2000
  • From March 1988 to June 1994, 275 CarboMedics cardiac valve prostheses(199 mitral, 70 aortic and 3 tricuspid) were implanted in 226 consecutive patients(mean age 39 years, male/female 90/136) by one surgical team operating on adult cardiac patients at Kyungpook University Hospital. Total follow up represented 16,848 patient-months(mean 76 months) and follow up rate was 96%. One hundred and forty-nine patients(66%) wer in NYHA functional class III or IV preoperatively, and 204 patients(99.5%) were in class I or II postoperatively. Early mortality was 4.9% and late death was 9.3%. The actuarial survival at 81 months was 86.l2$\pm$3.1%. The linearized incidence of valve-related death, prosthetic valve thrombosis, anticoagulation-related hemorrhage, non-structural dysfunction and reoperation were 0.71%, 0.43%, 0.07%, 0.21%, and 0.14% respectively. The 81-month rate of freedom from all valve related complications and deaths including hospital mortality was 88.1$\pm$2.5%. Thee facts suggest that the CarboMedics cardiac valve has excellent result, low incidence of valve-related complications and no structureal deterioration.

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Coronary Revascularization without Extracorporeal Circulation -Two Case Reports (체외순환을 사용하지 않은 관상동맥 우회술 -2례 보고-)

  • 홍종면;전용선
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1132-1135
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    • 1997
  • We have experienced two cases of coronary revascularization without extracorporeal circulation in a 63 year old female patient and a 75 year old male patient. The first patient had the lesion which was the nearly total occulusion of mid-LAD, about 90% luminal narrowing of second diagonal branch and less than 50% stenosis of proximal RCA. The other male patient had a single vessel disease involving about 95% stenosis of proximal LAD and 1st diagonal branch. PTCA failed in the irst patient because of relatively long sinus pause during procedure In both of the patients, the coronary revascularizations were done at distal LAD and diagonal branch using left internal mammary artery and saphenous vein graft under the beating state, respectively. The postoperative courses were uneventful and the patients were discharged without any complications.

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Endothelial Cell Seeding onto Extracellular Matrix for Development of Polyurethane Vascular Prosthesis (폴리우레탄 인공혈관을 위한 extracellular matrix 기질상의 내피세포이식)

  • Lee, Yoon-Shin;Park, Dong-Kook;Min, Byoung-Goo
    • Journal of Biomedical Engineering Research
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    • v.12 no.3
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    • pp.165-170
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    • 1991
  • Many experiments about endothelial cell seeding on artificial vessels were studied and conducted For this one or a combination of the extramatrix was used for the underlying matrix. But we used the whole ECM(extracellular matrix) that made excreated from flbroblasl. In thls study, we obtained human adult omental microvascular endothelium by collagenase digestion and used polyurthane sheets in order to make a new artificial vessel material. We cultured fibroblast on the polyurethane and gelatin - coated polyurethane. After confluent ingrowth we treated the polyure thane with triton in order to destroy the cytoskeleton and nucleus. We observed the preformed extra cellular matrix on the ployurethane and cultured the isolated microvascular endothelium. We also ok served the growth of microvascular endothelium on the polyurethane and gelatin. We conclude that the use of the whole ECM is promising fair as a new underying substrate for endothelial cell seeding on artificial vessels.

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Cardiac Surgery for the Patient with VVI Unipolar Pacing System -One Case- (VVI 단극유도의 심박조율치를 가진 환자의 개심술 -1례 치험-)

  • 정해동;최종범;최형호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.398-401
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    • 1998
  • A 56-year-old female with a permanent unipolar pacing(VVI) system underwent elective coronary bypass surgery and mitral valve replacement. Because the unipolar sensing is subject to considerable nonmyocardial electrical noise, the pacing function may be disturbed by the use of electrocautery. Temporary atrial and ventricular bipolar epicardial leads and external generator were used for maintaining A-V sequential pacing during the use of electrocautery. Before aortic cross-clamp was released after cardiac operation, regular cardiac rhythm could spontaneously be resumed with an integrated cardioplegic strategy, avoiding the use of defibrillator

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Clinical Study on Acute Renal Failure after Valve Replacement Surgery (인공판막치환술후 발생한 급성신부전에 대한 임상적 고찰)

  • 신현종
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.122-127
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    • 1994
  • A retrospective study of 737 consecutive patients surviving the first 24 hours who underwent valve replacement surgery from July 1980 to June 1993 was undertaken to determine the prevalence, variables that could be used to predict outcome and results of therapy for postoperative acute renal failure[ARF]. Twenty-one patients[2.8 %] developed acute renal failure. Positive risk factors noted in the development of postoperative renal failure included age, New York Heart Association class III & IV, endocarditis and elevated preoperative concentration of serum creatinine. The duration of cardiopulmonary bypass, aortic cross-clamping and the total duration of the operation also closely correlated with the incidence of ARF. The mortality rate for established ARF was 38.1% and ARF was associated with a significant increase in the length of hospitalization, ventilator support and intensive care unit stay. The incidence and mortality rate of oliguric renal failure was 38.1% and 85.7%. The highest mortality rate was associated with two or more postoperative complications and serum creatinine value exceeded 5 mg/dl. We concluded that therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure, and early institution of renal replacement therapy with intensive support probably gives the best chance for survival.

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Surgical Treatment of Prosthetic Valve Thrombosis (인공판막혈전증에 대한 외과적 치료)

  • 유영선;최세영
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1337-1341
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    • 1996
  • From September 1989 to March 1996, 13 patients with prosthetic valve thrombosis underwent reoperdtion on 16 occasions. The mean interval between implantation and reoperation was 27.8 months. The anticoagulation status was inadequate in 44% of th Instances. The majority(75%) were in NYHA functional class IV, 6 of them being in shock. Reoperation was performed for valve replacement(15 of 16 occasions) or thrombectomy(1 of 16 occasions) within 3 to 192 hours(mean 33.5 hours). Operative mortality at reoperation was 25%(4 patients). Re-thrombosis occurred In 3 patients. Long-term outcome was satisfactory in all survivors with a mean follow-up of 30.B months. The present results indicate that an early diagnosis and prompt surgical intervention is needed to decrease operative mortality.

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