• Title/Summary/Keyword: Aortic stenosis

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Transaortic Closure of Ventricular Septal Defect in Congenitally Corrected Transposition of Great Arteries with Pulmonary Stenosis (대동맥절개를 퇘한 교정형 대혈관전위증의 심실중격결손 봉합)

  • An, Hong-Nam;Lee, Jong-Tae;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.748-756
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    • 1988
  • Transaortic closure of ventricular septal defect, suturing a patch on the morphological right ventricular side in patients with congenitally corrected transposition of great arteries might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. In two patients[aged 6 and 16 years] with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary stenosis, transaortic closure of ventricular septal defect was performed. No postoperative complete heart block resulted. One hospital death occurred because of sepsis who had underwent reoperation due to bleeding from the aortotomy site. Minimal aortic regurgitation developed in another patient.

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Cuff Technique for Small-Diameter Vascular Grafts in the Systemic Arterial Circulation of the Rat

  • Cho, Sukki;Song, In Hag
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.423-426
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    • 2018
  • This study determined the feasibility of the cuff technique for small-caliber vascular grafts in a rat model. A graft was implanted with the cuff technique or suture technique in a 1-cm segment of the abdominal aorta in 12 rats. The mean aortic clamp time was 29 minutes with the cuff technique and 44 minutes with the suture technique; the cuff technique was significantly shorter. Abdominal angiography at 1 week after implantation showed no significant stenosis in 9 rats, focal stenosis of the mid-portion of the graft in 1 rat with each technique, and total occlusion of the graft in 1 rat with the suture technique. We have successfully used the cuff technique for anastomosis for small-caliber vascular grafts in an animal model.

Long-Term Follow-Up of the Half-Turned Truncal Switch Operation for Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis

  • Lee, Jong Uk;Jang, Woo Sung;Lee, Young Ok;Cho, Joon Yong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.112-114
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    • 2016
  • The half-turned truncal switch (HTTS) operation has been reported as an alternative to the Rastelli or $r{\acute{e}}paration$ $\grave{a}$ $l^{\prime}{\acute{e}}tage$ ventriculaire procedures. HTTS prevents left ventricular outflow tract (LVOT) obstruction in patients with complete transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS), or in those with a Taussig-Bing anomaly with PS. The advantages of the HTTS procedure are avoidance of late LVOT or right ventricular outflow tract (RVOT) obstruction, and of overstretching of the pulmonary artery. We report the case of a patient who underwent HTTS for TGA with VSD and PS, in whom there was no LVOT obstruction and only mild aortic regurgitation and mild RVOT obstruction, including observations at 12-year follow-up. Our experience with long-term follow-up of HTTS supports a solution for late complications after the Rastelli procedure.

Takayasu`s Disease Associated with Abdominal Coarctation and Renovascular Hypertension - Report of one case - (Takayasu 질환에서 신성 고혈압을 동반한 복부 대동맥 협착 수술 치험 - 1례 보고 -)

  • 이종락
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.791-798
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    • 1990
  • Takayasu’s disease produces the occlusive and aneurysmal lesions of major branches of the aorta. Angiography is the most important diagnostic procedure in Takayasu’s disease. Surgical treatment is often justified to avoid the possible lethal consequences of hypertension on the heart, kidney, and brain, as well as in the case of aneurysm because of its risk of rupture. We experienced one case of the Takayasu’s disease associated with abdominal coarctation and renovascular hypertension. The patient was 17 years old female and had suffered from hypertension for 14 months. On physical examination, BP was 150/100 mmHg in the right arm and 120/80 mmHg in the left arm. The pulses of the left brachial and femoral arteries were weakly palpable. Aortogram showed the stenosis of the left common and subclavian arteries, coarctation of the abdominal aorta, and stenosis of the right renal artery and complete occlusion of the left renal artery. The stenosis of the right renal artery and the occlusion of the left renal artery produced the renovascular hypertension. She underwent aorta-aortic bypass for the coarctation of the abdominal aorta and aorta-renal bypass for treatment of renovascular hypertension Postoperatively, both femoral pulses were equally palpable. On discharge, antihypertensive drugs were discontinued. She has remained normotensive for last one year.

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Echocardiographic Diagnosis of Subaortic Stenosis with Severe Deformation of Mitral Valve Apparatus in a Dog

  • Chung, Doo-ri;Yoon, Young-min;Hwang, Tae-sung;Choi, Moon-yeong;Jung, Dong-in;Yeon, Seong-chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.34 no.1
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    • pp.54-57
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    • 2017
  • A 1-year-old castrated male Schnauzer dog was presented with heart murmur. Auscultation revealed systolic murmur located at the left heart base (grade 5/6). There were no remarkable findings on thoracic radiographs. Two-dimensional echocardiography revealed subaortic tunnel-like obstruction at the entrance to the left ventricular outflow tract. Anterior mitral valve leaflet appeared to be tethered to septum with minimal motion. Chordae tendineae was abnormally thickened. Color Doppler analysis revealed turbulent flow starting below the aortic valve. Mitral regurgitation was presented during systole. Spectral Doppler recordings revealed high velocity flow through the aorta and mitral regurgitation. Based on echocardiographic examination, the dog was diagnosed with subaortic stenosis concurrent with mitral dysplasia. The patient was medicated with ${\beta}-blocker$ and diuretics. It has been doing well without apparent clinical signs at 2 year after the diagnosis.

Tetralogy of Fallot with Subpulmonary Ventricular Septal Defect: A Case Report (Subpulmonary VSD 를 동반한 활로 4증: 수술 치험 1례 보고)

  • 우종수
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.175-180
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    • 1978
  • A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.

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Surgical Treatment of Anomalous Connection of Left Coronary Artery to the Pulmonary Artery [ALCAPA] (주관상동맥-폐동맥 이상연결증의 외과적 수술요법)

  • 이정렬
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.228-233
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    • 1993
  • Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.

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Takayasu`s Arteritis; A Case Report (Takayasu 동맥염;치험 1례)

  • 유웅철
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.245-248
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    • 1993
  • Recently we experienced a case of Takayasu`s arteritis involving the major aortic branches. A 30 year-old female patient admitted with the complaints of dizziness, visual disturbance, headache and tingling sensation of upper extremities. Aortogram revealed nearly complete obstruction of the origin site of both common carotid arteries and right vertebral artery, and irregular luminal narrowing of the origin site of innominate artery and left subclavian artery, but opacification of right subclavian artery and left vertebral artery. Successful surgical treatment was accomplished with a bypass from the ascending aorta to the left common carotid artery using a tube graft. The left subclavian artery and right axillary artery were revascularized distal to the stenosis with tube grafts that extended from the aortic graft. Postoperative complications were atelectasis, lymph leakage and left phrenic nerve palsy. She discharged uneventually at postoperative 22 days and most of symptoms were relieved.

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Early Surgery in Valvular Heart Disease

  • Kim, Dae-Hee;Kang, Duk-Hyun
    • Korean Circulation Journal
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    • v.48 no.11
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    • pp.964-973
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    • 2018
  • The burden of valvular heart disease (VHD) is increasing with age, and the elderly patients with moderate or severe VHD are notably common. When to operate in asymptomatic patients with VHD remains controversial. The controversy is whether early surgical intervention should be preferred, or a watchful waiting approach should be followed. The beneficial effects of early surgery should be balanced against operative mortality and long-term results. Indications of early surgery in each of the VHD will be discussed in this review on the basis of the latest American and European guidelines.

Takayasu's Arteritis Associated with Coronary and Renal Arteries Stenosis (Takayasu씨 동맥염과 동반된 관상동맥 및 신동맥 협착)

  • 황재준;김학제;류세민;조원민;손영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.688-691
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    • 2002
  • Takayasu's arteritis is a chronic inflammatory disease of unknown cause. It predominantly affects the aortic arch and its branches. Concomitant involvement of coronary and renal arteries is a rare entity. In this report, we described successful treatment of a patient with Takayasu's arteritis associated with coronary and renal arteries stenosis. A 23-year-old woman was presented with chest pain on exertion. Angiographic studies demonstrated left main coronary, bilateral renal, and left subclavian arteries stenosis. She underwent angioplasty and stenting of bilateral renal artery. After one week, coronary artery bypass grafting using greater saphenous veins and aorto-subclavian bypass with PTFE vascular graft were done simultaneously. She was discharged on the 13th postoperative day without any complications.