• Title/Summary/Keyword: Arrhythmia surgery

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A study on the development of 64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • Chang, Byung-Chul;Kim, Nam-Hyun;Jung, Sung-Hun;Ra, Sang-Weon;Cho, Bum-Koo
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.88-91
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    • 1994
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh IIx) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1ksamples/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point in displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites, This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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Clinical Analysis for Solitary Pulmonary Nodule (고립성 폐결절의 임상적 고찰)

  • Hur, S.;Ahn, B.H.;Oh, B.S.;Kim, S.H.;Lee, D.J.
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1185-1191
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    • 1991
  • The clinical and pathological analysis of solitary pulmonary nodules were estimated in 35 patients with nodules who were surgically resected at the Dept. of Thoracic and Cardiovascular Surgery of Chonnam National University Hospital from July 1978 to Aug. 1989. The results were as follows: 1. Mean age of patients was 43.5 years extending from 11 years to fi7 years old and male to female ratio was 6: l. 2. Preoperative symptoms were complained of dull pain in the chest, cough, hemoptysis and general weakness in 69% of patients. 3. The histopathologic findings of surgically resected nodules showed benign nodule in 51% and malignancy 49%. The most frequent diseases were granuloma[67%] in benign nodules and squamous cell carcinoma[76%] in malignancy. In topographical region of nodules in the lung, benign granuloma was more prevalent in upper lobes, while malignancy was slightly more frequent in lower lobes. 4. The incidence of malignancy by age was extremely rare in patients with less than 35 years old, but in greater than 35 years of age, malignancy comprised up to 67% of patients. 5. Complications of thoracotomy were minor bleedings, wound infections and chest pain not to be required any reoperation except one patient died of sudden onset of arrhythmia after pneumonectomy.

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Intrapericardial Implantation of an Implantable Cardioverter-Defibrillator in a Child

  • Seong, Yong-Won;Kim, Woong-Han;Yoo, Jae-Suk;Kim, Hye-Seon;Min, Byoung-Ju;Lee, Young-Ok
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.61-63
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    • 2011
  • Implantable cardioverter defibrillator (ICD) can be a crucial therapeutic modality for pediatric patients with congenital heart disease, Brugada syndrome, long QT syndrome and cardiomyopathy. Because transvenous implantation of ICD is mostly unfeasible for pediatric patients due to anatomical and technical limitations, epicardial patch type or subcutaneous type ICD have been used. Implantation of these alternative ICDs, however, was reported to be frequently associated with significant complications. We report a case of successful intrapericardial implantation of a single coil-type ICD through the transverse sinus in a 27 month-old child weighing lesser than 10 kg, and it was inferred from this experience that this alternative technique may decrease complications and morbidities after ICD implantation in children.

Reoperations after Fontan Procedures (폰탄 술식 후에 시행한 재수술)

  • Lee, Cheul;Kim, Yong-Jin;Lee, Jeong-Ryul;Rho, Joon-Ryang
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.457-462
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    • 2003
  • Background: Surgical results of the Fontan procedures in patients with a single ventricle have improved. As the perioperative mortality continues to decline and late outcome is forthcoming, attention is now being directed toward late complications of the Fontan procedures. We retrospectively analyzed our experience with reoperations after Fontan procedures. Material and Method: Between January 1988 and December 2002, 24 patients underwent reoperations after Fontan procedures. The median age at Fontan procedures and reoperation was 3.3 years and 9.2 years, respectively. Types of initial Fontan procedures were atriopulmonary connection (n=11), lateral tunnel Fontan (n=11), and extracardiac conduit Fontan (n=2). Indications for reoperation included atrioventricular valve regurgitation (n=7), atrial arrhythmia (n=8), Fontan pathway stenosis (n=7), residual right-to-left shunt (n=5), etc. Result: Procedures performed at reoperation included atrioventricular valve replacement (n=6), conversion to lateral tunnel Fontan (n=5), conversion to extracardiac conduit Fontan (n=3), cryoablation of arrhythmia circuit (n=7), etc. There was no operative mortality. There were 2 late deaths. Mean follow-up duration was 2.7$\pm$2.1 years. All patients except two were in NYHA class I at the latest follow-up. Among 8 patients with preoperative atrial arrhythmia, postoperative conversion to normal sinus rhythm was achieved in 7 patients. Conclusion: Reoperations after Fontan procedures could be achieved with low mortality and morbidity. Reoperation may lead to clinical improvement in patients with specific target conditions such as atrioventricular valve regurgitation, refractory atrial arrhythmia, or Fontan pathway stenosis, especially in patients with previous atriopulmonary connection.

Surgical Treatment of Supraventricular Tachyarrhythmia -One case report- (상실성빈맥의 수술치험 -1예 보고-)

  • Kim, Chi-Kyung;Jeong, Jin-Yong;Kwack, Moon-Sup;Kim, Se-Wha;Lee, Hong-Kyun;Hong, Sun-Jo
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1137-1144
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    • 1988
  • Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60$^\circ{C}$ for 90 seconds. The accessory pathway was successfully ablated without specific problems.

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Cardiac Fibroma Involving Left Ventricle (좌심실에 발생한 심장 섬유종)

  • 신홍주;박정준;서동만;박인숙;고재곤;김영휘;김정선
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.275-278
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    • 2004
  • A 9-month-old male infant was admitted for evaluation of incidentally noticed cardiac mass. The patient had no symptoms and there was no hemodynamic abnormality. Echocardiographic finding showed a huge left ventricular free wall mural mass, which did not obstruct the left ventricular outflow tract. Maximal excision of the left ventricular free wall mass was performed. The pathologic finding revealed cardiac fibroma. During the 7-month of follow-up after surgery, there was no evidence of arrhythmia or tumor recurrence.

First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature

  • Valente, Tullio;Bocchini, Giorgio;Bigazzi, Maurizio Cappelli;Muto, Massimo;Golino, Paolo;Sica, Giacomo
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.310-312
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    • 2020
  • Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.

Repair of intracardiac defect under simple deep hypothermia in infancy without cardiopulmonary bypass: report of 3 cases (단순 초저온법에 의한 개심술: 3례 보)

  • 조범구
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.189-196
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    • 1984
  • Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

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Surgical Treatment of Chronic Pericarditis: Case Analysis of 19 Cases (만성 심낭염의 외과적 요법)

  • Lee, Dong-Jun;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.273-280
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    • 1978
  • 19 chronic pericarditis patients reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 10 years from January of 1968 to January of 1978. 2. There were 14males and 5 females in this series. Range of age varied from 110 days to 61 years. 2. There were two hospital death, one expired 2 days and another 3 days after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factor. 2. Clinical and histological study showed tuberculous origin in 8 cases, nonspecific chronic inflammatory changes in 6 cases and pyogenic infection cases in 5 patients. 2. The postoperative complications were observed in 6 cases, and the most common was cardiac arrhythmia and wound infection. 2. The extent of pericardiectomy should be confined to the left and right ventricles to correct the hemodynamic anomaly in general. The results of this procedure has been satisfactory in 89 percent of the cases. 2. Optimal myocardial function in cases of constritive pericarditis was the key to the successful outcome of this procedure.

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