• Journal of Chest Surgery
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• 제21권6호
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• pp.1145-1151
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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` for 90 seconds. The accessory pathway was successfully ablated without specific problems.

• Journal of Chest Surgery
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• 제24권2호
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• pp.171-181
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• 1991

Result of St. Jude Medical valve replacement are presented in 106 patients who underwent operation from January 1985 through July 1989. The patient were 52 males and 56 females. Total 136 of St. Jude Medical valves were implanted; 91 in mitral position, 45 in aortic position. The hospital mortality rate was 5.7%o[6 patients] and the late mortality rate was 2.0%[2 patients]. The causes of death were low cardiac output in 5, iatrogenic right ventricular rupture in 1, heart failure in 1, ventricular arrhythmia in l. And, the causes of valve related complication were anticoagulant related hemorrhage in 5 patients[0.03% /patient-year] and thromboembolism[0.01% /patient-year] in 2 patients. In conclusion, the performance of the St. Jude Medical valve compare most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

• Journal of Chest Surgery
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• 제26권8호
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• pp.620-626
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• 1993

Determination of preoperatibe pulmonary function is crucial in avoiding complications from pulmonary resection, especially pneumonectomy. Postoperative morbidity and mortality were correlated with the preoperative results of five widely used tests of pulmonary function in 40 patients who underwent pneumonectomy for bronchiectasis, pulmonary tuberculosis, and carcinoma of the lung. Factors analyzed following operation included 30-day mortality, the incidence of arrhythmia, the frepuency of respiratory complications, and the number of individuals requiring prolonged mechanical ventilation. There were statistically significant differences[p<0.001]in mean values among FVC, FEV1, FEV1/FVC and MVV. But the difference of the FEF25-75% was not statistically significant.

• Journal of Chest Surgery
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• 제28권4호
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• pp.335-339
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• 1995

Secundum atrial septal defect occupies about 10 to 15% of congenital heart diseases, and the surgical accomplishment is outstanding, so that the operative mortality is getting near to zero percent. But, the methods of correction, direct closure versus patch closure are still controversial and there is no absolute method about it. Some surgeons prefer direct closure technique for its simplicity and lesser thrombogenicity but others, afraid of arrhythmia and suture detachment after closure of large defect, prefer patch closure. Usually most surgeons use direct suture technique in small and moderate sized defects and patch closure in large defects. In our hospital, 156 cases of isolated secundum atrial septal defect were closed directly by double continuous over and over suture using 5-0 polypropylene[prolene , regardless their sizes and the amounts of shunt flow. There were no operative mortality and no serious complications such as heart block, suture detachment and embolism.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1245-1249
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• 1992

Tuberculosis developed in the pericardium usually occurs as diffuse constrictive pericarditis or effusive pericarditis which contains much pericardial effusion. But types such as localized abscess or tuberculoma are very rare. Myocardial tuberculosis is also very rare and mainly extended directly from hilar lymph node or spreaded hematogenously in miliary tuberculosis. It is known to be able to make arrhythmia or heart failure by invasion of conduction system or myocardial muscle mass, but it is usually discovered by incidental postmortem autopsy and rarely concerned by clinical basis. Recently we have experienced a case of localized intrapericardial tuberculous abscess which extended to myocardium and operated that successfully. So we would report them with reference study.

• Journal of Chest Surgery
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• 제22권1호
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• pp.116-122
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• 1989

During 22-year period ending in June 1988, operation was performed on 22 patients with primary heart tumor at Yonsei University College of Medicine. Mean age was 38.8*3.03[mean \ulcornerEM] ranging from 14 to 63 years old. Twenty cases were myxomas. Others were fibromyxoma and rhabdomyosarcoma. All patients complained of dyspnea on exertion. Nine cases had palpitation. Other constitutional symptoms were weight loss [7 cases], headache [4 cases], generalized edema [3 cases] and cough [3 cases]. Five cases had neurological symptoms and signs preoperatively. Preoperative NYHA Class was poor [Class II; 8 cases, III; 9 cases and IV; 5 cases]. The most common site of tumor origin was fossa ovalis limbus [16 cases; 72.8%]. Because of severe mitral regurgitation and of recurrent myxoma, 2 cases were reoperated for mitral valve replacement. Postoperative complications were postoperative mitral regurgitation [5 cases; 22.8%] and arrhythmia [4 cases; 18.2%], one of which was supra-His bundle block. All patient survived operation. Follow-up of 15 patients [mean 28.95*8.3 months] was good as functional class 1[8 cases] or II [7 cases]. More effective adjuvant therapy will be necessary to improve long-term prognosis for malignant primary heart tumor.

• Journal of Chest Surgery
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• 제19권4호
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• pp.595-605
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• 1986

From February 1986 through September 1986, the authors have experienced 6 cases of coronary artery bypass graft for patients with unstable angina. There were five males and one female who ranged from 39 to 65 years [mean, 53.3 years]. The extent of coronary disease was as follows: one-, two- and three-vessel diseases, all 2 cases respectively, and among them, 1 case had left main disease. Distal anastomoses were performed first with using saphenous vein grafts as conduits in all cases and sequential bypass methods were employed in 5 cases. Numbers of vein grafts were two in 2 cases and one in 4 cases. The mean time wasted for one distal anastomosis was 36 minutes. Post operative complications were leg-wound disruption [2 cases], transient psychosis [1 case] and perioperative myocardial infarction [MI] [1 case]. Sixty three year-old male patient associated with cardiomegaly, prior MI, ventricular arrhythmia, cardiac dysfunction and endocrinologic diseases preoperatively was expired in the operating room due to perioperative Ml. All survivors were asymptomatic and on discontinuing medical therapy on follow-up varying from 1 to 8 months.

• Journal of Chest Surgery
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• 제33권9호
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• pp.766-769
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• 2000

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by $\beta$-blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.

• Journal of Chest Surgery
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• 제32권10호
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• pp.958-961
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• 1999

A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.

• Journal of Chest Surgery
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• 제16권3호
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• pp.368-374
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• 1983

Combined type of primary lung cancer is a very rare form in clinical experience, which is 3 histologically different variants of bronchogenic carcinoma. These type had a well differentiated squamous carcinoma forming keratin pearls, well differentiated adenocarcinoma and pleomorphic undifferentiated cell carcinoma, usually small cell carcinoma. The patient, a male, 49-Y-0, was complaint coughing, mild dyspnea, blood tinged sputum and chest pain. Under diagnosis of lung cancer preoperatively, the right total pneumonectomy was performed with very difficulty such as arrhythmia, ventilation impairment during post operation course. The histology of specimen was disclose as 3 different histological type, combined lung cancer as squamoadenoundifferentiated carcinoma. The mediastinal nodes were freed from metastasis but the parietal pleural metastatic loci was found. The radio & chemotherapy were performed post-operatively. The patient had been experienced empyema at post-pneumonectomy space and then open drainage procedure and thoracoplasty had been added for treatment course. The patient is alive recently.