• Journal of Chest Surgery
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• 제23권6호
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• pp.1263-1269
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• 1990

Two patients with uncorrectable cyanotic cardiac anomalies underwent total cavopulmonary shunt[modified Fontan operation]. Case I was a 14 years old male with dyspnea and cyanosis after birth. Aortogram showed TGA combined with overriding of aorta, pulmonary stenosis, complete atrioventricular septal defect, interruption of inferior vena cava, and situs inversus totalis. We had performed total cavopulmonary shunt using with 16 mm Gortex Graft in single atrium to bypass the hepatic vein to pulmonary artery. Postoperatively, patient sustained low PaCO2 and low cardiac output and then expired at 19th postoperative day. The cause of death of the patient would be low cardiac output. Case II was a 6 years old female with dyspnea and cyanosis after birth. Aortogram showed tricuspid atresia[Type IIb], transposition of great arteries, atrial septal defect, ventricular septal defect and pulmonary stenosis, We had performed total cavo-pulmonary shunt using intraatrial baffle[tunnel] with Goretex patch. The postoperative course of this patient was good without event.

• Journal of Chest Surgery
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• 제14권2호
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• pp.153-160
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• 1981

Within the group of congenital cardiac anomalies manifesting dextrocardia and double-outlet right ventricle, ventricular non-inversion [S.D.L] is extremely rare. Recently, a 5 year-old boy underwent a successful surgical correction of dextrocardia associated with double-outlet right ventricle, ventricular non-inversion [S.D], ventricular septal defect, pulmonary stenosis, and patent foramen ovale. The operation consisted of construction of an internal baffle connecting the left ventricle to the aorta through the large ventricular septal defect [subaortic]. The pulmonary stenosis was managed by infundibulectomy and patch enlargement of the right ventricular wall. The patient`s postoperative recovery has been uneventful, and 2 months after the operation, he is doing well.

• Journal of Chest Surgery
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• 제15권3호
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• pp.346-354
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• 1982

A Complete transposition of the great arteries combined with V.S.D, A.S.D, dextrocardia, and P.S is a rare congenital anomaly. The patient was a 10 year-old female whose complaints were frequent URI, exertional dyspnea, and cyanosis at rest since birth. Cheat X-ray films showed Dextrocardia ; situs inversus, moderate cardiomegaly, and Characteristic egg-shape heart shadow. E.K.G, Echocardiography, Cardiac Catheterization, and Angio-Cardiography were performed. Open heart Surgery was done under diagnosis of d-TGA, Dextrocardia, V.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D. ($2.0{\times}2.0cm$. in diameter), V.S.D. type II ($1.5cm{\times}1.5cm$ in diameter), and pulmonary valvular stenosis were noted. Mustard operation using pericardial Baffle in the atrium for T.G.A. was perforsned. Teflon patch graft for closure of V.S.D. through tricuspid orifice and pulmonary Valvulotomy through pulmonary arteriotomy were performed. The post-op, low cardiac output Syndrome and dysrhythmicawere developed till Postoperative day #7, so that was controlled by inotropic and antiarrhythmic agents. After that, patient's conditions were Uneventful.

• Journal of Chest Surgery
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• 제16권3호
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• pp.349-355
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• 1983

Twenty-seven patients with double-outlet right ventricle underwent complete intracardiac repair between 1978 and 1983, June, at Seoul National University Hospital . Although definite aorto-mitral discontinuity was discovered in 20 patients, both great arteries arose wholly or mostly from the right ventricle in all cases. There were 17 cases with subaortic VSD, 6 with subpulmonic, 2 with doubly-committed, and 2 with non-committed VSD. Pulmonary stenosis was present in 21 patients. Intraventricular baffle repair was applied in 23 patients. Three patients required extracardiac conduit to establish continuity between right ventricle and pulmonary artery, and modified Fontan operation was performed in one patient. Over-all mortality rate was 37.0%, but recently 4 of 15 died [26.7%]. One late death occurred from infective endocarditis. Incremental risk factors were small patient size, subpulmonic or non-committed VSD, presence of PS, coronary artery anomalies, associated valvular lesion and other complicated anomalies. However, great artery relationship, restrictive VSD and transannular patch were not risk factors. No instances of complete heart block occurred. Of the survivors, all showed complete or in complete right bundle branch block and in one patient intermittent ventricular tachycardia had developed. The important cause of death was low cardiac output syndrome.