• Clinical and Experimental Pediatrics
• /
• v.49 no.9
• /
• pp.917-929
• /
• 2006

Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

• Journal of Chest Surgery
• /
• v.53 no.4
• /
• pp.222-225
• /
• 2020

Owing to varying clinical definitions of anastomotic stricture following esophageal reconstruction, its reported incidence rate varies from 10% to 56%. Strictures adversely impact patients' quality of life. Risk factors, such as the anastomosis method, leakage, ischemia, neoadjuvant chemoradiotherapy, and underlying disease have been mentioned, but conflicting information has been reported. Balloon dilation is regarded as a safe and effective treatment method for patients with benign anastomotic strictures. Reoperations are seldom required. The etiology and management of anastomotic strictures are reviewed in this article.

• Journal of Veterinary Clinics
• /
• v.26 no.2
• /
• pp.160-165
• /
• 2009

A 4-month-old intact male Boxer dog(9 kg of body weight) was presented with the primary complaints of heart murmur and exercise intolerance. Diagnostic studies revealed severe subaortic stenosis. Since the pressure gradient(PG) in stenotic aortic valve area was higher than ${\sim}120mmHg$(5.4 m/s of peak velocity), the dog was underwent balloon valvuloplasty. With this procedure, the peak aortic velocity was reduced to 3.9 m/s(${\sim}60mmHg$ of PG) and the clinical condition of dog was markedly improved. Periodic re-evaluations performed at monthly interval revealed no further deterioration. This is the first case report of subaortic stenosis treated by non-surgical palliative balloon valvuloplasty in Korea.

• Journal of Veterinary Clinics
• /
• v.32 no.4
• /
• pp.334-337
• /
• 2015

A 9-month-old castrated male French Bulldog (13 kg of body weight) was presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging studies found severe pulmonic stenosis (peak velocity > 5 m/s) with right ventricular hypertrophy. Because of higher pressure gradient between right ventricle and right ventricular outflow tract (> 100 mmHg), the dog was underwent balloon valvuloplasty through femoral vein. After procedure, the peak pulmonic velocity was reduced to 2.1 m/s (PG = 18 mmHg). Further follow-up study found no further deterioration, for 6 months to date. This is the first case report of pulmonic stenosis treated by transvenous balloon valvuloplasty through femoral vein in Korea.

• Korean Chemical Engineering Research
• /
• v.49 no.2
• /
• pp.238-243
• /
• 2011

In this study, we attempted a structural analysis in order to design a balloon type extracorporeal membrane oxygenator that can induce blood flow without using blood pumps for the purpose of complementing the weakness in the existing extracorporeal membrane oxygenator. To analyze the flow characteristic of the blood flow within the virtual model of extracorporeal membrane oxygenator, computational fluid dynamics(CFD) modeling method was used. The operating principle of this system is to make the surface of the extracorporeal membrane oxygenator keep contracting and dilating regularly by applying pressure load using a balloon, and the 'ime Function Value'that changes according to the time was applied by calculating a half cycle of sine waveform and a cycle of sine.waveform Under the assumption that the uni-directional blood flow could be induced if the balloon type extracorporeal membrane oxygenator was designed as per the method described above, we conducted a structural analysis accordingly. We measured and analyzed the velocity and pressure of blood flow at both inlet and outlet of the extracorporeal membrane oxygenator through CFD simulation. As a result of the modeling, it was confirmed that there was a flow in accord with the direction of the blood by the contraction/dilation. With CFD simulation, the characteristics of blood flow can be predicted in advance, so it is judged that this will be able to provide the most optimized design in producing an extracorporeal membrane oxygenator.

• Journal of Veterinary Clinics
• /
• v.34 no.4
• /
• pp.268-271
• /
• 2017

A 1.3 year-old Castrated male Bedlington terrier (10.0 kg of body weight) was presented with heart murmur and occasional coughing. Diagnostic imaging studies revealed supravalvular pulmonic stenosis (maximal velocity 2.91 m/s) from abnormal membranous structure (aperture) distal to the pulmonary valve in the main pulmonary artery. Further study also revealed pulmonic regurgitant (1.82 m/s of peak velocity, 13.2 mmHg of pressure gradient) jets started from the abnormal membranous structure. Since the dog had no obvious clinical signs related to heart failure, no interventional therapy including balloon dilation was considered in this case. Instead, medical treatment for preventing further deterioration of clinical signs related to PS was done with enalapril. This case report described a rare case of type III supravalvular PS in a dog, which has never been reported. Further deterioration of clinical signs has yet been recognized after medical treatment.

• Journal of Veterinary Clinics
• /
• v.33 no.2
• /
• pp.129-130
• /
• 2016

A 5-year-old male Laika dog was referred with chief complaint of dyschezia and tenesmus. The dog had rectal prolapse and it was corrected with rectal resection and anastomosis, a year ago. On rectal examination, the stricture of rectum was identified. The irregular scar tissues on serosal and muscular layers of rectum were noted and they were dispersed with partial thickness incision around rectum. Then, the colopexy and mechanical dilation with balloon catheter were applied. No recurrence of rectal prolapse and other complications were noted during follow up periods of 1 year. This report described a successfully corrected anastomotic rectal stricture in a dog.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.20 no.4
• /
• pp.211-215
• /
• 2017

Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification). Mytomycin-C application needs to be further evaluated. Stenting was reported to be successful in some refractory cases.

• Journal of Digestive Cancer Research
• /
• v.2 no.2
• /
• pp.82-84
• /
• 2014

We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

• Clinical Endoscopy
• /
• v.56 no.5
• /
• pp.537-545
• /
• 2023

Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.