• 보험의학회지
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• 제32권2호
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• pp.28-32
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• 2013

We studied trends of cardiac valve surgery using insurance data. 368 persons were included our study. We studied whether there are frauds or not. Only 4 cases were done at less than 1year from an insurance contract. We reviewed medical records of all persons. We could find the type of valve disease in 211 cases. The findings are atrial valve 40.1%, mitral valve 34.6% and others 25.3%. When we divided by materials of surgery, mechanical valves were used in 68.8% of men and 70.6% of woman. The main causes of valve disease were infection(55.1%). And degenerative valve disease 32% and congenital valve disease were 13%. We cannot find definite evidence of insurance frauds in the cardiac valve surgery. But there are some limitation in data analysis.

• Journal of Chest Surgery
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• 제51권3호
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• pp.161-166
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• 2018

Patient-prosthesis mismatch (PPM) is a controversial issue in current clinical practice. PPM has been reported to have a negative impact on patients' prognosis after aortic valve replacement in several studies, showing increased all-cause and cardiac mortality. Moreover, a close relationship has recently been described between PPM and structural valve deterioration in biological prostheses. In patients at risk for PPM, several issues should be considered, and in the current era of cardiac surgery, preoperative planning should consider the different types of valves available and the various surgical techniques that can be used to prevent PPM. The present paper analyses the state of the art of the PPM issue.

• Journal of Chest Surgery
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• 제56권6호
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• pp.394-402
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• 2023

Background: The optimal choice of valve substitute for aortic valve replacement (AVR) in pediatric patients remains a matter of debate. This study investigated the outcomes following AVR using mechanical prostheses in children. Methods: Forty-four patients younger than 15 years who underwent mechanical AVR from March 1990 through March 2023 were included. The outcomes of interest were death or transplantation, hemorrhagic or thromboembolic events, and reoperation after mechanical AVR. Adverse events included any death, transplant, aortic valve reoperation, and major thromboembolic or hemorrhagic event. Results: The median age and weight at AVR were 139 months and 32 kg, respectively. The median follow-up duration was 56 months. The most commonly used valve size was 21 mm (14 [31.8%]). There were 2 in-hospital deaths, 1 in-hospital transplant, and 1 late death. The overall survival rates at 1 and 10 years post-AVR were 92.9% and 90.0%, respectively. Aortic valve reoperation was required in 4 patients at a median of 70 months post-AVR. No major hemorrhagic or thromboembolic events occurred. The 5- and 10-year adverse event-free survival rates were 81.8% and 72.2%, respectively. In univariable analysis, younger age, longer cardiopulmonary bypass time, and smaller valve size were associated with adverse events. The cut-off values for age and prosthetic valve size to minimize the risk of adverse events were 71 months and 20 mm, respectively. Conclusion: Mechanical AVR could be performed safely in children. Younger age, longer cardiopulmonary bypass time and smaller valve size were associated with adverse events. Thromboembolic or hemorrhagic complications might rarely occur.

• Journal of Chest Surgery
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• 제57권1호
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• pp.96-98
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• 2024

The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

• Journal of Chest Surgery
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• 제20권3호
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• pp.557-564
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• 1987

From September 1980 to July 1986, 135 cases of cardiac valve surgery were performed under the cardiopulmonary bypass. Out of 135 cases, single valve surgery was 114 cases including open mitral commissurotomy 17, mitral annuloplasty 2, mitral valve replacement 85, and aortic valve replacement 10 and double valve surgery was 21 cases. There were 68 males and 67 females ranging from 9 to 57 years of age. Early death within 30 days after operation was 17 cases [12.6%] and caused of death were ventricular arrhythmia 5, low cardiac output syndrome 4, excessive bleeding 3, pulmonary complication 2, and so on. Among 118 early survivors, 5 cases [5.1%] of late death were developed over a period of 2 to 72 months, and main cause of death was fatal bleeding complication associated with anticoagulation therapy. Symptomatically, 91.8% of patients were in NYHA functional class I or II at the end of the follow-up.

• Journal of Chest Surgery
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• 제52권3호
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• pp.178-181
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• 2019

Prosthetic valve endocarditis with aortic root abscess is a serious condition requiring urgent surgical intervention. We present a case caused by an infected Bentall mechanical valve conduit after cardiac surgery in a patient who was referred for a suprasternal pulsatile mass. The patient also had 1 episode of sentinel haemorrhage.

• Journal of Chest Surgery
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• 제41권4호
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• pp.496-498
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• 2008

심장 유두상 섬유탄력종은 원발성 종양 중 두 번째로 많이 호발하는 양성종양으로 주로 심장판막에 발생한다. 그러나 대부분 한곳에서 발생하며 다발성으로 발생하는 경우는 전체 심장 유두상 섬유탄력종의 5%로 아주 드문 경우이다. 55세 여자가 내원 10일전부터 발생한 순간적인 어지러움 및 실신으로 내원 시 검사한 심초음파상 대동맥 판막에 부착된 다발성 종양이 발견되어 수술 시행하였으며, 대동맥 판막의 손상 없이 대동맥 판막에 부착된 종양만 제거하였고, 환자 퇴원 후 외래 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제27권3호
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• pp.187-190
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• 1994

Between March, 1989, and August, 1993, 10 patients underwent aortocoronary bypass surgery concomittant with cardiac valve replacement. They were 6 men and 4 women, the age ranging from 47 to 64. 7 patients underwent single valve replacement and 2 patients underwent double valve replacement, Another one patient underwent only CABG one year after valve replacement and he had no evidence of prosthetic valve failure. Total number of graft vessels were.15,14 were saphenous venous grafts and 1 was internal mammary artery graft. Dyspnea on exertion was frequent symptom and was found in all patients. 8 patients presented stable angina, only 1 patient presented postinfarct angina and another 1 patient presented no angina symptom. The graft was placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout operation. Postoperative course was uneventful and there was no hospital mortality, as was supported by many reports, it is our opinion that simultaneous valve replacement and aortotomy bypass graft does not increase the risk of cardiac valve replacement substantially.

• Journal of Chest Surgery
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• 제22권1호
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• pp.106-115
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• 1989

Clinical results with the xenograft cardiac valves were reviewed for 212 patients who underwent heart valve replacement from January 1981 to December 1987. One hundred and twenty-four Carpentier-Edwards k 88 Ionescu Shiley valves were used. Overall operative mortality was 11 out of 212[5.1%]: 5 out of 153[3.39o] for mitral valve replacement [MVR], 2 out of 34[5.9%] for aortic valve replacement [AVR], 0 out of 4[0%] for Tricuspid valve replacement [TVR], and 4 out of 21[19.1%] for double valve replacement [DVR;MVR+ AVR]. Two hundred and one operative survivors were followed up for a total of 824.3 patient-years [a mean 3.9*1.8 yrs], and the follow up was 78.1%. The linealized complication rates were 0.1% emboli / patient-year, 1.0% endocarditis/ patient-year and 2.2% overall valve failure / patient-year. A linealized rate of primary tissue failure was 0.7*/o/ patient-year. The actuarial survival rates including the operative mortality were 92*2.8% at 4 years and 85*4.3% at 7 years after surgery using the Xenograft cardiac valves. Probabilities of freedom from thromboembolism and overall valve failure were 73*11.0% and 69*2.4% at 7 years after surgery using the Xenograft cardiac valves respectively. The intrinsic durability of the Xenograft cardiac valves appears to be relatively well satisfactory over the long term [4 to 7 years] and the risk of failure appears well balanced by the advantages of a low incidence of thromboembolism and no mandatory anticoagulant therapy.

• Journal of Chest Surgery
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• 제8권2호
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• pp.89-100
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• 1975

Sixteen cases of cardiac valve replacements have been done in this department since 1970. Twelve cases of mitral valve replacement were done with Beall valve, 2 cases of aortic valve replacement with Starr-Edwards and Magoven valve and 2 cases of double valve replacement using Beall valve for mitral and Magovern valve for aortic. Three patients [18.8%] died during operation. Two cases [12.5%] of hospital mortality occurred because of congestive heart failure and asphyxia due to tracheomalacia 3 months after operation. Follow-up studies from two to 27 months showed excellent results except three cases of late mortality [18.8 %]. Thromboembolism occurred in two double valve replacement patients[12.5%]who were fatal.