• Title/Summary/Keyword: Cardiac artery stenosis

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Pre-and postoperative cardiac catheterization in 20 patients ungergoing closure of VSD whose murmur was sustained after open heart surgery (술후 심잡음이 들리는 심실중격결손증의 수술전후 혈역학적 비교)

  • 박병순
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.780-785
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    • 1984
  • We had studied 20 cases of VSD patients whose murmur was sustained after open heart surgery from 1977 to 1984. The postoperative cardiac catheterization was performed on post-op. 20th day. Their ages ranged from 5 to 25 years old. Among them, 4 patients had significant residual shunt which required reoperation. [1 patient; re-op, 3 patient; refused]. Sex ratio was 13:7 in male and female. Associated anomalies were PDA, ASD, Pulmonary stenosis, Mitral insufficiency. Except 1 case, all of them was Kirklin type II VSD. Postoperative complications were I RBBB, residual shunt, cardiac tamponade due to bleeding, wound infection. Preoperative pulmonary artery systolic pressure was highly related to residual shunt in our study. Postoperative LVEDV returned to normal range on the 3rd week.

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Surgical Correction of Double-outlet Right Ventricle with Atrioventricular Discordance - A case report - (심방심실착위를 동반한 양대혈관 우심실기시증의 수술치험 1례)

  • 최대융
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1471-1475
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    • 1992
  • Within the group of congenital cardiac anomalies manifesting atrioventricular discordance, there exists a subset of hearts characterized by the additional presence of double outlet of the morphological right ventricle. Most of these hearts have associated pulmonary stenosis and abnormal direction of the cardiac apex, and all have a ventricular septal defect. Recently, a 10-year old boy underwent successful surgical correction of double outlet right ventricle with atrioventricular discordance. Diagnostic confirmation was made by 2-D echocardiography, cardiac catheterization and cineangiocardiography. The operation consisted of patch closure of ventricular septal defect so as to leave both great arteries draining the systemic[morphologically right] ventricle, and insertion of an extracardiac valved conduit between the morphological left ventricle and the distal end of the proximally oversewn pulmonary artery. Postoperative course was uneventful.

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Effect of the Proximal Anastomosis Configuration of the Radial Artery in Patients Undergoing Coronary Artery Bypass Grafting

  • Yoon, Seung Keun;Song, Hyun;Lim, Ju Yong
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.117-126
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    • 2021
  • Background: Several factors, such as the degree of target vessel stenosis, are known to be associated with radial artery (RA) graft patency in coronary artery bypass grafting (CABG). There is a lack of data regarding the effect of the RA proximal configuration (aortic anastomosis versus T-anastomosis). This study evaluated the effects of the RA proximal configuration on the patency rate and clinical outcomes after CABG. Methods: We conducted a retrospective study, analyzing 328 patients who had undergone CABG with an RA graft. We divided the patients into 2 groups. The primary endpoint was RA patency and the secondary endpoints were overall mortality and major adverse cardiac and cerebrovascular events (MACCE). We performed a propensity score-matched comparison. Results: Aorta-RA anastomosis was performed in 275 patients, whereas the rest of the 53 patients received T-RA anastomosis. The mean age was 67.3±8.7 years in the T-RA anastomosis group and 63.8±9.5 years in the aorta-RA anastomosis group (p=0.02). The mean follow-up duration was 5.13±3.07 years. Target vessel stenosis ≥70% (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.20-0.91; p=0.03) and T-RA anastomosis configuration (HR, 2.34; 95% CI, 1.01-5.19; p=0.04) were significantly associated with RA occlusion in the multivariable analysis. However, T-RA anastomosis was not associated with higher risks of overall mortality and MACCE following CABG (p=0.30 and p=0.07 in the matched group, respectively). Conclusion: Aorta-RA anastomosis showed a superior patency rate compared to T-RA anastomosis. However, the RA proximal anastomosis configuration was not associated with mortality or MACCE.

Tracheoinnominate Artery Fistula -A Case Report- (기관 무명 동맥루 -1례 보고-)

  • 김맹호;김일현;김광택;김학제
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.536-539
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    • 1998
  • Tracheoinnominate artery fistula is a rare complication that can happen after tracheostomy, the mortality rate is high and it reqiures urgent surgical management. The patient had received a left pneumonectomy 30 years ago and post-operative course was in uneventful. And tracheostomy was performed for acute respiratory failure due to trachea stenosis for 2 months in recent. She was improved in general condition and changed to a 11 mm silicone Montgomery T-tube. On the 3rd day after the tube changed, she had cardiac arrest due to the excessive hemorrhaging due to tracheoinnominate artery fistula. We report an successusful experience for control of bleeding by an innominate artery fistula division and the Utley maneuver for the tracheoinnominate artery fistula. We report the operation method of bleeding control.

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Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis (양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상)

  • Jung, Ho Jin;Choi, Won Suk;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Lee, Jong Joo;Lee, Jun-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

A Case of Moyamoya Disease in a Child with Alagille Syndrome (Alagille 증후군 환아에서 발생한 Moyamoya병 1례)

  • Lim, Mi Rang;Lee, So Yaun;Kim, Deok Soo;Kim, Kyung Mo;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.86-90
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    • 2003
  • Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

Surgical Treatment of the Pulmonary Stenosis: A Report of 17 Cases (선천성 폐동맥협착증의 외과적 요법)

  • 김자억
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.481-487
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    • 1978
  • Seventeen patients of the congenital pulmenic stenosis were operated at the department of Thoracic Surgery, Seoul National University Hospital. There were thirteen male and four females, and ranging from six to thirty years of age. And it's incidence was 2.7% of congenital heart disease cases that were operated on. (Total 628) Seven case of trilogy of Fallot were excluded. Two cases of bacterial endocarditis were found. Right heart catheterization was done in all patients. Average right ventricular pressure was $121{\pm}35.8$mmHg, pulmonary artery $20{\pm}6.8$mmHg, and RV-PA pressure gradient $98{\pm}34.5$mmHg. The preoperative average time interval of A2-P2 which was checked at phonocardiography was $0.08{\pm}0.016$second, and was reduced to $0.03{\pm}0.009$second postoperatively. One was operated by Varco's procedure, another one was done by Brock's procedure, and fifteen patients were done by open heart surgery with heart-lung machine. Pure valvular stenosis was found in sixteen and infundibular stenosis in one case. And the combining anormalies were two patent ductus arteriosus, two patent foramen ovale, and one tricuspid valve hypoplasia. Two expired postoperatively at the begining stage of cardiac surgery in this Department. The remaining fifteen showed excellent operative results.

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The Application of a Bi-ventricular Assist Device for a Low Weight (2.4 kg) Neonate with Coarctation of the Aorta and Critical Aortic Stenosis (대동맥 축착증 및 심한 대동맥 협착을 가진 저체중 신생아(2.4 kg)의 수술 전후 발생한 심실 기능 부전의 치료에 대한 양심실 보조 장치 적용 치험 예)

  • Kwak, Jae-Gun;Park, Chun-Soo;Lee, Chang-Ha;Lee, Cheul
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.304-307
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    • 2010
  • A 5-day-old neonate (body weight=2.4 kg) with coarctation of the aorta and critical aortic stenosis underwent an interventional balloon valvuloplasty for aortic stenosis. During the intervention, cardiac arrest occurred due to injury of the right carotid artery by the guide wire. An extracorporeal membrane oxygenator (ECMO) was applied. After 1 day's support, total surgical correction was achieved; however, in the immediate postoperative period, cardiac function was severely depressed. We applied a bi-ventricular assist device (bi-VAD) instead of an ECMO and we were able to wean the patient off the bi-VAD device after 3 days' support. The patient was discharged without severe complications.

Traumatic Cardiac Perforation (외상성 심장파열의 외과적 고찰)

  • 성시찬
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.365-370
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    • 1979
  • The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.

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Congenitally Corrected Transposition of the Great Arteries Associated with ASD, VSD, and P.S (심방중격 결손증, 심실중격 결손증, 폐동맥 협착증을 동반한 교정형 대혈관 전위증)

  • Park, Sang-Seop;Hwang, Yun-Ho;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.769-775
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    • 1990
  • Congenitally corrected transposition of the great arteries is defined as the anomaly of atrioventricular and ventriculoarterial discordance. Although this condition is compatible with longevity, it is usually associated with other congenital cardiac anomalies, which result in a greatly shortened life span. This report describes a 2 years old female patient who had congenitally corrected transposition of the great arteries associated with ASD, VSD and pulmonary stenosis. The ASD was closed directly through the right atriotomy and the VSD was closed using Dacron patch through right ventriculotomy and the pulmonary[valvular, supra and subvalvular] stenosis was repaired with the use of a valved conduit woven Dacron vessel graft between the pulmonary ventricle and the main pulmonary artery.

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