• Journal of Veterinary Clinics
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• v.18 no.4
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• pp.358-362
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• 2001

Brain dead (BD) patients remain the largest source of solid organs for transplantation. BD has shown to decrease graft function and survival in rodent models. The aim of this study was to evaluate how brain death affects graft viability in the donor and kidney tolerance to cold preservation as assessed by survival in a canine transplantation. 13 Beagle dogs were used for the study. Brain death was induced by the sudden inflation of a subdural balloon catheter with continuous monitoring of arterial blood pressure and eletroencephalographic activity (n=3). Sixteen hours after conformation of brain death, kidney graft were retrieved (n=6). Non-BD donors served as controls (n=4). All kidneys were flushed with University of Wisconsin (UW) solution and preserved for 24 hours at 4$^{\circ}C$ before transplantation. Recipient survival rates, serum creatinine level were analyzed. Brain death induced the well-known Cushing reaction with a severe increase in blood pressure and tachycardia. Thereafter, cardiac function returned progressively to baseline within 8 hours and remained stable until the end of the experiment. All of dogs in both group transplanted were survived until 7 days (100%), and the kidneys showed functional early rejection at 8.3$\pm$0.5 days and 8.5$\pm$0.5 days after transplantation, in BD and allograft group, respectively. BD kidneys were functionally similar to control kidneys for 7 days after transplantated. Brain death has no deleterious effect on preservation injury and survival of dog kidney transplantation, although it induces changes in hemodynamic parameters. This study reveals that kidneys from BD donors do not exhibit more ischemia reperfusion injury, and support good early function and survival.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1049-1053
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• 1995

Although neoplastic involvement of the pericardium is frequently present postmortem, cardiac manifestations before death are uncommon, and cardiac tamponade as the initial presentation of cancer is rare. We are presenting a metastatic pericardial tumor with cardiac tamponade of unknown primary neoplasm. The patient brought to hospital in a state of unconscious. The chest x-ray film showed cardiomegaly with a globular heart shape and right pleural effusion. We underwent an anterior thoracotomy and pericardial window was created. The histopathologic finding of pericardium, pleural and pericardial effusion show a metastatic adenocarcinoma. The patient subsequently received adjuvent radiotherapy and chemotherapy, but he expired on the postoperative 132 day.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.309-316
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• 1987

Since the first report of successful ligation of patent ductus arteriosus in 1939, it`s surgical intervention has become a routine and relatively safe procedure. During the past ten years from Aug. 1975 to Aug. 1985, 107 cases were operated on for a patent ductus arteriosus at the Department of thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University. Clinical analysis of these cases was performed. Mean age at operation was 9.4 years, ranging from 20 months to 32 years. Sex ratio of female to male was 1.8;1. Most common symptoms were frequent respiratory infection, exertional dyspnea, and palpitation. Diagnosis was made by auscultation, 2 dimensional echocardiography, cardiac catheterization, and cineangiocardiography. A moderate to severe pulmonary hypertension was found in 42 cases [49.4%] in cardiac catheterization. Operative methods were multiple ligation of paten`. ductus arteriosus with or without Dacron or Teflon wrapping in 72 cases [68%], and division and suture in 34 cases [32%]. There were three operative deaths [2.8%]. The causes of death were hemorrhage from tearing of aorta, low cardiac output, and arrhythmia. All of these cases had moderate degree of pulmonary hypertension.

• Journal of Chest Surgery
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• v.23 no.6
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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.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1665-1668
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• 2008

Arrhythmia causes sudden cardiac death. In the past, there were medical limitations in finding the cause of arrhythmia. As an alternative solution for research of arrhythmia, there have been studies to find the causes of arrhythmia by producing a virtual heart model. Medically, arrhythmia has two main causes: abnormal occurrence of action potential and abnormal conduction of action potential. Based on these, the tachycardia, which is one of the arrhythmia, was manifested and the phenomenon of ventricular fibrillation was numerically analyzed in this study. For this purpose, an electrophysiological model of ventricular cells was implemented, which was subsequently applied to the reaction-diffusion partial differential equation to interpret the macroscopic conduction phenomenon in two-dimensional tissues. The ventricular fibrillation refers to a condition where several irregular waves occur in cardiac tissue, whose generation mechanism is pathologically related to the cardiac tissue.

• Journal of Chest Surgery
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• v.4 no.1
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• pp.43-50
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• 1971

Three patients who sustained penetrating stab wound of the heart have been treated successfully by emergency thoracotomy in the Department of Thoracic Surgery, Chonnam University Hospital. There were two knife and one glass wound. The location of the injury were all on the right ventricle, but in one patient, it was penetrated to ventricular septum. All patients were in shock with a systolic pressure under 60 mmHg when admitted to the emergency room. In one of the three patients, blood pressure was not detectable and subsequently cardiac arrest. Two patients required immediate thoracotomy because of intrathoracic hemorrhage and increased pericardial tamponade and the other one required prompt thoracotomy because of sudden onset of cardiac arrest. There were no death postoperatively. Two patients are living without any complication in 4 years and 4 weeks after operation. One who had penetrating wound to ventricular septum, turned to cardiac decompensation, but he is living now in 4$\frac{1}{2}$ years after operation. Exploratory thoracotomy should be performed immediately in all the patients in whom a penetrating wound of the heart or pericardial tamponade following a penetrating wound of the chest wall is suspected.

• Journal of Chest Surgery
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• v.25 no.5
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• pp.518-525
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• 1992

50 months experience with St-Jude Medical Cardiac Valve Prosthesis The St. Jude Medical valve has become our mechanical valvular prosthesis of choice because of favorable hemodynamic results that associated with marked clinical improvement and low incidence of thromboembolism. The data for this study was collected from April 1986 to May 1990, four years period. There were total of 110 patients[female 53, male 58] in this series with 22 isolated aortic valve, 66 isolated mitral valve, 20 double valve, 2 tricuspid valve replacement. The mean follow up time was 23 months. Postoperatively, 77% of cases were in New York Heart Association[NYHA] functional class I, and mild and moderate symptoms[NYHA II ] were present in 20% and there were very few patients remaining in higher functional classifications. In postoperative echocardiographic study showed marked improved cardiac function. The overall early mortality was 5.4% and was higher after double[13.3%] and mitral valve replacement[5.6%] and the late mortality was one case after mitral valve replacement due to endocarditis. The cause of death in early mortality was attributed to heart failure, acute renal failure, sepsis, etc.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.442-451
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• 2022

Background: This meta-analysis was conducted to evaluate the effect of fractional flow reserve (FFR) on clinical outcomes after coronary artery bypass grafting (CABG). Methods: Five online databases were searched for studies that (1) enrolled patients who underwent isolated CABG or CABG with aortic valve replacement and (2) demonstrated the effect of an FFR-guided strategy on major adverse cardiac events (MACE) after surgery based on a randomized controlled trial or adjusted analysis. MACE included cardiac death, acute myocardial infarction (MI), and repeated revascularization. The primary outcomes were all MACE outcomes and a composite of all-cause death and MI, and the secondary outcomes were the individual MACE outcomes. Publication bias was assessed using a funnel plot and the Egger test. Results: Six articles (3 randomized and 3 non-randomized studies: n=1,027) were selected. MACE data were extracted from 4 studies. The pooled analyses showed that the risk of MACE was not significantly different between patients who underwent FFR-guided CABG and those who underwent angiography-guided CABG (hazard ratio [HR], 0.80; 95% CI, 0.57-1.12). However, the risk of the composite of death or MI was significantly lower in patients undergoing FFR-guided CABG (HR, 0.62; 95% CI, 0.41-0.94). The individual MACE outcomes were not significantly different between FFR-guided and angiography-guided CABG. Conclusion: FFR-guided CABG might be beneficial in terms of the composite outcome of death or MI compared with angiography-guided CABG although data are limited.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.44-50
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• 2011

Background: Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. Material and Methods: Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. Results: Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. Conclusion: An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery.

• Journal of Chest Surgery
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• v.50 no.3
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• pp.171-176
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• 2017

Background: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. Methods: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was $8{\pm}11$ (high risk). Results: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow‐up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium ($53.4{\pm}7.5cm$) and the 19 patients who did not have reduction plasty ($48.7{\pm}5.7cm$). Conclusion: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.