• Journal of Chest Surgery
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• v.19 no.1
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• pp.122-133
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• 1986

Thirteen patients with cyanotic cardiac malformations having more complex intracardiac defects, hemodynamics and operative procedures than ones in Tetralogy of Fallot undertaken total surgical corrections from July 1981 to August 1985. The cases of corrective surgery for complex cardiac malformations were 3.9% of all congenital cardiac malformations and 12.6% of cyanotic cardiac malformations. Six patients died within 30 days after surgery. So operative mortality was 46%; Transposition of the great arteries, two of 4 patients, due to low cardiac output syndrome and tracheal bleeding ; Univentricular heart, one of 3 patients, due to bleeding; Corrected transposition of the great arteries, one of 2 patients, due to acute heart failure; Tricuspid atresia, one of 2 patients, due to low cardiac output syndrome; Double outlet right ventricle, one of single patient, due to respiratory failure. The cases of surgical correction for complex cardiac malformations are progressively increasing in numbers. The more accurate evaluation of anatomical condition and hemodynamics in preoperative diagnosis, studies on applicable surgical procedure and perioperative care of patients are necessary in the improvement of clinical and surgical results.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.29-34
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• 1972

Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.429-432
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• 1986

Cardiac myxoma is most significant benign tumors constituting nearly 50% of all primary cardiac tumors. Its diagnosis is important because prognosis is excellent by surgical therapy and is usually fatal if unrecognized and untreated. Recently the development of diagnostic procedure and cardiac surgery increased the accuracy of diagnosis and the opportunity of successful treatment. Two cases of left atrial myxoma removed successfully were presented.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.394-397
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• 2014

Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.260-264
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• 2019

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.273-281
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• 1999

Purpose: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. Materials and Methods: 118 patients (M: F=66: 52, $62.7{\pm}10.5$ years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-20l/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods ($14.6{\pm}5.6$ days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Results: Perioperative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease, Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. Conclusion : We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac 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.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.99-104
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• 2015

Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were $194.8{\pm}48.6$ minutes and $126.1{\pm}22.6$ minutes in mitral valve repair operations and $132.0{\pm}32.0$ minutes and $76.1{\pm}23.1$ minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was $128.3{\pm}43.1$ minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.186-193
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• 2023

Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30-day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0-7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.944-952
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• 1990

In 1989, We experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 27 years old male with mild dyspnea on exertion and easy fatigability. All clinical symptoms, physical examinations, laboratory findings, echocardiogram, cardiac catheterization and angiogram revealed supracardiac type T.A.P.V.D. drained through left innominate vein. Operation was done by manner of modified Schumacker procedure. The other case was 6 years old male with cardiac type drained to right atrium through coronary sinus. Two patients were well in postoperative 15 and 8 months.