• Journal of Chest Surgery
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• v.12 no.4
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• pp.355-360
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• 1979

Mitral and aortic valve replacement with tricuspid annuloplasty was undertaken in 5 patients out of 38 valvular surgery between the period from Jan. 1977 to May 1979 in the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital. All were male patients with age ranging from 18 to 42 years, and preoperative evaluation revealed one case in Class IV, and four cases in Class III according to the classification of NYHA. Preoperative diagnosis was confirmed by routine cardiac study including retrograde aorto- and left ventriculography, and there were two cases with MSi+ASi+Ti, two cases with MSi+Ai+Ti, and one case with Mi+Ai+Ti. Double valve replacement was performed under the hypothermic cardiopulmonary bypass with total pump time of 247 min. in average ranging from 206 min. to 268 min. During aortic valve replacement, left coronary perfusion was done in the first two cases, and cardiac arrest with cardioplegic solution proposed by Bretschneider was applied in the remained three cases. Starr-Edwards, Bjork-Shiley prosthetic valves and Carpentier-Edwards tissue valve were replaced in the aortic area, and Carpentier-Edwards and Angell-Shiley tissue valves were replaced in the mitral area with each individual combination [three prosthetic and two tissue valves in the aortic, and five tissue valves in the mitral area respectively]. Postoperative recovery was uneventful in all cases except one case with hemopericardium, which was managed with pericardiectomy on the postoperative 10th day in good result. Follow-up after double valve replacement of the all five cases for the period from 6 months to 33 months revealed satisfactory adaptation in social activity and occupation with cardiac function of Class I according to the classification of NYHA In all five cases.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.149-152
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• 2018

A 76-day-old infant weighing 3.4 kg was referred for surgical intervention for severe mitral valve stenoinsufficiency caused by leaflet fibrosis and calcification. He had ex perienced a cerebral infarction in the left middle cerebral artery territory, which was deemed attributable to an embolism of a calcified particle from the dysmorphic mitral valve. Because mitral valve replacement using a prosthetic valve was not feasible in this small baby, mitral valve replacement with a pulmonary autograft was performed. After a brief period of extracorporeal membrane oxygenation (ECMO) support, he was weaned from ECMO and was discharged home without further cardiovascular complications.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.92-99
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• 1980

From 1958 up to the end of April 1980, during the period of 12 years 1640 cardiac surgery cases including 1069 open heart surgery and 304 valve replacement cases, were operated in this Department. There were 1070 congenital anomaly and 570 acquired disease cases. In 1070 congenital anomaly cases 673 acyanotic and 397 cyanotic anomaly patients were noted. In acquired diseases 94 pericardial and 456 valvular cases were found. Among 456 valve cases 189 mitral stenosis, 133 mitral insufficiency, 30 aortic valve lesion, 97 double valve, and 7 triple valve lesion patients were noted. Among 304 valve replacement cases 209 mitral, 34 aortic, 5 tricuspid, 34 aortic with mitral, 20 mitral with tricuspid, and 2 triple valves were replaced. Annual increase `of open heart surgery cases and decrease of operative deaths were remarkable in recent years. In recent years Shiley** oxygenator in pump-oxygenator set up and Ionescu** bovine pericardial xenograft bioprosthesis were used for valve replacement mainly.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1119-1122
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• 1999

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.114-121
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• 1994

St. Jude Medical cardiac valve replacement was performed in 135 consecutive patients from Aug.1986 to Dec. 1991.72 had mitral, 28 had aortic, 1 had tricuspid and 34 had double valve replacement. The hospital mortality rate was 4.4% & the late mortality rate was 3.7 %. Follow-up was done on 115 surviving patients:mean follow-up period was 29.78 $\pm$ 18.32 months. Paravalvular leakage was observed in two patients, possible prosthetic valvular endocarditis wasobserved in one patient and other specific valve-related complications were none. The overall actuarial survival rate at 6 years were 91.6% in total, 96.4% in aortic, 95.5 % in mitral and 81.9 % in double valve replacement.We concluded, therefore that good clinical results and a low complication rate could be achieved with St. Jude Medical valve in short-term follow-up & long-term follow-up was also necessary.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.376-379
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• 2007

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair He had no problem after this event. He complained of dyspnea that stalled 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.432-434
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• 2015

Anticoagulation therapy is essential after cardiac valve surgery. However, spontaneous bleeding remains a major concern during anticoagulation therapy. Spontaneous gallbladder (GB) hemorrhage (hemobilia) is a rare occurrence during standard anticoagulation therapy. This report presents a case of GB hemorrhage that occurred shortly after initiating oral anticoagulant therapy in a patient who had undergone mitral valve replacement surgery.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.383-388
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• 2021

Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques. Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events. Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication. Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.661-671
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• 1992

From March 1988 to May 1991, 140 CarboMedics cardiac valve prostheses[75 mitral, 9 aortic and 28 double aortic-mitral] were implanted in 112 consecutive patients[mean age 36.7$\pm$11.6 years, male/female 48/76] by one surgical team operating on adult cardiac patients at Kyoungpook University Hospital Associated Surgical procedures were performed in 19 patients[16.9%]. Total follow up represented 2,345 patient-months[mean 22.4 months] and was 100% complete. Eighty-two patients[73%] were in NYHA functional class IIIor IV preoperatively and 102 patients [95%] were in class I or II postoperatively. Hospital[30 day] mortality was 4.4%, [3/75 mitral, 1/9 aortic, 1/28 double valve replacement] and late death was 1.7%. [1 /74 mitral, 1 /28 double valve replacement] The actuarial survival at 36 months was 94.0% after mitral, 80% after aortic, 92% after double valve replacement, and 93.2% for the total group. The linearized incidence of valve relater death, prosthetic valve thrombosis, anticoagulant related hemorrhage, and reoperation was 1.00%/pt-yr, 0.51%/pt/yr, 0.51%/pt-yr, and 0.51%/pt-yr respectively. The 36 month rates of freedom from valve replated death, thromboembolism, endocarditis, anti-coagulant related hemorrages, and reoperation were 98.75%, 99.08%, 100%, 99.04%, and 99.08% respectively. The 36 month rate of freedom from all valve related complications and deaths including hospital mortality was 90.2%. These fact suggest that the CarboMedics heart valve has excellent short-term result, low incidence of valve-related complications and valve dysfunction, and additional long term follow up study is necessary.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1180-1190
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• 1990

96 patients underwent cardiac valve replacement for valvular heart diseases consecutively between February 1986 to February 1990 in the Department of Thoracic and Cardiovascular Surgery of Yeungnam University Hospital. The follow up period was between 6 months and 4.5 years postoperatively[mean 23.4$\pm$13.1 months]. 75 cases got mitral valve replacement, 6 cases, aortic valve replacement, 15 cases, double valve replacement. 30[31.2%] patients were male and 66[68.8%] were female and the age ranged from 14 to 66 years old. Early hospital death within 30 days postoperation were 5 patients[5.2%], consisting of by low cardiac output in 2, infective endocarditis in 1, multiple organ failure with sepsis in 1 patient. There was no late postoperative death. Most common early postoperative complication was wound disruption [8.7%] and then low cardiac output, pneumothorax, pleural effusion in order. Most common late postoperative complications were minor bleeding episodes[8.7%] related to anticoagulant therapy which were consisted of frequent epistaxis in 3, gum bleeding in 2, hemorrhagic gastritis in 1, hypermenorrhea in 1, hematoma in right arm in 1 patient. Valve-related complications included valve thrombosis [1.6%/ patient-year], valve failure due to pannus formation[1.1% /patient-year], prosthetic valve endocarditis[1, 1%o/patient-year] and minor anticoagulant hemorrhage[4.4% /patient-year]. 5 cases of reoperations were performed in 4 patients due to valve failure and all of them were in the mitral positions[2.7% /patient-year]. Cardiothoracic ratios in the chest X-ray decreased at the 6th month and 1st year postoperation in all patients. But in New York Heart Association[NYHA] functional class IV, no change in cardiothoracic ratio was found between 6 months and 1 year postoperation. In the echocardiogram, the size of the cardiac chambers decreased, but ejection fraction increased postoperatively in each functional class. In the electrocardiogram, decreases were found in the incidence of atrial fibrillation, left atrial enlargement, left ventricular hypertrophy with right bundle branch block increasing postoperatively in each functional class. The actuarial survival rate was 98.4% for all patients, 98.7% for mitral valve replacement, 83.8% for aortic valve replacement, and 80% for double valve replacement at the end of a 4.5 year follow up period. Meanwhile the actuarial freedom rate was 91.5% for prosthetic valve endocarditis, 91.6% for thromboembolism, 89.0% for prosthetic valve failure and 83.7% for minor anticoagulant hemorrhage. Preoperative NYHA class III and IV were 75% of all patients, but 95% of all patients were up graded to NYHA class I and II postoperatively.