• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.153-162
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• 1999

The purpose of this study was to determine the effects of an rehabilitation educational program on anxiety, health compliance and quality of life of the patient with cardiac valve replacement. The 80 Subjects for the study were surveyed at the outpatient clinic in S medical center in Buchon City in Korea. Among them, 40 patients had been taught about the cardiac rehabilitation education program and 40 patients had not been taught while they were in the hospital. Those 2 groups of patients were surveyed with the instruments of Spilberger's anxiety scale, and the questionnaire of health compliance and quality of life. The data were analyzed by using $X^2$-test, t-test, Pearson's correlation. The results of this study were as follows: 1. Anxiety in educated group was significantly decreased (t=-2.60, p= .011) comparing to u n edu cat ed group. 2. The health compliance in educated group was significantly in creased (t=2.09, p= .040) comparing to uneducated group. 3. The quality of life of the two groups of pa tients was not different significantly (t=1.83, p= .072). 4. The correlation between anxiety and health compliance was significantly reversed (r=- .461, p= .000). The correlation between anxiety and quality of life was significantly reversed (r=- .654, p= .000). The relationship between health compliance and quality of life revealed significant (r=.438, p= .000). Considering above results, the cardiac rehabilitation educational program for the patients with the cardiac valve replacement was strongly recommended to be used.

• 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.28 no.8
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• pp.731-741
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• 1995

Cardiac valve allografts have been used as replacements for diseased valves and right ventricular outflow tract reconstruction, the long term follow-up of which has been reported satisfactory. For a good long-term result, it is essential that the allograft be viable at implantation. In this study, we aimed at preparing the cardiac valve allografts aseptically, preserving them at cold- and cryo-conditions, and testing the viability of the allografts after preservation by four methods. We tested the viability of the cardiac valve allografts preserved in cold refrigerated state[4$^{\circ}$C in nutrient media & in liquid nitrogen tank[cryopreservation under -149$^{\circ}$C for pre-planned time periods. The testing methods were 1 glucose utility test 2 tissue culture 3 thymidine uptake test and 4 histologic evidence by light microscopy. We observed no differences in the viability between cold- & cryo-groups and similar results among the methods for testing the viability. In conclusion, there was no difference in the viability between cold- and cryopreserved-allografts at least for 14 days of preservation. And glucose utility test and thymidine uptake test were satisfactory in the evaluation of the allograft viability, since they were easy and rapid with relatively quantitative results.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Journal of Chest Surgery
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• v.48 no.6
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• pp.422-425
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• 2015

Amyloid deposits in the heart are not exceptional in systemic amyloidosis. The clinical manifestations of cardiac amyloidosis may include restrictive cardiomyopathy, characterized by progressive diastolic and eventually systolic biventricular dysfunction; arrhythmia; and conduction defects. To the best of our knowledge, no previous cases of isolated tricuspid regurgitation as the initial manifestation of cardiac amyloidosis have been reported. We describe a rare case of cardiac amyloidosis that initially presented with severe tricuspid regurgitation in a 42-year-old woman who was successfully treated with tricuspid valve replacement. Unusual surgical findings prompted additional evaluation that established a diagnosis of plasma cell myeloma.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.272-276
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• 2015

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.

• Journal of Veterinary Clinics
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• v.33 no.6
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• pp.368-371
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• 2016

A four month-old intact female Maltese (weighing 1.8 kg) was present with major complaints of severe coughing and dyspnea. Diagnostic imaging studies revealed abnormally elongated chordae tendineae attached to anterior leaflet and shortened chordae tendineae attached to posterior leaflet of mitral valve causing mitral insufficiency and regurgitant blood flow into left atrium, indicating congenital mitral valve dysplasia. Therapy was directed to control existing clinical signs and to prevent further deterioration of cardiac enlargement using conventional cardiac medications. The dog is currently survived and being monitored at regular interval. This is the first case report describing mitral valve dysplasia causing mitral insufficiency of dog in Korea.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.55-57
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• 2019

Robotically assisted mitral valve repair has proven its efficacy during the last decade. The most suitable approach for patients with difficult anatomies, such as morbid obesity, sternal deformities, cardiac rotation, or vascular anomalies, represents a current challenge in cardiac surgery. Herein, we present the case of a 71-year-old patient affected by severe degenerative mitral valve regurgitation with pectus excavatum and a right aortic arch with an anomalous course of the left subclavian artery who was successfully treated using a Da Vinci-assisted approach.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.347-350
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• 1988

Recent advances in the managements of chronic renal failure have increased the number of the candidates for cardiac operation in patients with chronic renal disease. There have been reports that the operative mortality of the open cardiac surgery in patients with end stage renal diseases was equal to that of the patients with normal renal function. Aortic valve replacement and mitral annuloplasty was successfully performed in a patient with chronic renal failure, and the pre-and postoperative managements are presented.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1001-1012
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• 1989

In 1968, Carpentier and his associates introduced glutaraldehyde as a compound for preparing cardiac tissue valve, and this technique has provided a considerably more suitable and durable tissue valve substitute. To increase further durability of valve tissue, Reis and his colleagues designed a flexible stent to reduce the stress on the heterogeneous tissue valve mounted. However with the advent of more innovative mechanical valve currently, many bioprosthetic valves are being substituted by mechanical valves at our department of cardiothoracic surgery because of bioprosthetic valve failure. Main cause of bioprosthetic valves failure were calcification or/and tear of tissue valves. The purpose of this retrospective study is to clarify the relationship between the patients clinical profile during implantation of tissue valves and pathologic features of the failed bioprosthetic valve. From March, 1982 through June, 1988, 53 bioprosthetic heart valves that had been ex-planted from 45 patients at the department of cardiac surgery of Yonsei University Hospital were subjected to this study. The patients were 10 to 65 year-old [mean age: 30.3 yr] with 17 males and 28 females. Re-replacements of prosthetic valves were carried out twenty nine in mitral position, eight in aortic position and eight in both aortic and mitral position simultaneously. The grading and location for calcification of valves were verified by radiograms. The calcification of the explanted valves leaflets was graded from 0 to 4 plus according to Cipriano and associates method. The types of tear and perforation of leaflet were classified into four types as Ishihara has adopted initially in 1981. In younger age group under thirty three years, explanted tissue valves were significantly more affected in terms of grades of severity of valve calcification as compared with older age group [p < 0.035]. Valve calcification appeared more severe in male as compared to female [p< 0.002]. Ionescu-Shiley bovine pericardial bioprosthetic valves showed more severe calcification than Hancock porcine tissue valves [p< 0.035]. Calcium deposit was found very prevalent at the area of commissural attachment [86 % of all]. Type I of valve rupture was shown to be related with simultaneous calcification. However, the relation of explanted valve position, duration of implanted prosthetic valve, atrial fibrillation and anticoagulant therapy to the severity of bioprosthetic valve calcification were not significantly clear statistically [p > 0.05].