• Title/Summary/Keyword: Cardiomyopathy, dilated

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Early Results of the Heart Transplantation for End Stage Heart Failure (말기 심부전증 환자에 대한 심장이식술의 조기 성적)

  • 노준량;원태희
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.876-884
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    • 1997
  • Fourteen patients underwent orthotopic heart transplantation between March 1994 and May 1996 in Seoul National University Hospital. There were 9 male and 5 female patients, and the mean age was 40.8 $\pm$ 12.4 years ranged from 12 to 56 years. All patient were in NYHA Fc III or IV preoperatively. The underlying heart diseases were dilated cardiomyopathy in 11 and restrictive cardiomyopathy in 3. The mean age of donors was 24.9$\pm$ 10.2 years and the causes of the brain death were head trauma by traffic accidents in 8, subarachnoid hemorrhage in 2, 1 asphyxia, 1 fall down injury, 1 brain tumo , and 1 drowning, respectively The blood type was identical in 11, compatible in 2, and incompatible in 1 patient. The direct bicaval anastomosis technique was used in 11 cases, and standard right atrial anastomosis was done in the remaining 3 cases. The graft ischemic time was 158$\pm$44 minutes ranged 94 to 220 minutes. There were two hospital deaths(14.3%). The causes of deaths were 1 right ventricular failure followed by suspected cyclosporine induced hemolytic uremic syndrome and rejection, and 1 delayed massive bleeding, probably from rupture of the anastomotic pseudoaneurysm, respectively. The follow-up duration was 16$\pm$9 months(3 to 28 months). There was one late death(8.3%). All the other patients were in NYHA Fc I except one patient who was in hospital because of the acute rejection. The actuarial survival rates including hospital deaths were 93.7% at 1 month, 86.9% at 6 months, and 77$\pm$12% at 2 years. Conclusively, heart transplantation is the good strategy for the management of end stage heart disease with acceptable operative mortality and early follow-up results.

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Application of 40-channel SQUID Gradiometer System for the Comparison of Magnetocardiograms from Healthy Subjects and Patients with WPW syndrome and DCM (40 채널 SQUID 미분계 시스템을 이용한 정상인과 WPW 증후군 및 확장성 심근증 환자의 심자도 비교)

  • 정용석;권혁찬;김기웅;이용호;강찬석;김진목;박용기;김기영;박기락
    • Progress in Superconductivity
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    • v.5 no.1
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    • pp.38-44
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    • 2003
  • The aim of this study is to confirm clinical usefulness of magnetocardiogram (MCG) by analyzing MCG data of health subjects and patients with Wolff-Parkinson-White (WPW) syndrome and dilated cardiomyopathy (DCM). Measurement of MCG signals was done with a home-made 40-channel SQUID system. MCG signals of 30 healthy subjects were measured as the reference of MCG signals. Among the DCM patients, 7 patients showed abnormal the direction of T wave vector. For a WPW syndrome patient, we measured the MCG signals before and after the surgery. and compared the difference. From the measured magnetic field distribution, current vector map was obtained to show the myocardium current activity. By comparing the MCG signals and current maps, we showed the differences in the analysis results between the healthy subjects and patients with heart diseases.

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Severe Mitral Regurgitation Due to Coronary Vasospasm, Confirmed by Ergonovine Echocardiography (에르고노빈 심초음파로 확진된 승모판 폐쇄부전을 유발한 혈관연축 1예)

  • Cha, Jung-Joon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Kim, Haewon;Lee, Sung-Joo;Rim, Se-Joong;Choi, Eui-Young
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.120-123
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    • 2013
  • The common causes of organic mitral regurgitation (MR) include mitral valve prolapse (MVP) syndrome, rheumatic heart disease, and endocarditis. MR also occurs secondary to dilated cardiomyopathy and coronary artery disease. In acute severe MR, the hemodynamic overload often cannot be tolerated, and mitral valve repair or replacement must be performed immediately. We report herein a case of severe MR due to coronary vasospasm that was confirmed via ergonovine echocardiography in a 70-year-old man. He was scheduled to undergo mitral valve surgery, but it did not push through and he was put on medical therapy.

Cardiac Transplantation; 1 Case Report (심장이식 1례보고)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.224-227
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    • 1993
  • We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

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Chest Wall Reconstruction with a Transverse Rectus Abdominis Musculocutaneous Flap in an Extremely Oversized Heart Transplantation

  • Yim, Ji Hong;Eom, Jin Sup;Kim, Deok Yeol
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.89-92
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    • 2014
  • An 8-year-old girl diagnosed with dilated cardiomyopathy and Russell-Silver syndrome was admitted to our pediatric intensive care unit due to low cardiac output and multiple-organ dysfunction. The patient was placed on the heart transplant waiting list and extracorporeal membrane oxygenation was performed as a bridge to transplantation. After 17 days, heart transplantation was performed. The donor was a 46-year-old female (weight, 50 kg; height, 150 cm). The donor:recipient weight ratio was 3.37:1. Because the dimension and volume of the recipient's thoracic cage were insufficient, the sternum could not be closed. Nine days after transplantation, the patient underwent delayed sternal closure. To obtain adequate space, we left the sternum 4.5 cm apart from each margin using four transverse titanium plates. A transverse rectus abdominis musculocutaneous flap was chosen to cover the wound. Due to the shortage of donors, a size-mismatched pediatric heart transplantation is sometimes unavoidable. Closure of the opened sternum of a transplant recipient can be challenging. Sternal reconstruction after an extremely oversized heart transplantation with transverse titanium plate fixation and a musculocutaneous flap can effectively achieve sternal closure and stability.

One case of Coxsackievirus induced Pancarditis (Coxsackie Virus에 의한 Pancarditis 1례)

  • Jang, Chang Kyun;Cho, Byung Soo;Choi, Yong Mook;Cha, Sung Ho
    • Pediatric Infection and Vaccine
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    • v.2 no.2
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    • pp.200-206
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    • 1995
  • Myocarditis refers to inflammation, necrosis, or myocytolysis that may be due to many infectious, connective tissue and many other causes affecting the myocardium or involvement of the endocardium or pericardium. The most common manifestation is congestive heart failure, although arrhythmias and sudden death may be the first sign of myocarditis. Viral myocarditis is typically a sporadic but occasionally epidemic illness, noted as an acute potentially fulminant disease of 1-to 4-wk-old infants, as an acute but more benign myopericarditis of toddlers and young children. The most common casuative agent in viral myocarditis is Coxsackievirus and the outcome of the biopsy-proven chronic dilated cardiomyopathy associated with Coxsackievirus is poor without therapy. Myocarditis may be confirmed by percutaneous endomyocardial biopsy and the viral myocarditis may be diagnosed by the serological viral study with the clinical manifestations. He was admitted for the management of tachyarrhythmias occurred suddenly without prodromal symptoms and signs and diagnosed as viral pancarditis by serological Coxsackievirus study, echocardiogram, chest x-ray, EKG and other clinical manifestations.

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Bridge to Transplantation with a Left Ventricular Assist Device

  • Jung, Jae-Jun;Sung, Ki-Ick;Jeong, Dong-Seop;Kim, Wook-Sung;Lee, Young-Tak;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.116-119
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    • 2012
  • A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.

A Case of Bilateral Pheochromocytoma: Findings of US, CT, MRI and $^{131}I-MIBG$ Scan (양측성 갈색세포종의 초음파, CT, MRI와 $^{131}I-MIBG$ Scan 소견)

  • Yang, Seoung-Oh;Choi, Sang-Hee;Nam, Kyung-Jin;Lee, Yung-Il;Kim, Young-Dae;Kim, Jong-Seong
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.332-336
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    • 1990
  • Pheochromocytoma occurs at all ages but is most common in young to midadult life. In adults 10 percent of pheochronocytoma are bilateral. And bilateral lesions are common in the familial syndromes; within Multiple Endocrine Neoplasia (MEN) kindreds over half with pheochromocytomas have bilateral lesions. We report a case of bilateral pheochromocytoma firstly detected by ultrasonogram. This 24-year-old male was normotensive and had symptoms of dilated cardiomyopathy and elevated VMA level. CT and MRI were performed to evaluate the tissue nature and associated abnormalities. $^{131}I-MIBG$ scan seems to be the imaging of choice in patients with suspected multicentric/bilateral or recurrent or metastatic pheochromocytomas.

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The First Pediatric Heart Transplantation Bridged by a Durable Left Ventricular Assist Device in Korea

  • Shin, Jung Hoon;Park, Han Ki;Jung, Se Yong;Kim, Ah Young;Jung, Jo Won;Shin, Yu Rim
    • Journal of Chest Surgery
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    • v.53 no.2
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    • pp.79-81
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    • 2020
  • Treatment options for children with end-stage heart failure are limited. We report the first case of a successful pediatric heart transplantation bridged with a durable left ventricular assist device in Korea. A 10-month-old female infant with dilated cardiomyopathy and left ventricular non-compaction was listed for heart transplantation. During the waiting period, the patient's status deteriorated. Therefore, we decided to provide support with a durable left ventricular assist device as a bridge to transplantation. The patient was successfully bridged to heart transplantation with effective support and without any major adverse events.

Role of Protein Kinase C $\delta$ in an Early Stage of Coxsackievirus-B3-Induced Apoptosis in HeLa Cells

  • Rark Jung-Hyun;Cho Du-Hyong;Yun Cheol-Won;Soh Jae-Won;Jee Young-Mee;Park Sang-Ick;Jo In-Ho;Nam Jae-Hwan
    • Journal of Microbiology and Biotechnology
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    • v.16 no.4
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    • pp.550-555
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    • 2006
  • CVB3 is a virulent human pathogen that induces myocarditis and ultimately dilated cardiomyopathy. Although several apoptotic factors are involved in the cell death induced by CVB3, the upstream signal transduction factors of CVB3-induced apoptosis are still unclear. We explored and characterized the role of PKC $\delta$ in CVB3-infected cells. PKC $\delta$ was cleaved after CVB3 infection and was activated at 6 h postinfection. PKC $\delta$ was also translocated into the nucleus via mitochondria after CVB3 infection, and overexpression of wild-type PKC $\delta$ reduced the apoptotic cell death caused by CVB3. These results indicate that PKC $\delta$ has an antiapoptotic role in CVB3 infection.