• Journal of Chest Surgery
• /
• v.51 no.1
• /
• pp.35-40
• /
• 2018

Background: The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in Korea have not been reported. We analyzed the outcomes of MPM in the context of multimodal treatment, including surgery. Methods: The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared. Results: The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23). Conclusion: Multimodal treatment incorporating surgery did not show better outcomes than non-surgical treatment. A nationwide multicenter data registry and prospective randomized controlled studies are necessary to optimize the treatment of MPM.

• Journal of Chest Surgery
• /
• v.45 no.3
• /
• pp.141-147
• /
• 2012

Background: Although the aortic valve-sparing procedure has gained popularity in recent years, it still remains challenging in patients with advanced aortic regurgitation (AR). We compared the long-term outcomes of the aortic valve-sparing procedure with the Bentall operation in patients with advanced aortic regurgitation secondary to aortic root dilatation. Materials and Methods: A retrospective review of 120 patients who underwent surgery for aortic root dilatation with moderate to severe AR between January 1999 and June 2009 was performed. Forty-eight patients underwent valve-sparing procedures (valve-sparing group), and 72 patients underwent the Bentall procedure (Bentall group). The two groups' overall survival, valve-related complications, and aortic valve function were compared. Results: The mean follow-up duration was $4.9{\pm}3.1$ years. After adjustment, the valve-sparing group had similar risks of death (hazard ratio [HR], 0.61; p=0.45), and valve related complications (HR, 1.27; p=0.66). However, a significant number of patients developed moderate to severe AR in the valve-sparing group at a mean of $4.4{\pm}2.5$ years of echocardiographic follow-up (p<0.001). Conclusion: Both the Bentall operation and aortic valve-sparing procedure showed comparable long-term clinical results in patients with advanced aortic regurgitation with aortic root dilatation. However, recurrent advanced aortic regurgitation was more frequently observed following valve-sparing procedures.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.158-167
• /
• 2022

Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.

• Proceedings of the PSK Conference
• /
• 2002.10a
• /
• pp.430.2-431
• /
• 2002

Cardiovascular complications are high in the diabetic patients. Especially, acute coronary heart diseases (CHD) can be prevented by use of antiplatelet agents. This study was to determine the efficacy of antiplatelet therapy on prevention of cardiovascular events in diabetic patients. METHODS: The medical charts of 132 diabetic patients at Hanyang University. Kuri Hospital from January 1996 to January 2000 were reviewed retrospectively. (omitted)

• Journal of Chest Surgery
• /
• v.19 no.4
• /
• pp.672-677
• /
• 1986

From April, 1984 to August, 1986, 214 cases of cardiovascular surgeries had been performed at Yeungnam University Hospital consisting 158 open heart surgeries and 56 non-open heart surgeries. The leading cardiac anomaly of open heart surgeries was ventricular septal defect which was 43% of congenital heart diseases, and most of remaining non-open heart surgeries were ligating patent ductus arteriosus. We had observed 33 postoperative complications such as wound problems, transient arrhythmia, postpericardiotomy syndrome, bleeding requiring reoperation and so on. 3 cases of surgical mortality were present [2 in congenital heart diseases and 1 in acquired heart disease], which resulting 1.9% of surgical mortality rate in the open heart surgeries.

• Journal of Chest Surgery
• /
• v.44 no.1
• /
• pp.83-85
• /
• 2011

The thoracic duct cyst is an extremely rare cystic lesion in the mediastinum. Surgical treatment of the cyst is necessary to confirm histologic diagnosis and prevent potential complications such as spontaneous or traumatic rupture of the cyst and chylothorax.

• Journal of Chest Surgery
• /
• v.46 no.1
• /
• pp.72-75
• /
• 2013

Percutaneous vertebroplasty is a relatively easy and minimally invasive procedure used in treating vertebral fractures. However, the procedure has many complications, one of which is bone cement leakage, which happens frequently. Leakage to the paravertebral venous system, in particular, may lead to especially devastating consequences. Here we report a case of a 65-year-old male patient with an intracardiac foreign body (bone cement) that generated a perforation on the right ventricle, and result in hemopericardium after percutaneous vertebroplasty. We performed open heart surgery to remove the foreign body.

• Journal of Chest Surgery
• /
• v.48 no.4
• /
• pp.302-305
• /
• 2015

Pseudoaneurysm with arteriovenous fistula is a rare complication of arthroscopy, and can be diagnosed by ultrasonography, computed tomography, magnetic resonance imaging, or angiography. This condition can be treated with open surgical repair or endovascular repair. We report our experience with the open surgical repair of a pseudoaneurysm with an arteriovenous fistula in a young male patient who underwent arthroscopy five months previously.

• Journal of Chest Surgery
• /
• v.46 no.5
• /
• pp.357-361
• /
• 2013

Left ventricular free wall rupture (LFWR) is rare, but is one of the most serious complications of myocardial infarction and is associated with high mortality. Several operative techniques have been attempted, but early diagnosis and prompt surgical management are crucial for a positive patient outcome. We report three cases of LFWR successfully treated with surgical methods.

• Journal of Chest Surgery
• /
• v.33 no.3
• /
• pp.231-239
• /
• 2000

Background: This retrospective study tries to identify specific risk factors that may increase complication rates after the surgical treatment of tuberculous destroyed lung. Material and method: A retrospective study was performed on forty-seven patients, who received surgical treatment for tuberculous destroyed lung in the Department of Thoracic and Cardiovascular Surgery at Hanyang University Hospital from 1988 to 1998, to identify specific preoperative risk factors related to postoperative complications. Fisher's exact test was used to identify the correlations between the complications and right pneumonectomy, preoperative FEV1, predicted postoperative FEV1, massive hemoptysis, postoperative persistent empyema. Result: Hospital mortality and morbidity rates of the patients who received surgical treatment for tuberculous destroyed lung were 6.4% and 29.7%, respectively. In view of the hospital mortality and morbidity rates as a whole, predicted postoperative FEV1 less than 0.8L(p<0.005), preoperative FEV1 less than 1.8L(p=0.01), massive hemoptysis(p<0.005), postoperative persistent positive sputum cultures(p<0.0005), and the presence of multi drug resistant tuberculosis(p<0.05) presented statistically significant correlations. Among the postoperative complications, bronchopleural fistula, the most common complication, was found to have statistically significant corrleations with the preoperative empyema(p<0.05) and postoperative persistent positive sputum cultures(p<0.05). Conclusion: Although mortality and morbidity rates after surgical treatment of tuberculous destroyed lung were relatively low, when predicted postoperative FEV1 was less than 0.8L, when preoperative FEV1 was less than 1.8L, when massive hemoptysis was present, when postoperative sputum cultures were persistently positive, and when multi drug resistant tuberculosis was present, the rates were significantly higher.