• 제목/요약/키워드: Cardiovascular dysfunction

검색결과 356건 처리시간 0.026초

심폐바이패스하의 심박동상태에서 시행한 관상동맥우회로술 ("On-Pump" CABG on the Beating Heart - Two case report -)

  • 신종목;김기봉
    • Journal of Chest Surgery
    • /
    • 제32권5호
    • /
    • pp.480-483
    • /
    • 1999
  • 심폐바이패스와 심정지액을 이용하여 심장을 완전히 정지시킨 상태에서 원위부 관상동맥 문합을 시행하는 방법이 현재 관상동맥우회술에서 널리 사용되고 있다. 하지만, 심정지액을 이용한 심정지하의 관상동맥우회술은, 특히 고위험군 환자에서 수술중 심근의 허혈성 손상을 완전히 배제하지는 못하고 있다. 이런 측면에서 볼 때, 심폐바이패스를 사용치 않는 방법이 관상동맥우회술중 심근의 허혈성 손상을 방지하고 심폐바이패스의 합병증을 줄이기 위한 이상적인 방법이라 할 수 있겠지만, 이는 기술적으로 항상 가능한 것은 아니다. 이에 저자들은 좌심실 구출률이 25%로 좌심실 기능 저하가 심했던 경우와, 경피적 관상동맥확장술 중에 심인성 쇼크가 초래된 경우 등의 고위험군 환자에서 시행한 심폐바이패스하의 심박동상태에서의 관상동맥우회술 2례를 보고하는 바이다

  • PDF

양대혈관 좌심실기시에서 좌심실에서 우심실로의 폐동맥간 전위술의 치험 -1례 보고- (Pulmonary Trunk Translocation from LV to RV in Double-Outlet Left Ventricle -A case report-)

  • 김상익;최진호;전태국;박표원
    • Journal of Chest Surgery
    • /
    • 제34권11호
    • /
    • pp.854-857
    • /
    • 2001
  • 양대혈관 좌심실기시는 양대혈관이 좌심실에서 기시하는 드문 선천성 심장기형으로 정확하게 진단하기가 어렵다. 환아는 생 후 2개월에 대동맥축착교정술 및 폐동맥교약술을 받았던 3세된 남아로 대동맥하 심실중격결손, 단일관상동맥을 동반한 양대혈관 좌심실기시로 진단되어 심실중격결손의 첩포봉합, 난원공개존의 봉합 폐동맥 교약부 절제, 그리고 폐동맥간을 좌심실에서 분리 후 우심실로 전위시켜 우심실 유출로 재건술을 받았다. 본 술식은 술 후 좋은 혈역학적 특성을 보였고, 자가조직을 사용함으로써 전위된 폐동맥의 성장잠재성과 판막 기능의 보존으로 술 후 폐동맥 폐쇄부전과 관련된 우심실기능부전의 가능성이 줄어드는 장점이 예상되므로 문헌 고찰과 함께 보고한다.

  • PDF

횡경막성 내장탈출증: 1례 보고 (A Case of Eventration of the Diaphragm)

  • 박광훈;최인환
    • Journal of Chest Surgery
    • /
    • 제6권2호
    • /
    • pp.243-248
    • /
    • 1973
  • Eventration of the diaphragm is, by definition, abnormally high or elevated position of diaphragm as a result of paralysis, aplasia or atrophy of varing degrees of muscle fibers, and the cause of which may be congenital or acquired. The unbroken continuity of the diaphragm differentiates it from diaphragmatic hernia. The clinical manifestations of the condition, if present, are usually due to the interference of the ventilatory function of the lung and digesive dysfunction due to gastrointestinal distorsion. Treatment consists of surgical repair of the relaxed diaphragm to it`s normal position. A ease of left sided eventuration of the diaphragm, 31 year old officer, was found by chance after traffic accident with chief complaints of hemoptysis and multiple superficial contusions. Routine chest roentgenogram and barium study of the colon revealed moderately elevated left hemidiaphragm with displacement of the splenic flexure of the colon into the left chest. Past history revealed frequent attack of upper respiratory infection and some abnormal condition on his left chest announced by screen cheek of chest X-ray at the time of entrance for his army service 3 years before. Plication of the relaxed diaphragm through left thoracotomy was done and result was excellent as seen on Fig. 5. Cause of eventration of the left hemidiaphragm was due to paralysis of the left phrenic nerve which was tested during thoracotomy.

  • PDF

Canonical Transient Receptor Potential Channels and Their Link with Cardio/Cerebro-Vascular Diseases

  • Xiao, Xiong;Liu, Hui-Xia;Shen, Kuo;Cao, Wei;Li, Xiao-Qiang
    • Biomolecules & Therapeutics
    • /
    • 제25권5호
    • /
    • pp.471-481
    • /
    • 2017
  • The canonical transient receptor potential channels (TRPCs) constitute a series of nonselective cation channels with variable degrees of $Ca^{2+}$ selectivity. TRPCs consist of seven mammalian members, TRPC1, TRPC2, TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7, which are further divided into four subtypes, TRPC1, TRPC2, TRPC4/5, and TRPC3/6/7. These channels take charge of various essential cell functions such as contraction, relaxation, proliferation, and dysfunction. This review, organized into seven main sections, will provide an overview of current knowledge about the underlying pathogenesis of TRPCs in cardio/cerebro-vascular diseases, including hypertension, pulmonary arterial hypertension, cardiac hypertrophy, atherosclerosis, arrhythmia, and cerebrovascular ischemia reperfusion injury. Collectively, TRPCs could become a group of drug targets with important physiological functions for the therapy of human cardio/cerebro-vascular diseases.

신생아에서 발생한 심장 섬유종의 외과적 치료 -1례 보고- (Successful Removal of a Cardiac Fibroma in Infant)

  • 김시호;조범구;홍유선
    • Journal of Chest Surgery
    • /
    • 제28권5호
    • /
    • pp.491-494
    • /
    • 1995
  • A fibroma arising in the right ventricle outflow tract of a 14 month-old infant was successfully removed. The patient was first seen because of shortness of breath and tachycardia. Pertinent clinical and laboratory findings included a grade II/VI systolic murmur, blood pressure of 120/60 mmHg, slight cardiomegaly on chest X-ray, a mass obstructing the outflow tract of the right ventricle on echocardiography and magnetic resonance imaging. On october 30,1992, under cardiopulmonary bypass, a 4cm x 3cm x 3cm tumor was resected from the right ventricular outflow tract, together with a portion of the ventricular wall. Histologically, it was diagnosis as a fibroma. The patient was sent home on the 6th postoperative day following an uneventful recovery form the operation. Although cardiac fibroma is the second most common cardiac tumor in infancy and childhood, it is usually found in the left ventricle and one arising in the right ventricle is considered rare. Although it is a benign tumor, it could produce a severe cardiac dysfunction and even sudden death, depending on its size and location. With the advance in diagnostic techniques and operative management, there is a renewed interest in the early detection and operative removal of these tumors. The case herein presented is the first such case successfully managed and reported in the Korean literature.

  • PDF

심방교체수술을 시행한 대혈관 전위증환자에서의 동맥전환술-1례 보고- (Conversion Arterial Switch Operation for Failed Sensing Procedure in TGA with VSD -One Case Report-)

  • 조유원;서동만
    • Journal of Chest Surgery
    • /
    • 제29권1호
    • /
    • pp.86-89
    • /
    • 1996
  • 심실중격 결손을 동반한 대 혈관전위 에서 심방교체술(denning Procedure)후에 동맥전환술로 성공적인 치료를 했기에 보고하는 바이다 15개월 남아는 생후 8개월에 심방교체술(Senning operation)을 받은 이후에 심부전의 악화로 입원하였다. 혈관조영술상 우심부전, 삼천판막 폐쇄부전 및 잔류 심실중격 결손이 있었고, 심도자 검사에서 폐동맥심실/(LV/RV) 압력비는 75185여서 Senning (심방교체술)을 해체하고, 심실중격 결손은 포편 (patch)봉합하였으며, 폐동맥 밴딩하지않고 동맥전환술을 시행하였다. 수술후 심실기능이 정상으로 회복되었고 잘지내고 있다.

  • PDF

복부 대동맥류의 외과적 치료 (Surgical Treatment of the Abdominal Aortic Aneurysm)

  • 황석하
    • Journal of Chest Surgery
    • /
    • 제26권5호
    • /
    • pp.355-359
    • /
    • 1993
  • Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

  • PDF

Korean red ginseng inhibits arginase and contributes to endothelium-dependent vasorelaxation through endothelial nitric oxide synthase coupling

  • Shin, Woosung;Yoon, Jeongyeon;Oh, Goo Taeg;Ryoo, Sungwoo
    • Journal of Ginseng Research
    • /
    • 제37권1호
    • /
    • pp.64-73
    • /
    • 2013
  • Korean red ginseng water extract (KG-WE) has known beneficial effects on the cardiovascular system via inducting nitric oxide (NO) production in endothelium. Endothelial arginase inhibits the activity of endothelial nitric oxide synthase (eNOS) by substrate depletion, thereby reducing NO bioavailability and contributing to vascular diseases including hypertension, aging, and atherosclerosis. In the present study, we demonstrate that KG-WE inhibits arginase activity and negatively regulates NO production and reactive oxygen species generation in endothelium. This is associated with increased dimerization of eNOS without affecting the protein expression levels of either arginase or eNOS. In a vascular tension assay, when aortas isolated from wild type mice were incubated with KG-WE, NO-dependent enhanced vasorelaxation was observed. Furthermore, KG-WE administered via by drinking water to atherogenic model mice being fed high cholesterol diet improved impaired vascular function. Taken together, these results suggest that KG-WE may exert vasoprotective effects through augmentation of NO signaling by inhibiting arginase. Therefore, KG-WE may be useful in the treatment of vascular diseases derived from endothelial dysfunction, such as atherosclerosis.

우심이 조직내의 Tumor necrosis Factor-${\alpha}$와 Interleukin-6의 함량 (The Contents of Tumor Necrosis Factor-${\alpha}$ and Interleukin-6 in Right Auricular Tissue)

  • 김송명;신현우;박성달;이재성
    • Journal of Chest Surgery
    • /
    • 제33권1호
    • /
    • pp.1-6
    • /
    • 2000
  • Background: TNF-$\alpha$ plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-$\alpha$ and IL-6 on the assumption that TNF-$\alpha$ and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. Material and Method : Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-$\alpha$ and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. Conclusion: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-$\alpha$ IL-6 in each group were independent of each data.

  • PDF

CarboMedics 기계판막의 단기 임상 성적 (Short-term Clinical Experience with CarboMedics Valve)

  • 우석정
    • Journal of Chest Surgery
    • /
    • 제25권6호
    • /
    • pp.661-671
    • /
    • 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.

  • PDF