• Title/Summary/Keyword: Cyanosis

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Malignant Hyperthermia in Open Heart Surgery -One Case Report- (개심술에서 발생한 악성 고열증 -1예 보고-)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.15 no.2
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    • pp.230-237
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    • 1982
  • Malignant hyperthermia has been reported by many authors since Denborough [1960] first described concerning anesthetic death in a family. Malignant hyperthermia is characterized by a hypermetabolic state [tachycardia, tachypnea, hypercarbia, hypoxia, cyanosis, hypotension, high fever and muscle rigidity] and is related to a hereditary defect of skeletal muscle. In susceptible individuals, it is triggered by potent inhalational anesthetics, depolarizing muscle relaxant [Succinylcholine], amide type local anesthetics [prototype lidocaine] and occasionally by stress due to emotional and environmental factors. Unrecognized and untreated malignant hyperthermia is associated with a very high mortality rate. Recently authors have experienced malignant hyperthermia in 5 year old male child who was diagnosed to have patent ductus arteriosus and interatrial septal defect associated with congenital physical deformities such as short stature, hypotrophic muscles and genu valgus deformity of lower extremity, indirect inguinal hernia and Ramphant caries.

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Bilateral Submammary Skin Incision for Open Heart Surgery (유방하 피부절개를 통한 개심술)

  • 김기봉
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1095-1098
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    • 1988
  • Congenital cystic adenomatoid malformation[CCAM] is a rare disease that cause respiratory distress in the newborn and infants, but is one of the two causes along with lobar emphysema. This malformation has the pathologic characteristics which can be differentiated from other forms of diffuse cystic disease, i.e. CCAM is marked proliferation of the terminal bronchioles and that can enlarge rapidly by air trapping in cystic areas. The CCAM has a clinical importance because of rapid worsening respiratory distress, with tachypnea, subcostal retraction and cyanosis. This is a strict surgical condition and after operation[lobar, segmental resection or pneumonectomy] the symptoms relieved obviously. We experienced 6 cases of CCAM from July, 1980 to September, 1987 at the Department of Cardiovascular and Thoracic Surgery, Severance Hospital, College of Medicine, Yonsei University. The male patients were two and female patients were four. The age distribution was from premature to 10 year old. One of them was 27 weeks gestational premature female who was borne dead. The other 5 patients were performed on thoractomy[1 case pneumonectomy and 5 cases lobectomy]. The postoperative courses were good and no complications were seen.

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Eisenmenger syndrome: report of 3 cases (Eisenmenger 증후군 3례 보)

  • Song, Won-Yeong;Lee, Jong-Tae;Lee, Gyu-Tae
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.250-256
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    • 1984
  • Eisenmenger syndrome is a condition which systemic arterial blood oxygen unsaturation occurs if obstruction in the pulmonary capillaries raises the pulmonary vascular resistance and pulmonary arterial pressure to or beyond systemic levels and then a significant right to left shunt develops across a preexisting cardiac septal defect or an aortopulmonary communication-We have experienced 3 cases of similar condition. Case I is 24 year old man who has had cyanosis and dyspnea on exertion since childhood. His pulmonary arterial pressure was 110/80mmHg. He was operated under diagnosis of the mitral stenosis and tetralogy of Fallot, but it was finally discovered that he had patent ductus arteriosus and ventricular defect was closed with perforated prosthetic patch, but the patient expired due to right heart failure low cardiac output. Case II was 16 year old female who had pulmonary hypertension of 110/85mmHg. She was diagnosed as Eisenmenger syndrome combining with atrial septal defect and patent ductus arteriosus. Case III was 20 year old male. His pulmonary arterial pressure was 110/70mmHg and the underlying defect was patent ductus arteriosus.

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Systemic-Pulmonary Shunts Using Microporous Expanded Polytetrafluoroethylene (Polytetrafluoroethylene 을 이용한 체-폐동맥 단락술)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.314-319
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    • 1985
  • Nineteen patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] graft between September, 1983, and April, 1985. Age ranged from 3 months to 18 years, and seven of them were less than 12 months old. There were seventeen Great Ormond Street type of modified Blalock-Taussig shunts, and two central polytetrafluoroethylene shunt [ascending aorta-right pulmonary artery]. There was one postoperative death [1/19=5.3%] in a 10 Kg child born with pulmonary atresia and ventricular septal defect associated with patent ductus arteriosus. He had another anomaly of imperforated anus. Relief from cyanosis was achieved in other eighteen patients with variable degree. Eighteen survivors have been followed up from 1 month to 19 months. Clinical status, auscultation, oxygen partial pressure of arterial blood, and hemoglobin have been used to establish shunt patency in all survivors. By above criteria, all survivors have good patent shunt.

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Ebstein`s Anomaly A Case Report of Plication and Tricuspid Annuloplasty (Ebstein 심기형 수술치험 1례 보고)

  • 이종수
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.391-397
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    • 1985
  • Ebstein`s anomaly is a rare congenital cardiac malformation and characterized by downward displacement of an abnormal tricuspid valve cusps. But until now, the ideal surgical correction is still controversial. We present a case of Ebstein`s anomaly experienced lately. The patient was 13 year old girl with the complaints of dyspnea on exertion, fatigability and cyanosis. Echocardiography revealed downward displacement of septal leaflet of tricuspid valve and atrialized right ventricle. Cardiac catheterization and cineangiography revealed ASD and large right atrium. During operation, the atrialized right ventricle was plicated and tricuspid annuloplasty was done. And the two secundum type ASD`s were closed by direct suture closure. The patient`s postoperative course was uneventful and discharged on the 24th postoperative days.

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A Case Report of Pulmonary Atresia with Pulmonary Artery, PDA and Ventricular Septal Defect (동맥관개존증, 심실중격결손 및 폐동맥이 동반된 폐동맥 폐쇄증: 1예보고)

  • Yun, Yang-Gu;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.212-216
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    • 1991
  • A surgical correction was successfully performed in a adult female who had pulmonary atresia with almost non-confluent pulmonary artery, PDA and ventricular septal defect. Initially as a first stage of corrective surgery isolation of patent ductus arteriosus, ligation of aortopulmonary collaterals and identification of the pathologic anatomy of left pulmonary artery through left posterolateral approach were performed. At the second stage, a week after the initial operation, total correction was done making both pulmonary arteries confluent with albumin coated woven-dacron graft, external valved conduit and closure of large VSD of subarterial and perimembranous type. The PDA was ligated with previously encircled heavy stitch soon after partial bypass was started. Although massive bleeding from anastomotic site of dilated left pulmonary artery to the graft occurred preoperatively, postoperative functional improvement was excellent in terms of disappearance of cyanosis and normal exercise tolerance.

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Surgical treatment of tracheal stenosis due to paratracheal tuberculous lymphadenitis.* (결핵성 임파결절에 의한 기관 협착증 치험 1)

  • 강채규
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.213-217
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    • 1987
  • ; A 15 years old girl was operated due to tuberculous paratracheal lymph node enlargement resulted in marked narrowing of lower part of trachea. She had suffered from sputum expectoration difficulty, which was developed dyspnea and cyanosis. 1st operation was simple removal of enlarged paratracheal lymph node through Rt. thoracotomy but restenosis sign developed 2 months later in spite of Anti-Tbc. medication. 2nd operation was resection of constricted tracheal portion [2.5cm] 8 end to end anastomosis under Extra Corporeal Circulation. Under Extra Corporeal Circulation trachea reconstruction offered many conveniences during operation. Till now, she has been follow up checked for one year, she was very good post-operation state without any restenosis signs.

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Total Anomalous Pulmonary Venous Drainage with A.S.D. (전페정맥 이상환류 (TAPVD)의 치험 1례)

  • O, Jae-Sang;Park, Yeong-Gwan;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.110-117
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    • 1980
  • This is a case report of total anomalous pulmonary venous drainage with Atrial septal defect, which was corrected surgically by intracardiac procedure under total cardiopulmonary bypass. This 9 years old girl, she complained mild cyanosis, exertional dyspnea, and frequent upper respiratory infection from 3 months age. The chest X-ray showed cardiomegaly and a "snow man appearance", she has systolic murmur with splitting of S2. The diagnosis was confirmed with right heart catheterization, the catheter was reached to right pulmonic vein passed through right atrium, right superior vena cava, innominate vein, left superior vena cava, and common venous trunk. On 28th, Dec. 1979, an anastomosis between common pulmonary venous trunk and left atrium, Pericardial patch closure of ASD, and ligation of left superior vena cava were performed with Extra-corporeal circulation. The postoperative course was uneventful and discharged with excellent general condition.Total Anomalous Pulmonary Venous Drainage with A.S.D. with A.S.D.

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Hypoplastic RV: report of 2 cases (우심실 발육부전이 동반된 선천성 심장질환의 치험 2례 보)

  • 박영식
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.632-635
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    • 1984
  • Hypoplastic RV was rarely combined with various other intracardiac anomalies. We experienced the excellent result after surgical correction in these 2 patients. 1. F/7: Combined anomalies were, [1] Hypoplastic Rt. Coronary art.[2] Hypoplastic RV [3] ASD [secundum] & [4] PS [infundibular & valvular] After CP Bypass, [1] Direct suture of ASD [2] Infundibulectomy [3] Pul valvulotomy & [4] Patch enlargement of RVOT with Pericardial monocusp were done 2. F/14: Combined anomalies were, [1] Hypoplastic RV [2] P5 [infundibular] [3] T5 [4] VSD [Type II] [5] ASD [secundum] & [6] 2\ulcornerA-V Block fter CP Bypass, [1] Infundibulectomy [2] Tricuspid valvulotomy [3] Patch repair of VSD & ASD & [4] Implantation of permanent pacemaker were done. Above operations resulted in marked improvement with disappearance of cyanosis & dyspnea.

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Correction of Funnel Chest: A Report of 4 Cases (누두흉의 수술교정)

  • 노준량
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.153-162
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    • 1974
  • Four patients with funnel chest deformity corrected in the Department of Thoracic Surgery, Seoul National University Hospital are presented. The first case was a 21-year old female with cyanosis, clubbed fingers and systolic murmur on the left infrascapular region on physical examination associated with agenesis of the right lung. The deformity was of asymmetrical funnel chest, in which the left hemithorax was more sunken. She was corrected by the method of Funnel Costoplasty of Wada. The second case was a three years old boy whose anterior chest wall was symmetrically deformed, and he was corrected by the method of Ravitch using Adkins strut under the sternum. The third was a 22-year old man with symmetrical deformity, and was corrected by the method described by Shannon in 1973. The last patient was a 22-year old man and he had dyspnea on exertion, palpitation and apical systolic murmur with symmetrical funnel chest deformity. He was also corrected by Ravitch operation, All of them has excellent result.

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