• Journal of Chest Surgery
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• 제18권4호
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• pp.598-604
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• 1985

One hundred consecutive patients with the Tetralogy of Fallot underwent total correction at National Medical Center during the period 1977 to 1984, Oct. During this study period, we adopted more active policy towards reconstruction of right ventricular outflow tract across pulmonary valve. The mortality was 48% for patients less than 15 kg and 19% in patients above 15kg. Initially Bretschneider`s solution was used as cardioplegia, which was replaced by St. Thomas` solution since 1983, Jan. After then overall mortality dropped to 9% compared to 45% of initial learning period. Heart block occurred In 11 patients, 10 of whom died of combined low cardiac output syndrome. Pure low cardiac output syndrome was noted in 18 patients, most of whom responded to medical measures well except 4 patients. Recently sepsis of Serratia marcescence, which occurred explosively during several months to open heart surgery patients, attacked 3 tetralogy patients resulting in 2 hospital deaths. Our experience has shown that body weight, choice of cardioplegia and accumulation of experience as well as advance of operative and postoperative techniques are still important factors affecting survival rate at initial learning period.

• Journal of Chest Surgery
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• 제13권3호
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• pp.229-232
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• 1980

Approximately 5 percent of infective endocarditis are limited to the right side of the heart, the tricuspid valve being the usual site of involvement. Usually there is no underlying cardiac disease, and the vegetations occur on previously normal tricuspid leaflets. This paper reports a case of bacterial endocarditis involving the bio-tricuspid valve in a patient with tetralogy of Fallot, and who required prosthetic valve replacement in addition to surgical therapy for the congenital lesions.

• Journal of Chest Surgery
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• 제13권2호
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• pp.125-129
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• 1980

A patient with anomalous coronary artery crossing right ventricular outflow tract in association with Tetralogy of Fallot underwent total correction. The left anterior descending coronary artery was originated from right coronary artery anterior to the pulmonary valve ring. The incision from outflow tract to pulmonary artery tunneled underneath the aberrant artery and patch graft across the pulmonary valve ring to enlarge outflow of right ventricle and stenotic pulmonary valve ring.

• Journal of Chest Surgery
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• 제12권4호
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• pp.336-338
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• 1979

The electrocardiographic changes produced at surgery in all patients undergoing total correction of tetralogy of Fallot at the Seoul National University Hospital from 1961 through August 1979, were reviewed. Particular attention was directed to the presence of postoperative right bundle branch block combined with left anterior hemiblock and its prognosis. 14 patients [9.4%] out of 149 who were survived for 30 days postoperatively, showed right bundle branch block with left anterior hemiblock pattern in electrocardiography. But no complete heart block was occurred in these l 4 patients during the follow up periods of 2-56 months.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2008년도 춘계학술대회
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• pp.72-72
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• 2008

• Journal of Chest Surgery
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• 제26권11호
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• pp.886-889
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• 1993

The DiGeorge syndrome is a rare congenital anomaly of absent or hypoplastic thymus and parathyroid glands. Authors experienced a case of DiGeorge syndrome with complex cardiac anomaly. The complex cardiac anomaly was tetralogy of Fallot with origin of the right pulmonaly artery from the posterolateral ascending aorta.His face showed hypertelorism,short philtrum,"fish-like"mouth and micrognathia. This patient underwent total correction of tetralogy of Fallot and end-to-side anastomosis between right pulmonaly artery and side of main pulmonaly artery. He expired on postoperative second day due to right heart failure and hypoxia.d hypoxia.

• Journal of Chest Surgery
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• 제19권1호
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• pp.160-164
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• 1986

Tetralogy of Fallot with absent pulmonic valve is a rare cardiac malformation. The most significant symptoms during early infancy are secondary to bronchial compression resulting from the dilated pulmonary arteries. The clinical diagnosis was confirmed by echocardiography, cardiac catheterization and cardioangiography. A case of TOF with absent pulmonic valve was successful operated upon without insertion of the pulmonic valve. The narrow pulmonic valve annulus was enlarged with a transannular pericardial patch graft. The postoperative course was uneventful.

• Clinical and Experimental Pediatrics
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• 제46권4호
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• pp.315-318
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• 2003

• Journal of Chest Surgery
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• 제25권1호
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• pp.32-41
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• 1992

From August 1982 to December 1991, 58 consecutive infants with tetralogy of Fallot underwent primary repair. Age ranged from 22 days to twelve months [n=58, 8.7$\pm$2.7 months] and body weight from 3.1 to 13 kilograms [n=58, 7.8$\pm$1.7 kilograms]. Qne infant had absence of the pulmonary valve; one had Ebstein`s anomaly and one had supramitral ring. Thirty-two patients [56%] experienced anoxic spell. Preoperative pulmonary artery indices were measured in 38 cases, ranging 126-552mm2/M2BSA[n=38, 251$\pm$79mm2/M2BSA]. All infants required a right ventricular outflow tract patch; in 41, the patch extended across the pulmonary valve annulus, in 13 of them, monocusps were constructed. All had patch closure of ventricular septal defect. Two infants had REV operation for avoiding injury to the canal branch of the right coronary artery which cross the right ventricular out flow tract. Post repair PRV/LV were measured at operating room in 40 cases, which revealed mean value of 0.49$\pm$0.12 [range: 0.25-0.74]. The hospital mortality was 10.3% [6 patients], and causes of deaths were right heart failure due to sustained right ventricular hypertension[4] and right ventricular outflow tract obstruction, intractablesuraventricular tachyarrhythmia[1], hypoxia[1] due to residual right to left shunt across the atrial septal defect in patient associated with Ebstein`s anomaly. All infants were doing well at follow-up from 1 to 101 months[20.6 months /patient, 1, 072 patient-month] Serial postoperative echocardiograms revealed no residual ventricular septal defects and estimated RVOT gradients between 0 and 40 mmHg except 3 cases [50, 50, 60 mmHg]. There were no late deaths and late ventricular arrhythmias or congestive heart failure. Redo operations were done in 2 cases because of residual right ventricular outflow tract obstruction. This experience with infants with tetralogy of Fallot suggests that, if mortality is tolerable, eletive repair of tetralogy of Fallot could be reasonably undertaken during the first year of life, and even better results could be anticipated along with improvement of methods of myocardial protection and postoperative care.

• Korean Journal of Radiology
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• 제20권1호
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• pp.102-113
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• 2019

Objective: To assess the accuracy and potential bias of computed tomography (CT) ventricular volumetry using semiautomatic three-dimensional (3D) threshold-based segmentation in repaired tetralogy of Fallot, and to compare them to those of two-dimensional (2D) magnetic resonance imaging (MRI). Materials and Methods: This retrospective study evaluated 32 patients with repaired tetralogy of Fallot who had undergone both cardiac CT and MRI within 3 years. For ventricular volumetry, semiautomatic 3D threshold-based segmentation was used in CT, while a manual simplified contouring 2D method was used in MRI. The indexed ventricular volumes were compared between CT and MRI. The indexed ventricular stroke volumes were compared with the indexed arterial stroke volumes measured using phase-contrast MRI. The mean differences and degrees of agreement in the indexed ventricular and stroke volumes were evaluated using Bland-Altman analysis. Results: The indexed end-systolic (ES) volumes showed no significant difference between CT and MRI (p > 0.05), while the indexed end-diastolic (ED) volumes were significantly larger on CT than on MRI (93.6 ± 17.5 mL/m² vs. 87.3 ± 15.5 mL/m² for the left ventricle [p < 0.001] and 177.2 ± 39.5 mL/m² vs. 161.7 ± 33.1 mL/m² for the right ventricle [p < 0.001], respectively). The mean differences between CT and MRI were smaller for the indexed ES volumes (2.0-2.5 mL/m²) than for the indexed ED volumes (6.3-15.5 mL/m²). CT overestimated the stroke volumes by 14-16%. With phase-contrast MRI as a reference, CT (7.2-14.3 mL/m²) showed greater mean differences in the indexed stroke volumes than did MRI (0.8-3.3 mL/m²; p < 0.005). Conclusion: Compared to 2D MRI, CT ventricular volumetry using semiautomatic 3D threshold-based segmentation provides comparable ES volumes, but overestimates the ED and stroke volumes in patients with repaired tetralogy of Fallot.