• Journal of Chest Surgery
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• 제21권1호
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• pp.136-142
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• 1988

Between February, 1983, and March, 1987, thirty-one systemic-pulmonary shunts were performed in 28 patients with cyanotic congenital heart disease. Age ranged from 8 months to 28 years [mean age, 5.4 years, Weight ranged from 7 kg to 48 kg [mean weight, 16kg]. There were 4 classic Blalock-Taussig shunts, 5 central polytetrafluoroethylene shunts, 1 aorta-right pulmonary artery shunt with graft, and 21 modified Blalock-Taussig shunts. One patient required another shunt immediately due to insufficient pulmonary blood flow with patent graft. There was no postoperative death. Conduit diameters included 4mm [2 cases], 5 mm [22 cases], and 6 mm [3 cases]. Long term follow up was available in 27 patients [96.4%] with mean period of 20 months [range, 4 months to 49 months]. The effectiveness of shunt was evaluated by cardiac catheterization with angiography [15 patients] or clinically. They showed improvement of systemic oxygen saturation values by 12% and decrease of hemoglobin by 2.3gm/dl [P<0.01]. There were 2 shunt occlusion in central shunts at 32 and 48 months respectively, and one narrowing of graft in modified Blalock-Taussig shunt at 12 months. The patency rate was 91.6% at 24 months for 5 mm grafts in modified Blalock-Taussig shunt.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1125-1127
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• 1997

본 8kg, 18개월 환아는 다른 병원에서 심실 중격 결손증 수술을 받았으며 수술후 합병증으로 약물치료를 받아 왔으나 심실 비대와 심부전증이 악화되었으며 본원에서 시행한 심도자 결과 좌심실과 대동맥간 혈압 차이는 55mmHg를 보였다. 본원에서는 이와 같은 소아에서의 심실 중격 결손증 수술후 발생한 대동맥 판막하 협착증의 성공적 수술 증례를 보고하는 바이다.

• Journal of Chest Surgery
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• 제28권1호
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• pp.73-77
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• 1995

We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

• Clinical and Experimental Pediatrics
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• 제55권1호
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• pp.24-28
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• 2012

Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

• 한국광학회지
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• 제26권1호
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• pp.1-8
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• 2015

심혈관 질환은 심장마비의 가장 흔한 원인으로 관상동맥의 협착으로 심근에 산소와 영양분을 제대로 공급하지 못하게 되어 발생하게 된다. 이를 내과적으로 치료하기 위해 심혈관 중재술이 시행되는데 이때 스텐트 삽입 여부, 위치, 크기, 그리고 스텐트 삽입 후 혈관벽과의 밀착 여부를 평가하기 위해 혈관 내 광간섭단층촬영(OCT, optical coherence tomography) 내시경 진단검사를 시행한다. 본 논문에서는 이러한 심혈관 OCT 원리와 기술 동향, 그리고 실제 의료현장에서 심혈관 OCT의 임상적 응용 및 활용가치를 소개하고자 한다.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1133-1137
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• 1991

Congenital coronary arteriovenous fistula is relatively uncommon and often associated with additional congenital and acquired heart disease. If coronary arteriovenous fistula is suspected, the diagnosis can be made readily by cardiac catheterization and selective coronary arteriography. Surgical treatment is very satisfactory, with a low mortality and apparent good long term result. Recently, we experienced one case of congenital coronary arteriovenous fistula which was associated with aortic stenosis and regurgitation. The tortuous fistula tract was noted between the left anterior descending coronary artery and the main pulmonary artery. Under the cardiopulmonary bypass, aortic valve replacement[Carbomedics 23mm] and suture closure of the draining orifice of coronary arteriovenous fistula in the main pulmonary artery just above the pulmonary valve were performed, Postoperative hospital course was uneventful and the patient was discharged postoperative 9th day without any problems.

• Journal of Chest Surgery
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• 제24권5호
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• pp.491-497
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• 1991

Coronary arteriovenous fistula is a relatively rare congenital heart disease and it drains into right atrium, right ventricle, pulmonary artery, coronary sinus or superior vena cava. We experienced one case of fistulous communication between right coronary artery and right ventricle which was most common condition. The patient was a 12 year old female and the only sign was continuous cardiac murmur. The cardiac catheterization and coronary angiography showed the fistulous communication between right coronary artery and right ventricle and aneurysmal dilatation of right coronary artery. Under the cardiopulmonary bypass with the hypothermic cardioplegia, fistula opening[7mm] which was located at right ventricle below the tricuspid valve annulus between septal and posterior leaflet was closed with 4 - 0 prolene continuous suture through right ventriculotomy. Her postoperative course was uneventful.

• Journal of Chest Surgery
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• 제22권4호
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• pp.680-686
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• 1989

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origin of the coronary arteries. It may occur in several different anatomical form. Three type have been described; the hourglass, the hypoplastic and the membranous type, each term identifying the gross characteristic of the lesion causing by the aortic obstruction. Non cardiovascular condition commonly associated with supravalvular aortic stenosis are mental retardation, facial anomalies, hypercalcemia, etc. The diagnosis can be established preoperatively by left heart catheterization and selective angiography. Recently, we experienced a case of multiple localized supravalvular aortic stenosis involving, just above the sinus Valsalva and just proximal of the innominate artery. The surgical correction which was performed by a vertical incision across the each narrowing of aorta with replacement of diamond shaped double velour Woven Dacron patch under the CPB. He was discharged without any event.

• Journal of Chest Surgery
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• 제23권2호
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• pp.245-252
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• 1990

To see the change of pulmonary arterial pressure after mitral valve replacement, postoperative cardiac catheterization and echocardiographies were performed in 12 patients of mitral valvular disease with pulmonary hypertension[systolic pulmonary arterial pressure>50 mm Hg]. The mean follow-up duration was 35.4[range: 15-47] months per patient. The following results were obtained. 1] Preoperative systolic pulmonary arterial pressure value of 66.17\ulcorner10.73mmHg decreased significantly to 29.17\ulcorner6.86mmHg postoperatively[p<0.01]. 2] Preoperative Pp/Ps value of 0.67\ulcorner0.13 decreased significantly to 0.28\ulcorner0.06 postoperatively[p<0.01]. 3] Preoperative PAWP value of 29.00\ulcorner4.02mmHg decreased significantly to 9.92\ulcorner4.27 mmHg postoperatively[p<0.01]. 4] Preoperative LAD value of 5.58\ulcorner1.20cm decreased significantly to 4.37\ulcorner0.67cm postoperatively [p<0.01]. In conclusion, pulmonary arterial hypertension secondary to mitral valvular disease could be reduced to normal range after successful mitral valve replacement.

• Journal of Chest Surgery
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• 제16권1호
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• pp.34-39
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• 1983

The syndrome of anomalous muscle bundle dividing the right ventricle into two pressure chambers has been described by many authors. The malformation should not be confused with tetralogy of Fallot itself because the obstructive hypertrophic bands are usually proximal to the right ventricular infundibulum. One case [11 years old male] of double chambered right ventricle due to aberrant muscle bundle with intact ventricular septum is presented. The pressure gradient was 68 mmHg between inflow and outflow tracts of right ventricle on cardiac catheterization. On opening the right ventricle, there noted stenosis of outflow tract by infundibular membrane, hypertrophied anomalous muscle bundle, thickened moderator band & hypertrophied anterior papillary muscle. Open heart surgery was carried out with the aid of extracorporeal support, Anomalous muscle bundle [1.0 cm x 4.0 cm] and infundibular membrane were resected safely. The hypertrophied moderator band was cut at mid-portion and anterior papillary muscle was split vertically. The postoperative course was uneventful and discharged in good condition 2 weeks later.