• Title/Summary/Keyword: Heart surgery

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Chemical Pleurodesis Using Tetracycline for the Management of Postoperative Pneumothorax Recurrence

  • Jun Tae Yang;Sahri Kim;Hyoung Soo Kim;Hee Sung Lee;Yong Joon Ra;Hong Kyu Lee
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.240-243
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    • 2023
  • Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.

Clinical Experiences of Open Heart Surgery [50 Cases] (개심술 치험 50례)

  • 임진수
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.692-699
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    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

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Open-heart surgery using Del-Nido cardioplegia in two dogs: partial atrioventricular septal defect and mitral repair

  • Won-Jong Lee ;Chang-Hwan Moon;Wonkyoung Yoon;Mihyung Kim ;Woo-Jin Kim ;Kyung-Min Kim ;Haebeom Lee;Seong-Mok Jeong ;Jae Hyeon Yu ;Dae-Hyun Kim
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.47.1-47.7
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    • 2023
  • Del-Nido cardioplegia (DNc) is a single-dose cardioplegia that is widely used in human medicine because of its long duration. In this report, we describe two cases of open-heart surgery with cardiopulmonary bypass (CPB) using DNc. One dog was diagnosed with partial atrioventricular septal defect, and the other dog was diagnosed with myxomatous mitral valve disease stage D. Both dogs were treated with open-heart surgery with DNc to induce temporary cardiac arrest. No complications from DNc were observed, and the patients were discharged. Veterinary heart surgeons should consider DNc as an option for temporary cardiac arrest during open-heart surgery with CPB.

Consideration on Application of Modified Monitored Anesthetic Care in Plastic Surgery (성형외과 영역의 수술 시 마취하 감시관리의 응용에 대한 고찰)

  • Cho, Geon;Suh, In-Suck;Choi, Young-Ryong;Chung, Mi-Hwa;Tak, Kyoung-Seok;Park, Young-Kyu;Kim, Jae-Hyun;Ko, Eung-Yeol;Sung, Ha-Min
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.7-14
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    • 2011
  • Purpose: Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. Methods: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods. Results: The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia. Conclusion: The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.

Surgical Repair of Ebstein's anomaly by Modified Carpentier's Method - 2 cases report - (변형적 Carpentier 방법에 의한 Ebstein 기형의 수술적 교정 -1 례 보고-)

  • Lee, Gun;Kim, Woong-Han;Lee, Chang-Ha;Na, Chan-Young;Jeong, Yoon-Seop;Jeong, Do-Hyun;Kim, Soo-Cheol;Lee, Young-Tak;Kim, Chong-Whan;Kim, Sung-Nok;Park, Young-Kwan
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.216-219
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    • 1998
  • Ebstein's anomaly is a complex malformation that can be treated by various surgical techniques, either repair or replacement of the abnormal tricuspid valve, with variable results. The essence of the malformation is the downward displacement of the septal and posterior leaflets into the ventricle, resulting in the formation of an atrialized portion of the right ventricle. The aim of surgical repair is to correct the tricuspid valve dysfunction and to plicate the atrialized portion of the right ventricle A 12-months old female was admitted with the diagnosis of Carpentier type A of Ebstein's anomaly with severe tricuspid regurgitation. She successfully underwent operation with vertical plication of right ventricle and reimplantation of tricuspid leaflets. Postoperatively cardiac size was significantly reduced and tricuspid regurgitation was trivial in echocardiography. She was diacharged the 14th postoperative day.

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Aortic Valve Papillary Fibroelastoma - Report of 1 Case- (대동맥판막에 위치한 유두상 섬유탄력종)

  • Kim Jae Hyun;Oh Sam Sae;Lee Chang-Ha;Baek Man Jong;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.316-318
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    • 2005
  • Papillary fibroelastomas are benign, and they are the second most common primary cardiac tumors usually involving the cardiac valve. Papillary fibroelastoma attached to the free margin of right coronary cusp of the aortic vlave was found incidentally during the work-up of a 51-year-old woman, who was presented with palpitation and dyspnea. During the operation, the tumor mass was excised without leaving defect on the aortic valve leaflet.

Right Ventricular Perforation and Left Hemothorax by Permanent Transveneous Pacemaker Lead - Report of 1 Case- (영구 경정맥 심박조율기 도자에 의한 우심실 천공과 좌측 혈흉 -1예 보고-)

  • Kim Jae Hyun;Kim Gun Gyk;Oh Sam Sae;Baek Man Jong;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.312-315
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    • 2005
  • Bleeding due to cardiac perforation by endocardial pacemaker lead is a rare complication. We report one case of left hemothorax due to right ventricular perforation after the insertion of permanent transvenous pacemaker. Operative finding showed a pacing lead penetrating right ventricle, pericardium, and left pleura sequentially, but there was no evidence of hemopericardium.

Extra-Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass

  • Lim, Junghyeon;Cho, Sung Woo;Lee, Hee Sung;Kim, Hyoung Soo;Kim, Yong Han;Park, Bong Suk
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.308-311
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    • 2017
  • A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

Papillary Fibroelastoma of Pulmonary Valve with Congestive Heart Failure -A case report- (심부전을 동반한 폐동맥 판막의 유두상 섬유탄력종 - 1예 보고 -)

  • CheKar, Jay-Key;Ahn, Byoung-Hee;Oh, Sang-Gi;Jeong, In-Seok;Yun, Chi-Hyeong;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.176-179
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    • 2010
  • Cardiac papillary fibroelastomas are the second most common primary tumor of the heart and they most commonly affect the left cardiac valves. However, occurrence of this tumor on the right side of the heart has been rarely reported, with only a few cases having been documented on the pulmonary valve. We present here a rare case of a papillary fibroelastoma that occurred on the pulmonary valve and this was successfully managed by replacing the pulmonary valve in a patient with congestive heart failure.

Thoracoscopic Repair of a Right-sided Congenital Diaphragmatic Hernia -A case report - (흉강경을 이용한 우측 선천성 횡격막 탈장 수술 -1예 보고-)

  • Jo, Tae-Jun;Lee, Jae-Woong;Lee, Weon-Yong;Hong, Ki-Woo;Ahn, Su-Min;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.155-158
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    • 2007
  • A congenital diaphragmatic hernia, which mainly occurs in the left thorax, requires an emergency operative procedure during the neonatal periods. A right-sided congenital diaphragmatic hernia is rare, and often detected after the neonatal period due to the mild symptoms. Traditionally, the treatment repairs the diaphragmatic defect via a thoracotomy. However, good results of thoracoscopic repairs have been reported. Herein, the case of a 5-month-old girl, who received a thoracoscopic repair of a right-sided congenital diaphragmatic hernia, is reported.