• Title/Summary/Keyword: Heart valve surgery

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Clinical analysis of 60 cases of open heart surgery (개심술 치험 60례 보)

  • Kim, Su-Seong;Kim, Yeong-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.389-397
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    • 1984
  • Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

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A Study on Self-Care Agency and Quality of Life in Patients with Heart Valve Surgery (심장판막수술환자의 자가간호역량과 삶의 질 연구)

  • Bae, Jae-Mun;Shim, Moon-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.3975-3983
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    • 2011
  • This study aims to survey patients who underwent a heart valve so as to define their self-care Agency and quality of life, as well as the effect of their self-care Agency on their quality of life. One hundred ten outpatients in two university hospitals in the City of D were surveyed using a structured questionnaire. The findings of this study revealed that for the life quality of patients with a surgery of heart valve, out of a total of 4.0 points, self-care Agency was an average 2.71 points, while life quality was an average 2.96 points, showing not so high scores. Also, it was also found that the higher the physical skills of patients with a surgery of heart valve (${\beta}$=.625, p<.001) were, the higher the quality of their life was. In conclusion, self-care Agency was confirmed as a determinant of the life quality of patients with a surgery of heart valve, and it was found that the higher the self-care Agency of patients with a surgery of heart valve, the higher their life quality was. Thus, in order to enhance the self-care Agency of patients with a surgery of heart valve, nursing assessment of their physical, psychological and mental areas, as well as corresponding appropriate nursing interventions need to be developed.

Biventricular Repair of Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect by Arterial Switch -Report of 1 case - (비상관성 심실중격결손증을 동반한 양대혈관우심실기시증 환자에서의 동맥전환술을 이용한 양심실성 교정 - 1예 보고 -)

  • Kim, Jae-Hyun;Kim, Woong-Han;Chang, Yun-Hee;Na, Chan-Young;Oh, Sam-Se;Baek, Man-Jong;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Jo, Won-Min;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.687-690
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    • 2003
  • Although surgical options for double outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) are vary in accordance to the morphological characteristics, it is very difficult to use biventricular repair technique when there is tricuspid chordae originating from conal septum or when the distance between the tricuspid valve and the pulmonic valve is too short. We report our clinical experience of biventricular repair of DORV with non-committed VSD by VSD rerouting to the pulmonary artery and arterial switch in case of a presence of conal tricuspid chordae and short distance between the tricuspid valve and the pulmonic valve.

Aortic valve replacement in the patient with rheumatic heart disease (류마치스성 심장질환 환자에서 대동맥판막치환)

  • An, Jae-Ho;Lee, Yeong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.346-355
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    • 1984
  • 77 cases of Aortic Valve Replacement, which were composed of 64 rheumatic valvular heart disease and 13 combined congenital heart disease, were operated at Seoul National University Hospital for Aortic valvular disease during the period from June 1968 to December 1983. Among these 64 rheumatic aortic valvular heart disease cases, 8 patients were expired during and immediate after operation and overall mortality rate was 12.5%. For more precise remarks, these patients were divided into two periodic groups, 1st period [from 1968 to 1976] and 2nd [from 1977 to 1983] when annual open heart surgery were over 100 cases, and in 1st period three of four patients were died and in 2nd period five of sixty patients were died and its mortality rate was 8.3%. There were 12 cases of postoperative complication, which were 3 cases of remaining other valvular heart disease required MVR, 2 paravalvular leaks [one of them got Redo AVR], 4 thromboembolism or problem of anticoagulant therapy, 2 late death due to SBE with replaced valve failure and one functional AS with small sized valve. Operative death was affected by pump-time and aortic cross-clamping time, heart size, Ejection Fraction, LVEDP and symptom duration, and other many factors may influence the survival rate. Improved operative technique and myocardial protection and meticulous evaluation of the preoperative patient status will make the AVR safer.

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Thrombolytic Therapy for Prosthetic Mitral Valve Thrombosis of Pregnant Patient -A Case Report- (임신중 발생한 인공승모판 혈전증의 혈전 용해제를 이용한 치료 -치험 1례 보고-)

  • 김영대
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.858-861
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    • 1994
  • Prosthetic valve thrombosis is rare but it is one of fatal complication after heart valve surgery. Improvements of the valve design and the material have decreased the frequency of thrombosis but have not eliminated completely. And some cases of prosthetic valve thrombosis during pregnancy were reported inspite of adequate anticoagulation therapy.Urgent surgical intervention is indicated for prosthetic valve thrombosis but it is associated with high operative risk, therefore medical thrombolytic therapy such as urokinase or streptokinase therapy is regarded as an alternative therapy. This is a case report of the successful thrombolytic therapy for valve thrombosis in a pregnant patient after mechanical mitral valve replacement.

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Left Atrial Myxoma Associated with Mitral Regurgitation and Coronary Artery Disease (승모판막폐쇄부전 및 관상동맥질환과 동반된 좌심방 점액종)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Park, Yoon-Ock;Moon, Hyun-Soo;Paik, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.862-865
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    • 2003
  • Obstructive intracardiac lesions, like mitral stenosis or insufficiency (MR), by myxomas of the left atrium have been commonly reported, but the attenuation of MR by myxoma combined with coronary artery disease is very rare. We report a 70-year-old female patient whose left atrial myxoma had attenuated moderate MR to mild MR and required mitral valve surgery after removal of the myxoma. She also had coronary artery disease, severe pulmonary hypertension and moderate tricuspid regurgitation due to the mitral valve lesions obstructed by myxoma. The patient underwent removal of myxoma, mitral and tricuspid valve reconstructions, and coronary artery bypass grafting. She was discharged at the postoperative 14 day without any problems.

Mortality Analysis of Open Heart Surgery (75 Cases) (개심수술후의 사망예에 대한 임상적 고찰)

  • 김광택
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.167-173
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    • 1980
  • From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

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Changes of Microembolic Signals after Heart Valve Surgery (심장 판막 수술 후 미세색전의 변화)

  • 조수진;이은일;백만종;오삼세;나찬영
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.316-320
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    • 2003
  • Background: The detection of circulating microemboli by transcranial Doppler ultrasonography (TCD) has the potential to select the patients with high risk for future symptomatic brain embolism. We prospectively evaluated the positive rate and the frequency of microembolic signals (MES) before and after the heart valve surgery (HVS). Material and Method: Fifty in-patients with heart valve disease were enrolled in this study. Patients with history of previous stroke or heart valve surgery were excluded. Two unilateral TCD monitoring sessions were peformed from middle cerebral artery for 1-hour, before and after HVS. Result: Mechanical Heart valves were implanted in 28 patients, tissue valves were implanted in 10 patients, and remaining 12 patients received mitral valve repair. Positive rate of MES was significantly increased after HVS (50%), compared to that of before HVS (8%, p=0.00). There was no relation between MES after HVS and intensity of anticoagulation, cardiac rhythm, patients' age, and history of hypertension. The positive rate of MES after implantation of mechanical heart valve (71.4%) was significantly higher than those after implantation of tissue valve or mitral valve plasty (p=0.002). Conclusion: Positive rate of MES was increased significantly after the implantation of HVS. The changes of MES in those with mechanical prosthesis may be related to the increased risk or embolism after Hvs.

Clinical Experience of Cardiovascular Surgery : A Report Of 2032 Cases (심장 혈관질환 2032 수술 례 보고)

  • 이영균
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.375-384
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    • 1980
  • Since 1958 up to the end of October 31, 1980, 2032 cases of cardiovascular lesions were operated, including 1225 open heart surgery and 354 valve replacement patients. There were 1271 Congenital anomaly cases and 761 acquired lesions including 149 vascular lesions. Among 1~271 congenital malformations 819 cases belong to acyanotic and 452 to cyanotic group. Over all mortality was 11.1 %, consisting of 12.4% for congenital and 8.9% for acquired lesions. Mortality for 1225 open heart surgery cases was 15% and 13.8% for various 354 valve replacement cases. In most of the open heart surgery cases Shiley oxygenator was utilized and Ionescu-Shiley bovine pericardial xenograft bioprosthesis**** valves were used mainly for valve replacement.

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Clinical Evaluation of Multiple Valve Replacement (심장다판치환술의 임상적 고찰)

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.160-166
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    • 2000
  • Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

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