• Title/Summary/Keyword: Left Atrium

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Penetrating chest trauma from a "less lethal" bean bag in the United States: a case report

  • Gloria Sanin;Gabriel Cambronero;Megan E. Lundy;William T. Terzian;Martin D. Avery;Samuel P. Carmichael II;Maggie Bosley
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.421-424
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    • 2023
  • This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.

Unroofed Coronary Sinus and its Surgery; Associated with Partial Atrioventricular Canal Defect and Common Atrium (관상정맥동 결손과 좌상대정맥의 좌심방환류에 대한 수술및 수술방법의 연구;부분형 방실관결손과 공통심방이 동반된 1례)

  • 이상호
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.312-315
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    • 1993
  • The malformation consisted of persistent left SVC terminating in left atrium, absence of coronary sinus, and atrial septal defect is considered as a developmental complex anomaly. We observed such a case associated with partial atrioventricular canal defect and common atrium. We operated it by intraatrial roofing [tunneling] along its course of the posterior wall of the left atrium using bovine pericardial patch, which was designed to contain some of thebesian veins, thereby, left superior vena caval and some coronary venous blood would be drained into venous side. Associated lesions were also corrected.

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Reconstruction of Aorto-mitral Fibrous Skeleton in Complicated Native Valve Endocarditis -A Case Report- (심내막염 환자에서의 Aorto-mitral fibrous skeleton의 재건술 -치험 1례-)

  • Min, Gyeong-Seok;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.183-187
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    • 1995
  • This is a report of successful management of a patient with complicated native valvular endocarditis. Initially stable patient showed sudden collapse at the end of 4th week of antibiotics coverage. Echocardiography revealed that previous vegetation at the Aorto-mitral Fibrous Skeleton[AMFS developed into a false aneurysm, perforated to left atrium and caused fistulous communication between left ventricle and left atrium. Extensive debridement was performed including part of the ascending aorta, aortic cusps, the AMFS, anterior mitral cusp and roof of the left atrium. Reconstruction of the AMFS with tailored single piece of autologous pericardium enabled the implantation of mechanical valves at the aortic and the mitral position. Ascending aorta and roof of the left atrium were repaired with autologous pulmonary artery patch graft and another autologous pericardial patch. The patient was discharged on postoperative 16th day and followed - up till now without any residuae or sequelae.

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Primary Malignant Fibrous Histiocytoma of the Left Atrium - A Case Report - (좌심방내에 발생한 악성 섬유성 조직구종 치험1례)

  • 김택진
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.357-360
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    • 1991
  • Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life. The tumor occurs principally in one of the extremities or in the abdominal cavity or retroperitoneum, but very rarely in the heart. We report a case of M.F.H. that arose from the posterior wall of the left atrium. A 50 years old woman was presented with signs and symptoms of severe congestive heart failure. On 2-D echocardiographic exam, a huge mass was found in the left atrium. The mass was excised under open heart surgery. Histologic examination revealed that the tumor was actually a malignant fibrous histiocytoma.

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Mitral Valve Surgery Via Dome of the Left Atrium (Dome 접근법을 이용한 승모판막 수술)

  • 최용선;류상완;홍성범;박종춘;김상형;안병희
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.722-725
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    • 2004
  • Mitral valve surgery is most commonly performed through the left atriotomy via the inter-atrial groove or trans-septal approach. An alternative method for approaching to the mitral valve is via the dome of the left atrium located between the ascending aorta and superior vena cava. Although this approach was described 30 years ago, it has not been popularized in mitral valve surgery. We introduce our recent experiences with mitral valve surgery carried out through the dome of the left atrium with brief review of literature.

Congenital Aneurysm of The Left Atrium -A Case Report- (선천성 좌심방 류 -1례 보고-)

  • 홍남기;정태은;이정철;한승세;이동협
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.752-755
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    • 2000
  • Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.

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Ultrasound Imaging of Normal Cardiac Structures with Convex Scanner in Puppies (강아지에서 컨벡스스캐너를 이용한 정상적인 심장구조물의 초음파상)

  • Jeong Soon-wuk;Park Hee-myung;Han Sook-hee;Yoon Jung-hee;Han Hong-ryul
    • Journal of Veterinary Clinics
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    • v.11 no.2
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    • pp.529-537
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    • 1994
  • Sector scanner which has a conical end is used to image through the intercostal space because heart is protected by the ribs. Cardiac data published all around the world were also obtained by sector scanner. Although scanners being used in every small animal practice and animal hospital at college in Korea include convex ape and linear type, linear type is not appropriate f3r cardiac scan because of a wide contact surface. The purpose of this study is to establish ultrasonographic images of normal cardiac structures by measuring shape, size of reflectable cardiac structure according to restraint position in scanning normal heart of the puppies with 6.5 MHz convex scanner(SonoAce 4500, Medison, Korea) used in our veterinary teaching hospital, Seoul national university. Seventeen male and female puppies considered having healthy hear by X-ray and clinical examination are used feom April to July 1994. Scanning point selection of probe head and the distinction of imaged cardiac structures were accomplished by necropsy and cardiac scanning performed through thoracotomy under general anesthesia. At 10 o'clock position of transducer(at an angle of 30$^{\circ}$ between imaginary line from elbow joint to 3rd sternum and probe head, 60$^{\circ}$ from body surface, 4th intercostal space of right thorax) with the marker of scanner toward the head of dogs right atrium, left atrium and left ventricle were observed in 2, 3, 4, 5 intercostal space(2cm from the sternum) of experimental dog positioned ventrodorsally under general anesthesia. Under these conditions, the numerical values of imaged diastolic hear are as follows : the distance from skin to apex(mean$\pm$S.D) 47.53$\pm$6.94mm, thickness of left ventricular wall 6.00$\pm$1.60mm, length of left ventricle 16.27$\pm$5.31mm, width of left ventricle 15,33$\pm$4.25mm, length of left atrium 12.33$\pm$3.82mm, width of left atrium 11. 33$\pm$3.94mm, length of right atrium 1.00$\pm$2.41mm, width of right atrium 11.21$\pm$2.76mm and the area of left ventricle 270.92$\pm$109.81mm$^2$, area of left atrium 98.00$\pm$41.08mm$^2$, area of right atrium 62.75$\pm$21.04mm$^2$.

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Double Outlet Left Atrium: A rare form of the atrioventricular septal defect with malposition of the atrial septum (좌심방 양심실 연결증 [DOLA])

  • Lee, Jae-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.273-278
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    • 1985
  • The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

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Development of a stroke output control algorithm using a fuzzy logic for a left ventricular assist device

  • Choi, Jae-Soon;Choi, Won-Woo;Park, Seong-Keun;Park, Seong-Keun;Min, Byoung-Goo
    • 제어로봇시스템학회:학술대회논문집
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    • 1995.10a
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    • pp.514-517
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    • 1995
  • A new stroke output control algorithm with a fuzzy logic for an electrohydraulic left ventricular assist device(EH-LVAD) was developed. The EH-LVAD pumps out blood from left atrium actively. Excessive suction of blood may cause fatal damage in left atrium. The LVAD has to provide a maximal stroke output without collapse of left atrium. In this study a new fuzzy algorithm for predicting and detecting suction and doing proper action on LVAD without using an extra pressure sensor but with bellows pressure signal and motor current signal is developed. The performance of the fuzzy control algorithm is demonstrated by the results from mock circulatory experiments.

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Cor Triatriatum Associated with Atrial Septal Defect and Partial Anomalous Pulmonary Venous Return: Report of A Case (부분 폐정맥 환류이상과 심방중격 결손증을 동반한 삼중방심의 치험 1례)

  • 이철주
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.440-445
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    • 1985
  • Cor triatriatum is a variant of abnormal connection between the pulmonary vein and true left atrium, which is separated from accessory left atrium receiving pulmonary venous blood flow by fibromuscular diaphragm. Usually it is diagnosed after operation because difficulty in visualization of the diaphragm by conventional diagnostic tools. We experienced a rare entity of congenital heart disease diagnosed as car triatriatum with atrial septal defect and partial anomalous pulmonary venous return after completing operation, which was diagnosed as ASD with PAPVR preoperatively. Anomalous right pulmonary venous opening was located at right atrium, secundum type defect of atrial septum was present, and dual chambered left atrium without connection was also seen. Excision of the diaphragm and wide patch repair of ASD including right pulmonary vein were performed with good postoperative results. Herewith, we report this case with review of literatures.

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