• Journal of Chest Surgery
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• 제16권3호
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• pp.331-336
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• 1983

Cor triatriatum is a rare congenital malformation of the heart, in which a septum stretches in a transverse or oblique plane through the left atrium, thus separating it into two compartments. The upper one connects with the pulmonary veins, and the lower one connects with the left ventricle. Due to the rarity of, and great difficulty in-diagnosing, cor trlatrlatum, data On the surgery of this disease are of necessity very limited and so accurate pre-operative diagnosis was very difficult to make. `We experienced a case of the cyanotic congenital heart disease which was diagnosed as a large atrlal septal defect with streaming venous blood from inferior vena cava to left atrium through atrial septal defect in August, 1982. We found that there were transverse septum in the left atrium through atrlal septal defect, the pulmonary venous drainage were located in the upper chamber of the left atrium, and the lower chamber was connected with the left atrial appendage, mitral valve and `left ventricle. But our case had not any opening in this transverse septum and the right atrium was connected with the upper chamber of the left atrium through the upper part of the atrlal septal defect, and was communicated with the lower chamber of the left atrium through the lower part of the atrlal septal defect. We excised the transverse septum and repair this atrial septal defect with Woven Dacron patch accompanying with the drainage of coronary sinus to right atrium. The post-operative course was not eventful and he was discharged with good result on the post-operative 8th day, and has been in good .condition up to now for longer than 10 months.

• Journal of Chest Surgery
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• 제28권1호
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• pp.60-65
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• 1995

Congenital diverticula of the cardiac ventricle have been reported as arising either from the left ventricle or, rarely from both ventricles. A diverticulum arising from the right ventricle alone is very rare. Furthermore the diverticulum associated with double chambered right ventricle was extremely rare. We experienced a 62 years old female of double chambered right ventricle combined with congenital right ventricular true diverticulum. She had complained intermittent chest pain and mild dyspnea on exertion during 8 months. The chest X-ray and chest CT showed protruded abnormal density at anterolateral side of right ventricular outflow tract. Preoperative angiography demonstrated a double chambered right ventricle and a right ventricular diverticulum. In operative finding, there was found a anomalous muscle band, dividing the right ventricle into an inflow and outflow portion, and a 5x6cm sized right ventricular diverticulum arised from conus region with a stenotic orifice of 1.5cm in diameter. The diverticulum was open toward the infundibulum, and its orifice was approximately 1cm in diameter. On treatment, the diverticulum orifice was closed directly and the abnormal muscle band was resected in order to widen the right ventricular outflow tract. The postoperative result was satisfactory and good without specific complications.

• Journal of Chest Surgery
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• 제38권1호
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• pp.63-66
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• 2005

전벽의 급성심근경색에 의한 좌심실류가 있는 경우 수술적 전측심실내복원술(SAVER)은 좌심실의 무운동과 이상운동 구획을 분리하여 정상적인 좌심실 원형구조와 심근벽의 긴장도를 정상적인 수준으로 감소시켜 줌으로써 혈역학적 향상을 기할 수 있는 술식이다 저자들은 급성심근경색에 의한 좌심실류로 좌심실류절제술을 시행 받은 과거력이 있는 40세 남환에서 12년간에 걸친 remodelling의 결과로 진행된 말기심부전의 치료방법으로써 다시 수술적 전측심실내복원술을 시행한 후 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제46권3호
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• pp.223-225
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• 2013

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

• Journal of Chest Surgery
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• 제19권4호
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• pp.683-687
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• 1986

A direct communication between the left ventricle and right atrium is a relatively uncommon defect. Familiarity with this anomaly has become increasingly important, however, since the preoperative findings may be identical with those of an atrial septal defect. The left ventricle is directly related to the right atrium over. an area of the membranous ventricular septum which extends superior to the septal attachment of the right atrioventricular valve in the LV-RA communication. The clinical triad of a ventricular septal defect murmur, cardiac enlargement, and an arteriovenous shunt at atrial level is characteristic of the malformation. A 2-year-old boy with left ventriculo-right atrial communication has operated at the Maryknoll Hospital. Under the cardiopulmonary bypass, the atrium was opened, there was a jet-blood stream just above the atria-ventricular portion adjacent to the septal leaflet of the tricuspid valve.

• 대한핵의학회지
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• 제21권2호
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• pp.155-165
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• 1987

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis-of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intra cardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs, intracardiac shunt could be differenciated from extracardiac shunts.

• Journal of Chest Surgery
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• 제42권1호
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• pp.96-99
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• 2009

좌관상동맥동과 비관상동맥동에서 발생하여 좌심실로 파열된 발살바동 동맥류에 기인한 울혈성 심부전을 주소로 내원한 37세 남자 환자의 수술적 체험 1예를 보고하고자 한다. 술전 심초음파에서 발살바동 주위의 낭성 구조물이 관찰되었고 좌심실 비대와 심한 대동맥판폐쇄부전이 관찰되었고 발살바동맥류와 대동맥-좌심실터널을 감별진단의 범주에 두었다. 수술 소견에서 좌관상동맥동과 비관상동맥동 모두 좌심실로 통하는 누공을 가지고 있었다. 좌심실로 파열된 누공은 bovine pericardium으로 봉합하였으며 대동맥근부는 21 mm St. Jude Epic Supra tissue valve와 24 mm Hemashild의 복합도관을 사용하여 교정된 Bentall 수술을 시행하였다. 환자는 수술 후 15일째 퇴원하였으며, 2개월간 정기적으로 외래추적 관찰중이다. 이에 저자들은 본 질환의 희귀성과 함께 수술적 방법을 알리고자 증례보고 하는 바이다.

• 한국임상수의학회지
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• 제11권2호
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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$.

• Journal of Chest Surgery
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• 제20권2호
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• pp.404-410
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• 1987

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

• 한국인공지능학회지
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• 제6권2호
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• pp.17-22
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• 2018

According to the World Health Organization, the top 10 causes of death worldwide include heart disease. Heart diseases include coronary disease, which induces acute myocardial infarction. Ticagrelor drugs are being used to treat acute alliances, but it has become difficult to breathe due to the drugs. In a related study, Tobias predicted that uric acid causes acute respiratory distress independently of other factors, including BNP. And in the Ahmad study, serum uric acid numbers were related to the left ventricle depending on the level of uric acid. Experimental data are data used after 155 patients who received coronary intervention took ticagrelor. The research methods were leveraged by gradient decent algorithm and linear regression. In order to avoid overfitting in the experiment, training data and test data were separated into 70 and 30 percent respectively. The experimental results lacked the predictability of other attributes except DT in the correlation coefficient and crystal coefficient. However, all attributes related to dyspnea other than DT are determined to be related to causing relaxation of the heart in the left ventricle. Therefore, the attribute causing dyspnea is determined to be an attribute causing relaxation of the heart of the DT and left ventricle.