• 제목/요약/키워드: Left atrial appendage

검색결과 45건 처리시간 0.022초

양성 상공정맥 증후군 -1예 보고- (Benign superior vena cava syndrome -A case report-)

  • 한병선
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.449-452
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    • 1986
  • A patient with benign superior vena cava syndrome caused by the thrombus and fibrotic membrane in superior vena cava is described. Surgical treatment of superior vena cava syndrome remains controversial still. After endvenectomy and thrombectomy of superior vena cava, angioplasty with use of Gore-Tex patch and bypass graft using 10mm diameter Dacron vessel graft from left innominate vein to right atrial appendage were performed. The early postoperative course was uneventful with achievement of good decompression. But 12 months later, the symptoms of superior vena cava syndrome were reoccurred.

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우측 상대정맥의 좌심방으로 이상환류의 수술치험 (Surgical Correction of Anomalous Right Superior Vena Cava[RSVC] into the Left Artium as an Isolated Anomaly - Report of a case -)

  • 백희종
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1455-1460
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    • 1992
  • Anomalous drainage of the right superior vena cava into the left atrium is a very rare congenital cardiac anomaly. Recently a patient with this venous anomaly was surgically corrected and forms the basis of this report. Patient findings were as follows: The patient has no other symptom but cyanosis which prompted cardiac evaluation Chest PA and electrocariogram were usual. Cross-sectional echocardiogram showed normally connected heart without intracardiac defect, Inferior vena cava drained normally into right atrium and coronary sinus was not dilated. Contrast, given into the right atrium, appeared in the left atrium This rare venous anomaly was confirmed by surgery. Surgical correction consisted of division of superior vena cava above the junction of left atrium and reanastomosis into right atrial appendage. Postoperative digital subtracion angiography confirmed the successful repair. She has doing well for 6months since operation. Systemic venous anomalies without intracardiac defect are very rare. However this anomalies should be considered in the differential diagnosis of cyanosis. The successfully corrected case is reported and literature is reviewed.

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삼중방심 치험 1례 (Cor Triatriatum (A case report))

  • 인강진
    • Journal of Chest Surgery
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    • 제22권4호
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    • pp.667-671
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    • 1989
  • Cor triatriatum is a rare congenital malformation of the heart in which a diaphragm stretches in a transverse plane through the left pulmonary venous chamber, thus creates two subchambers. The proximal chamber connects with the pulmonary veins, and the distal one has left auricle and the mitral valve. A 3 year old boy who had Cor triatriatum underwent surgical excision of the abnormal diaphragm in March, 1989 in Chungnam University Hospital. An obliquely oriented fibromuscular diaphragm divided the left atrium into a proximal chamber which was connected to the pulmonary veins and a distal chamber which had the atrial appendage and the mitral valve. The opening in the diaphragm was 5 mm in diameter. There were no associated abnormalities. The abnormal diaphragm was completely excised. The postoperative result was excellent.

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좌심방이에서 발생한 혈전을 모방한 심장의 일차성 신경 내분비 종양 (A Primary Neuroendocrine Tumor Mimicking a Thrombus in the Left Atrial Appendage)

  • 김명경;김성목;김은경;정동섭;최연현
    • 대한영상의학회지
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    • 제83권2호
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    • pp.444-449
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    • 2022
  • 심장에서 발생하는 종양의 대부분은 원격 전이이며 일차성 심장 종양은 드물다. 그중에서도 심장의 일차성 신경내분비 종양은 더 드물게 보고되고 있다. 우리는 기저질환이 없는 환자에서 발생한 좌심방이 종괴에 대해 보고하고자 한다. 종괴의 위치, 초음파에서의 움직임, 환자의 뇌경색 발생으로 혈전을 의심하였다. 그 후 종괴에 대한 수술적 절제를 시행하였고, 신경 내분비 종양으로 진단받았다.

개심술 치험 10례 보고 (Clinical experience of open heart surgery: report of 10 cases)

  • 임승평
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.75-82
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    • 1983
  • This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

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Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation

  • Yun Gi Kim;Ha Young Choi;Jaemin Shim;Kyongjin Min;Yun Young Choi;Jong-Il Choi;Young-Hoon Kim
    • Korean Circulation Journal
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    • 제52권5호
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    • pp.368-378
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    • 2022
  • Background and Objectives: Recurrence rates after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients are not low especially in non-paroxysmal AF. The diameter of left atrium (LA) has been widely used to predict the recurrence after RFCA for decades. However, LA diameter represents structural remodeling of LA and does not reflect electrical remodeling. We aimed to determine the predictive value of electrical remodeling of LA which is represented by the amount of low voltage zone (LVZ). Methods: We performed a retrospective cohort analysis of AF patients who underwent de novo RFCA in a single-center. Results: A total of 3,120 AF patients with de novo RFCA were analyzed. Among these patients, 537 patients underwent an electroanatomic mapping with bipolar voltage measurement of LA. The diameter of LA and flow velocity of LA appendage (LAA) differed significantly according to quartile group of LVZ area and percentage: patients with high LVZ had large LA diameter and low LAA flow velocity (p<0.001). Freedom from late recurrence (LR) was significantly lower in patients with high LVZ area and percentage (p<0.001). The diameter and surface area of LA had area under curve (AUC) of 0.592 and 0.593, respectively (p=0.002 for both). The predictive value of LVZ area (AUC, 0.676) and percentage (AUC, 0.671) were both superior compared with LA diameter (p=0.011 and 0.027 for each comparison). Conclusions: In conclusion, LVZ can predict freedom from LR after RFCA in AF patients. Predictive value was higher in parameters reflecting electrical rather than structural remodeling of LA.

Functional Insufficiency of Mitral and Tricuspid Valves Associated With Atrial Fibrillation: Impact of Postoperative Atrial Fibrillation Recurrence on Surgical Outcomes

  • Kitae Kim;Jin Kim;Sung-Ho Jung;JaeWon Lee;Joon Bum Kim
    • Korean Circulation Journal
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    • 제53권8호
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    • pp.550-562
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    • 2023
  • Background and Objectives: To identify the factors associated with adverse outcomes following surgery for functional insufficiency of the mitral valve (MV) or tricuspid valve (TV) associated with atrial fibrillation (AF). Methods: We evaluated 100 patients (age, 66.5±10.0 years; 47 males) who consecutively underwent surgery for functional insufficiency of the MV or TV associated with AF between January 2000 and December 2020 at our center. The primary outcome was a composite endpoint of all-cause death, valve reoperation, congestive heart failure (CHF) requiring rehospitalization, and stroke. Results: During follow-up (532 patients-years [PYs]), adverse events included death in 16 (3.0%/yr), MV reoperation in 1 (0.2%/yr), CHF in 14 (2.6%/yr), and stroke in 5 (0.9%/yr) patients, demonstrating a 5-year rate of freedom from the primary endpoint of 69.5%. The rate of postoperative AF was high even in those who underwent AF ablation (n=92), with cumulative rates of 48.1% at 1 year and 60.2% at 5 years. In multivariable analyses, the primary outcome was significantly associated with age (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 1.02-1.10; p=0.005), chronic kidney disease (aHR, 7.76; 95% CI, 2.28-26.38; p=0.001), left atrial appendage exclusion (aHR, 0.35; 95% CI, 0.16-1.78; p=0.010), and postoperative AF as a time-varying covariate (aHR, 3.33; 95% CI, 1.50-7.40; p=0.003). Conclusion: Among patients undergoing surgery for functional atrioventricular insufficiency associated with AF, a significant proportion showed recurrence of AF over time after concomitant AF ablation, which was significantly associated with poor clinical outcomes.

Thirty-Three Years Old Modified Senning Operation

  • Michalis, Alkiviadis;Kanakis, Meletios A.;Thanopoulos, Vassilios;Laskari, Cleo;Mitropoulos, Fotios A.
    • Journal of Chest Surgery
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    • 제47권4호
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    • pp.394-397
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    • 2014
  • Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

둔상에 의한 외상성 좌심실 파열환자를 성공적으로 치료한 예 (Successful Treatment of Blunt Traumatic Rupture of the Left Atrial Appendage and Pericardium: A Case Report)

  • 경규혁;정성호;홍석경
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.168-170
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    • 2011
  • Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.