• Title/Summary/Keyword: Left heart ventricle

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Open Heart Surgery:Clinical Analysis of 180 Cases (개심술 180례에 대한 임상적 고찰)

  • 나명훈
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.460-471
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    • 1994
  • Between Feb. 1990 and Aug. 1993, 180 cases of the open heart surgery were performed under cardiopulmonary bypass in the Department of Thoracic & Cardiovascular surgery, Gil General Hospital. There were 83 cases with congenital heart diseases [CHD] and 97 cases with acquired heart diseases [AHD]. The CHD consisted of 78 acyanotic[mortality: 3.8 %] and 5 cyanotic cases with heart anomaly[mortality:l case]. The AHD were 97 cases, which contained 53 valvular, 27 ischemic heart diseases, 10 aortic diseases, 5 cases with myxoma, 1 case with post-infarct VSD, and 1 case with removal of infected pacing wire in right ventricle. In the 53 valvular heart diseases, there were 45 cases with valve replacement[MVR 27, AVR 9,MVR + AVR 9] and 8 cases with valvuloplasty. The number of the implanted prosthetic valves were 53. In MVR, 25 St. Jude, 6 Sorin, 3 Carpentier-Edward and 2 Intact medical valves were used. In aortic position, 13 St. Jude, 3 Sorin and 1 Intact medical valves were applied. The operative mortality was 5.6 % [3/53]. The annuloplasty applying artificial ring was performed in 17 patients[4 cases associated with MVR] and the number of the implanted ring was 19, which included 14 Duran ring[10 mitral, 4 tricuspid] and 5 Carpentier ring [3 mitral, 22 tricuspid]. In the 27 ischemic heart diseases, there were 9 cases with left main coronary artery lesions, 7 one vessel, 5 two vessels, and 6 three vessels. Average number of anastomosis was 2.8 per patient. The operative mortality was 14.3 % [4/27]. Among the 10 patients with aortic diseases, 7 cases were aortic dissection[type A: 5, type B: 2] and 3 cases were descending thoracic aortic aneurysm. The operative morality occurred in 3 cases. The overall mortality and the operative mortality of congenital and acquired heart disease was 7.8 %, 4.8% and 10.4%, respectively.

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The Extent of Late Gadolinium Enhancement Can Predict Adverse Cardiac Outcomes in Patients with Non-Ischemic Cardiomyopathy with Reduced Left Ventricular Ejection Fraction: A Prospective Observational Study

  • Eun Kyoung Kim;Ga Yeon Lee;Shin Yi Jang;Sung-A Chang;Sung Mok Kim;Sung-Ji Park;Jin-Oh Choi;Seung Woo Park;Yeon Hyeon Choe;Sang-Chol Lee;Jae K. Oh
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.324-333
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    • 2021
  • Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

Valvular Pulmonic Stenosis with Congestive Heart Failure in a Fox Terrier (폭스테리어 종에서의 울혈성 우심부전을 동반한 판막형 폐동맥판 협착증)

  • Jung, Dong-In;Park, Ki-Tae;Wang, Ji-Hwan;Kim, Young-Ki;Lee, Kyung-Woo;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.133-138
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    • 2011
  • A 4-year-old female Fox Terrier dog (weighting 8 kg) with history of severe abdominal distention and anorexia was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed right ventricular enlargement (right axis deviation and deep S wave) and right atrial enlargement (P pulmonale). Diagnostic imaging studies revealed hypertrophy of right ventricle, enlargement of right atrium and tricuspid regurgitation and turbulence in the pulmonary artery in right parastenal short axis view. Based on the diagnostic findings, the dog was diagnosed as a case of valvular pulmonic stenosis.

The Contents of Tumor Necrosis Factor-${\alpha}$ and Interleukin-6 in Right Auricular Tissue (우심이 조직내의 Tumor necrosis Factor-${\alpha}$와 Interleukin-6의 함량)

  • 김송명;신현우;박성달;이재성
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.1-6
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    • 2000
  • Background: TNF-$\alpha$ plays a major role in producing left ventricular dysfunction cardio-myopathy pulmonary edema and inhibits the compensatory mechanism of congestive heart failure. IL-6 is an acute reactant of immune reaction and also known to control immune reaction but its function in the myocyte was not clearly investigated. Author's performed this experiment to investigate the contents of TNF-$\alpha$ and IL-6 on the assumption that TNF-$\alpha$ and IL-6 may reside in nonfailing heart that has gone cardiac surgery and play some role in cardiac function. Material and Method : Right auricular tissues were sampled from 12 patients who had undergone total corrective surgery for both congenital and acquired heart diseases from January 1998 to June 1998 in Kosin Universcfy Gospel hospital. The quantitive analysis of TNF-$\alpha$ and IL-6 were assessed by ELISA method in right auricular tissue. Hemodynamic values about the pressure of ventricle atrium aorta pulmonary artery and cardiac index pulmonary and systemic vascular resistance and cardiac output were measured by echocardiography and cardiac catheterization and biochemical analyses of LDH & AST were done before operation. statistical analysis was by Paired Student t-test. Patients were divided into children(under 15 years olds) and adults groups and the data was compared beween two groups. Conclusion: Mild pulmonary hypertension and increased pulmonary vascular resistance were existed in both group. The contents of tissue TNF-$\alpha$ IL-6 in each group were independent of each data.

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The Norwood Operation in Infants with Complex Congenital Heart Disease (복잡 선천성 심기형 환자에서의 Norwood 술식)

  • 박정준;김용진
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.263-269
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    • 1997
  • From April 1987 to May 1996, 13 infants underwent a Norwood operation for complex congenital heart diseases including hypoplastic left heart syndrome (n : 7), mitral stenosis with small VSD and subaortic stenosis (n : 1), mitral atresia with ventricular septal defect, coarctation of aorta, and subaortic stenosis (n = 1), interrupted aortic arch with ventricular septal defect and subaortic stenosis (n : 1), tricuspid atresia with transposition of the great arteries (n = 1), and complex double-inlet left ventricle (n : 2). All patients without hypoplastic left heart syndrome were associated wit hypoplasia of ascending aorta and arch. Age at operation ranged from 3 days to 8.7 months (mean 60.6 $\pm$ 71.6 days, median 39 days). The operative mortality( < 30 days) was 46% (6 patients). Late mortality was 15% (2 patients). All operative deaths occured during the Erst 24 hours after the operation as a result of cardiopulmonary bypass weaning failure (5 patients) and sudden hemodynamic instability postoperatively (1 patient). Late death was due to aspiration pneumonia in two cases. There are 5 long-term survivals (39%). Three of them have undergone a two-stage repair with a modified Fontan operation in two and total cavopulmonary shunt in one at 12, 17, 4.5 months after Norwood procedure with no mortality. Two patients have entered a three-stage repair strategy by undergoing a bidirectional cavopulmonary shunt at 3 and 5.5 months after initial operation with 1 operative death. The actuarial survival rate for all patients at the first-stage operation, including hospital deaths and ate death was 30.8% at 1 year. In conclusion, the operative mortality of Norwood operation was relatively high compared to other operation for major cardiac anomalies, continuing experience will lead to an improvement in result.

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Vegetative Endocarditis and Thrombus Formation Associated with Escherichia coli in a Thoroughbred Horse

  • Yang, Hyoung-Seok;Kim, Jin-Young;Han, Jeong-Hee;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.213-217
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    • 2017
  • A 1-year and 8-month-old male, thoroughbred horse showed fever ($39.8^{\circ}C$), cardiac murmur, tachycardia up to 80 beats/min, anorexia, depression and lameness for about 2 months. The dead horse was referred to pathology laboratory at the College of Veterinary Medicine in Jeju National University. At necropsy, Severe protruding multiple rough cauliflower-like yellowish red nodules ranged $5{\sim}6{\times}2{\sim}3cm$ in size were attached on the mitral valve of the left heart. A yellowish red long stick-shaped thrombus $15{\times}3.5{\times}1.5cm$ in size was also present inside the right ventricle. Multifocal infarcts were scattered in the myocardium and renal cortex. Histopathologic examination revealed that morphologic diagnosis were vegetative endocarditis, thrombus in right ventricle, infarcts in myocardium and kidney, pulmonary congestion and edema, and splenic congestion. The isolated bacteria from vegetative lesions and thrombus were confirmed as Escherichia (E.) coli based on the bacterial culture and VITEK 2 system. Based on the gross and histopathologic features, and bacterial test, this case was diagnosed as vegetative endocarditis with thrombus formation associated by E. coli in a thoroughbred horse.

Modified Extracardiac Fontan Procedure in a Univentricular Heart with Separate Hepatic and Inferior Vena Caval Drainage (분리된 간정맥 및 하대정맥 환류를 동반한 단심실 환자에서의 변형 심장외 도관 폰탄술식 - 1례 보고 -)

  • Lee, Jeong-Ryeol;Lee, Cheul;Chang, Ji-Min
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.781-783
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    • 2001
  • In a patient with single ventricle associated with complex systemic and/or pulmonary venous drainage, intraatrial Fontan procedure is sometimes technically difficult due to the complex spatial relationship between their orifices in the atrium. We report a case of the modified extracardiac conduit Fontan procedure in a patient with a single ventricle in which the inferior vena cava and the hepatic vein drained separately into the atrium and the intraatrial orifice of the hepatic vein was abut to the orifice of the left lower pulmonary vein.

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Role of Adenosine in the Activation of Myocardial Catalase Induced by Brief Regional Ischemia

  • Kim, Young-Hoon;Kim, Chan-Hyung;Kim, Gi-Tae;Choi, Hong;Park, Jong-Wan;Kim, Myung-Suk
    • The Korean Journal of Physiology and Pharmacology
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    • v.3 no.1
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    • pp.53-57
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    • 1999
  • The activities of myocardial antioxidant enzymes are known to increase in the hearts preconditioned with the brief episodes of ischemia. This study was undertaken to elucidate the possible involvement of adenosine in the stimulation of myocardial catalase induced by the brief regional ischemia in rabbit hearts. Coronary artery descending the middle anterior wall of left ventricle was occluded for 15 min, followed by 1 hr of reperfusion. Upon reperfusion after the brief ischemia, the activity of catalase increased significantly in both ischemic and non-ischemic parts of myocardium. Pretreatment of the heart with theophylline, a non-specific adenosine receptor blocker, completely abolished the increase of catalase activity in both the ischemic and non-ischemic regions of myocardium. On the other hand, the administration of exogenous adenosine instead of the ischemia failed to increase the catalase activity in in vivo hearts. Moreover, adenosine infusion did not affect the catalase activity in the isolated, perfused hearts either. These results suggest that the endogenous adenosine released from the ischemic myocardium is involved in the activation of catalase induced by brief ischemia, but that adenosine may not be a final direct activator of cellular catalase in the myocardium.

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Massive Thromboembolism Owing to the Left Ventricular Thrombus Associated with the Hypereosinophilic Syndrome

  • Kim, Ji Seong;Park, Samina;Kim, Hyung-Kwan;Jeon, Yun-Seok;Min, Seung-Kee;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.478-482
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    • 2014
  • A 39-year-old man presented with cough, chest discomfort, and weight loss. On the basis of the patient history and laboratory findings, he was diagnosed with the hypereosinophilic syndrome. Transthoracic echocardiography revealed a large thrombus in the left ventricle. Medical treatment with anticoagulation and immunosuppression was commenced immediately. Fourteen days after the initial diagnosis, the patient presented with acute pain in his right leg. Computed tomographic angiogram showed embolic occlusion of the infrarenal abdominal aorta and bilateral iliac (including common, external, and internal iliac) arteries. Emergent thromboembolectomy and left ventricular thrombectomy were performed. The postoperative course was uneventful, and the patient has undergone follow-up for 2 months without any evidence of recurrence of thromboembolism.

Changes in Cardiac Structure and Function After Kidney Transplantation: A New Perspective Based on Strain Imaging

  • Darae Kim;Minjeong Kim;Jae Berm Park;Juhan Lee;Kyu Ha Huh;Geu-Ru Hong;Jong-Won Ha;Jin-Oh Choi;Chi Young Shim
    • Journal of Cardiovascular Imaging
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    • v.31 no.2
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    • pp.98-104
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    • 2023
  • BACKGROUND: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT). METHODS: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|. RESULTS: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups. CONCLUSIONS: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.