• Journal of Chest Surgery
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• v.36 no.9
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• pp.683-686
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• 2003

Isolated right ventricular hypoplasia is a rare clinical entity. We describe a case of right ventricular hypoplasia, single atrium and spongy myocardium of left ventricle. The volume of right ventricle was half the volume of left ventricle and z-value of tricuspid valve was -4 preoperatively The patient, 6-year-old boy, underwent atrial partitioning with 3 mm fenestration, Postoperative course was smooth and he tolerated the biventricular state well during follow-up. Follow-up catherterization was done 27 months later The tricuspid valve grew well (z-value= -0.4) and atrial septal fenestration is closed spontaneously. This article reports a case of successful biventricular repair in a patient with isolated right ventricular hypoplasia.

• Journal of radiological science and technology
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• v.45 no.2
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• pp.151-158
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• 2022

The Cardiac Gated Blood Pool (GBP) scintigram, a nuclear medicine imaging, calculates the left ventricular Ejection Fraction (EF) by segmenting the left ventricle from the heart. However, in order to accurately segment the substructure of the heart, specialized knowledge of cardiac anatomy is required, and depending on the expert's processing, there may be a problem in which the left ventricular EF is calculated differently. In this study, using the DeepLabV3 architecture, GBP images were trained on 93 training data with a ResNet-50 backbone. Afterwards, the trained model was applied to 23 separate test sets of GBP to evaluate the reproducibility of the region of interest and left ventricular EF. Pixel accuracy, dice coefficient, and IoU for the region of interest were 99.32±0.20, 94.65±1.45, 89.89±2.62(%) at the diastolic phase, and 99.26±0.34, 90.16±4.19, and 82.33±6.69(%) at the systolic phase, respectively. Left ventricular EF was calculated to be an average of 60.37±7.32% in the ROI set by humans and 58.68±7.22% in the ROI set by the deep learning segmentation model. (p<0.05) The automated segmentation method using deep learning presented in this study similarly predicts the average human-set ROI and left ventricular EF when a random GBP image is an input. If the automatic segmentation method is developed and applied to the functional examination method that needs to set ROI in the field of cardiac scintigram in nuclear medicine in the future, it is expected to greatly contribute to improving the efficiency and accuracy of processing and analysis by nuclear medicine specialists.

• Journal of Chest Surgery
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• v.45 no.2
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• pp.116-119
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• 2012

A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.529-537
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• 2005

Background: Historically the Fontan operation in patients with single ventricle and heterotaxy syndrome has been associated with high mortality because of systemic or pulmonary anomalous venous drainage, incompetent common atrioventricular valve, right ventricle type univentricular heart, and arrhythmia. Material and Method: A retrospective review of 62 patients $(age:\;54.79\pm33.97\;months)$ with heterotaxy syndrome who underwent a extracadiac Fontan operation between 1996 and 2005 was performed. Twenty one patients had left atrial isomerism, and 41 had right isomerism. The Fontan procedure was staged in all but 2 patients, and a fenestration was less placed in left isomerism. Result: Left isomerism was associated more with interrupted inferior vena cava and pulmonary arteriovenous fistula, and right isomerism was associated more with anomalous pulmonary venous drainage, common atrioventricular valve and morphologic right ventricle. There were 3 hospital deaths$(4.8\%)$ and 3 late deaths $(5.2\%)$ with a follow-up duration of $48.8\pm31.0$ months. Eight-year survivals were $90.5\pm6.4\%$ in left isomerism and $88.6\pm5.4\%$ in right isomerism (p=0.94). At 8 years, freedom from reoperation was $73.9\pm11.3\%$ in left isomerism, and $82.3\pm6.7\%$ in right isomerism (p=0.87). Atrioventricular valve regurgitation progressed after Fontan operation in heterotaxy syndrome, and reoperation for pulmonary arteriovenous fistula and permanent pacemaker implantation for sinus node dysfunction were required more in left isomerism. Conclusion: The extracardiac Fontan operation can now be performed in patients with heterotaxy syndrome with excellent survival. However, morbidity in terms of postoperative atrioventricular valve regurgitation, arrhythmia, and pulmonary arteriovenous fistula remains significant.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.635-642
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• 1985

Double outlet left ventricle [DOLV] is a rare cardiac anomaly in which both great arteries arise entirely, or predominantly above the morphologically left ventricle. About 100 cases of DOLV have been reported in the literatures by 1984. We have experienced eight cases of DOLV at Seoul National University Hospital during the period from October 1981 to July 1905. Ages of the patients were ranged from 12 months to 24 years old, and chief complaints on admission were frequent URI and DOE in 5 cases and cyanosis in other 3 cases. In all eight patients, Cardiac catheterization and cineangiography were performed but pre-operative diagnoses were incorrect except one case [VSD in 2 cases, DORV in 2cases, c-TGA in 2 cases and TOF in one case] We have performed total corrective surgery in seven patients. In case I, patch closure of VSD aligning aorta and pulmonary artery with LV, ligation of proximal pulmonary artery and the use of external valved conduit from RV to PA have been employed. In other 6 cases, intraventricular repair using boomerang shaped Dacron patch with correction of associated anomalies were employed. In remaining one patient who had coexistent PDA and coarctation of aorta, we have performed coarctoplasty and PDA ligation initially and the patient is waiting for subsequent total corrective procedure. In seven patients whom we have performed total corrective surgery, there is one hospital mortality due to right heart failure and one complication of complete heart block necessitating permanent pacemaker implantation. All survivors are doing well in follow up period of 9 months to 4 years. To our knowledge, this is the first report of surgical experiences for DOLV in the Korean literature.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.277-280
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• 2015

We report the case of a 37-year-old man who suffered from biventricular failure due to left isomerism, inferior vena cava interruption with azygos vein continuation, bilateral superior vena cava, double outlet of right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and isolated dextrocardia. Heart transplantation in patients with systemic venous anomalies often requires the correction and reconstruction of the upper & lower venous drainage. We present a case of heart transplantation in a patient with left isomerism, highlighting technical modifications to the procedure, including the unifocalization of the caval veins and reconstruction with patch augmentation.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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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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• v.15 no.2
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• pp.204-212
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• 1982

The presence of left atrial thrombus in mitral stenosis has been reported to be associated with several factors. These are age, sex, presence of atrial fibrillation, episodes of congestave heart failure, calcification of mitral valve, embolic episode, etc. Since none of these single factor has been always related to the presence of left atrial thrombus, related risk factors to left atrial thrombosis were studied in patients with mitral stenosis using chi square test. We had operated on 191 cases of mitral valvular heart disease from Jan. 1978 to June 1981 at Severance Hospital, Yunsei University College of Medicine. The left atrial thrombi were present in 41 cases among 191 cases of mitral valvular heart disease and it was present in 31 cases among 89 cases of pure mitral stenosis. Only 10 cases among 74 cases of mitral stenoregurgitation had left atrlal thrombi, whereas no left atrlal thrombus was found in patients with pure mitral regurgitation. Related risk factors studied herein were sex, episodes of congestive heart failure, atrial fibrillation, pulmonary capillary wedge pressure, mitral valve area calculated by Gorlin and Gorlin`s formula cardiac output and left atrial dimension by echocardiogram. In this study presence of atrial fibrillation was deemed to be one of the most potential risk factors and other factors of age, duration of symptoms, episode of embolization, calclfication of mitral valve, associated aortic and tricuspid valve disease, ejection fraction of left ventricle by cineangiocardiogram and echocardiogram were not significantly related to the presence of left atrlal thrombi in a statistical viewpoint.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.202-208
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• 1987

Congenital coronary artery fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common then those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber followed by the right atrium and the pulmonary artery. Recently we experienced two cases of congenital coronary artery fistula which originated from the left coronary artery each other. The first case was 17 moth-old-male, who have had the symptoms of frequent URI, dyspnea and continuous murmur in physical examination. The fistulous communication was noted between the left circumflex coronary artery and the right ventricle with aneurysmal dilation of RV wall. The proximal opening of the fistulous tract was directly close with partial aneurysmorrhaphy of RV wall. Also the termination site of fistulous tract in RV chamber was closed. The second case was 35-year-old female, who have had the symptom of exertional dyspnea and continuous murmur in physical examination. The tortuous and dilated fistulous tract was noted between the left anterior descending coronary artery and the pulmonary artery. The proximal opening of the fistula was ligated near the left anterior descending coronary artery with preservation of normal continuity of coronary artery. And the dilated tortuous vessel was excised. Also the terminal site in pulmonary artery was directly closed just above the pulmonic valve. Postoperative hospital courses of two patients were uneventful without any specific complications and discharged without problems.

• The Korean Journal of Physiology
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• v.20 no.2
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• pp.175-183
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• 1986

Since it was proposed that vanadate may be an ‘ideal endogenous regulator of the $Na^+,\;K^+-ATPase$ activity (Cantley et at, 1979), vanadate has been a subject of intensive research and a variety of its physiological effects have been described (Nechay, 1984). In isolated guinea pig heart muscle vanadate shows a positive inotropic effect on ventricular muscle, while it induces a negative inotropic effect on atrial muscle. But its underlying mechanism has not been elucidated so far. Therefore, in this study the flux rates of calcium ion into and from guinea pig heart muscle were measured to throw some light on the underlying mechanism, because those rates have been known to be closely related to the cardiac contractility and the results are summarized as follows: 1) Calcium efflux rates from the intracellular $Ca^{++}$ pool (compartment 4) of both guinea pig left atrium and right ventricle were significantly reduced by vanadate and their pool sizes were significantly increased by vanadate. 2) The magnitude of calcium influx into left atrium was reduced by vanadate, While the magnitude of calcium influx into right ventricle was not affected by vanadate. From these results, it may be concluded that the positive inotropic effect of vanadate on the ventricular muscle was due to a reduced efflux rate of calcium ion and its negative inotropic effect on atrial muscle was resulted from a reduced influx of calcium ion.