• Journal of Chest Surgery
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• v.22 no.6
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• pp.1084-1087
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• 1989

Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.203-206
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• 1996

To understand the local fluid dynamics for different desists of Fontan operation, five models were made out of Pyrex glass to facilitate in-vitro study. Model I, II and III have same position of the center of the anastomosis of the IVC( inferior vena cava) with that of the SVC(superior vena cava), but Model IV and V have 10 mm offset between them. Also the anastomotic junction angles are different(Model I and $IV:90^{\circ}$, Model II and $V:70^{\circ}$, Model $III:45^{\circ}$). These models were then connected to a flow loop for flow visualization study. In Model I any dominant vortex was not seen in the central region of the juntion, but a large unstable vortex was created in the Model II and III. In Model IV and V a significant stagnation region was created in the middle of the offset region. It also showed that the flow direction from the IVC and SVC to the LPA(left pulmonary artery) and RPA(right pulmonary artery) highly depends on the offset of the junction rather than the anastomotic junction angle.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.871-880
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• 1990

We clinically evaluated 182 cases of the ventricular septal defect that we experienced at the Department of Thoracic and Cardiovascular Surgery, Maryknoll Hospital from March 1986 through June 1990. Of the 182 cases, 95 patients were male and 87 patients were female. Their age distribution ranged from 8 month to 37 years and their mean age was 8.1 years. The most common chief complaint was frequent upper respiratory infection. Among them, 46 patients had associated cardiac anomalies, which were subdivided as follow; 9 cases of patent foramen ovale, 8 cases of infundibular stenosis, 6 cases of pulmonary valvular stenosis, 4 cases of left superior vena cava, and etc. The most common preoperative abnormal EKG finding was left ventricular hypertrophy in 22 cases. Ninety-three patients[51.1%] underwent simple closure of the VSD and the rest[48.0%] underwent patch closure. In anatomical classification by Kirklin type I constituted 24.2%; type II, 74.8%, type III, 0.7%, and the mixed type of type I and II, 0.5%, The important postoperative EKG changes were noted in 38 cases[20.9%], 18 cases of which were incomplete right bundle branch block. Thirty-three patients[18.1%] developed minor and major complications, and five patients died, overall operative mortality being 2.7%.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.130-132
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• 2018

Coronary sinus ostial atresia (CSOA) with persistent left superior vena cava (LSVC) in the absence of an unroofed coronary sinus is a benign and rare anomaly that may be taken lightly in most instances. However, if overlooked in patients undergoing univentricular heart repair such as bidirectional Glenn or Fontan-type surgery, fatal surgical outcomes may occur due to coronary venous drainage failure. We report a case of CSOA with a persistent LSVC that was managed through coronary sinus rerouting during a total cavopulmonary connection, and provide a review of the literature regarding this rare anomaly.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.258-264
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• 1985

The experience with operative treatment for total correction of Fallot at the department of Thoracic and Cardiovascular Surgery, Keimyung University Dong San Medical Center from July 1980 to July 1984 was reviewed. There were 37 males and 12 females and their ages ranged from 3 years to 30 years, with the average age of 12.2 years. Sixty nine point four percent of patients were younger than 15 years of age. The most frequent type of right ventricular outflow stenosis was the combined type [pulmonary valvular and infundibular stenosis] containing 41 patients [83.7%] and there were 9 deaths in this group. The major associated lesions included Patent foramen ovale in 20 patients [40.8%], Atrial septal defect in 7 patients [14.3%], Left superior vena cava in 4 patients [8.2%], Right sided aortic arch in 2 patients [4.1%] and Patent ductus arteriosus in 11 patient [2.0%]. The pulmonary valvotomy was performed in 41 patients and patch graft reconstruction of the right ventricular outflow tract was performed in 23 patients. In 11 patients the monocusp patches were used. Thirty-five patients [71.4%] had the right bundle branch block postoperatively. There were 11 postoperative deaths with hospital mortality rate of 22.4% and the leading causes of death were low output syndrome, bleeding, and cerebral embolism.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.151-156
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• 1985

A clinical analysis was done on 50 cases of ventricular septal defect, operated from April 1981 to March 1984 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. Among 50 cases, 34 cases were males and 16 cases were females. Their age ranged from 1 to 26 years and the mean age was 9.7 years. The main symptoms at admission were frequent upper respiratory infection [50%], exertional dyspnea [42%] and palpitation [34%]. In anatomical classification by Kirklin, type I constituted 20%, type II 76%, type IV 4%. Associated congenital cardiac lesions were pulmonic stenosis [6 cases], patent foramen ovale [5 cases], aortic insufficiency [3 cases] and persistent left superior vena cava [1 case]. When a normal electrocardiogram pattern was present, Qp/Qs, Rp/Rs and pulmonary artery systolic pressure and Pp/Ps were relatively low. Among cases of above 1 cm2/M2 BSA in size of defect, Pp/Ps and pulmonary artery systolic pressure were increased than the cases of below 1 cm2/M2 BSA [P=0.01]. The postoperative right bundle branch block was occurred in 21 cases [75%] among 28 cases of right ventriculotomy approach. The operative mortality was 2% [1 case] among 50 cases and complication rate was 14% [7 cases].

• Journal of Chest Surgery
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• v.7 no.1
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• pp.85-92
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• 1974

During the years 1959 to 1974, 99 patients with patent ductus arteriosus were admitted to National University Hospital. These includes 5 patients with additional cardiovascular and 5 patients with severe pulmonary hypertension. All were operated upon except three refused operation. In all instances, the diagnosis was made by history and physical, roentgenological and electrographic examinations. In addition, in 53 patients, special diagnostic procedures were carried out either for diagnosis or for evaluation of pulmonary hypertension and associated cardiovascular anomalies. Right cardiac catheterization was resorted to in 51 patients. In one of these patients catheterization was incorrectly interpreted [ventricular septal defect]. Retrograde aortogram was performed in two patients. In both cases the ductus itself was visualized on the x-ray film. An additional vascular anomaly, namely the persistent left superior vena cava, was confirmed by retrograde angiogram in one of them. In 5 cases the pulmonary arterial pressure was elevated well over 80 mmHg. In these instances,the operative mortality was 80% [4 out of 5 patients]. The management of patent ductus arteriosus when associated with severe pulmonary hypertension. and/or other cardiac anomalies is controversial. Opinions differ as to how to close the ductus and to repair the cardiac anomalies as well as to whether a one-staged or two-staged procedure should be resorted to. The author is of the that each case must be evaluated individually before any specific surgical treatment is ou.tlined. The literature on the subject is reviewed in this paper.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.297-302
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• 2003

Background : Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occurred.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.619-623
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• 1998

A 51-year-old male with chronic renal failure had marked swelling and tenderness of the right arm. Venography revealed central vein occlusion involving stenosis of right proximal subclavian vein, right internal jugular vein, and left distal innominate vein, and obstruction of right brachiocephalic vein. Multiple obstruction of these veins was thought to have resulted from repeated subclavian catheterization. Right subclavian-superior vena cava was bypassed with 10 mm Gore-tex vascular graft and then left subclavian vein with 8 mm Gore-tex vascular graft was bypassed to the 10 mm Gore-tex vascular graft. The results were excellent.