• Title/Summary/Keyword: MVR

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Clinical Experience of Open Heart Surgery; 1000 Cases (심장수술 1,000례의 임상적 고찰)

  • 조광현
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.282-293
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    • 1993
  • From Sep. 1985 to Dec. 1992, total 1000 cases of open heart surgery [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College Of Medicine, Inje University.Among the total 1,000 cases of OHS, there were 823 cases with congenital heart diseases [CHD] and 177 cases with acquired heart diseases [AHD]. The age distribution was 9 days [4.0 kg] to 49 years in CHD and 11 to 64 years in AHD, In the 823 cases of CHD, there were 763 acyanotic cases and 60 cyanotic cases. The CHD cases consisted of 520 VSD [63.2 %], 177 ASD [21.5 %], 60 TOF[7.3 %], 27 PS [3.3 %], 17 ECD [2.1%], 7 Valsalva sinus rupture [0.9 %], 4 TGA [0.5 %], 3 Ebstein`s anomaly [0.4%], 3 DORV[0.4%], and others. The corrective operations were applied for congenital heart disease with the result of 2. 8 % hospital mortality. In the 177 AHD, 168 cases were valvular heart diseases, 7 cases were cardiac tumors and one LA thrombus and one annuloaortic ectasia. In the 168 valvular heart diseases, there were 115 single valve replacement cases [16 AVR, 99 MVR], 20 cases of double valve replacement[AVR & MVR], 15 cases of MVR with TVA, and 10 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 199`. In MVR, 66 of St. Jude Medical valves, 78 ofCarpentier-Edward valves, and 5 of Ionescu-Shiley valves were used. In AVR, 38 of St. Jude Medical valves and 12 of Carpentier-Edward valves were used.The hospital operation mortality rate of congenital acyanotic, cyanotic, and acquired heart diseases were 1.6%, 18.3 % and 3.4% respectively. The overall mortality rate was 2.9 % [29/1000].

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Clinical Effect of Left Ventricular Dysfunction in Patients with Mitral Stenosis after Mitral Valve Replacement

  • Park, Kwon Jae;Woo, Jong Soo;Park, Jong Yoon;Jung, Jae Hwa
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.350-355
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    • 2016
  • Background: Mitral stenosis (MS) remains one of the important heart diseases. There are many factors that influence the clinical outcomes, and little is known about how left ventricular (LV) dysfunction clinically affects the prognosis of the patient with MS after mitral valve replacement (MVR). We reviewed our clinical experiences of MVR in patients with MS who had LV dysfunction. Methods: Between January 1991 and January 2013, 110 patients with MS who underwent MVR were analyzed and divided into two groups according to ejection fraction (EF). Group 1 ($EF{\leq}45%$) included 13 patients and group 2 (EF>45%) included 97 patients. Results: Thromboembolism occurred in 8 patients after MVR (group 1: n=3, 23.1%; group 2: n=5, 5.2%) and its incidence was significantly higher in group 1 than in group 2 (p=0.014). There were 3 deaths each in groups 1 and 2 during follow-up. The overall rate of cardiac-related death in group 1 was significantly higher than in group 2 (group 1: n=3, 23.1%; group 2: n=3, 3.1%; p=0.007). The cumulative survival rate at 1 and 15 years was 83.9% and 69.9% in group 1 and 97.9% and 96.3% in group 2 (p=0.004). The Cox regression analysis revealed that survival was significantly associated with postoperative stroke (p=0.011, odds ratio=10.304). Conclusion: This study identified postoperative stroke as an adverse prognostic factor in patients with MS after MVR, and a s more prevalent in patients with LV dysfunction. Postoperative stroke should be reduced to improve clinical outcomes for patients. Preventive care should be made in multiple ways, such as management of LV dysfunction, atrial fibrillation, and anticoagulation.

Left Ventricular Rupture Related to MVR - 2 Case Report - (승모판 치환술에 관련된 좌심실 파열[2례])

  • 최순호
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.605-610
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    • 1992
  • Improving intraoperative and postoperative myocardial protection and better construction and design of valvular prosthesis has reduced the mortality of MVR. But, ventricular rupture after MVR occurred occasionally and represented a potentially lethal complication. Transverse midventricular disruption presented as refractory myocardial failure immediately on termination of bypass or later often on initial period of good hemadynamics. From Jan., 1985 through Dec., 1991 131 MVRs were performed as isolated or combined procedures. Rupture of the posterior wall of left ventricle was observed in 2 patients. There were 2 type III ruptures Prevention is of utmost importance, and by taking certain precautions, the chance of ventricular rupture can be reduced. Repair should always be done by patch technique in the aid of the use of cardiopulmonary bypass with cardioplegic arrest. When the laceration is in the middle of the posterior left ventricle, external repair with the pericardial patch can be attempted first.

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The Effect of Chordae Preservation in Mitral Valve Replacement (승모판막 치환술에 있어 건삭 보존의 효과)

  • 김공수;조중구;구자홍;김태호
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.353-357
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    • 1999
  • Background: Mitral valve replacement(MVR) with chordal preservation in patients with mitral vlavular disease has been proven to be beneficial for left ventricular function and for reduction of postoperative complication. Material and Method: From January 1995 to July 1996, the early postoperative results of mitral valve replacement were compared between 20 patients who underwent chordae resection(classic MVR group) and 10 patients who underwent chordae preservation(preservation MVR group) in the Department of Thoracic and Cardiovascular Surgery, Chunbuk National University Hospital. Result: There was no significant difference between the two groups in age, sex, NYHA functional class, cardiothoracic ratio, echocardiographic finding, cardiopulmonary bypass time and aortic cross clamping time. The difference between preoperative and postoperative cardiothoracic ratio after 3 months was not statistically significant. At echocardiographic left ventricular evaluation, ejection fraction and fractional shortening decreased slightly in the preservation group then preoperative value (p=0.47, p=0.12), however, decreased significantly in the classic MVR group(p=0.03, p=0.04), and were statistically significant between the two groups(p=0.03, p=0.02). Conclusion: We conclude that MVR with chorda preservation seems to have a beneficial effect on postoperative left ventricular performance in mitral valve disease than the classic MVR.

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Clinical Results of the Mechanical Cardiac Valves (기계판막의 임상적 평가)

  • 박창권
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.161-170
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    • 1991
  • Clinical results with the Mechanical cardiac valves were reviewed for 261 patients who underwent cardiac valve replacement from September, 1985 to July, 1990. of the Mechanical valves used, 156 were Carbomedics, 109 Duromedics, 52 St. Jude and 11 Bjork-Shiley. Overall hospital mortality was 14 out of 261[5,36%]: 9 out of 159[5.66%] for MVR, 1 out of 35[2.86%] for AVR and 4 out of 67[5.96%] for DVR[AVR+MVR]. Two hundred and forty seven operative survivors were followed up for a total 466.8 patient-years, ranged from 1 month to 4.9 years [a mean 1.8 years] and the follow up was 96.0%. There were 12 valve-related complications: three from thromboembolism, three from valve thrombosis, three from prosthetic valve endocarditis, two from paravalvular leak and the other one from hemorrhage. Actuarial rate free from all valve-related complication at 4.9 years was 96$\pm$1.3%. There were 11 late deaths: two from thromboembolism, one from valve thrombosis, one from prosthetic valve endocarditis, one from hemorrhage and the others 6 from non-valve-related complications. Actuarial survival rate at 4.9 years was 94$\pm$2.0%. 96$\pm$3.0% for MVR, 94$\pm$4.2% for AVR and 91$\pm$3.7% for DVR[AVR+MVR]. And there are 7 reoperations: three from paraprosthetic leak, two from prosthetic valve endocarditis and two from valve thrombosis. Actuarial rate free from reoperation at 9 years was 96$\pm$2.9%. On the basis of this 4.9 years of experience, the pyrolytic carbon mechanical valves appears to be an excellent mechanical prosthesis for cardiac valve replacement, in terms of hemodynamic performance, low mortality and low thrombogenecity.

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Clinical evaluation of the Hancock porcine xenograft valve (Hancock 판막의 임상적 평가)

  • 김종환
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.281-288
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    • 1987
  • A total and consecutive 163 patients underwent cardiac valve replacement using the Hancock porcine xenograft cardiac valves from 1 976 to 1984. Of 198 substitute valves, 177 were the Hancock valves. One hundred twenty-nine patients[79.1%] had single valve replacement: MVR 118, AVR 8 and TVR 3; 33[20.3%] had double valve replacement: MVR+AVR 27 and MVR+TVR 6; and a single case had triple valve replacement. Other surgical procedures were added in 34 patients. The operative mortality rate within 30 days of surgery was 6.1%, and it was, however, 4.2%, with single MVR. Late mortality rate was 6.7% or 1.95%/patient-year of a linealized mortality rate. Early survivors of 153 patients were followed up for a total of 565.1 patient-years [a mean of 44.3*27.1 months]. The linealized annual complication rates were: 1.95% emboli/patient-year, 0.89% bleeding/patient-year 1.24% endocarditis/patient-year, and 4.25% overall failure/patient-year. Primary tissue failure occurred at a rate of 1.59%/patient-year. The actuarial survival rates including operative mortality were 87.0*4.1% and 77.3*6.6% at 5 and 11 years after surgery respectively. The probability of freedom from thromboembolic complication of 89.2*3.4% at 5 years after surgery lasted unchanged upto 11 years. The probability of freedom from overall valve failure was 81.3*4.5% at postoperative 5 years, and it dropped down to 26.2*19.4% at 11 years, although the latter was statistically insignificant because of a small number of patients entering into the years approaching the follow-up end. However, the probability of freedom from the primary tissue failure was 81.3*10.6% at postoperative 9 years, which coincides closely with the speculated rate of tissue degeneration of about 20% in 10 years. These clinical results confirm the low thrombogenicity of the Hancock porcine valve and the reasonable failure rate of tissue degeneration.

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Open Heart Surgery 110 Cases in One Year(1987) (연간 (1987년) 개심술 110례에 대한 검토)

  • 조광현
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.351-365
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    • 1988
  • During one year[1987], 110 cases of open heart surgeries were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje Medical College. And the results were summarized as follows. 1. Among the 110 cases, there were 77 cases of congenital heart diseases and 33 cases of acquired heart diseases. Age range of the congenital patients was 8 months to 30 years with the mean age of 8 years, and acquired patients was 16 to 56 years with the mean age was 32 years. 2. The heart lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 50 of membrane type and 60 of bubble type. For all cases GIK[glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 77 congenital anomalies, there were 67 cases of acyanotic patients[ASD: 12, VSD: 50, PS: 1, AP window: 1, Gerbode defect: 1, ECD: 2] and 10 cases of cyanotic patients[TOF: 10], and to all of which the appropriate radical operations were applied. 4. Among the 33 acquired diseases, there were one case of left atrial myxoma, one of annuloaortic ectasia, 20 of mitral valve diseases[MS: 2, MSr: 8, MR: 2, MRs: 8], 9 of double valve diseases[MRs+AR: 1, MRs+ARs: 2, MRs+TR: 1, MSr+TR: 3, MSr+ASr: 1, MSr+ARs: 1], 2 of triple valve diseases[MSr+AR+TR: 1, MSr+ASr+TR: 1]. The left atrial myxoma was removed well with right atriotomy and atrial septal approach. And to the annuloaortic ectasia, Bentall operation was applied with good result. Mitral valve replacement[MVR] was applied to 20 cases of mitral valve diseases, double valve replacement[MVR+AVR] was applied to 6 cases of double valve diseases, MVR & tricuspid annuloplasty[TVA] was applied to 3 cases of mitral 5. The number of replaced valve were 39 in 31 cases. In MVR, 5 of mechanical valves[St. Jude Medical Valve] and 26 of tissue valves[Carpentier-Edward valve] were used. In AVR, 3 of mechanical valves and 5 of tissue valves were used. 6. Postoperative complications were occurred in 23 cases, and among them 21 cases were recovered with intensive cares, but 2 cases were expired[mortality: 1.8%].

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An Indexing Technique for Range Sum Queries in Spatio - Temporal Databases (시공간 데이타베이스에서 영역 합 질의를 위한 색인 기법)

  • Cho Hyung-Ju;Choi Yong-Jin;Min Jun-Ki;Chung Chin-Wan
    • Journal of KIISE:Databases
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    • v.32 no.2
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    • pp.129-141
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    • 2005
  • Although spatio-temporal databases have received considerable attention recently, there has been little work on processing range sum queries on the historical records of moving objects despite their importance. Since to answer range sum queries, the direct access to a huge amount of data incurs prohibitive computation cost, materialization techniques based on existing index structures are recently suggested. A simple but effective solution is to apply the materialization technique to the MVR-tree known as the most efficient structure for window queries with spatio-temporal conditions. However, the MVR-tree has a difficulty in maintaining pre-aggregated results inside its internal nodes due to cyclic paths between nodes. Aggregate structures based on other index structures such as the HR-tree and the 3DR-tree do not provide satisfactory query performance. In this paper, we propose a new indexing technique called the Adaptive Partitioned Aggregate R-Tree (APART) and query processing algorithms to efficiently process range sum queries in many situations. Experimental results show that the performance of the APART is typically above 2 times better than existing aggregate structures in a wide range of scenarios.

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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Enhanced Image Mapping Method for Computer-Generated Integral Imaging System (집적 영상 시스템을 위한 향상된 이미지 매핑 방법)

  • Lee, Bin-Na-Ra;Cho, Yong-Joo;Min, Sung-Wook;Park, Kyung-Shin
    • 한국HCI학회:학술대회논문집
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    • 2006.02a
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    • pp.535-540
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    • 2006
  • 집적 영상(Integral Imaging) 시스템은 관찰자가 특수안경의 착용 없이 육안으로 3 차원 영상을 볼 수 있는 무안경식 양안시차 디스플레이 방식 중 하나로, 수직, 수평 시차와 총천연색의 영상을 제공한다. 집적영상 시스템은 3 차원 정보를 2 차원 엘리멘탈 이미지 (Elemental image)의 형태로 저장하는데, 엘리멘탈 이미지는 조금씩 다른 방향에서 제한된 크기로 촬영된 이미지이다. 엘리멘탈 이미지는 컴퓨터 그래픽으로 만들어질 수도 있는데, 이를 이용하는 집적 영상 방식을 CG 직접 영상 시스템이라 한다. 이와 같이 컴퓨터 계산에 의해 엘리멘탈 이미지를 얻는 과정을 이미지 매핑 (Image mapping)이라 부른다. 이제까지 제안된 이미지 매핑 방식에는 점대점 (Point to Point), MVR (Multi-Viewpoint Rendering), PGR (Parallel Group Rendering) 이 있다. 그러나 이런 방식들은 계산량이 많거나 렌즈 어레이 개수의 증가에 의해 속도에 영향을 받는 단점이 있어, 아직 가상현실 같은 실시간 CG 응용 분야에 사용하기 어려운 문제가 있다. 본 논문에서는 VVR (Viewpoint Vector Rendering)이라는 기존의 방법과 비교해 향상된 새로운 이미지 매핑 방법을 제안한다. 먼저 VVR 개념을 자세히 설명한 후 VVR 을 사용한 집적 영상 시스템을 구현하여 MVR 방법과 비교 분석한 실험결과와 개선되어야 할 방향을 제시한다.

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