• Journal of Chest Surgery
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• v.17 no.3
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• pp.389-397
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• 1984

Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.59-66
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• 1984

After open heart surgery, the patient must be carefully observed and adequately managed for his survival. This report reviewed 10 cases of ventricular septal defect and 12 mitral valvular diseases as hemodynamics early after open heart surgery. For postoperative 24 hours, clinical status was evaluated for left atrial pressure, central venous pressure,DP[LAP-CVP], peak systolic pressure, heart rate, urine amount, and other clinical findings. Especially, on postoperative fourth hour, cardiac output was most decreased, when the changes of monitoring were compared with two groups with or without using cardiotonics. Finally, we concluded as followings; 1.Postoperatively, variation of CVP was noted in VSD, but mitral valvular disease was more variable change of LAP. 2.DP was 1.3\ulcorner.4 cmH2O in VSD, and 6.4\ulcorner.2 cmH2O in mitral valvular disease. 3.Parameter using cardiotonic was CVP in VSD, and LAP in mitral valvular disease.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.752-758
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• 1994

From July 1983 to December 1992, 145 patients with mitral valvular disease underwent open heart surgery at Chonbuk National University Hospital. Of these patients, 89 patients[61.4%] required mitral valve replacement. 56 patients [38.6 %] had mitral valve repair. There were 32 women and 24 men and the mean age was 34.3 years[range 6 years to 62 years].There were 23 cases of pure mitral stenosis, 19 cases of mitral regurgitation and 14 cases of mixedmitral valvular disease. The mean duration of symptom was 4.53 years and mean mitral valvularorifice diameter[in cases of pure stenosis and mixed mitral valvular lesion] was 0.96 cm. According to the NYHA classification, the distribution of patients preoperatively was as follows; class IIa, 15 patients; class lib, 17 patients; class III, 22 patients; class IV, 2 patients. Four patients[7%] had an embolic history preoperatively. 24 patients[ 43 %] were in atrial fibrillation. In cases of pure mitral stenosis, the technique used included open mitral commissurotomy[21atients], open mitral commissurotomy with mitral annuloplasty[2 patients]. In mixed mitral valvular disease, open mitral commissurotomy[ll patients] and open mitral commissurotomy with mitral annuloplasty[l patient] were performed. In cases of mitral regurgitation, mitral annuloplasty[5 patients], mitral valvuloplasty[6 patients], mitral annuloplasty with valvuloplasty [3 patients] and ring annuloplasty [5 patients] were performed.There was one perioperative death related to acute renal failure and sepsis. One late death was occurred related to heart failure after 10 months postoperatively. One patient required reoperation due to restenosis and no embolic episode was occured. After operation, 34 patients were in NYHA functional class I, 20 patients were in class IIa.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.273-278
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• 2001

Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.77-84
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• 1969

Retrograde left cardioangiographic studies using Amplatz spring coil guide catheter were carried out in 30 cases of acquired mitral valvular diseases. Of these 12 cases were compatible with the clinical diagnosis which were made pre-angiocardiographically. Eighteen out of 30 cases were diagnosed as pure mitral stenosis or mitral insufficiency which had been clinically diagnosed as mitral stenoinsufficiency or mitral stenosis with aortic insufficiency. The rate of difference is 60%. Twenty-five cases or 83% of all cases were operated. Of these 6 cases, the degree of regurgitation through the mitral valves were able to be evaluated cardioangiography and were confirmed by open heart operation. The retrograde left cardioangiography is considered to be a useful tool in conclusive dianosis of clinically equivocal mitral valvular diseases.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1015-1018
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• 1997

Median sternotomy incision is world-widely used for open heart surgery, especially in valvular heart disease. But recently, minimally invasive approach by the right parasternal incision for valvular heart disease was introduced with the many merits by small incision. We experienced 1 case of mitral valve repalcement by right parasternal incision and extended transseptal approach. This technique has no specific compli ations or problems compared with the median sternotomy and was proven by the excellent exposure. Cosmetically, the patient was satisfied with the incision.

• 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.24 no.10
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• pp.967-972
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• 1991

Between Feb. 1982 and July 1990, 173 patients [male: 89, female: 84] Who underwent heart valve replacement for acquired valvular heart disease on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University, were reviewed for return to work after heart valve replacement. The replaced valve were mitral [128, 74.0%], aortic[10, 5.8%], mitral & aortic[35, 20.2%]. Two tricuspid valve replacement were excluded. Several important factors influencing the return to work were age, the employment status before surgery, the number of replaced valve, the pre - op NYHA functional class and cardiac function [ejection fraction]. These factors were closely related to the optimal time of heart valve replacement. It can be concluded that the rate of return to work and the quality of life would be improved if valve replacement were performed at an earlier stage of valvular heart disease.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.1-9
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• 1988

The left atrial [LA] dimension and atrial fibrillation [AF] in patients with mitral valvular heart diseases have been thought to be related to hemodynamic burden to the LA depending on severity of stenosis or regurgitation of mitral valve, left ventricular contractility and the heart conditions. If hemodynamic burden persists long, it can affect the LA wall and structural change of the LA wall itself can developed. So the structural change of the LA wall could be thought to be related to the LA dimension and AF. To verify this relation, the LA wall biopsy was performed in 26 patients with rheumatic mitral valvular heart disease at the left atriotomy incision margin which was posterior to the interatrial groove after completion of surgery to the mitral valve such as valve replacement or commissurotomy. Relation of the pathological state of the LA wall to AF and the LA dimension measured by M-mode echocardiography was studied. The conclusions were as follow. 1. There was tendency that degree of fibrosis of myocardium of the LA wall was related to the LA dimension. 2. There was more chance that patients who had severe fibrosis of myocardium of the LA wall had pre and postoperative AF. 3. There was no relation between reduction rate of the LA dimension before and after surgery and degree of fibrosis of myocardium of the LA wall.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.270-275
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• 1988

The results of the clinical observations on the 76 cases of the mitral valvular heart disease treated in the Department of Thoracic and Cardiovascular Surgery, Chung-nam National University Hospital during the period of 3 years from June, 1983 to July, 1986, are as follows: l. Of 76 cases, 43 were male and 33 were female with sex ratio of 1.3:1. 2. The age of the patient varied widely from 12 years of the youngest to 60 years of the oldest. 3. The main clinical symptoms on admission were dyspnea on exertion[100%], palpitation[42%], generalized weakness[29%], indigestion[18%], hemoptysis[16%]. 4. The preoperative functional levels according to NYHA classification were class II, III, IV in 9%, 63%, 28% respectively. 5. All 76 patients were operated on under direct vision using extracorporeal circulation, open mitral commissurotomy was done in 15 cases, mitral valve replacement in 37 cases, mitral valve replacement and aortic valve replacement in 11 cases, mitral valve replacement and tricuspid annuloplasty in 8 cases. 6. The operative mortality was 11.8% and results of the operation were good and excellent in 65 cases of survivors.