• Journal of Chest Surgery
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• v.12 no.2
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• pp.127-134
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• 1979

During the 4 years period to be reported, 34 operations were performed on the mitral valve in the department of Thoracic and cardiovascular surgery, Korea University hospital, from Aug. 1975 to April 1979. At the first 1-year period, the closed technique was used in 12 patients. After that, open-heart surgery was used routinely; 8 patients had open mitral commissurotomy and 14 patients had valve replacement. There were 18 men and 16 women with sex ratio of 1.1: 1. The age of the patients varied widely from 18 years of the youngest to 46 years of the oldest-average aged of 32.5 years. All had symptoms and the mean duration of symptoms was 6 years and 1 month. Preoperative atrial fibrillation was 47% and embolizations were in 3 of 34 patients. The operative mortality was none for the closed and 14% for the open technique combined rate of 9 per cent which were valve thrombosis, brain embolism and left pulmonary vein rupture in deauriculization. But surviving patients undergoing open heart surgery enjoyed symptomatic benefits comparable to these of the patients of closed.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.996-1000
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• 1989

Open heart surgery begun at 1959 in Korea. From that time to 1979, the surgery was performed below 100 cases in a year. However,that was performed above, 1,000 cases in a year from 1981. During the recent three years, i.e., 1985, 1986, and 1987, the annual operative cases were 3614,4503, and 4906, and then the mortality rates were progressively decreased to 6.2%, 5.3 %, and 5.0 %. In these time, overall mortality rate above 1 year old was 5.0 % versus that below 1 year old 17.9 9o in congenital heart diseases. These results are statistically different between two groups. Of the valvular heart disease cases, which occupied 97 % of total acquired heart disease, individual incidence was in mitral 68 %, and aortic 28%. The operative method was mainly valve replacement. Operative mortality for valve surgery in total was 4.4 %. Until 1985, bioprosthetic valve was frequently implanted but mechanical valve has been done more frequently in these days. Coronary artery bypass graft was large portion [67 * 75 %] of open heart surgery in western, but was below 1 % in Korea. However our diet patterns have been changed. Therefore we think the incidence of coronary artery disease will be increased. So we will be familiar to this field.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.04a
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• pp.137-150
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• 2009

Background: Heart failure can develop secondary to various heart diseases (e.g. mitral valvular insufficiency, congenital heart defects, heart worm infection). The clinical signs of heart failure can be confused with those of other conditions, such as respiratory disease. Therefore, specific, sensitive, rapid and inexpensive blood tests for heart failure are desirable. Cardiac troponins, natriuretic peptides and cytokines have been more recently used as indicators of heart disease in humans and animals. These peptides are sensitive to changes in vasoconstriction and dilation within the heart and are used for the diagnosis and prognosis of heart failure. Methods: Previously developed and newly developed cardiac biomarkers will be discussed for understating clinical implications and diagnostic values in heart diseases in small animals

• Journal of Chest Surgery
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• v.10 no.2
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• pp.315-326
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• 1977

From 1958 to October 1977, 294 cases of acquired heart disease were operated. There were 68 cases of pericardium, 3 trauma, 2 foreign body, one cardiac thrombus, 3 atrial myxoma, 2 left atrial and 1 right atrial, 2 Budd-Chiari syndrome, and 214 valvular heart disease. Out of 214 cases of valve operation 73 valves were replaced in 64 patients. Male to female ratio was 1.46: 1. The youngest age was 14 years in male and 18 in female. The oldest was 54 years in male and 52 in female. Fifty-five cases of single valve were replaced, consisting of 47 mitral and 8 aortic valves. There were 9 double valve replacement cases which consist of 7 mitral and aortic and 2 mitral .and tricuspid valves. Six varieties of prosthetic valves, 3 ball and 3 disc types and 3 kinds of xenograft tissue valves were utilized. Beall, BjSrk-Shiley and Starr-Edwards prosthetic valves and Hancock valves were used mainly. For single valve 34. 5% and for double valve replacement 44% mortality were noted. There were 23 operative deaths out of 64 patients, over all mortality rate of 36.9%. Mortality for mitral valve replacement was 29.5%. But in recent 12 consecutive cases one death occurred, showing 8.3% mortality. In earlier days thrombocyte anti-adhesive drug dipyramidole-persantin-aspirin and/or SP 54 were adminstered. But in recent cases after heparinization, coumadin and Persantin were prescribed routinely.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1122-1131
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• 1995

One hundred eighty-eight patients[August.23,1988,through July.30,1994 underwent aortic[AVR , mitral[MVR , or double [DVR valve replacement with the St.Jude Medical prosthesis. The author analyzed 100 patients with valvular heart disease,who underwent valve replacement with the St.Jude Medical prothesis from 1990 to 1994, at Hanyang University hospital Cardiovascular department. Information on volume and functional change of the heart chamber can be obtained by cardiac echocardiography and cartheterization. Out of 100 patients, 40 patients were male[40% and 60 patients were female [60% . Age ranged from 13 years to 68 years, with mean age of 42.6 years. Mean height was 160.3cm and mean body weight was 54.9Kg. According to NYHA functional classification, class III is most frequent and 60 patients could be classfied under it. MVR [involved Redo MVR was performed in 40 patients, AVR [involved Redo AVR was performed in 18 patients, and DVR [involved Redo DVR was performed in 42 patients. Warfarin [Coumadin anticoagulation was recommended for all patients. Life long warfarin anticoagulation was necessary to all patients who underwent valve replacement with St.Jude Medical prosthesis. Ideal prothrombin time was maintained about 30% during warfarinization. There were no case of mechanical failure. It followed a comparison of echocardiography before and after valve replacement at Hanyang University hospital [30 patients and a preoperative evaluation of cardiac catheterization and angiography [64 patients . The St.Jude Medical cardiac valve is a viable alternative in the surgical therapy of valvular heart disease.

• The Korean Journal of Nuclear Medicine
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• v.7 no.2
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• pp.27-34
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• 1973

Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

• 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.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.598-606
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• 1997

Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients'ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68%), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufaciency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) : type I, 24 patients(55%) ; type III, 4 patients (9%) i and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring amluloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae transposition(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07$\pm$0.11 cm2 mean $\pm$standard error), improved ventricular contractiliy in 41 patients(93%), ab ence of MR in 23(53%), trace MR in 18(42%), and garde II MR in 2 patients(5%).

• Journal of Chest Surgery
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• v.25 no.9
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• pp.976-981
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• 1992

The results of the clinical observations on the 158 cases of the mitral valvular heart disease treated at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from June, 1986 to December, 1991 were as follows; 1. There were 50 men and 108 women with sex ratio 1: 2.2. 2. The age of patient varied widely from 13 years to 65years. 3. The preoperative functional level accoridng to the NYHA classification were class II, III, IV in 18%, 67%, 15%. 4. All 158 patients were operated on under direct vision using extracorporeal circulation, mitral valve replacement in 118 cases, mitral and aortic valve replacement 40 cases. 5. The follow up period was between 2 months and 65 months postoperatively. [mean 30.1 months] 6. The early operative motality was 5.7%[9 cases], late motality was 4%[6 cases]. 7. The cardiothoracic ratio in the chest X-ray decreased at the 6th month postoperation. [pre-op: 0.60$\pm$0.07, post-op: 0.56$\pm$0.06 p<0.01]

• Journal of Chest Surgery
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• v.37 no.7
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• pp.613-616
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• 2004

Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.