• Journal of Chest Surgery
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• v.29 no.3
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• pp.311-314
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• 1996

Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

• Journal of Yeungnam Medical Science
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• v.15 no.2
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• pp.350-358
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• 1998

Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLB) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.180-183
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• 2010

Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.77-81
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• 1980

We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.58-61
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• 1999

Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.75-82
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• 1983

This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

• 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.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.679-683
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• 1998

From June 1995 to May 1997, we have implanted 52 Sorin Bicarbon mechanical valves in 41 patients. They were 16 men and 25 women, and their mean age was 47.4${\pm}$14.8(range; 18∼74 y.o.). 35(27 mm∼31 mm) were in mitral position, 15(19 mm∼25 mm) in aortic position, and 2(31 mm) in tricuspid position. 3 CABGs and a tumor excision were taken concomittantly. 35 patients were primary operation, and 6 were re-do operations. By intraoperative transesophageal doppler echocardiography, transvalvular peak/mean pressure gradient was 6.1${\pm}$2.7/2.4${\pm}$1.4 mmHg in mitral position and 27.6/10.7 mmHg in aortic position. The effective valve opening area in mitral position was 3.2${\pm}$0.6 cm2. Follow-up was total 508.6 patient-months, and mean follw-up was 12.7${\pm}$9.2 months. NYHA class was improved from 2.6${\pm}$0.6 to 1.2${\pm}$0.3 in average postoperatively. During that period, there was no operative death. 2 late non-valve related deaths were occurred. One was died of COPD, and the other was possible acute myocardial infarction. Among 7 postoperative complications, one valve related complication(minimal paravalvular leakage) was noticed. In conclusion, Sorin Bicarbon mechanical valve is believed one of the safe choice in clinical settings. It showed excellent hemodynamic and mechanical functions, and very low postoperative valve related complications in short term clinical experience.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.195-198
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• 2016

We report a 72-year-old male with known myelodysplastic syndrome who presented to the emergency department with a 7-day history of fever and dyspnea. Echocardiography revealed a round echogenic mass $13{\times}16mm$ in size attached to the atrial side of the tricuspid valve. Considering the high risk of infective endocarditis in the patient with a low absolute neutrophil count ($130/mm^3$), emergency surgery was performed. Intraoperatively, a single gelatinous neoplasm was resected, and subsequent reconstruction of the involved leaflet was accomplished using autologous pericardium. The tumor was pathologically confirmed as papillary fibroelastoma with no evidence of infective endocarditis. Papillary fibroelastoma is a rare cardiac neoplasm that occurs in either the mitral or aortic valves. Interestingly, a few cases of tricuspid valve papillary fibroelastoma have been reported so far. Similar echocardiographic findings between vegetation and tricuspid valve neoplasm make it difficult to distinguish these two disease entities.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.250-255
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• 1980

Myxoma is a benign growth constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical therapy and is usually fatal if unrecognized and untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We report a case of left atrial myxoma which was diagnosed by echocardiogram before surgery, and was successfully removed with the aid of extracorporeal circulation. The patient was a 24-year old woman who had suffered from mitral valvular symptoms for 2 months before admission. At operation, a tumor, measuring 5.2 x 4.3 x 4.7 cm, was extremely friable, villous gelatinous mass and it was removed from its origin near the closed fossa ovalis, including its stalk and a portion of the septum. The postoperative course was uneventful. The patient is clinically well and without symptoms of heart disease.