• 제목/요약/키워드: Myectomy

검색결과 17건 처리시간 0.023초

Minimally Invasive Trans-Mitral Septal Myectomy to Treat Hypertrophic Obstructive Cardiomyopathy

  • Kim, Hong Rae;Yoo, Jae Suk;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제48권6호
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    • pp.419-421
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    • 2015
  • A 43-year-old man with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was admitted to our hospital with aggravated exertional dyspnea and successfully treated with robotic transmitral septal myectomy. Minimally invasive transmitral septal myectomy may be a feasible surgical option for the treatment of HOCM in selected cases as an alternative to transaortic myectomy.

Tips for Successful Septal Myectomy in Patients with Hypertrophic Cardiomyopathy

  • Kim, Jae Hyun
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.227-230
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    • 2018
  • Septal myectomy is the gold-standard treatment of hypertrophic cardiomyopathy. However, it involves the risk of incomplete resection of septal muscles or iatrogenic septal perforation depending on the surgeon's practice. Herein, we suggest a few tips for successful septal myectomy and present a relevant case.

개에서의 윤상인두근 이완불능증의 진단 및 수술적 치료 1예 (Diagnosis and surgical management of cricopharyngeal achalasia in a dog)

  • 최호정;정성목
    • 대한수의학회지
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    • 제46권1호
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    • pp.57-61
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    • 2006
  • A 3-month-old, 2.8 kg, female Cocker spaniel was presented with chronic history of dysphagia since weaning. Video fluoroscopic examination revealed swallowing problems in the upper esophageal sphincters. It was diagnosed as cricopharyngeal achalasia. Cricopharyngeal and thyropharyngeal myectomy was performed. One day after surgical management, normal swallowing movement was observed in the video fluoroscopic examination of the dog. There was no evidence of recurrence for 15 months.

Subtotal Myectomy for Recurrent Cricopharyngeal Dysphagia in a Dog

  • Hong, Sung-jin;Park, Sung-guon;Kim, Sang-yeoun;Moon, Hee-sup;Park, Wan-sang;Kim, Jun-su;Kang, Sung-hun;Lee, Jae-hoon
    • 한국임상수의학회지
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    • 제34권4호
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    • pp.291-294
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    • 2017
  • An 8-month-old Chow-Chow dog presented with dysphagia and regurgitation, and was diagnosed with cricopharyngeal dysphagia (CPD). Cricopharyngeal myotomy did not improve the clinical signs. Three months after the initial surgery, a subtotal myectomy of cricopharyngeal muscle with partial thyropharngeal myotomy was performed. The clinical improvement was maintained for more than one year after the second surgery. Subtotal myectomy of cricopharyngeal muscle can be considered for dogs with CPD that do not respond to myotomy.

특발성 비후성 대동맥판하 협착증 및 승모판 폐쇄부전증 -3례 보고- (Idiopathic Hypertropic Subaortic Stenosis with Mitral Regurgitation -Report of 3 Cases-)

  • 강청희
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.313-317
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    • 1994
  • Surgical treatment is possible for the obstructive form of hypertrophic cardiomyopathy and transaortic left ventricular septal myectomy and myotomy has been the procedure of choice. If coexisting intrinsic mitral valve disease exists, mitral valve replacement has been performed. But abnormal systolic anterior motion of anterior mitral leaflet[SAM] with intrinsic normal mitral valve disease is the typical feature of IHSS and we prefer not to replace mitral valve. 3 patients underwent transaortic myotomy and myectomy for IHSS with mitral regurgitation. 2 patients of them have coexisting intrinsic mitral valve diseases such as mitral valve vegetation and chorda rupture. Concomittent mitral valve replacement were performed. 1 patient shows SAM of mitral anterior leaflet but has intrinsic normal mitral valve morphologically and transepicardial echocardiogram and direct monitoring of pressure gradient during the operative procedure gives better information for subsided mitral regurgitation. Post operative course during the 12 months follow-up was uneventful.

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비후형 심근증 환아에서 시행한 광범위 중격절제술 - 1예 보고 - (Extended Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy -Report of a case-)

  • 이재항;곽재건;정의석;오세진;장형우;김웅한
    • Journal of Chest Surgery
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    • 제39권10호
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    • pp.775-778
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    • 2006
  • 비후형 심근증은 심근의 부적절한 비대로 유발되며 호흡곤란, 흉통, 실신, 그리고 급사에 이르기까지 다양한 임상 양상을 보인다. 이러한 증상은 주로 좌심실유출로의 협착으로 인해 발생하며 이를 해결하기 위해 심실중격절제술이 고안되었다. 하지만 기존의 고전적인 중격절제슬은 대동맥절개술을 통해 진행되었으며, 이는 심실 중격의 중앙부위에 병변이 존재할 경우 시야 확보의 어려움과 병변으로의 접근이 용이하지 않아 극히 일부분의 심실중격절제술만을 시행할 수밖에 없었다. 따라서 좌심실 유출로의 협착 및 승모판막의 수축기전방운동 등이 완벽하게 해결되지 않는 경우가 흔하였고 이러한 경우 환자의 증상 호전과 생존기간의 연장에도 한계가 있었다. 본 증례에서는 이러한 환아에게서 좌심실 심첨부의 절개를 통해 비후된 유두근과 건삭을 포함한 광범위 중격절제술(extended septal myectomy)을 시행하였다. 수술 후 환아의 증상은 호전되었으며 심초음파 및 방사선학적 소견상 특별한 문제없이 10개월째 외래 경과 관찰 중이다.

Left Ventricular Enlargement Procedure in a Patient with Diffuse-Type Hypertrophic Cardiomyopathy: A Case Report

  • Han, Dong Youb;Park, Sung Jun;Jung, Sung-Ho
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.180-182
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    • 2022
  • Surgical septal myectomy is the preferred treatment option for patients with medically intractable obstructive hypertrophic cardiomyopathy. Extended transaortic septal myectomy is a widely performed surgical procedure for patients with subaortic obstruction. The transapical approach may provide an alternative surgical option in less common phenotypes, such as apical hypertrophy or long-segmental septal hypertrophy. In this report, we describe a case of a procedure performed to achieve left ventricular enlargement procedure using a combined transaortic and transapical dual approach in a patient with diffuse-type hypertrophic cardiomyopathy with apical aneurysm and mid-cavity obstruction.

난치성 연축성 발성장애 환자에서 갑상피열근 절제술 및 선택적 반회후두신경 절제술 1예: 장기 추적 관찰 (A Case of Thyroarytenoid Myectomy with Selective Recurrent Laryngeal Nerve Section in Intractable Spasmodic Dysphonia: A Long-Term Follow-Up)

  • 이윤지;안유영;박기남;이승원
    • 대한후두음성언어의학회지
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    • 제31권1호
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    • pp.35-38
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    • 2020
  • Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

대동맥판폐쇄부전을 동반한 국소성 (A Case of Localized Subaortic Stenosis Associated with Aortic Regurgitation)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.780-784
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    • 1996
  • 국소성 대동맥하협착은 뚜렷한 막성(discretemembraneous)에서 광범위한 터널형 협착에 이르는다 양한 병변을 보이며 드물지 않게 대동맥팥폐쇄부전이 동반된다. 이러한대동맥하협착과대동맥판폐쇄 부전은 시간이 경과함에 따라 진전되는 것으로 알려져 있으므로 조기수술이 고려되어야 한다. 븐 병 원에서는 중등도의 대동맥 판폐쇄부전이 동반된 국소성 대동맥하협착 환자 1례를 치헙하여 좋은 결과를 얻었다. 수술은 대동맥 판륜 하부의 섬유근성조직 (fibromuscular tissue)을 절제하고 비후된 심실중격에 근절제 및 근절개를 병 행 하였으며, 대동맥 판성 형술 및 교련하부판륜성 형술로 대동맥 판폐 쇄부전을 교정하였 다. 퇴 원 당시의 심장초음파검사에서 좌심실-대동맥간 수축기 압력 차이가 술전에 비 해 현저히 감소하였고 대동맥판폐쇄부전의 소견은 보이지 않았다.

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Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

  • Wooil Kim;Minje Lim;You Joung Jang;Hyun Jung Koo;Joon-Won Kang;Sung-Ho Jung;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1054-1065
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    • 2021
  • Objective: We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods: From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results: During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and -9.4 mL, and 6.0 mL and -3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion: Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.