• Title/Summary/Keyword: Pulmonary stenosis

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The Usefulness and Safety of Natural Stent in a Canine Model of Tracheal Stenosis (Nd-YAG laser를 이용한 기관협착 동물모델에서 Natural 스텐트의 안전성 및 유효성 -Dumon 스텐트와의 비교 실험-)

  • Kim, Ho-Joong;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Kim, Jhin-Gook;Suh, Soo-Won;Kwon, O-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.431-438
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    • 2002
  • Background : In order to investigate the usefulness and safety of Natural Stent, we performed this study in a canine model of tracheal stenosis induced using Nd-YAG laser. Materials and Methods : After tracheal stenosis was induced in 12 Mongrel dogs using Nd-YAG laser, either Dumon (n=6) or Natural (n=6) stent was inserted into the trachea. To assess the degree of stent migration and mucostasis, bronchoscopy was performed every week for 4 weeks, after which all stents were removed. One week after stent removal, tracheal stenosis was evaluated by bronchoscopy. Results : The degree of stent migration was not different between the dogs with Dumon stent ($3.0{\pm}0.8$) and those with Natural ($2.0{\pm}1.0$), nor was the degree of mucostasis, at Dumon ($1.7{\pm}0.5$) and Natural Stent ($1.5{\pm}0.6$), respectively. One week after stent removal, the degree of tracheal stenosis was not different between the Dumon ($1.5{\pm}0.5$) and the Natural group ($1.0{\pm}0.4$). In addition, there was no death and the degree of tracheal stenosis remained always within the safe limit (less than 2.0) in all animals. Conclusion : In a canine model of tracheal stenosis induced using Nd-YAG laser, the usefulness and safety of Natural Stent were similar to those of Dumon Stent. A clinical trial is necessary to document the usefulness and safety of Natural Stent in patients with tracheal stenosis.

Evaluation of plasma N-terminal pro-brain natriuretic peptide and troponin I concentrations in dogs with congenital ventricular outflow tract stenosis

  • Kim, Gye-Dong;Suh, Sang-IL;Park, In-Chul;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.56 no.4
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    • pp.223-227
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    • 2016
  • This study evaluated the levels of cardiac biomarkers in dogs with either pulmonic stenosis or aortic stenosis and the correlation between biomarkers and the severity of stenosis assessed by the echocardiography. To achieve this study goal, 38 dogs (10 healthy control dogs, 15 dogs with pulmonic stenosis and 13 dogs with aortic stenosis) were examined. The jet velocity and pressure gradient in this study population were measured by echocardiographic estimation, after which the study group was subdivided by the severity of stenosis. The plasma cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured in this study group. The median concentrations of cTnI and NT-proBNP of the disease group were significantly higher than those of the control group, and these increased gradually as stenosis worsened. The severity of stenosis and the concentrations of cTnI and NT-porBNP were also found to be significantly correlated. Finally, the plasma cTnI and NT-proBNP tests were found to beneficial for differentiating clinical patients, predicting the progression of disease, and monitoring the outcome of interventional therapy for stenosis.

cor triatriatum dexter combined with pulmonary stenosis (폐동맥 협착증을 동반한 우측 삼중심방 -1예 치험-)

  • Kim, Hyuck;Lee, Joon-Young;Lee, Hong-Sub;Jun, Suk-Chul;Lee, Kyu-Whan;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.313-318
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    • 1986
  • A rare anomaly, Cor triatriatum dexter combined with pulmonary stenosis and patent foramen ovale in a 2-years- old female is presented. Abnormal embryologic development of the right sinus venosus valve caused partial membranous septation of the right atrium. Most cases have been recorded at necropsy either as an incidental finding or in association with severe congenital heart disease. In this case, Cor triatriatum dexter was diagnosed preoperatively by cineangiography and echocardiography.

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Coronary Arterial Fistula Combined with Coronary Artery Stenosis - A case report - (관상동정맥루에 동반된 관상동맥협착증의 수술치험 1례)

  • 고정관
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.661-666
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    • 1989
  • Congenital coronary arterial fistulae are the most prevalent hemodynamically significant congenital coronary artery malformations. Definition of congenital coronary arterial fistula is a direct communication between a coronary artery and the lumen of one of the four cardiac chambers or coronary sinus or SVC, pulmonary artery or pulmonary vein close to the heart. It is often associated with additional congenital or acquired heart disease. A 49 year old male patient was admitted with the chief complaints of anginal pain and exertional dyspnea for 9 months. He was diagnosed as the right coronary arterial fistula combined with right coronary arteriosclerotic stenosis and old inferior myocardial infarction by cardiac evaluation. The right coronary arterial fistula was communicated between the just distal portion of acute marginal branch and coronary sinus. The operative procedure was as followings; after suture ligation of fistula opening in the coronary sinus under beating heart, coronary arterial bypass grafting with saphenous vein was performed at the just proximal portion of the posterior descending branch under cardiopulmonary bypass. The postoperative course was uneventful and he was discharged without anginal pain at the 8th postoperative day.

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Noonan Syndrome with Double-Chambered Right Ventricle and Atrial Septal Defect -1 Case Report- (Noonan 증후군에 동반된 DCRV와 심방중격결손증 -1례 보고-)

  • Park, Young-Woo;Lee, Seock-Yeol;Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.419-421
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    • 2000
  • Noonan syndrome is characterized by typical facies, congenital heart defect, and some clinical features similar to Turner syndrome, but with normal chromosomes. The most commonly associated cardiac defects are pulmonary valvular stenosis and strial septal defect. We experienced a case of Nonan syndrome associated with pulmonay valve stenosis with double-chambered right ventricle and atrial septal defect and cryptorchidism. Pulmonary valvotomy was done through transannular incision. Hypertrophied muscle bundles were excised. Atrial septal defect was closed directly. RVOT was reconstructed with pericardial transannular patch. Orchiopexy was performed simultaneously without any problem.

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Successful Surgical Correction of Dextrocardia Associated with Double Outlet Right Ventricle and Ventricular Non Inversion [S.D.L.]: A Case Report (우심증 [S.D.L.] 및 우심실 복형출구증 [DORV] 이 동반된 선천성 심기형의 수술치험 1예)

  • Kang, Myung-Sik;Cho, Bum-Koo;Hong, Pil-Hun
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.153-160
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    • 1981
  • Within the group of congenital cardiac anomalies manifesting dextrocardia and double-outlet right ventricle, ventricular non-inversion [S.D.L] is extremely rare. Recently, a 5 year-old boy underwent a successful surgical correction of dextrocardia associated with double-outlet right ventricle, ventricular non-inversion [S.D], ventricular septal defect, pulmonary stenosis, and patent foramen ovale. The operation consisted of construction of an internal baffle connecting the left ventricle to the aorta through the large ventricular septal defect [subaortic]. The pulmonary stenosis was managed by infundibulectomy and patch enlargement of the right ventricular wall. The patient`s postoperative recovery has been uneventful, and 2 months after the operation, he is doing well.

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Surgical experience of congenitally corrected transposition of great arteries (SLL) -Case report- (심실중격결손과 근동맥류출로협책을 동반한 교정형대혈관전환증 치험 1례(SLL))

  • O, Bong-Seok;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.164-169
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    • 1983
  • The patient in whom corrected transposition of the great vessels is an isolated congenital anomaly has a physiologically normal circulation. A 19 year old male was perforemd with surgical correction for congenitally corrected transposition of great arteries (SLL) associated with ventricular septal defect (type I) and severe pulmonary stenosis. After right sided ventriculotomy, ventricular septal defect was repaired with Dacron patch and to provide adequate relief of severe valvar stenosis of pulmonary artery, valvulotomy was done. On immediate postoperative period, complete heart block and lower cardiac output state were ocurred, but adequate blood pressure could be maintained under using of inotropic agent and temporary pace-maker.

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Transaortic Closure of Ventricular Septal Defect in Congenitally Corrected Transposition of Great Arteries with Pulmonary Stenosis (대동맥절개를 퇘한 교정형 대혈관전위증의 심실중격결손 봉합)

  • An, Hong-Nam;Lee, Jong-Tae;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.748-756
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    • 1988
  • Transaortic closure of ventricular septal defect, suturing a patch on the morphological right ventricular side in patients with congenitally corrected transposition of great arteries might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. In two patients[aged 6 and 16 years] with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary stenosis, transaortic closure of ventricular septal defect was performed. No postoperative complete heart block resulted. One hospital death occurred because of sepsis who had underwent reoperation due to bleeding from the aortotomy site. Minimal aortic regurgitation developed in another patient.

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Complete Transposition of Great Arteries Combined with VSD and Pulmonic Stenosis (S.D.D.) -One Case Report- (대혈관전위증 (S.D.D.) 치험 1례)

  • 강면식
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.207-214
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    • 1979
  • This 3-year-old girl was observed frequent exertional dyspnea and cyanosis at crying since birth. She was not premature baby and delivered at full term normally. On physical examination, she was underdeveloped-body weight 13.5 kg, height 99 cm.- and cyanotic. There was severe clubbing on fingers. There was grade II/VI ejection systolic murmur on left lateral border of the sternum. The preoperative examinations [EKG, echocardiogram, cardiac catheterization and biventriculogram] showed that complicated T.G.A. combined vena cava[S.D.D.]. Preoperatively, we decided the corrective surgery of Rastelli operation using a. pulmonary valved conduit. The operation was performed under total circulatory arrest using deep profound hypothermia combining with extracorporeal circulation. On operation, the anatomy of the heart showed that, 1. The subaortic conus was seen and subaortic muscles were hypertrophied. 2. The VSD[type II], behind the subaortic conus-about 1 cm. in diameter, was visible only through LV cavity and, 3. The pulmonary valve ring was hypoplastic and pulmonary valvular stenosis was seen also. The subpulmonic area [LV outflow tract] was obstructed with hypertrophied muscle and mitral valve. 4. Left superior vena cava was drained to RA via coronary sinus. 5. LAD coronary artery was originated from right coronary artery and ran anterior to the pulmonary artery. According to above anatomy, we performed the VSD closure with Teflon patch, and Mustard operation combined with LV-to-pulmonary artery bypass graft using the valve contained [Hancock 16 mm] conduit. Postoperatively, adequate blood pressure could be maintained under the state of using inotropic agent [epinephrine]. On the second postoperative day, the patient died of cardiac arrest due to low cardiac output syndrome, acute renal failure and pulmonary edema.

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Tracheal Stenosis by Extraluminal Compression (외인성 기관협착)

  • Choi, Jong-Ouck;Kim, Yong-Whoan;Park, Jung-Soo;Jung, Kwang-Yoon;Min, Hun-Ki;Choi, Geon
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.57-62
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    • 1996
  • Tracheal stenosis can be classified into intrinsic stenosis secondary to tracheal inflammatory lesion or mass effect and extrinsic stenosis secondary tumors of thyroid, esophagus and mediastinum. Extrinsic stenosis which is frequently encountered in clinical setting could be often overlooked due to mild symptom. Recently, even with the increasing interest in extrinsic tracheal stenosis there are limitation in it's diagnosis and treatment. The purpose of this study is to provide guidance in the diagnosis and treaonent of extrinsic tracheal stenosis. Here, we report the etiology, symptoms, radiologic findings, pulmonary fuction finding, treatment and its results in 26 cases of extrinsic tracheal stenosis. Causes of extrinsic tracheal stenosis included compression of aiway by thyroid benign tumor in 13 cases to be the most common, next by thyroid malignancy in 9 cases, metastatic mediastinal turner in 2 cases, 1 case each for esophageal cancer and parathyroid cancer. In 3 cases simple tracheal resection and end to end anastomosis were done, 1 cases underwent total laryngectomy, and 8 cases were treated by conservative management, where all cases failed in treatment. The remaining 14 cases were successfully treated by removing the causes and maintaining tracheal tube insertion for amount of time. Extrinsic tracheal stenosis due to benign conditions were treated satisfactorily by removing mass, however with the malignant causes there was considerable amount of difficulty in treatment.

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