• 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 Trauma and Injury
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• v.28 no.2
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• pp.67-70
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• 2015

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.66-70
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• 2014

A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.

• Korean Journal of Radiology
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• v.22 no.11
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• pp.1894-1908
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• 2021

Double outlet right ventricle (DORV) is a relatively common congenital heart disease in which both great arteries are connected completely or predominantly to the morphologic RV. Unlike other congenital heart diseases, DORV demonstrates various anatomic and hemodynamic subtypes, mimicking ventricular septal defect, tetralogy of Fallot, transposition of the great arteries, and functional single ventricle. Because different surgical strategies are applied to different subtypes of DORV with ventricular septal defects, a detailed assessment of intracardiac anatomy should be performed preoperatively. Due to high spatial and contrast resolutions, cardiac CT can provide an accurate characterization of various intracardiac morphologic features of DORV. In this pictorial essay, major anatomic factors affecting surgical decision-making in DORV with ventricular septal defects were comprehensively reviewed using three-dimensional cardiac CT data. In addition, the surgical procedures available for these patients and major postoperative complications are described.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.320-329
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• 2003

Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.329-335
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• 2002

Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1019-1023
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• 1997

The anomaly which the right pulmonary artery originates from the ascending aorta is a rare and usually fatal form of congenital heart disease. This lesion is often associated with a patent ductus arteriosus. Death frequently occurs in early infancy. Anomalous origin of the right pulmonary artery is much more common than anomalous origin of the left pulmonary artery. The anomalous right pulmonary artery usually arise from the posterior aspect of the ascending aorta close to the aortic valve. We report a 1 month-old infant with right pulmonary artery arising from the ascending aorta, which was corrected successfully by direct anastomosis to the main pul onary artery.

• Journal of Veterinary Clinics
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• v.20 no.2
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• pp.248-251
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• 2003

Esophageal obstruction as a result of persistence of the right aortic arch was diagnosed in a 3-month-old male Persian cat. Regurgitation right after weaning and retardation were noted in this cat. Survey radiographic signs on the lateral view include ventral deviation of the thoracic trachea caused by draping of the dilated esophagus over the dorsum of the trachea and a distinct interface of the dorsal wall of the esophagus silhouetting with the cranial thoracic hypaxial muscles. On the ventrodorsal view, the cranial mediastinum was widened with soft tissue density. The trachea was deviated to the right. In an esophagram, the segmental dilation of the esophagus with constriction of the lumen just cranial to the heart base was apparent. Thoracotomy was performed and corrective surgery was carried out. At surgery, it was confirmed that the esophagus was constricted at the cranial to the base of the heart.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.157-160
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• 1994

Primary tumors of the heart are extremely rare, and about 25 per cent of primary cardiac tumors are malignant. Recently, We experienced a case of primary cardiac liposarcoma occurred on the right ventricular outflow tract and extended into the main pulmonary artery. The patient was 57 year-old man and the chief complaints was severe exertional dyspnea. Emergency operation to relieve the right ventricular outflow tract obstruction was performed under cardiopulmonary bypass. The tumor was 5$\times$4$\times$3 cm in size and infiltrated into the right ventricle and ventricular septum. The tumor in the main pulmonary artery was removed without any difficulty but the on the right ventricular outflow tract was difficult to remove completely. The patient was recovered without any specific problems. After successful surgical resection and postoperative radiotherapy the patient discharged with good condition. Herein, the clinical characteristics of cardiac liposarcoma, the problems in differential diagnosis, the prognosis and current therapy are reviewed.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.286-290
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• 2013

Air injected into the epidural space may spread along the nerves of the paravertebral space. Depending on the location of the air, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia may occur. However, cases of motor weakness caused by air bubbles after caudal epidural injection are rare. A 44-year-old female patient received a caudal epidural injection after an air-acceptance test. Four hours later, she complained of motor weakness in the right lower extremity and numbness of the S1 dermatome. Magnetic resonance imaging showed no anomalies other than an air bubble measuring 13 mm in length and 0.337 ml in volume positioned near the right S1 root. Her symptoms completely regressed within 48 hours.