• Title/Summary/Keyword: Surgical repair

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Failure of Mitral Valve Repair in a Dog with Severe Mitral Regurgitation (심한 이첨판 역류를 가진 개에 실시한 이첨판 성형술의 실패 원인)

  • Kim, Min-Su
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.416-421
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    • 2012
  • A 10-year-old 4-kg spayed female Chihuahua with severe congestive heart failure was referred for surgical treatment. Through several examinations, the dog was diagnosed as severe mitral regurgitation (MR) and moderate TR. Because of the poor prognosis associated with continuation of medical management, surgical repair of the mitral valve was considered as the treatment option for the dog. The mitral valve repair was performed undergoing cardio pulmonary bypass (CPB) circuit. However after mitral repair, the dog was died without recovery from anesthesia. Many risk factors associated with failure of cardiac surgery are included CPB management, hypothermia, organ dysfunction, hemorrhage, hypotension, electrolyte & acid base imbalance, and infection. Although the dog is died from the operation, it is an important to reveal the factors of failure in veterinary clinic. From the case report, causes of failure of mitral valve repair can be considered from the failure of oxygenation and gas exchange by hypothermia and serious hypotension with low heart rate by low cardiac output syndrome (LCOS). Through the several considerations from this case, it is known that coming cardiac surgery for mitral valve repair is required to be more careful for successful operation. Further it can be brought to increase success rate in further operation.

effect f Technique of repair on the development of intraventricular conduction disturbancees of surgery for ventricular septal defects; Analysis of 218 patients from January 1983 to October 1984 (심실중격결손증의 수술방법이 심실내 전도장애에 미치는 영향)

  • 노준량
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.232-237
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    • 1986
  • The intraventricular conduction disturbances have been documented after correction of ventricular septal defects by any surgical route but debated its etiology. And so the frequency of conduction disturbances following right ventriculotomy, right atriotomy and pulmonary arteriotomy for closure of ventricular septal defects was compared in various conditions. The present series consists of 218 patients with ventricular septal defects. They had the surgical repair at the Seoul National University Hospital from January 1983 to October 1984. Conduction disturbances were studied with conventional 12 leads electrocardiogram. Of the 218 VSD`s 139 patients were repaired via vertical right ventriculotomy, 45 patients via right atriotomy, 34 patients via pulmonary arteriotomy. 1] Of 218 patients the frequency of RBBB was 26.1% and the frequency of RBBB + LAH was 6.0%. 2] There is no statistical difference between right ventriculotomy group [30.2%] and right atriotomy group [24.4%]. But there is significant difference between right ventriculotomy group and pulmonary arteriotomy group [11.8%] [P<0.05]. 3] In respect to anatomical classification by Kirklin`s method, the frequency of RBBB was higher in type II [32.1%] than in type I [14.9%]. [P<0.05] But in each anatomical type, there is no influence of the various surgical approach on the incidence of postoperative RBBB. 4] The frequency of RBBB was 31.8% in patch closure group and 14.3% in direct closure group. [P<0.05] Although the result suggests that there is no significant difference in various surgical approaches on the incidence of postoperative conduction disturbances, it may be reduced by a new-ventricular approach or a limited incision at right ventricular outflow tract in right ventricular approach.

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Tibiotarsal and Ulnar Fracture Repair in a Great Horned Owl (Bubo virginianus)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.218-220
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    • 2008
  • A 1.4 kg adult great homed owl was presented to the University of Missouri-Columbia Veterinary Teaching Hospital after being found by the side of the highway. Physical examination revealed soft tissue injuries to the left wing and leg, and good body condition (body score 4/5). The radiographs revealed comminuted fracture of the diaphysis of the left tibiotarsus (severe) and ulna (mild). Closed reduction of the fracture was performed to the left tibiotarsus and ulna. System combining an intramedually (IM) Kirschner pin, IM Kirschner pin for external skeletal fixation, and polymethylmethacrylate was used for fracture repair. At 13 weeks, radiographs revealed that bridging callus was well formed over cortices of the fracture area. No physical, behavioral, or other assessable impairment was found during the rehabilitation period.

Biventricular Repair in DORV with Remote VSD (비수임형 양대혈관 우심실기시증에서의 양심실 교정술)

  • 박순익;박정준;윤태진;서동만
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.76-79
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    • 2004
  • The remote location of VSD relative to the aortic valve imposes considerable surgical difficulties in the repair of DORV with noncommitted VSD. We report a successful biventricular repair of the anomaly with VSD rerouting to pulmonary artery followed by arterial switching operation.

Endovascular Treatment for Common Iliac Artery Injury Complicating Lumbar Disc Surgery : Limited Usefulness of Temporary Balloon Occlusion

  • Nam, Taek-Kyun;Park, Seung-Won;Shim, Hyung-Jin;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.261-264
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    • 2009
  • Vascular injury during lumbar disc surgery is a rare but potentially life-threatening complication. It has been managed by open vascular surgical repair. With recent technologic advance, endovascular treatment became one of effective treatment modalities. We present a case of a 32-year-old woman who suffered with common iliac artery injury during lumbar disc surgery that was treated successfully by endovascular repair with temporary balloon occlusion and subsequent insertion of a covered stent. Temporary balloon occlusion for 1.5 hours could stop bleeding, but growing pseudoaneurysm was identified at the injury site during the following 13 days. It seems that the temporary balloon occlusion can stall bleeding from arterial injury for considerable time duration, but cannot be a single treatment modality and requires subsequent insertion of a covered stent.

Ruptured Abdominal Aortic Aneurysm after Endovascular Aortic Aneurysm Repair

  • Lee, Chung-Won;Chung, Sung-Woon;Kim, Jong-Won;Kim, Sang-Pil;Bae, Mi-Ju;Kim, Chang-Won
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.68-71
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    • 2011
  • In treating uncomplicated abdominal aortic aenurysm, endovascular aortic aneurysm repair (EVAR) has been employed as a good alternative to open repair with low perioperative morbidity and mortality. However, the aneurysm can enlarge or rupture even after EVAR as a result of device failure, endoleak, or graft migration. We experienced two cases of aneurismal rupture after EVAR, which were successfully treated by surgical extra-anatomic bypass.

Emergency Repair Using Cervico-median Sternotomy for Cervicothoracic Penetrating Injury (경흉부 관통상에 대한 경부와 정중흉골절개술을 이용한 치험 1례)

  • Lee, Hyun Joo;Kim, Hyun Koo;Choi, Young Ho
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.136-139
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    • 2008
  • A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-year-old woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).

Laparoscopic Rectovaginal Septal Repair without Mesh for Anterior Rectocele

  • Kwak, Han Deok;Ju, Jae Kyun
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.177-179
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    • 2018
  • A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.

A novel modification of Bardach's two-flap palatoplasty for the repair of a difficult cleft palate

  • Mir, Mohd Altaf;Manohar, Nishank;Chattopadhyay, Debarati;Mahakalkar, Sameer S
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.75-79
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    • 2021
  • Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach's two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.

Robotic Intraoperative Tracheobronchial Repair during Minimally Invasive 3-Stage Esophagectomy

  • Marano, Alessandra;Palagi, Silvia;Pellegrino, Luca;Borghi, Felice
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.154-157
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    • 2021
  • Tracheobronchial injury (TBI) is an uncommon but potentially fatal event. Iatrogenic lesions during bronchoscopy, endotracheal intubation, or thoracic surgery are considered the most common causes of TBI. When TBI is detected during surgery, concomitant surgical treatment is recommended. Herein we present a case of successful robotic primary repair of iatrogenic tracheal and left bronchial branch tears during a robot-assisted hybrid 3-stage esophagectomy after neoadjuvant chemoradiotherapy. A robotic approach can facilitate the repair of this injury while reducing both the potential risk of conversion to open surgery and the associated increased risk of postoperative respiratory complications.