• Journal of Chest Surgery
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• v.27 no.7
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• pp.576-580
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• 1994

For 26 months since August 1991, 10 consecutive patients with congenital left ventricular outflow tract obstruction underwent corrective surgery in Pusan Paik Hospital. Their ages ranged from 2 to 18 years. There were 6 male and 4 female patients. According to stenotic site, obstruction were classified into supravalvular [n = 5], subvalvular [n = 4], valvular stenosis [n = 1]. We have performed patch enlargement of ascending aorta [n = 2], supravalvular membrane resection and patch enlargement of ascending aorta [n = 3], subvalvular membrane resection [n = 2], subvalvular membrane resection and left ventricular myectomy [n = 2] and aortic annuloplasty with Dacron patch and aortic valve replacement [n = 1]. Preoperative mean value of systolic pressure gradient were 85.0 $\pm$29.2mmHg[supravalvular], 70.0mmHg[valvular], 72.5 $\pm$ 22.5mmHg[subvalvular], and 78.5 $\pm$ 24.3mmHg[total]. Postoperative mean value of systolic pressure gradient were 31.0 $\pm$ 8.9mmHg[supravalvular], 0mmHg[valvular], 15.0 $\pm$ 10.8mmHg[subvalvular], and 21.5 $\pm$ 13.9mmHg[total]. Postoperative systolic pressure gradient was decreased significantly[p = 0.001]. Postoperative course and short-term follow up results were good except one case of transient heart failure.

• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.511-519
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• 2016

Left ventricular diastolic dysfunction is mostly observed in patients with cardiac disease, such as myocardial ischemia or LVH, but linking is usually observed in healthy people without heart disease. Evaluation of left ventricular diastolic failure in normal cardiac output(systolic function) conditions can affect the progress and prognosis of heart failure. The direct relevance to the epicardial adipose tissue metabolism in cardiovascular engine for generating a bioactive moleculer, which leads to dysfunction of the later had a direct effect on myocardial heart. The purpose of this study is to measure the thickness of the epicardial adipose tissue was to study the relevance of the assessment of diastolic dysfunction in systolic function in normal conditions. Results epicardial adipose tissue thickness and diastolic dysfunction was analyzed to have a high correlation in a statistically significant level. In particular, the epicardial adipose tissue thickness measured at the measuring section EAT2 and diastolic function evaluation E' was found to have a high correlation. Thus epicardial adipose tissue thickness variation is believed can be used as a predictor to evaluate the left ventricular diastolic dysfunction.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.46-57
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• 1978

Ventricular septal defect was the most common congenital Heart disease admitted to the Severance Hospital from December, 1963 to June 30. 1977. A total of 1,811 cardiac patients received cardiac catheterization in the CardiacCenter of Yonsei University Medical College. Out of the 1,811 cardiac patients, 791 cases had congenital heart disease and of these 172 cases had ventricular septal defect. This amounted to 21.7% of all those with congenital heart disease. Seventy cases of ventricular septal defect operated on in the chest surgery department are presented. Of these 70 cases of ventricular septal defect, 54 cases were male and 16 cases were female. Their ages ranged from 4/12 months to 32 years. The ratio of systolic pressure of the main pulmonary to systemic artery [Pp/Ps] for 29 of the 59 isolated ventricular septal defects was below 45 percent. Pp/Ps ratio for 19 of the 59 isolated ventricular septal defects was 75 percent. The patients were mostly below fifteen years of age. Out of 64 cases, there were 36 cases of type II defects, 20 cases of type I, 4 cases of type III , 2 cases of type IV, one case of both type II and one case of left ventricular right atrial communication. The anomalies associated with ventricular septal defect were 13 in all; 4 cases of aortic insufficiency, 3 cases of ruptured aneurysm of the sortie sinus of valsalva, 2 cases of ruptured aneurysm of the sortie sinus of valsalva with aortic insufficiency, 2 cases of patent ductus arteriosus, one case of ruptured aneurysm of the aortic sinus of valsalva with atrial septal defect [secundum type] and one case of atrial septal defect [secundum type]. Overall mortality was 8.6 percent. The mortality in pulmonary artery banding was 37.5 percent. The causes of mortality were in one case congestive heart failure, in one case asphyxia and in one case respiratory insufficiency. Tile mortality in ventricular septal defect associated with pulmonary hypertension was 7.1 percent. The cause of mortality was in one case low cardiac output syndrome. There was no mortality in the ventricular septal defects without pulmonary hypertension and mortality in the ventricular septal defect. In ventricular septal defect associated with combined anomalies, the causes mortality were in one case respiratory insufficiency and in one case congestive heart failure.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.559-563
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• 1996

We have experienced a patient, 16 year-old male, with ventricular septal defect with tricuspid recur- gitation due to blunt chest trauma. He suffered from congestive heart failure after the trauma. Echocardiogram and cardiac catheterization revealed left to right shunt at the ventricular level (muscu- far portion of interventricular septum) and tricuspid regurgitation. At the time of the operation, marked systolic thrill was palpable over the rlght ventricle near the apex and a chorda tendina was seen sharply ruptured just near the medial papillary muscle. We repaired the ventricular septal defect with a Dacron patch and chordal reconstruction with autologous pericardium. The postoperative course was uneventful and the patient was discharged in good condition.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.161-165
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• 1994

We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.1-9
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• 1989

We have performed one case of autotransplantation and 11 cases of orthotopic homotransplantation using Korean mongrel dogs, and have scrutinized the hematologic and hemodynamic results. The mean weight of recipients was 15.42*1.2kg and varied from 14kg to 20kg. During the operation, anesthesia and other technical procedures including cardiopulmonary bypass were similar to the usual methods in human cardiac transplantation. It was found that the hematologic values were similar to those of human beings although there was wide variance. Hemodynamically the mean systolic and diastolic arterial pressures were 165.0* 12.9 mmHg and 100.0 *11.8 mmHg respectively, and the mean heart rate was 155.5*23.5/min. All cases died within 24hrs, and the mean survival in all but 6 cases where operative death occurred was 6.83*8.01 hrs[range 2-21 hrs]. The major causes of deaths were bleedings in 7 cases, failure to protect myocardium during the procedure in 2 cases, pulmonary edema in 1 case and multiorgan failure in 2 cases. From the above results we concluded that the most frequent complication was bleeding, and the cardiopulmonary bypass flow of 50-500ml/kg min was not suitable to the dog in CPB. In further experiment after this study, the technical and the bypass flow was increased. Bleeding was not significant. And the immunosuppresion during operation and postoperative period was tried.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.49-59
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• 1981

This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

• Journal of the Institute of Convergence Signal Processing
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• v.22 no.2
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• pp.51-56
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• 2021

The brachial systolic blood pressure and pulse pressure are the predictors of cardiovascular disease in individuals over 50 years of age. As the stiffness increases, the reflex amplitude and pressure in the late systole increase, resulting in an increase in left ventricular load and myocardial oxygen demand. Therefore, it is necessary to study how stiffness affects blood pressure. In this study, the blood pressure pulse waves were measured before and after taking the drug, and the blood pressure pulse wave was measured before and after myocardial heart transplantation in patients with heart failure. The correlation between R, L, and C components of the Windkessel model was estimated by increasing blood pressure. As a result of modeling the parameters of the Windkessel model using the curve fitting method, the increase in blood pressure and decrease in systolic rise time were due to the increase in the L component in the RLC Windkessel model. Among the various mechanical characteristics of blood vessels, the most important parameter affecting high BP waveform is the inertance.

• Journal of Veterinary Clinics
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• v.19 no.1
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• pp.110-113
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• 2002

An atrial septal defect (ASD) is a congenital hole in the atrial septum that allows flow between the two atria. Small ASDs are usually well-tolerated defects and do not result in significant clinical abnormalities. In large ASDs or in the presence of other cardiac defects, clinically significancy is increased. Atrial septal defects in 2 Dogs with cardiac and respiratory signs were diagnosed at seoul animal medical center. In ascultation, systolic murmur and the splitting of second heart sound were heard at pulmonary or tricuspid valve region. In radiograph, right-sided cardiomegaly, pulmonary artery dilation, increased pulmonary vasculature makings, and pleural effusion or pulmonary edema signs were observed. In echocardiography, the region, location and size of septal defect was identified. Also, the direction and degree of shunt was measured. These dogs were treated with medicine for cardiac failure. One dog is well-tolerated, the other dog died.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.241-249
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• 1977

Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.