• Journal of Chest Surgery
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• 제16권4호
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• pp.476-484
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• 1983

Ventricular septal defect[VSD] associated with aortic regurgitation[AR] represents 2 to 7.5% of all VSD which is most common congenital heart disease. The aortic valve may by normal in infants with VSD, but the aortic regurgitation may be developed in these patients later. The aortic valve became fibrotic, thickened, deformed and prolapsed, so these late deformities require to be corrected with plication, valvuloplasty or aortic valve replacement [AVR]. There are some controversy between the early repair of VSD alone and the late repair of VSD and aortic valve till now. From December 1971 to August 1983, we had experienced 24 patients of VSD associated with AR which constitute 6.5% of our total patients with VSD. The VSD was subpulmoary [type I] in 14[58.3%], subcristal [type II] in 8[33.3%], atrioventricular canal type[type III] in 1, and combine of type I and II in 1. Patch repair of VSD was made in 15 patients and direct suture of small VSD in 9.14 patients had aortic plication of valvuloplasty and 9 had AVR accompanying VSD repair, and 1 patient had VSD closure alone. The postoperative courses of these patients were uneventful except in some cases. A patient who was undertaken AVR with Starr-Edwards ball valve and VSD closure, died due to left ventricular failure and low cardiac output syndrome. Follow up shows, in 14 patients with aortic plication or valvuloplasty, AR was developed in 9. In 9 AVR, there were two later complications which were paravalvular leakage in one and re-AVR due to subacute bacterial endocarditis in another.

• Journal of Chest Surgery
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• 제26권11호
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• pp.821-826
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• 1993

Between January 1983 and December 1992, we had experienced 79 patients of ventricular septal defect [ VSD ] associated with aortic insufficiency [AI] which constitute 4.6 % of total numbers of VSD. The mean age of the patients was 10.2 years with a range of 1 to 35 years and the average degree of aortic insufficiency classified by Sellers was 2.1. The type of VSD was subpulmonic in 57 patients and perimembranous in 22. Most common pathologic finding causing AI was prolapse of right coronary cusp [ 54 cases ; 71.4% ] ,followed by prolapse of both right and non-coronary cusp[ 12 cases ; 7.9% ]. VSD closure alone was performed in 51 patients and their mean age was 7.7 years [ ranged 1 to 13 years ]. VSD closure and aortic valve reconstruction was performed in 22 patients, VSD closure and aortic valve replacement in 6 patients, and the mean age of the patients was 14.5 years [ ranged 2 to 28 years ], 20.4 years [ ranged 18 to 35 years ] respectively. There was no hospital mortality. All patients were followed up from 1 month to 9 year 4 months [average; 21.4 months ] and there was one late death. Our data suggests that, early closure of VSD without any manipulation on the valve may be sufficient procedure to improve or at least withhold progression of AI in children and furthermore patients with VSD associated AI should be corrected promptly after diagnosis.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1238-1243
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• 1990

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease. The most common. form of congenital heart disease is the VSD, of which natural history is spontaneous closure, pulmonary vascular disease, symptoms, and endocarditis. The incidence of endocarditis is relatively low. But endocarditis is almost universally fatal if untreated. Two cases of VSD with endocarditis, 4 \ulcorneryear male and 17 \ulcorneryear female, were treated at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University. In the First case, the VSD was perimembranous type and vegetation located on the septal leaflet of the tricuspid valve. After 7 week medical treatment, simple closure of the VSD, removal of vegetation, and tricuspid annuloplasty were performed. In the second case. the VSD was subpulmonic type and the pulmonic valve was destructed due to vegetation. So the VSD was closed with interrupted 4 \ulcorner0 Prolene sutures and the pulmonic valve was excised. Postoperative course of all cases was uneventful.

• Journal of Chest Surgery
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• 제25권4호
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• pp.424-428
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• 1992

Post-AMI VSD is an infrequent but often catastrophic complication of acute myocardial infarction In general, the mortality is associated with end organ failure due to low output syndrome. Therefore, a stable hemodynamic is necessary to prevent the end organ failure. If a supportive therapy does not accomplish it, surgical intervention should be considered. Recently, we have experinced a case of post-AMI VSD with cardiogenic shock. Early recognition and surgical repair of post-AMI VSD gave us a good result. Postoperative result was satisfactory and recovery was uneventful. We believe that early surgical repair can be lifesaving in the case of post-AMI VSD with cardiogenic shock.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1045-1048
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• 1995

Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period.Recently we experienced surgical correction of pulmonary atresia with VSD. The case was 2 month old male patient diagnosed as pulmonary atresia with VSD and PDA. Atretic pulmonary artery segment from Rt ventricular infundibulum to pulmonary artery was lcm in length. The pulmonary trunk tapered toward Right ventricular infundibulum and resulted in blind pouch with diameter of lmm. The left pulmonary artery was stenosed at just proximal and distal part to which PDA was connected. Total correction was undertaken which consisted of PDA ligation, dacron patch closure of VSD, establishment of continuity between right ventricle and pulmonary artery with autogenous pericardium. Postoperative systolic fight ventricular pressure and left ventricular pressure ratio was 0.7. In patient with pulmonary atresia with VSD it is advisable to perform a corrective operation, whenever the size and anatomy of pulmonary artery are acceptable for it.

• Journal of Chest Surgery
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• 제18권1호
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• pp.7-12
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• 1985

The frequency of intraventricular conduction disturbance [IVCD] following right ventriculotomy and right atriotomy approach for ventricular septal defect [VSD] closure was compared in various conditions. Of the 170 isolated VSD patients, 114 patients were repaired via right ventriculotomy and 56 patients were repaired via right atriotomy. The results were as follows; 1. The frequency of IVCD was 45.6% in right ventriculotomy, and 21.2% in right atriotomy group [P<0.01]. The frequency of IVCD following transverse ventriculotomy and vertical ventriculotomy was not significantly different. 2. The frequency of IVCD in subarterial VSD following right ventriculotomy and right atriotomy was not significantly different. But the frequency of IVCD in perimembranous VSD was 50.8% in right ventriculotomy and 27.5% in right atriotomy group [P<0.01]. 3. The frequency of IVCD was higher in groups with larger VSD and it was more significant in right ventriculotomy group. 4. The frequency of IVCD was higher in patch graft closure and it was more significant in right ventriculotomy group. 5. Overall frequency of IVCD was lower in right atriotomy than right ventriculotomy group.

• Journal of Chest Surgery
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• 제20권4호
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• pp.780-785
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• 1987

Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2012년도 춘계학술대회 논문집
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• pp.265-266
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• 2012

• Journal of Chest Surgery
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• 제27권1호
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• pp.24-30
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• 1994

Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1143-1143
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• 2005

흉부 관통상에 의해 심실중격결손이 동반된 대부분의 환자들은 내원 시 활력징후가 불안정하여 심폐소생술 및 응급 개흉술을 시행받게 되는데, 이러한 경우 심장과 흉부 손상의 위치 및 정도에 대한 자세한 검사가 이루어지지 않은 상태이므로 발견되지 않았거나 잔존하는 이상 소견들이 수술 후 검사에서 발견될 수 있고 이에 대한 재수술을 필요로 하는 경우도 있다. 심실중격결손의 심도자술을 통한 폐쇄는 수술을 대처할 수 있는 방법으로서, 특히 수술 후 잔존하는 단락의 경우 이차 수술의 위험을 피할 수 있다. 저자들은 흉부 자상에 의한 심실벽의 열창 및 심실중격결손을 수술적 방법으로 봉합한 후 잔존하는 심실중격결손을 기구($Amplatzer^{(R)}$ VSD occluder)를 이용한 중재적 심도자술로 치료한 증례를 문헌 고찰과 함께 보고한다. 심도자술 6개월 후 시행한 심초음파검사에서 잔존하는 심실 좌우 단락은 없었고, 심실 크기와 기능도 정상이었고, 현재 상태는 양호하여 정상적으로 학교생활을 하고 있다.