• Journal of Chest Surgery
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• v.19 no.2
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• pp.280-287
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• 1986

Between March 1978 and August 1985, 29 cases at various congenital heart diseases were reoperated because of remnant shunt of residual anomalies at Seoul National University Hospital. They were consisted of 10 cases of Tetralogy, 4 simple VSD, 6 complicated VSD. 3 partial ECD, and 5 other rare congenital anomalies. The interval between the initial and the second procedure ranged from 1 day to 122 months [mean; 26.9 months]. In 4 cases of them, the second procedure was done during initial hospitalization within 3 weeks post-operatively. The primary operation intended to be corrective surgery except four whose primary operation was palliative or exploratory one even though it was done with extracorporeal circulation. The indication for second operation was mainly residual shunt or valvular obstruction due to patch detachment or inadequate relief of stenotic lesion. Others were paravalvular leak, valvuloplasty failure, prosthetic valve failure, and inadequate primary diagnosis. Four patients were dead [14.3%]; three complicated VSD`s and one Tetralogy. There were 7 cases of nonfatal complication with subsequent improvement except one [diffuse cerebral dysfunction].

• Journal of Chest Surgery
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• v.36 no.10
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• pp.776-779
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• 2003

An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10 x 6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1191-1203
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• 1990

Pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries [abbreviated as PA+VSD+MAPCA in the following] has limited the success of attempts at accurate diagnosis and complete surgical repair. From April 1986 to September 1990, 23 patients with PA+VSD+MAPCA among 96 patients of PA+VSD in Seoul National University Children’s Hospital were encountered. The group comprised 14 male and 9 female patients with ages ranging from 17 days to 177 months [mean 49.6 months]. We operated one stage total repair on good pulmonary artery sized two patients by R.E.V. [Reparation a l’etage ventriculaire] and Rastelli operation respectively. And the 11 patients who had independent MAPCAs and hypoplastic central pulmonary artery were dealt with unifocalization and modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients later. We successfully had managed 7 patients whose MAPCAs could be ligated with modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients with R.E.V or Rastelli operation. Recently, three obstruction after 11 unifocalization procedures made us to try palliative right ventricle-pulmonary artery conduit operation by Gore-Tex vascular graft interposition under cardiopulmonary bypass. And so we managed another 3 patients with these procedures for the purpose of pulmonary artery growth whose central pulmonary artery were severely hypoplastic. We experienced one death after second stage repair whose central pulmonary artery was created by 12mm Gore-Tex vascular graft and was unifocalized.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.190-194
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• 2016

Double outlet right ventricle (DORV) and transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS) are complex heart diseases, the treatment of which remains a surgical challenge. The Rastelli procedure is still the most commonly performed treatment. Aortic root translocation including an arterial switch operation is advantageous anatomically since it has a lower possibility of conduit blockage and the left ventricle outflow tract remains straight. This study reports successful aortic root transpositions in two patients, one with DORV with VSD and PS and one with TGA with VSD and PS. Both patients were discharged without postoperative complications.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.122-128
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• 1993

This series compromised 31 patients with pulmonary hypertension of 282 patients of ventricular septal defect(VSD) who underwent operation at the department of Thoracic and Cardiovascular Surgery in Chonnam University Hospital, from January, 1986 to December, 1991. Pulmonary hypertension was noted in 59 of 280 cases of VSD. Of them, 31 cases underwent cardiac catheterization on postoperative 8th to 77th month. Age at operation was ranged from 10 months to 29 years (mean 9.13 years). 17 patients were male and 14 patients were female. Results of follow-up studies were as follows: Cardiothoracic ratio was decreased from 0.59${\pm}$0.04 to 0.54${\pm}$0.03 (p=NS). Postoperative systolic pulmonary arterial pressure (PAPs), mean pulmonary arterial pressure (PAPm), and systolic right ventricular pressure (RVPs) were decreased significantly (p<0.001). And also Rp/Rs was decreased from 0.37${\pm}$0.21 to 0.14${\pm}$0.06 (p<0.02). However, systemic arterial pressure (SAP), right atrial pressure (RAP), and pulmonary capillary wedge pressure (PCWP) were changed insignificantly. There were significant relations of follow-up period with the decrement of PAP(p<0.005). In contrary, ther were no relations between the decrement of PAP and the age at operation. These data suggested that the long-term hemodynamic changes remained to be determined in some of the patients, even though they Were asymptomatic, with pulmonary hypertension.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.129-134
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• 1993

We compared postoperative results according to the different surgical approach in 180 cases of isolated ventricular septal defects operated at the department of Thoracic and Cardiovascular Surgery in Kyungpook University Hospital from January 1987 to December 1991. Of the 180 cases, 109 were males and 71 females, age ranging from 6 months to 15 years (mean: 5.6 years) and body weight ranging from 6 to 52㎏(mean : 20㎏). According to Soto's classification, perimembranous types were comprised of 119 cases (66％), doubly committed subarterial type 49 cases(27％), and muscular type 12 cases(7％). Patients were divided into three groups according to the incision methods: right atriotomy group (39％), right ventriculotomy group (47％), and pulmonary arteriotomy group (14％). The mean aortic cross clamp time was shorter in right atriotomy group (39 min.) than right ventriculotomy group (79min.) in the cases of large perimembranous VSD (P＜0.001). Spontanous recovery rate of cardiac rhythm after VSD closure was higher in right atriotomy group (51％) than right ventriculotomy group (32％) in the cases of perimembranous VSD (P＜0.05). The incidence of postoperative RBBB was 17.6％ with no statistical differences between right atriotomy group(17.9％) and right ventriculotomy group(19.2％). Overall mortality rate was 5.6％(10 cases) with no significant differences according to surgical approach.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.15 no.5
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• pp.384-398
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• 1990

This paper compares and shows the characteristics of various PWM strategies used to generate pulse signals of voltage source inverter. We designed the inverter using PTR and constituted the variable speed drive (VSD) system. For each PWM strategy, acoustic noise level, line-to-line voltage and current waveform, and current harmonic spectrum are measured with respect to the VSD of induction motor. The Suboptimal PWM strategy showed the similar harmonic effects to those of the Optimal PWM strategy. In addition, the microprocessor application was available to the former. The TP PWM strategy was excellent in that it could reduce the CPU load and increase the output voltage since the strategy could control only two phase of the three.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1482-1486
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• 1992

Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.165-173
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• 1986

During the 4 year period from 1982 through 1985, twelve patients have undergone operations for discrete subaortic stenosis with good short-term clinical result at Department of Thoracic and cardiovascular Surgery, S.N.U.H. According to the cineangiographic and operative findings, nine of the 12 patients were classified as Deutsch type I, the other 3 as type II, and eleven of the 12 had one or more associated anomalies of the cardiovascular system such as PDA[5], VSD[5], left SVC[2], MS[1], COA[1], supramitral membrane[1], DORY[1], right aortic arch[1], DCRV[1], and TOF[1] [one with Shone`s complex], and three of them had secondary cardiac disorders such as aortic regurgitation[3],mitral regurgitation[2], and tunnel shaped dynamic obstruction of left ventricular outflow tract[2]. We have performed membrane resection via oblique aortotomy with retraction of the aortic cusps in 7 cases and via VSD from right cardiac chamber in 5 cases with large VSD and have also performed the operations on the correctable associated anomalies. There was only one operative death in patient with associated TOF due to neurologic complication and no other postoperative difficulties except in one patient with transient heart block resolved spontaneously on postoperative 3rd day. To our knowledge, this article is the first report of operation for discrete subaortic stenosis in Korean literature.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.124-129
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• 1999

Background: Ventricular septal defect(VSD) that causes pulmonary hypertension increase right ventricular workload. Echocardiographic assessment of right ventricular systolic time interval (RVSTI) has been used to predict pulmonary artery pressure in various cardiopulmonary diseases. This study was undertaken in infants with simple VSD to observe the alteration of the right ventricular workload through the changes of RVSTI after repair of VSD. Material and Method: We evaluated heart rate, the ratio of the left atrium/aortic root diameter (LA/Ao), right ventricular pre-ejection period(RVPEP), right ventricular ejection time(RVET), and its ratio(RVPEP/RVET) as a predictor of right ventricular workload in 12 children with simple VSD. These were measured three times at the preoperative period, at the 3 month and between 6 month and 1 year(average 9.5${\pm}$1.8month) after repair of VSD by M-mode & Doppler echocardiograph from the pulmonic valve echogram. Result: Heart rate was decreased significantly after repair(137.1${\pm}$13.7 vs 114.4${\pm}$21.1 and 104.1${\pm}$10.2, p<0.01). LA/Ao ratio was decreased significantly after repair(1.71${\pm}$0.32 vs 1.47${\pm}$0.33 and 1.39${\pm}$0.23, p<0.05). RVPEP/RVET were decreased after repair (0.38${\pm}$0.09 vs 0.32${\pm}$0.08 and 0.29${\pm}$0.09, p<0.01). Heart rate corrected RVPEP/RVET were significantly decreased only after 6 months(0.32${\pm}$0.03 vs 0.30${\pm}$0.05 and 0.28${\pm}$0.06, p<0.05). Conclusion: We found elevated right ventricular workload was progressively decreased until more than 6 months after repair and the RVSTI may serve a useful guide in postoperative care for children with VSD.