• Journal of Chest Surgery
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• 제46권5호
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• pp.353-356
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• 2013

A 74-year-old man was diagnosed with aortic root aneurysm and two-vessel coronary disease. Echocardiographic assessment revealed an enlarged sinus of Valsalva 60 mm in diameter with mild aortic regurgitation. Florida sleeve repair was performed using a vascular graft combined with coronary artery bypass grafting. The postoperative course was uncomplicated and follow-up echocardiographic evaluations showed an aortic root diameter of 38 mm without aortic insufficiency up to 1 year after surgery.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1111-1114
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• 1999

Cor triatriatum is a rare congenital heart disease that is often lethal in children if not correctly identified and properly managed, Characteristically an anomalous membrane divides the left atrium into two chambers one located posterosuperiorly which is connected to the common pulmonary venous trunk and the other anteroinferiorly which is connected to the left atrial appendage and the mitral valve. Eight patients with Cor triatriatum were been seen at our hospital from 1984 to 1999. The clinical presentation diagnostic evaluation and surgical results are outlined in this retrospective review. Resection of the obstructing anomalous atrial membrane was performed using a hypothermic cardiopulmonary bypass in all cases. Right atriotomy was performed in all patients and left atriotomy was performed in a patient who had poor preoperative general conditions and serious cardiac defects(TAPVR & hypoplastic left ventricle) died of low cardiac output during the immediate postoperative period. The postoperative course has been excellent in the remaining. Cor triatriatum is amenable to surgical repair with excellent results when diagnosed early and in those who are not complicated by other complex cardiac anomalies.

• Journal of Chest Surgery
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• 제44권1호
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• pp.58-60
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• 2011

A seventeen-month-old male baby, who had received conventional biventricular repair for congenitally corrected transposition of the great arteries, underwent excision of supratricuspid ring. Although tricuspid valve annulus was marginally small on direct inspection in the operating theater, circumferential excision of supratricuspid ring alone completely relieved the right ventricular inflow obstruction.

• Journal of Chest Surgery
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• 제44권1호
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• pp.18-24
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• 2011

Background: We evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease. Material and Methods: From November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was $7.6{\pm}6.5$ years and follow-up duration was $22.7{\pm}12.3$ months. Results: There were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was $55.3{\pm}8.1%$ and ejection fraction of postoperative six month was $54.7{\pm}6.5%$. Left atrial size of preoperative and postoperative were $61.5{\pm}11.6\;mm$ and $53.1{\pm}8.4\;mm$ at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033). Conclusion: The Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.

• Tuberculosis and Respiratory Diseases
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• 제58권2호
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• pp.174-178
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• 2005

기관지 정맥류는 기관지 정맥압이 상승하는 승모판 협착증이나 폐정맥 폐쇄증에서 이차적으로 발생할 수 있다. 기관지 정맥류는 주로 좌측 주기관지에서 관찰되며, 드물지만 기관지 정맥류의 파열로 대량 객혈이 가능하고 사망할 수도 있다. 저자들은 중증 승모판 협착증 환자에서 동반된 기관지 정맥류를 기관지내시경에서 우연히 관찰하였고 승모판치환술 후 기관지 정맥류가 호전되어 이를 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제26권4호
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• pp.282-293
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• 1993

From Sep. 1985 to Dec. 1992, total 1000 cases of open heart surgery [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College Of Medicine, Inje University.Among the total 1,000 cases of OHS, there were 823 cases with congenital heart diseases [CHD] and 177 cases with acquired heart diseases [AHD]. The age distribution was 9 days [4.0 kg] to 49 years in CHD and 11 to 64 years in AHD, In the 823 cases of CHD, there were 763 acyanotic cases and 60 cyanotic cases. The CHD cases consisted of 520 VSD [63.2 %], 177 ASD [21.5 %], 60 TOF[7.3 %], 27 PS [3.3 %], 17 ECD [2.1%], 7 Valsalva sinus rupture [0.9 %], 4 TGA [0.5 %], 3 Ebstein`s anomaly [0.4%], 3 DORV[0.4%], and others. The corrective operations were applied for congenital heart disease with the result of 2. 8 % hospital mortality. In the 177 AHD, 168 cases were valvular heart diseases, 7 cases were cardiac tumors and one LA thrombus and one annuloaortic ectasia. In the 168 valvular heart diseases, there were 115 single valve replacement cases [16 AVR, 99 MVR], 20 cases of double valve replacement[AVR & MVR], 15 cases of MVR with TVA, and 10 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 199`. In MVR, 66 of St. Jude Medical valves, 78 ofCarpentier-Edward valves, and 5 of Ionescu-Shiley valves were used. In AVR, 38 of St. Jude Medical valves and 12 of Carpentier-Edward valves were used.The hospital operation mortality rate of congenital acyanotic, cyanotic, and acquired heart diseases were 1.6%, 18.3 % and 3.4% respectively. The overall mortality rate was 2.9 % [29/1000].

• Journal of Chest Surgery
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• 제12권1호
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
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• 제29권3호
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• pp.311-314
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• 1996

1985년 1월 부터 1994년 12월 까지 10년간 부산대학교 흉부외과에서는 18명의 심장 점액종 환자를 수 술하였다. 17례는 좌심방 점액 종이 었고 1례는 우심방 점액종이었다. 환자의 연령은 15세에서 62세 사이로 평균 42.6세 였고 여자가 13명 남자가 5명이었다. 술전 증상으로는 운동시 호흡곤란이 전례 에서 있었 고 심계항진이 9례, 흉통이 5례, 실신을 경험한 경우가 3례 있었으며 대부분이 전신적 무력감, 체중감소, 발열, 기침, 상복부 불쾌감 등의 다양한 동반증상이 있었다 진단은 1례의 우심방 점액 종을 제외한 나머지 17례의 좌심방 점액종에서는 심장초음파검사만으로 충분하였다 수술소견상 점액 종의 부착 부위는 난원공이 12례, 난원공 이외의 심발중격이 3례, 승모판막윤이 1례, 좌심방벽이 2례 였으며 점액종의 크기와 형태는 다양하였다. 점액종을 제거하기위한 접근은 8례에서는 우심방 절개를, 10례에서는 양심방 절 개를시행하였다. 수술로 인한 조기 및 만기 사망례는 없었고 외래 추적중재발례도 없었다. 심장점액 종의 외과적 치료는 거의 완치가 가능하며 예후가 좋은 것으로 여겨진다.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.350-358
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• 1998

Antiphospholipid antibody syndrome(APS) is a well-known clinical syndrome characterized by recurrent arterial or venous thromboses, recurrent fetal loss, thrombocytopenia, together with high titers of sustained anticardiolipin antibody(aCL) or lupus anticoagulant(LA). Although systemic lupus erythematosus(SLB) and APS may coexist, a high proportion of patients manifesting the APS do not suffer from classical lupus or other connective tissue disease. The patient has been defined as having a primary antiphospholipid antibody syndrome. We experienced one case of primary APS with recurrent fetal loss, recurrent cerebral infarctions, positive anticardiolipin antibody IgG and fluttering vegetation on the mitral valve, without other connective tissue diseases including SLE. Forty-three old female had 2 out of 11 criteria for the diagnosis of SLE, such as thrombocytopenia and positive antinuclear antibody, but did not meet whole criteria. The patient was treated with ticlopidine, and anticoagulant therapy was recommended.

• Journal of Chest Surgery
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• 제43권2호
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• pp.180-183
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• 2010

승모판하 좌심실류는 흑인들에서 주로 발생하는 드문 질환이다. 저자들은 심실성 빈맥을 동반한 승모판하 좌심실류의 수술 치험을 보고하고자 한다. 환자는 68세 남자로 수술은 통상적인 저체온 심폐 바이패스 하에서 진행하였다. 심첨부를 들어올리고 좌심실 후방 기저부에 위치한 심실류에 직접 종절개를 넣고 먼저 심실류의 목에 해당하는 부위의 심내막을 돌아가며 고주파절제술(radiofrequency ablation)을 시행한 다음 승모판 및 판막하 구조물을 피해 첨포를 이용한 심실내 심실류봉합술(endoaneurysmorrhaphy)을 시행하였다. 수술 후 경과는 양호하였으며 현재 술 후 2년 정도 경과한 상태로 부정맥의 재발이나 승모판 기능이상은 관찰되지 않고 있다.