• Title/Summary/Keyword: Valve disease

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Surgical Treatment of Coarctation of Aorta Less Than 2 Years Old (2세 이하의 대동맥교약증)

  • 홍은표
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.604-608
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    • 1993
  • Coarctation of aorta is rather common congenital cardiovascular disease in the western contries, but it is known to be less than 2 % in Korea. From June 1986 to December 1992, seven patients of surgically treated coarctation of aorta who were less than 2 years old, were experienced at Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. The patients included six male and one female, with ages in the range of one month and 24 months. Four patients were preductal type and three juxtaductal. Associated cardiac anomalies were present in all patients and they were PDA[6 cases], ASD[3], VSD[2], bicuspid aortic valve[2], aortic stenosis[1], mitral regurgitation[1], and tricuspid regurgitation[1]. The operative procedures were four end to end anastomosis and three subclavian flap aortoplasty. Mean aortic cross clamping times were 37.3 minutes in patients with end to end anastomosis and 30.3 minutes in patients with subclavian flap aortoplasty. There were two operative deaths in patients who were treated with subclavian flap aortoplasty and pulmonary artery banding. One patient who had been treated with subclavian flap aortoplasty was complicated with postoperative mild paraplegia in lower limb. Pulmonary artery banding has been disappointing in our patients, and the data was suggestive that earlier total repair of complicated coarctation might improve survival.

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Long-Term Follow-Up of the Half-Turned Truncal Switch Operation for Transposition of the Great Arteries with Ventricular Septal Defect and Pulmonary Stenosis

  • Lee, Jong Uk;Jang, Woo Sung;Lee, Young Ok;Cho, Joon Yong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.112-114
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    • 2016
  • The half-turned truncal switch (HTTS) operation has been reported as an alternative to the Rastelli or $r{\acute{e}}paration$ $\grave{a}$ $l^{\prime}{\acute{e}}tage$ ventriculaire procedures. HTTS prevents left ventricular outflow tract (LVOT) obstruction in patients with complete transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS), or in those with a Taussig-Bing anomaly with PS. The advantages of the HTTS procedure are avoidance of late LVOT or right ventricular outflow tract (RVOT) obstruction, and of overstretching of the pulmonary artery. We report the case of a patient who underwent HTTS for TGA with VSD and PS, in whom there was no LVOT obstruction and only mild aortic regurgitation and mild RVOT obstruction, including observations at 12-year follow-up. Our experience with long-term follow-up of HTTS supports a solution for late complications after the Rastelli procedure.

Extraanatomic Aortic Bypass through a Median Sternotomy in a Patient with Coarctation of Aorta Associated with Annuloaortic Ectasia - A case report - (대동맥근부 확장을 동반한 대동맥 축착증 환자에서 정중흉골절개를 통한 외해부학적 대동맥 우회로술 - 1예 보고 -)

  • Kim, Kyung-Hwa;Jo, Jung-Ku;Choi, Jong-Bum;Seo, Yeon-Ho;Kim, Tae-Yun
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.308-311
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    • 2010
  • Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.

Development of the Portable Drug Delivery Systems with a Piezoelectric Micropump (압전 마이크로펌프 방식의 휴대용 약물전달장치 개발)

  • Kim, Sei Yoon;Kim, Young Tae;Seo, Hyun Bae
    • Journal of Drive and Control
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    • v.12 no.4
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    • pp.71-76
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    • 2015
  • The therapy of injecting a fixed amount of a prescribed drug for a predetermined time is an effective treatment in relieving pain during anticancer treatments. Due to recent medical technology development, cancer is currently classified as a disease that can be managed in the patient's lifetime. If patients were able to use a drug delivery system that was portable, sustainable and had an accurate flow control, they would be able to inject medication whenever they need. In this study we developed a piezoelectric micropump for a drug delivery system by designing a pump chamber, check valve and diaphragm. We also developed a driving circuit that consumes low power and to which we applied a variety of signals. We fabricated a portable drug delivery system with this piezoelectric micropump and driving circuit. In addition, through a performance test, we confirmed that the system can precisely control the drug flow rate.

Surgical Treatment of the Pulmonary Stenosis: A Report of 17 Cases (선천성 폐동맥협착증의 외과적 요법)

  • 김자억
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.481-487
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    • 1978
  • Seventeen patients of the congenital pulmenic stenosis were operated at the department of Thoracic Surgery, Seoul National University Hospital. There were thirteen male and four females, and ranging from six to thirty years of age. And it's incidence was 2.7% of congenital heart disease cases that were operated on. (Total 628) Seven case of trilogy of Fallot were excluded. Two cases of bacterial endocarditis were found. Right heart catheterization was done in all patients. Average right ventricular pressure was $121{\pm}35.8$mmHg, pulmonary artery $20{\pm}6.8$mmHg, and RV-PA pressure gradient $98{\pm}34.5$mmHg. The preoperative average time interval of A2-P2 which was checked at phonocardiography was $0.08{\pm}0.016$second, and was reduced to $0.03{\pm}0.009$second postoperatively. One was operated by Varco's procedure, another one was done by Brock's procedure, and fifteen patients were done by open heart surgery with heart-lung machine. Pure valvular stenosis was found in sixteen and infundibular stenosis in one case. And the combining anormalies were two patent ductus arteriosus, two patent foramen ovale, and one tricuspid valve hypoplasia. Two expired postoperatively at the begining stage of cardiac surgery in this Department. The remaining fifteen showed excellent operative results.

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Surgical Experience of Takayasu` Arteritis (Takayasu 동맥염의 외과적 경험)

  • 김욱성
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.926-933
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    • 1993
  • We experienced 20 patients with Takayasu`s disease who required 22 surgical procedures for critical arterial stenoses, aneurym of descending thoracic aorta, and aortic regurgitation from 1986 to 1993.Five patients had type I arteritis, seven patients had type II , seven patients had type III, and one patients had type IV.15 patients were female and 5 patients were male.Patients` ages ranged from 17 to 47 years and mean age was 29.1 years. The surgical procedures were as follows;autotransplantations of kidney[3], aortic valve replacements[2], ascending aorta-bilateral internal carotid artery bypasses[2], unilateral renal artery bypasses[2], bilateral renal artery bypasses[3], replacement of descending thoracic aorta[1], ascending aorta-abdominal aorta bypass[1], ascending aorta-right internal carotid artery bypass[1], ascending aorta-right internal carotid artery and left subclavian artery bypass[1], left common carotid artery-left-subclavian artery bypass[1], pulmonary artery angioplasty[1], left femoro-bilateral axillary bypass[1] and others[2]. There was no hospital death.Mean duration of follow-up was 42.7 months[ranged from 3 to 96 months].There was one late death and late mortality rate is 5.9%.Two patients was underwent second vascular procedures, one after 5 years and the other after 5 months.The other patients have done well after surgery.

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Aorticopulmonary Window: one case report (대동맥중격결손증[수술치험 1예])

  • 최영호
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.302-306
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    • 1981
  • Aorticopulmonary window is a rare anomaly among congenital heart disease. Various terms have been suggested including A-P window, A-P fenestration, fistula, aorticseptal defect etc. The defect lies usually between the left side of the ascending aorta and right wall of the pulmonary artery just anterior to the origin of the right main pulmonary artery. We have experienced one case of aorticopulmonary septal defect which was diagnosed as V5D with pulmonary hypertension in 1 4/12 year old, 7.2 Kg, male patient. Operation was done under the hypothermic cardiopulmonary bypass using 5t. Thomas cardioplegic solution. Vertical right ventriculotomy over the anterior wall of RVOT revealed no defect in the ventricular septum, and incision was extended up to the main pulmonary artery to find the source of massive regurgitation of blood through MPA. Finger tip compression of the aorticopulmanary window was replaced with Foley bag catheter balloon, and the $7{\times}10$ mm aorticoseptal defect located 15mm above the pulmonic valve was sutured continuously wih 3-0 nylon suture during azygos flow of cardiopulmonary cannula which was located distal to the window resulted massive air pumping systemically, and temporary reversal of pumping was tried to minimize cerebral air embolism. Remained procedure was done as usual, and pump off was smooth and uneventful. Postoperatively, patient was attacked frequent opistotonic seizure with no recovery sign mentally and p.hysically. Vital signs were gradually worsen with peripheral cyanosis and oliguria, and cardiac activity was arrested 1485 minutes after operation. Autopsy was performed to find the sutured window and massive edema of the brain.

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Ascending Aortic Dissection Late After Aortic Valve Replacement (대동맥 판막 치환술 후 만기에 발생한 상행 대동맥 박리증)

  • 오정훈;이동협;이정철;정태은;이장훈;한승세
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.630-633
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    • 2001
  • Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system and has a wide variety of manifestations. It is associated with almost any drug given during anesthesia, except neuromuscular relaxants, and treated with the cholinesterase inhibitor physostigmine. The diagnosis of central anticholinergic syndrome is often made when symptoms resolve promptly after the administration of physostigmine. We present a case of a central anticholinergic syndrome diagnosed by treatment with physostigmine, in a patient who received closure of patent foramen ovale associated with stroke.

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Cystic Mass on Right Atrium of Unusual Form of Chiari's Network: A Case Report

  • Bae, Chi-Hoon;Kwon, Oh-Choon;Lee, Sub;Lee, Chul-Ho;Cho, Jun-Woo
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.254-256
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    • 2012
  • Chiari's networks are present in 1.5% to 4% of the population. They are a congenital disease characterized by a remnant of the right valve of sinus venosus and rarely have clinical significance. Chiari's network, as the name implies, has network-like shape, but there are other forms of appearance. We have experienced a case of a 60-year-old woman who had a cystic mass on the right atrium. Surgical treatment was performed forthe mass removal and differential diagnosis of the mass. There was no evidence of other tumor, but Chiari's network. As cystic form of Chiari's network have not been reported before, it is the first report of cystic form of Chiari's network.

Multi-vessel Small Thoracotomy (MVST) CABG with Robot-assisted Bilateral ITA Harvesting - A case report - (수술 로봇을 이용한 양측 내흉동맥 채취 후 시행한 최소 침습적 다혈관 관상동맥 우회술 - 1예 보고 -)

  • Chung, Jin-Woo;Lee, Jae-Won;Je, Hyoung-Gon
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.264-267
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    • 2008
  • The da Vinci telemanipulator system (Intuitive Surgical, Sunnyvale, CA USA) is the most advanced robotic surgical system and has been increasingly used for cardiac surgical procedures. We report out first clinical experience of use of the da Vinci telemanipulator system for endoscopic harvesting of the bilateral thoracic artery andmulti-vessel small thoracotomy off pump CABG for 3-vessel disease. The da Vinci telemanipulator system has been previously utilized primarily for mitral valve surgery.