• Journal of Chest Surgery
• /
• v.22 no.6
• /
• pp.1036-1043
• /
• 1989

Seventy eight patients underwent operation for combined multiple valve disease, with an overall early mortality of 14.1 % from January, 1983 to September, 1988 in the department of thoracic and cardiovascular surgery of Pusan National University Hospital. All of the above cases had combined multiple valve procedures. There were 33 mitral valve replacements and tricuspid annuloplasties, 33 aortic and mitral valve replacements, 5 aortic and mitral valve replacements with tricuspid annuloplasties, 3 aortic valve replacements and mitral annuloplasties, 1 open mitral commissurotomy and tricuspid annuloplasty and, 1 mitral valve replacement and primary closure of tricuspid valve cleft, 1 mitral valve replacement and aortic commissurotomy, 1 mitral, aortic and tricuspid valve replacement were done. 44 were male and 34 were female and the age distribution was from 14 to 57 with mean 38 year old. According to NYHA[New York Heart Association] classification, 49 patients were class I, 19 patients were class Il and 10 were class IV. Average perfusion time was 205.3 minutes. The live patients perfusion time was 178.7 minutes while that of dead ones was 272.0 minutes. Early deaths within 30 days from operation were 11 cases, 6 of which were due to low cardiac output, 3 were acute renal failure and 2 were cardiac rupture. The 65 patients were followed up from 2 to 30 months for a total 20.6 patient years. 1 patient committed suicide because of postoperative depression 1 year after operation. All of the survivors were enjoying their daily life and their NYHA class was superior to the preoperative ones.

• Journal of Biomedical and Translational Research
• /
• v.19 no.4
• /
• pp.79-85
• /
• 2018

Echocardiography is one of the most useful diagnostic techniques for differentiating heart disease as well as mitral valve lesion. Forty client-owned small breed dogs (weight, 2.3-13.2 kg) aged between 8-17 years with myxomatous mitral valve degeneration (MMVD) were included in the present study. The diagnosis of MMVD in dogs was made based on the clinical signs, chest radiography data, and echocardiographic findings. Echocardiographic examinations were conducted in accordance with recommended standards for dogs. M-mode, Doppler, and 2D echocardiography were performed in left and right lateral recumbency. 2D echocardiography was used to measure LA and Ao diameter from 2D short axis at the level of the aortic valve. In the comparison of conventional echocardiography indices in dogs with different stages of heart failure with MMVD, significant differences were observed in E/A ratio (p=0.005), EDV (p<0.001), EDVI (p<0.001), E-peak velocity (p= 0.001), ESV (p=0.028), ESVI (p=0.004), LA (p<0.001), LA/Ao Ratio (p<0.001), LVIDd (p<0.001), LVIDd/Ao Ratio (p<0.001), LVIDs (p=0.036), LVIDs/Ao Ratio (p=0.002), and MR Velocity (p=0.026). In addition, distinct correlations were found in EDV (r=0.712), LA/Ao ration (r=0.830), LVIDd (r=0.724), and LVIDd/Ao ratio (r=0.759). This study found that known conventional echocardiographic indices, including EDV, LA/Ao ratio, LVIDd dimension, and LVIDd/Ao ratio correlated with the severity of MMVD in point of significant differences and distinct correlations.

• Journal of Chest Surgery
• /
• v.13 no.3
• /
• pp.167-173
• /
• 1980

From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

• Journal of Chest Surgery
• /
• v.48 no.2
• /
• pp.129-133
• /
• 2015

Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

• Journal of Chest Surgery
• /
• v.11 no.3
• /
• pp.281-295
• /
• 1978

Last year in this department 100 cases of open heart surgery were done annually. This year 200 cases of open heart surgery were scheduled. During the first 6 months of this year 112 open heart surgery cases were done with 13 deaths [11.6%]. There were 72 cases of cougenital malformation with 9 operative deaths [12.5%], consisting of 23 acyanotic cases with one death [4.5%] and 49 cases of cyanotic cases with 8 deaths [16.3%]. Out of 40 tetralogy of Fallot, 6 cases expired [15%]. For 39 cases of acquired valvular heart disease and one Ebstein anomaly valves were replaced with 4 operative deaths [10%]. Single valve replacement in 33 with 3 operative deaths and double valve replacement in 7 cases with one death were noted. Two patients expired among 28 mitral valve replacement cases [7.1%]. Among 7 double valve replacement patients, consisting of 3 mitral and aortic and 4 mitral and tricuspid valve replacement one case expired. In a case of Ebstein anomaly, tricuspid valve was replaced with plication of atrialized right ventricle successfully. The operative result was excellent.

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.175-183
• /
• 2009

Background: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement or pediatric mitral lesions can cause problems such as a lack of growth potential. There re only limited experiences with mitral valve repair at any institution, so the purpose of his study is to evaluate the outcomes of mitral valve repair n pediatric patients. Material and Method: Sixty-four consecutive children (28 males and 36 females) with a mean age of $5.5{\pm}4.7$ years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups: group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without trial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). Result: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there as no significant difference among the groups. The median follow-up was 4.6 years range: $0.5{\sim}12.2$ years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of $2.1{\pm}1.1$ procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there ere significant differences according to the repair strategies. Conclusion: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.

• Journal of Chest Surgery
• /
• v.30 no.2
• /
• pp.146-151
• /
• 1997

Between December 1993 and March 1996, 75 patients had undergone ubannular procedures in mitral valve reconstruction. Their mean age was 45 years and they consisted of 28 males and 47 females. The cause of mitral disease in 75 patients were classified as follow : 29 cases were degenerative, 40 cases were rheumatic, 3 cases were congenital, 2 cases were infectious and 1 case was ischemic. Average number of mitral anatomical lesion per patient was 3.1 and we used average 1.5 procedures on subannular structure in mitral valve per patient. Subannular procedures were chordae shortening 21, chordae transfer 22, new chordae formation 20, papillary muscle splitting 33, shortening of papillary muscle 2. Intraoperative transesophageal echocardiography was carried out for providing an immediate and accurate assessment of the adequacy of the reconstruction. There was no operative death. Patients have been followed up from 2 to 29months, mean 12.5. There were two failures that necessitated reoperation. The mean functional class (NYHA) was 3.19 preoperative and improved to 1.12 postoperatively. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data. In conclusion, subannular procedure in mitral valve repair when feasible is stable and safe with a low prevalence of reoperation.

• Journal of Chest Surgery
• /
• v.30 no.10
• /
• pp.1015-1018
• /
• 1997

Median sternotomy incision is world-widely used for open heart surgery, especially in valvular heart disease. But recently, minimally invasive approach by the right parasternal incision for valvular heart disease was introduced with the many merits by small incision. We experienced 1 case of mitral valve repalcement by right parasternal incision and extended transseptal approach. This technique has no specific compli ations or problems compared with the median sternotomy and was proven by the excellent exposure. Cosmetically, the patient was satisfied with the incision.

• 한국전산유체공학회:학술대회논문집
• /
• 2008.03b
• /
• pp.492-495
• /
• 2008

As the obesity patients increase recently, breath disease such an OSA(obstructive sleep apnea) is also increasing. When the breath disease occurs, the risk comes to be high. Dependence degree the PAP(positive airway pressure) is also coming to be high. The mechanical simulator is composed cylinder, valve, ball screw and the motor that they correspond to the lung and airway, the diaphragm of the human. In order to confirm the characteristic of the motor and the valve, it accomplished an test. The simulator traces breath pattern against the normal breath and the OSA.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.649-654
• /
• 1985

After first successful mitral valvotomy by Harken and Bailey in 1948, improvement of surgical technique and cardiac device may last rapidly for several years, but there after many patients deteriorate because of various causes, so incidence of reoperation for cardiac valvular disease has increased time by time. This paper is concerned with 21 patients in whom a second operation has been carried out from Jan. 1963 to Aug. 1984 at the department of Thoracic and Cardiovascular department, National Medical Center. Of 21 patients, 7 were male and 14 were female, and ages ranged from 14 to 37 years The second operation are classified into groups of secondary closed mitral commissurotomy [3 cases], open commissurotomy following closed mitral commissurotomy [1 case], Valve replacement following closed mitral commissurotomy [14 cases] or bioprosthetic valve replacement [3 cases]. Main cause of reoperation was restenosis or steno insufficiency, and that of bioprosthetic valve failure was bacterial endocarditis [1 case], fibrous tissue overgrowth on the Xenograft [1 case] and technical failure [1 case]. Early operative mortality was absent, but during follow-up, 4 patients died, so late mortality was 19.0%, and main cause of death was congestive heart failure.