• Title/Summary/Keyword: Valvular heart disease

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Clinical experience of open heart surgery: 211 cases (개심술 211례에 대한 임상적 고찰)

  • 강인득
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.804-810
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    • 1984
  • Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

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A Clinical Study of Valve Repair of the Mitral Valvular Disease (승모판막 질환의 판막 재건술에 대한 임상연구)

  • 김민호
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.752-758
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    • 1994
  • From July 1983 to December 1992, 145 patients with mitral valvular disease underwent open heart surgery at Chonbuk National University Hospital. Of these patients, 89 patients[61.4%] required mitral valve replacement. 56 patients [38.6 %] had mitral valve repair. There were 32 women and 24 men and the mean age was 34.3 years[range 6 years to 62 years].There were 23 cases of pure mitral stenosis, 19 cases of mitral regurgitation and 14 cases of mixedmitral valvular disease. The mean duration of symptom was 4.53 years and mean mitral valvularorifice diameter[in cases of pure stenosis and mixed mitral valvular lesion] was 0.96 cm. According to the NYHA classification, the distribution of patients preoperatively was as follows; class IIa, 15 patients; class lib, 17 patients; class III, 22 patients; class IV, 2 patients. Four patients[7%] had an embolic history preoperatively. 24 patients[ 43 %] were in atrial fibrillation. In cases of pure mitral stenosis, the technique used included open mitral commissurotomy[21atients], open mitral commissurotomy with mitral annuloplasty[2 patients]. In mixed mitral valvular disease, open mitral commissurotomy[ll patients] and open mitral commissurotomy with mitral annuloplasty[l patient] were performed. In cases of mitral regurgitation, mitral annuloplasty[5 patients], mitral valvuloplasty[6 patients], mitral annuloplasty with valvuloplasty [3 patients] and ring annuloplasty [5 patients] were performed.There was one perioperative death related to acute renal failure and sepsis. One late death was occurred related to heart failure after 10 months postoperatively. One patient required reoperation due to restenosis and no embolic episode was occured. After operation, 34 patients were in NYHA functional class I, 20 patients were in class IIa.

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Coronary Arteriovenous Fistula Associated with Valvular Heart Disease (심장판막증이 동반된 관상동정맥루 -수술치험 1례-)

  • 임승현
    • Journal of Chest Surgery
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    • v.27 no.7
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    • pp.624-627
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    • 1994
  • Congenital coronary arteriovenous fistula is a rare cardiac defect that causes coronary arterial flow to drain into the right cardiac chambers, the pulmonary artery, the coronary sinus, or the left cardiac chambers. The most frequently involved vessel is the right coronary artery. We experienced a case that had a coronary arteriovenous fistula associated with valvular heart disease. With the cardiopulmonary bypass done under hypothermia, mitral valve replacement was accomplished and the fistulas of both proximal and distal portions of the right coronary artery were closed with 3-0 prolene. Postoperative course was uneventful.

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The Usefulness of Transesophageal Echocardiography During Heart Surgery (개심술을 시행하는 환자에서 경식도 심초음파의 이용)

  • 조규도;김치경
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1205-1213
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    • 1997
  • This study reviewed useful aspects of the intraoperative transesophageal echocardiography among the patients in whom heart surgery were undertaken between January 1996 and July 1996 at St.Pauls hospital, Medical College of Catholic University, Seoul, Korea. During that period, 61 patients were operated on because of valvular heart disease(25 patients), coronary artery disease(22 patients), congenital heart disease(13 patients), and combined coronary artery disease and valvular heart disease(1 patient). Two patients(1 redo-VSD and 1 valvular heart diease) needed repeated aortic cross clamping and complementary procedures because of incomplete initial procedures. There was no incidence of air embolism. We could observe significant relationship of cardiac output monitoring methods either by thermodilution technique and transesophageal echocardiography by linear regression analysis(p<0.001). We tested myocardial response(percentage of systolic wall thickness, PSWT) with low dose dobutamine challenge to predict post-CABG myocardial perfusion. And the test showed statistically significant resp.onse(sensitivity 76%, specificity 94.7%, positive predictive value 95%, negative predictive value 75%). These results suggest that cardiac surgeon could draw more benefits by intraoperative transesophageal echocardiography.

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A Clinical Study for Return to Work after Heart Valve Replacement - A Case Report - (심장판막 치환술후 직업복귀에 대한 임상적 고찰)

  • 김현경
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.967-972
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    • 1991
  • Between Feb. 1982 and July 1990, 173 patients [male: 89, female: 84] Who underwent heart valve replacement for acquired valvular heart disease on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University, were reviewed for return to work after heart valve replacement. The replaced valve were mitral [128, 74.0%], aortic[10, 5.8%], mitral & aortic[35, 20.2%]. Two tricuspid valve replacement were excluded. Several important factors influencing the return to work were age, the employment status before surgery, the number of replaced valve, the pre - op NYHA functional class and cardiac function [ejection fraction]. These factors were closely related to the optimal time of heart valve replacement. It can be concluded that the rate of return to work and the quality of life would be improved if valve replacement were performed at an earlier stage of valvular heart disease.

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A Report of Left Heart Failure by Aortic Valvular Stenosis in a Mongrel Dog (개에서 대동맥판막협착에 의한 좌심부전 증례)

  • 김관우;황순신;김방실;김유정;조경오;오기석;김종택;박인철;손창호
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.83-86
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    • 2004
  • A 4 year old mixed female dog was presented dyspnea, anorexia and syncope. In blood smear test, a lot of heartworm larvae were observed. In thoracic radiography, "reverse D" shape was observed. So, this case was considered with heartworm disease. In echocardiography, marked left heart hypertrophy was presented. In M-mode view, aortic valvular stenosis was found. After mongrel dog died, aortic valvular stenosis was reconfirmed in necropsy. After all, the dog died of pulmonary edema because of aortic valvular stenosis caused left heart failure.t failure.

Clinical Study of Ventricular Function Following Open Heart Surgery by Radionuclide Angiocardiogram - left ventricular ejection fraction by ECG gated blood pool scan - (방사성 동위원소를 이용한 개심술 전후의 심실기능 변화에 관한 연구: ECG gated blood pool scan을 이용한 ejection fraction 검사)

  • Lee, Jeong-Cheol;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.25-34
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    • 1986
  • Recently, radionuclide angiocardiogram is one of the most common procedure for assessment of ventricular performance due to its distinctive advantages such as safety, accuracy, and ease of repeated studies. Also, measurement and comparison between pre and postoperative left ventricular ejection fraction [LVEF] are meaningful for assessing the severity of myocardial damage which occurred during open heart surgery and the status of myocardial recovery. We obtained pre and post operative LVEF using radionuclide angiocardiogram on 30 patients composed of atrial septal defect, ventricular septal defect, cyanotic congenital heart disease, and valvular heart disease who undergone the open heart surgery from March to august 1984. The study revealed that ventricular septal defect and mitral valvular heart disease showed 8.1% and 6.2% decreases of postoperative LVEF, respectively. But, there are little increases of postoperative LVEF in the atrial septal defect and cyanotic congenital heart disease. In ventricular septal defect, each group of Qp/Qs over 2.0 and systolic pulmonary artery pressure over 50mmHg showed significant 17% and 14.7% decreases of postoperative LVEF, respectively. Considering the duration of the aortic cross clamping times and closing methods of VSD, each group of duration over 30 min. and of patch closure showed 13.9% and 14.2% decreases of LVEF between pre and postoperative status respectively which was significant finding statistically.

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The Clinical Study of 1500 Cases in Open Heart Surgery (개심술1,500례의 임상적 고찰)

  • 김주홍
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.914-921
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    • 1994
  • From May 1977 to November 1993, 1, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. In 1500 cases of open heart surgery 975 cases[65%] were congenital heart disease and 525 cases[35%] were acquired heart disease. In 975 cases of congenital heart disease, there were 812 cases[83%] of acyanotic congenital heart anomaly and 163 cases of cyanotic congenital anomaly. In 525 cases of acquired heart disease, most cases were valvular heart disease in which 557 valves were implanted. The each operative mortality of congenital and acquired disease was 7.7% and 7.4% respectively and then overall mortality rate was 7.6%. There has been increasing incidence of open heart surgery in infants in recent years. After 1990, 28 cases of infant open heart surgery below the 12month were performed. Most lowest weight was 2, 200g[15 days]. Operative mortality of open heart surgery in infant with weight below the 10kg was very high as a 25.7%.

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Epidemiologic Profile of Patients With Valvular Heart Disease in Korea: A Nationwide Hospital-Based Registry Study

  • You-Jung Choi;Jung-Woo Son;Eun Kyoung Kim;In-Cheol Kim;Hyung Yoon Kim;Jeong-Sook Seo;Byung Joo Sun;Chi Young Shim;Se-Jung Yoon;Sahmin Lee;Sun Hwa Lee;Jun-Bean Park;Duk-Hyun Kang
    • Journal of Cardiovascular Imaging
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    • v.31 no.1
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    • pp.51-61
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    • 2023
  • BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

Clinical experience of open heart surgery: 12 cases (개심술 치험 보고: 12예)

  • 최영호
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.289-294
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    • 1983
  • The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

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