• 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 Chest Surgery
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• 제17권2호
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• pp.305-314
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• 1984

From May 1977 to April 1984, 204 cases of open heart surgery were performed under cardiopulmonary bypass. There were 99 male and 105 female patients ranging in age from 19 months to 58 years. 136 cases [66.7%] were congenital heart disease, and 68 cases [33.3%] were acquired heart disease, which were 66 valvular disease [97.1%], 1 IVC obstruction, and 1 myxoma. There were 136 congenital heart anomaly with 16 operative deaths [11.8%], consisting of 94 acyanotic cases with 7 death [7.4%] and 42 cases of cyanotic cases with 9 deaths [21.4%]. In 66 patients of acquired valvular disease, 52 valves were implanted; 47 mitral valve replacement with 4 death [8.5%] and 5 double valve replacement [MVR+AVR] with 1 death [20%]. Postoperative, warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 11.8% in congenital anomaly, and 11.8% in acquired heart disease, overall mortality rate was 8.5%.

• Journal of Chest Surgery
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• 제16권2호
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• pp.147-156
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• 1983

Over a period from May, 1977 to SEptember, 1982, 101 cases ofopen heart surgerywere done under cardiopulmonary bypass. There were 50 male and 51 female patients, and the ages of the patients ranged from 19 months to 48 years. Sixty-nine cases were congenital heart disease and 32 cases were acquired heart disease, which consisted of 30 valvular disease, 1 IVC obstruction, and 1 myxoma. Among the 30 cases of valvular disease, 12 MVR, 4 MVR+TAP, 2 MVT+AVR, 1 MAP, and 11 OMC were done. There were 3 operative deaths (17.5%) in 16 MVR, 1 in 2 MVR+AVR, and 1 in 11 OMC. Operative mortality in 69 congenital heart disease was 13.0% ; 3 deaths (6.7%) in 45 acyanotic and 6(25.0%) in 24 cyanotic cases. The overall mortality for 101 cases was 14.8%; 13.0% for congenital and 18.8% for acquired heart disease.

• 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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• 제21권4호
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• pp.641-648
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• 1988

Between April 9, 1986 and September 2, 1987, 134 patients underwent open heart surgery with hypothermic cardiopulmonary bypass and cold blood cardioplegia. There were 65 patients[48.5%] of acyanotic congenital cardiac anomalies, 19 patients[14.2%] of cyanotic congenital cardiac anomalies, and 50 patients[37.3%] of acquired heart diseases, which included 49 valvular diseases and 1 myxoma. In 84 congenital cardiac anomalies, 44 patients were male and 40 patients were female ranged in age from 2 years to 57 years. In 50 acquired heart diseases, 18 patients were male and 32 patients were female ranged in age from 10 years to 65 years. The common congenital defects operated were VSD in acyanotic cardiac patients, and Tetralogy of Fallot in cyanotic cardiac patients. Among 50 acquired heart diseases, 49 patient underwent operation for cardiac valvular lesions. 33 patients had mitral valve replacement and 7 patients had aortic valve replacement. 1 patient underwent aortic valvuloplasty and 8 patients had double valve replacement. The operative mortality rate was 3.1%[2 out of 65 patients] in acyanotic cardiac patients, 5.3%[1 out of 17 patients] in cyanotic cardiac patients, and 12.0%[6 out of 50 patients] in acquired cardiac patients, with overall mortality rate of 6.7%[9 out of 134 patients].

• Journal of Chest Surgery
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• 제34권8호
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• pp.626-629
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• 2001

선천선 다발성 판막질환(Congenital Polyvalvular Disease)은 결체조직의 이상으로 인해 한 개 이상의 심장판막에 비정상적 기형을 초래하는 질환으로 그 원인은 아직 확실히 알려져 있지 않다. 이 질환은 제 18번 또는 13∼15번 삼염색체 증후군에서 자주 관찰되며, 심실중격결손증, 동맥관 개존증 등의 심장기형을 동반하기도한다. 환아는 산전 초음파 검사에서 우심방내의 종괴가 발견되었고, 출생 후 시행한 심초음파 검사에서 삼첨판위의 혈종 또는 점액종이 의심되어 수술을 시행하였다. 종괴는 삼천판막의 전판막첨과 중격판막첨으로부터 완전히 제거되었고 병리학적 검사에 불규칙하게 두꺼워지고 결절화되어 있었으며, 석회화와 골화의 소견을 보였다. 태아의 산전 심초음파 검사에서 판막에 석회화 소견이 관찰될 때 선천성 다발성 판막질환도 염두에 두어야 할 의미 있는 소견이라고 생각된다. 저자들은 선천성 다발성 판막질환 1예를 경험하여 이의 임상 및 조직소견을 문헌 고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
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• 제13권4호
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• pp.394-404
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• 1980

During the period of June 1976 October 1980 131 cases of Open heart Surgery was performed at the National Medical Center in Seoul under the extracorpocal circulation. 77 cases were congenital heart disease and 54 were acquired heart disease. The age of the patients ranged between 2$\frac{1}{2}$ and 51 years. For all patients partial hemodilution technique and moderte hypothermia was used during extracorporeal circulation and cardioplegia was done for myocardial protection since April 1978. 41 of congenital cases were non-cyanotic group and 1 case died. 36 of congenital cases were cyanotic group and revealed very high mortiality rate (16 death, 39%). 53 of acquired cases were cases of valvular heart disease, 34 mitral (3 death), 1 aortic, 4 mitral with aortic 12 mitral with tricuspid (3 death), 2 triple valves (2 death), and revealed mortality rate of 15.1% (8 death). 1 of acquired cases were left atrial myxoma. There were 25 cases of operative death and over all motality rate was 19.1%.

• Journal of Chest Surgery
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• 제18권1호
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• pp.62-68
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• 1985

10 patients with mitral regurgitation associated with various congenital cardiac anomalies were treated by reconstructive techniques in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the period of 2 years from 1982 to 1984. There were mitral valvular cleft in one case, chordae tendineae rupture associated with congenital multiple cardiac-anomalies [VSD, PDA, prolapse of aortic non-coronary cusp through VSD] in one case, elongated chordae tendineae after removal of left atrial myxoma in one case, and mitral annular dilatation associated with VSD in 3 cases, large PDA in 2 cases, aortic regurgitation [bicuspid valve] in one case, and unknown origin in one case. Owing to the various pathology above mentioned, reconstructive surgical approach to mitral incompetence is accordingly complicated and a combination of the following different procedures were properly used case by case, that is, suture of chordae tendineae, shortening of elongated chordae tendineae, closure of VSD, ligation of PDA, aortic valvuloplasty, mitral annuloplasty with mattress suture, etc. All patients were survived and they have been excellent postoperative results.

• Journal of Chest Surgery
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• 제18권3호
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• pp.398-406
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• 1985

103 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1984. There were 90 congenital cardiac anomaly and 13 acquired heart diseases. Out of 90 congenital cardiac anomaly, 63 cases of acyanotic group and 27 cases of cyanotic group were noted. In 63 cases of acyanotic group, 11 ASD, 45 VSD and 7 other acyanotic anomaly were included. In 27 cases of cyanotic group, 4 Trilogy of Fallot, 15 TOF, 3 Pentalogy of Gasul and 5 other cyanotic anomaly were found. Among 13 cases of acquired heart diseases, 12 valvular lesions and 1 atrial myxoma were noted. Two open mitral commissurotomy and ten valve replacements were performed for 12 valve lesions. The frequent complications were acute respiratory insufficiency and low cardiac output syndrome occurred in 5 cases. The perioperative mortality was 4.8% in acyanotic congenital cardiac anomaly, 7.4% in cyanotic congenital cardiac anomaly, and 0% in acquired heart diseases. Overall mortality for 103 cases of open heart surgery was 4.9%.

• Journal of Chest Surgery
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• 제20권3호
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• pp.489-497
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• 1987

Six hundred and twenty two cases of open heart surgery were performed at Sejong General Hospital in 1986. And also, 117 cases of non open heart cardiac surgery had been performed during same period. Among the 622 open heart cases, 548 were congenital cardiac diseases and 74 were acquired heart diseases. In congenital heart patients, 422 were acyanotic and 126 were cyanotic. There were 52 cases of infant open heart Surgery below 12 months. Acyanotic group were consisted of 314 VSD, 66 ASD, 13 AVSD, 9 PDA, 8 ASD + PS, 4 AS, and 8 other rare cardiac cases. And cyanotic group were consisted of 84 TOF, 15 DORV, 5 Trilogy, 4 Ebstein`s anomaly, 3 PS + TR, 3 TGA, 3 TAPVR, 3 Pulmonary atresia and 6 other rare cardiac diseases. Majority of the acquired heart cases were valvular heart diseases. And there were also 4 cardiac myxoma and one endomyocardial fibrosis in acquired heart disease group. The operative results were as follows: Overall operative mortality, 5.3%: acyanotic 2.4%: cyanotic 15.8% and acquired heart disease, 8.5%.