• Journal of Chest Surgery
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• v.37 no.10
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• pp.856-860
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• 2004

Interrupted aortic arch with concomitant intracardiac defects is a rare congenital anomaly that has an unfavorable natural course. We report a successful staged operation of interrupted aortic arch with apical muscular ventricular septal defect associating esophageal atresia with tracheoesophageal fistula in a 3-day-old neonate weighing 2.6 kg. We repaired esophageal atresia through the right thoracotomy and subsequently performed extended end-to-end anastomosis of the aortic arch with pulmonary artery banding through the left thoracotomy at same operation. The apical muscular VSD was repaired 87 day after first operation. The patient required multiple additional interventions before closure of the apical muscular ventricular septal defect, such as pyloromyotomy for idiopathic hypertrophic pyloric stenosis, anterior aortopexy for airway obstruction, and balloon aortoplasty for residual coarctation. She is now doing well.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.63-66
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• 2010

Apical muscular ventricular septal defects (VSDs) are relatively rare conditions among all the different types of VSDs. Apical VSDs are difficult to treat because of they are difficult to visualize through a trans-atrioventricular approach, and especially in infants. Treatment by left ventriculotomy is associated with long-term ventricular dysfunction. Catheter-based intervention still shows less than satisfactory results and this type of intervention may not be possible in small infants. This report describes the benefits of right apical ventriculotomy in terms of successful closure of the lesion without harming the ventricular function.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.754-758
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• 1995

Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.747-753
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• 1995

Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.718-721
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• 1998

The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP(unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD(2.0 cm in diameter) with severe pulmonary hypertension(116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.986-990
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• 1997

Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect; 1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective me hod to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.122-126
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• 2014

Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intraaortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.516-519
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• 2009

Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

• Journal of Chest Surgery
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• v.23 no.1
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• pp.16-21
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• 1990

From November 1978 through June 1989, 33 patients aged 3 months to 27 years [mean 9.7 years] underwent repair of intracardiac defects associated with corrected transposition. Five patients had had previous palliative surgery. Operation were performed in 31 for ventricular septal defect, 22 for pulmonary outflow tract obstruction, 16 for atrial septal defect, and 5 for anatomical tricuspid valve regurgitation. Pulmonary outflow tract obstruction was relieved by pulmonary valvotomy in 9, Rastelli procedure in 5, modified Fontan procedure in 3, and by REV procedure in 5 patients recently. Early mortality was 21.2%[7/33] and no late mortality during follow up period. Two had residual pulmonary outflow tract obstruction and one residual VSD. In eight patients, transient arrhythmia was found but soon returned to sinus rhythm. Five patients developed complete heart block and 2 were given permanent pacemaker insertion. There were 8 RBBB, 1 LBBB and one second degree atrioventricular block patients, but all showed no clinical significance. This report suggests that surgical repair of intracardiac defects associated with corrected transposition can be achieved with acceptable low risk. Though the mortality is still high, we can improved the result by advancing surgical technique, knowledge of the special conduction system, and by improving postoperative care.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.687-690
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• 2003

Although surgical options for double outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) are vary in accordance to the morphological characteristics, it is very difficult to use biventricular repair technique when there is tricuspid chordae originating from conal septum or when the distance between the tricuspid valve and the pulmonic valve is too short. We report our clinical experience of biventricular repair of DORV with non-committed VSD by VSD rerouting to the pulmonary artery and arterial switch in case of a presence of conal tricuspid chordae and short distance between the tricuspid valve and the pulmonic valve.