• 제목/요약/키워드: Ventricular outflow tract, right

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진돗개에서 심장초음파 측정치와 평가와 임상적 응용 (Echocardiograpyhic Assessment and Clinical Application of Cardiac Disease in Korea Jin-do Dog III. Detection of Heartworm)

  • 박인철;강병규;손창호
    • 한국임상수의학회지
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    • 제17권1호
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    • pp.194-204
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    • 2000
  • Echocardiography was performed to obtain the optimal planes for diagnosis of canine heartworm disease in 11 dogs. Imaging planes were taken the left ventricular outflow tract long-axis view, 4-chamber long-axis view, chordae tendineae level short-axis view and modified pulmonary arteries level short-axis view in the right parasternal window, and aptical 4-chamber long-axis view in hte left parasternal window. After echocaridography, the pulmonary artery valve pat was ligated with double 1-0 silk under the general anesthesia to prevent heartworm moving from pulmonary artery to right ventricle. The dogs were euthanized and examained for heartworms in heart and great vessels. Many adult heartworms were identified ultrasonographically within main pulmonary artery, bifurcation of pulmonary artery and right pulmonary artery, but not identified within right ventricle and atrium. At necropsy, adult heartworms were mainly found in pulmonary artery in 11 days, and also found in right ventricular outflow tract and right ventricle in 2 of 11 dogs. The modified pulmonary arteries level short-axis view was the best imaging plane for identifiying heartworms because the main pulmonary artery, branches of pulmonary artery and right pulmonary artery could be showed. The aortic root internal dimension (AOID) and right pulmonary atery internal dimension (RPAID) were measured from the modified pulmonary ateries level short-axis view and left ventricular outflow tract long-axis view. The RPAID and RPAID/AOID was higher in heartworm infected dogs than normal Korea Jin-do dogs in modified pulmonary arteries level short-axis view, and the AOID, RPAID and RPIAID/AOID was higher than in left ventricular outflow tract long-axis view, respectively. These results indicate that the pulmonary arteries were the major habitat of adult heartworm in canine heartworm disease and the modified pulmonary arteries level short-axis view was the best imaging planes for identifying heartworms because the main pulmonary arteries could be showed. Therefore the modified pulmonary arteries level short-axis view can be used for diagnosing heartworm disease and for monitoring dilation of pulmonary artery.

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Hybrid Right Ventricular Outflow Stent Insertion in a Small Neonate with Muscular Pulmonary Atresia with Intact Ventricular Septum: A Case Report

  • Byeong A Yoo;Jae Suk Baek;Chun Soo Park
    • Journal of Chest Surgery
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    • 제56권4호
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    • pp.290-293
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    • 2023
  • Pulmonary atresia with intact ventricular septum (PAIVS) is a rare congenital heart disease that often needs a critical decision on whether to open the right ventricular outflow tract (RVOT). Significant morbidity and considerable mortality might preclude the safe use of percutaneous or surgical right ventricular decompression in patients with muscular PAIVS. We report the case of a 21-day-old neonate weighing less than 3 kg who underwent hybrid RVOT stent insertion as initial palliation for muscular PAIVS and subsequent anatomical correction at 5 months of age, with 6 years of follow-up.

제2형 동맥간의 심장외 도관을 사용하지 않는 완전교정술 -1례 보고- (Surgical Repair of Type II Truncus Arteriosus Without a Extra-cardiac Conduct -A Case Report-)

  • 조은희
    • Journal of Chest Surgery
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    • 제28권6호
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    • pp.619-622
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    • 1995
  • We report a successful surgical correction of type II truncus arteriosus without using a extra-cardiac conduit in an 2 month-old infant. The truncal root is transected, and the confluence of branch pulmonary arteries is brought anterior to the aorta by using Lecompte`s maneuver. The aorta is then reconstructed directly with an end-to-end anastomosis. The right ventricular outflow tract is reconstructed by anastomosing the posterior wall of the confluence directly to the upper part of the vertical right ventriculotomy. A monocusp ventricular outflow patch is then placed anteriorly to complete reconstruction of the right ventricular outflow tract. The patient had an uncomplicated postoperative course and was discharged on the 9th postoperative day.

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좌전하행 관상동맥의 이상주행을 동반한 활로씨 4증후군 (치험 1례 보고) (Total Correction of Tetralogy of Fallot with Anomalous Left Anterior Descending Coronary Artery)

  • 조범구
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.125-129
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    • 1980
  • A patient with anomalous coronary artery crossing right ventricular outflow tract in association with Tetralogy of Fallot underwent total correction. The left anterior descending coronary artery was originated from right coronary artery anterior to the pulmonary valve ring. The incision from outflow tract to pulmonary artery tunneled underneath the aberrant artery and patch graft across the pulmonary valve ring to enlarge outflow of right ventricle and stenotic pulmonary valve ring.

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우심실내 석회화된 혈전;치험1례 (Calcified Right Ventricular Mass; A Case Report)

  • 박기진
    • Journal of Chest Surgery
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    • 제26권7호
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    • pp.548-551
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    • 1993
  • Calcified right ventricular thrombi are very rare.One case of large clacified thrombus in right ventricle being seen in a 65-year old man, is presented. He had dyspnea and generalized edema.The chest film showed a large calcified mass in cardiac shadow especially in lateral view.On echocardiography and chest computed tomography, large calcified mass density occupied nearly entire right ventricular outflow tract.The mass removal was performed through right ventriculotomny.The mass was whitish, stony hard, measured 4 cm x 4.5 cm x 8 cm, tightly attached to right ventricular infundibular septum and ventriculoinfundibular fold.

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심실중격결손이 없는 폐동맥페쇄증 환아에서 체외순환 없이 시행한 고식적 수술치험 1례 (Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum without Extracorporeal Circulation - Report of One Case -)

  • 박철현;이신영;김창호
    • Journal of Chest Surgery
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    • 제24권7호
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    • pp.719-724
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    • 1991
  • A case of pulmonary atresia with intact ventricular septum was presented in a 10-month-old cyanotic female patient, which was congenitally rare. Infant with pulmonary atresia and intact ventricular septum usually require urgent surgical intervention. Angiogram showed the pulmonary atresia at the level of the pulmonary valve, the hypoplasia of tricuspid valve and atrial septal defect without patent ductus arteriosus. We performed the pericardial patch graft on the right ventricular outflow tract and pulmonary artery after ventriculotomy using pacemaker wire as electrical saw and main pulmonary arteriotomy and then modified Waterston shunt from the ascending aorta to patch on the right ventricular outflow tract without extracorporeal circulation. Patient was postoperatively good condition.

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선천성 복잡 심기형 환자의 외과적 교정술시 동종이식편의 적용에 관한 연구 (Application of Homograft in the Surgical Correction of Complex Congenital Cardiac Malformations)

  • 지현근
    • Journal of Chest Surgery
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    • 제28권11호
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    • pp.1038-1044
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    • 1995
  • We have been used cryopreserved homograft valves for right ventricular outflow tract[RVOT reconstruction since November 1993. The homograft valves were harvested from the hearts of brain dead patients or hearts of transplant recipients. There were 12 male and 10 female patients. Their ages ranged from 5 months to 13 years[mean age,39.2 $\pm$ 37.4 months and the weight ranged from 5 to 48kg [mean weight, 13.7$\pm$ 9. l kg . The diagnoses included pulmonary atresia with ventricular septal defect [n=14 , tetralogy of Fallot[n=4 , truncus arteriosus[n=3 , and double outlet right ventricle with pulmonic stenosis[n=l .Monocuspid homograft patches were used for RVOT widening or REV[reparation l`etage ventriculaire operations in 4 patients. We also used homograft as valved conduits for RVOT reconstruction in 17 patients and left ventricular outflow tract reconstruction in anatomically corrected transposition in 1 patient. Among them size-reducing technique [converting a tricuspid valved conduit into a bicuspid valved conduit were applied to six patients for the correction of size mismatching. The mean follow-up period was 10.6 $\pm$ 5.4 months. There was one operative death[4.5% due to bleeding and one reoperation for removal of vegetation on the homograft leaflet. Postoperative echocardiography documented no significant homograft insufficiency and RVOT obstructions.In short-term, the homograft valves provide excellent hemodynamic characteristics, even though further studies are necessary to evaluate the long-term results.

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동맥근 농양 및 좌심실유출호 가성 심실류 환자에서 폐동맥 자가이식편을 이용한 대동맥근부치환술 -1례 치험 보고- (Aortic Root Replacement with Pulmonary Autograft in Patient with Subaortic Abscess and False Aneurysm in Left Ventricular Outflow Tract -Report of A Case-)

  • 장병철
    • Journal of Chest Surgery
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    • 제28권7호
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    • pp.704-707
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    • 1995
  • The use of the patient`s pulmonary valve for replacement of the patient`s diseased aortic valve was introduced and developed by Mr. Donald Ross. The long term benefits of having a normal, fully viable, trileaflet semilunar valve in aortic position was demonstrated. A 38 year old male had histories of failures of previously implanted aortic prosthetic valves twice and evidence of progressive heart failure. At operation, aortic root abscess was found; the abscess extension to adjacent structures and partial valve dehiscence had occurred. The patient underwent replacement of the aortic root with autologous pulmonary valve, autologous pericardial patch repair of left ventricuar outflow tract and recontruction of the right ventricular outflow tract and pulmonary artery with prosthetic valved conduit. Postoperatively, the patient recovered well. Postoperative doppler echocardiography demonstrated minimal central regurgitation in new aortic valve. Aortic root replacement with pulmonary autograft in a patient of recurrent aortic root abscess and false aneurysm of left ventricuar outflow tract was experienced and reported with follow up echocardiography.

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관통성 흉부 자상에 의한 심실중격 결손증: 증례보고 (Ventricular Septal Defect by Penetrating Chest Trauma - Report of One Case -)

  • 김문환;이철주
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.429-434
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    • 1992
  • We experienced a rare case of traumatic ventricular septal defect by penetrating stab injury The patient was 26-year-old women who got stab wound at the left anterior third intercostal space and left sternal border with a knife. seven hours after admission, the patient was undertaken an emergency thoracotomy due to hypovolemic shock caused by massive bleeding from transected left internal mammary artery, vein, and right ventricular outflow tract. On postoperative second day, the patient was suffered from moderate dyspnea, and arterial blood gas analysis and chest X-ray revealed hypoxemia and pulmonary edema. Right heart cardiac catheterization with Swan-Ganz Cathater showed oxygen step-up between right atrium and main pulmonary artery and a 1.6:1 ratio of pulmonary to systemic blood flow. At operation, harsh systolic thrill was palpable along right ventricular outflow tract. Through small vertical right ventriculotomy, the linear ventricular septal laceration on infundibular septum was noticed, and its size was 1.5cm with sharp margin This defeat was repaired by three interrupted matress sutures using Prolene 4-O with pledget. Her postoperative course was uneventful, and she discharged with good physical condition.

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양측 관상동맥-폐동맥간 동맥루 치험 1례 (Bilateral Coronary Artery-Pulmonary Artery Fistula - Reports of a Case-)

  • 문경훈
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.583-587
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    • 1988
  • Bilateral coronary artery-pulmonary artery fistula is very uncommon congenital heart disease which occupy small percentage of all coronary arterio-venous fistulas. We experienced a case who was 52 years old female with bilateral coronary artery-pulmonary artery fistula. She complained exertional dyspnea k angina[coronary steal syndrome]. On physical examination, any cardiac murmur was not audible. There was no 0y step-up in right heart catheterization. But selective coronary angiography revealed tortuous aberrant vessels which originated from the canal branch of the right coronary artery k the left anterior descending coronary artery. Both aberrant vessels traversed the right ventricular outflow tract, and conjoined just proximal the pulmonic annulus and drained into the main pulmonary artery. The operation was performed under the extracorporeal circulation with beating heart. The procedures were suture-ligation of the draining orifice in main pulmonary artery & the feeding vessels on the right ventricular outflow tract. Postoperatively her complaints were completely disappeared and the selective coronary angiography revealed no left-to-right shunt.

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