• Journal of Chest Surgery
• /
• v.36 no.7
• /
• pp.510-513
• /
• 2003

Annuloaortic ectasia, aortic regurgitation(AR), and ventricular septal defect(VSD) in patients with right ventricular hypoplasia is a very rare condition. We report a patient who underwent aortic root replacement with a composite graft for annuloaortic ectasia associated with VSD and AR in right ventricular hypoplasia. The patient was a 19 year-old male. Transthoraic echocardiogram and cardiac catheterization revealed a perimembranous VSD (2 cm in diameter), severe AR, annuloaortic ectasia, bipartite right ventricle with hapoplasia, and hypoplastic tricuspid valve. Operative findings showed that free margins of the right and noncoronary cusps were markedly elongated, thickened, and retracted, and commissure between the right coronary cusp and the noncoronary cusp was fused and calcified. VSD was closed with an autologous pericardial patch and composite graft aortic root replacement using direct coronary button reimplantation was performed, and the hypertrophic muscle of the right ventricular outflow tract was resected. The patient had transient weaning failure of cardiopulmonary bypass and was discharged at the postoperative 14 days without any problems.

• Journal of Chest Surgery
• /
• v.30 no.12
• /
• pp.1197-1204
• /
• 1997

Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.

• Journal of Chest Surgery
• /
• v.13 no.4
• /
• pp.418-421
• /
• 1980

During the period from August 1959 to end of July 1980, 69 cases of Type I VSD were noted among 235 cases of ventricular septal defect who were operated utilizing cardiopulmonary bypass in the Department of Cardio-thoracic Surgery, College of Medicine, Seoul National University(29.4%). During the same period 1162 open heart surgery cases were experienced among whom 778 cases were congenital anomalies. There were no significent differences between Type I '||'&'||' other tvpo:s of VSD in sex and age distribution. In Type I VSD frequency of aortic regurgitation association was much higher than rest of the types. (8.7% to 2.6%). Necessity of patch closure in Type I was not different from other types. The high incidence of Type I VSD is quite similar to Japanese references which show quite higher ratio compared with from Euroamerican caucasian patients materials. All cases were operated on with bubble type oxygenator mainly Shiley**" oxygenator utilizing hypothermic hemodilution perfusion technique.echnique.

• Journal of Veterinary Clinics
• /
• v.37 no.3
• /
• pp.153-156
• /
• 2020

A 14-year-old intact female Cocker Spaniel dog, weighing 6.8 kg, presented with chief complaints of severe cough, dyspnea, anorexia, and exercise intolerance. It had the characteristics of a blood clot, the evidence of mitral regurgitation, a high left atrial/aortic root ratio, and pericardial effusion with a left atrial rupture due to myxomatous mitral valve degeneration (MMVD) was strongly suspected. Traditional therapy (pimobendan, furosemide, enalapril, and spironolactone) for heart failure with MMVD was provided twice a day orally, and partial pericardiectomy was performed for pericardial effusion. The medical prescriptions for MMVD were continued, and the patient's heart disease was well-controlled. However, it suddenly died 3 months after the operation.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.236-244
• /
• 1990

To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

• Journal of Veterinary Clinics
• /
• v.16 no.2
• /
• pp.523-528
• /
• 1999

Subaortic stenosis in a 2.9kg, 3-month-old pug dog and a 11 kg, 4-month-old Rott -weiler dog showing signs of dyspnea, tachypnea, anorexia, exercise intolerance and depression was diagnosed with electrocardiography, thoracic radiography and ultrasonographic evaluation. In electrocardiography, PR interval widening, R wave amplitude increase in lead II in case 2, ST segment depression and left axis deviation in case 1 and 2 were identified. In thoracic radiographs, enlarged left ventricle and atrium, caudal displacement of left crus of diaphragm and caudal part of cranial mediastinum widening were identified in ventrodorsal view. In lateral view, left ventricular enlargement, secondary dorsal deviation of trachea and post-stenotic dilation of aorta were seen. Also, edematous pulmonary changes were shown in peri-hilar area. In ultrasonographic examination, left ventricular dilatation, pericardial effusion and subaortic valvular ridge were seen with real time B-mode in right parasternal long axis view. Aortic valve regurgitation was identified in color-Doppler mode.

• Proceedings of the Korean Society of Veterinary Clinics Conference
• /
• 2008.10a
• /
• pp.192-192
• /
• 2008

• Journal of Chest Surgery
• /
• v.2 no.1
• /
• pp.77-84
• /
• 1969

Retrograde left cardioangiographic studies using Amplatz spring coil guide catheter were carried out in 30 cases of acquired mitral valvular diseases. Of these 12 cases were compatible with the clinical diagnosis which were made pre-angiocardiographically. Eighteen out of 30 cases were diagnosed as pure mitral stenosis or mitral insufficiency which had been clinically diagnosed as mitral stenoinsufficiency or mitral stenosis with aortic insufficiency. The rate of difference is 60%. Twenty-five cases or 83% of all cases were operated. Of these 6 cases, the degree of regurgitation through the mitral valves were able to be evaluated cardioangiography and were confirmed by open heart operation. The retrograde left cardioangiography is considered to be a useful tool in conclusive dianosis of clinically equivocal mitral valvular diseases.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.557-562
• /
• 1985

One case of anatomically corrected malposition of the great arteries was managed at department of cardiothoracic surgery, Chungnam National University Hospital at May, 1984. Anatomically corrected malposition of the great arteries was an extremely rare congenital heart disease. Only 21 cases were reported in English literatures. If there are no associated cardiac disease, the patient will have normal life span. This 39 year old man had suffered from exertional dyspnea for 6 years. He had carried out normal military service as a sergeant for 8 years, and his life was not restricted before this episode. He had operated under diagnosis of mitral stenoinsufficiency & tricuspid regurgitation but died because of lower cardiac output.,br> At autopsy, the great arteries were malpositioned but viscera and lung were normal position and picture. The aortic valve was located left and anterior to the pulmonic valve and there are bilateral conus in this anatomically corrected malposition of the great arteries. The coronary arteries were normal distribution.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.748-756
• /
• 1988

Transaortic closure of ventricular septal defect, suturing a patch on the morphological right ventricular side in patients with congenitally corrected transposition of great arteries might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. In two patients[aged 6 and 16 years] with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary stenosis, transaortic closure of ventricular septal defect was performed. No postoperative complete heart block resulted. One hospital death occurred because of sepsis who had underwent reoperation due to bleeding from the aortotomy site. Minimal aortic regurgitation developed in another patient.