• Title/Summary/Keyword: aortic regurgitation

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Computed Tomography and Magnetic Resonance Imaging Findings of Bicuspid Aortic Valve and Related Abnormalities of the Heart and Thoracic Aorta

  • You Jin You;Sung Min Ko
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.960-973
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    • 2023
  • The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. The morphology of the BAV varies with the presence and position of the raphe and is associated with the type of valvular dysfunction and aortopathy. Therefore, accurate diagnosis and effective treatment at an early stage are essential to prevent complications in patients with BAV. This pictorial essay highlights the characteristics of BAV and its related congenital cardiovascular malformations, valvular dysfunction, aortopathy, and other rare cardiac complications using multimodal imaging.

Quantitative Doppler echocardiography during Dobutamine stress test in canine mitral regurgitant model

  • Choi, Hojung;Won, Sungjun;Lee, Kichang;Choi, Mincheol;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.44 no.2
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    • pp.317-322
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    • 2004
  • This study was performed to evaluate echocardiographic parameters in dogs with experimental mitral regurgitation subjected to dobutamine stress testing. In 8 beagle dogs, a 4-prong grasping forceps was inserted into the left ventricle through the carotid artery with fluoroscopic guidance. The disruption of chordae or mitral valve leaflet was performed. Echocardiographic protocols included quantitative Doppler echocardiography and M-mode measurement for evaluating left ventricle function. After all measurement was obtained at rest, dobutamine was infused incrementally. In stress testing, all measurement also was performed at rest as the same method. In stress Doppler echocardiography, regurgitant fraction and aortic stroke volume was increased significantly (P<0.001). Effective regurgitant orifice and regurgitant volume was not changed. In M-mode examination, fractional shortening was increased significantly at stress test (P<0.001). From the results obtained in this study, it could be suggested that dobutamine stress echocardiography increase left ventricle performance in non-functional mitral regurgitation and quantitative Doppler echocardiography is non-invasive, accurate method in valvular regurgitation.

Surgical Treatment of Coarctation of Aorta Less Than 2 Years Old (2세 이하의 대동맥교약증)

  • 홍은표
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.604-608
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    • 1993
  • Coarctation of aorta is rather common congenital cardiovascular disease in the western contries, but it is known to be less than 2 % in Korea. From June 1986 to December 1992, seven patients of surgically treated coarctation of aorta who were less than 2 years old, were experienced at Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. The patients included six male and one female, with ages in the range of one month and 24 months. Four patients were preductal type and three juxtaductal. Associated cardiac anomalies were present in all patients and they were PDA[6 cases], ASD[3], VSD[2], bicuspid aortic valve[2], aortic stenosis[1], mitral regurgitation[1], and tricuspid regurgitation[1]. The operative procedures were four end to end anastomosis and three subclavian flap aortoplasty. Mean aortic cross clamping times were 37.3 minutes in patients with end to end anastomosis and 30.3 minutes in patients with subclavian flap aortoplasty. There were two operative deaths in patients who were treated with subclavian flap aortoplasty and pulmonary artery banding. One patient who had been treated with subclavian flap aortoplasty was complicated with postoperative mild paraplegia in lower limb. Pulmonary artery banding has been disappointing in our patients, and the data was suggestive that earlier total repair of complicated coarctation might improve survival.

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Postoperative Transesophageal Echocardiographic Evaluation in Patients with Cardiac Valve Replacement (경식도 심초음파 검사를 이용한 판막대치술 환자의 평가)

  • 조건현
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.265-270
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    • 1991
  • Since advent of the prosthetic cardiac valve replacement, much efforts for accurate assessing value function in-vivo have been attempted. To evaluate the postoperative functional and morphological status of the replaced cardiac valve prosthesis, 33 patients with valve replacement were studied by transthoracic and transesophageal 2-dimensional echocardiac imaging as well as by color Doppler flow velocity imaging. Twenty four patients had mitral valve replacement. 6 patients had aortic valve replacement and 3 patients had both mitral and aortic valve replacement. There were 34 mechanical and 2 biological prosthesis. Comparing to transthoracic echocardiography, transesophageal approach showed transvalvular regurgitant jet flow amid the prosthetic mitral valve ring during. systole and much clear visualization of cardiac chamber behind prosthesis which could give shadowing effect to ultrasound beam. According to the quantitative grading by the length and area of mitral regurgitant flow, 24 out of 27 mitral valves revealed mild degree regurgitation considered as physiological after prosthetic bileaflet valve replacement and the other 3 valves including 2 biological prosthesis had moderate degree regurgitation which was regarded as pathologic one. 2 cases of left atrial thromboses and 1 case of paravalvular leakage which were not visible by transthoracic approach were identified by transesophageal echocardiography in patients with mitral valve replacement and patients with aortic valve replacement respectively. We conclude that in patients with prosthetic mitral valve replacement, transesophageal 2-dimensional imaging with color Doppler can suggest reliable information beyond that available from the transthoracic access even though it gives patient some discomfort to proceed.

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Aneurysm of the Sinus of Valsalva Oissecting into the Ventricular Septurn Associated with Paravalvular Leakage After Double Valve Replacement (판막 치환 수술 후 생긴 판막 주위 누출과 관련된 대동맥동류의 심실 중격 박리-1례 보고-)

  • 정일상;이영탁
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.719-723
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    • 1997
  • We experienced a case of aneurysm of the sinus of Valsalva dissecting into the ventricular dseptum. This dissection was induced by paravalvular leakage after aortic and mitral valve replacement. This 37-year-old male was admitted via emergence room due to progressive dyspnea. He had undergone aortic valve replacement(carbomed c" 23 mm) and mitral valve replacement(carbomedic 31 mm) due to aortic regurgitation and mitral regurgitation about 6 years prior to admission and followed up regularly. The diagnosis was made by transthoracic and transesophageal echocardiography and reconfirmed by root aortography. The inlet of the ventricular septal aneurysmal sac was repaired by one layer suture with 3-0 prolene of the endocardium, epicardium and homograft muscle shoulder altogether. Postoperative course was uneventful and the patient was discharged on the 11th postoperative day. day.

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Surgical Treatment of Discrete Subaortic Stenosis (대동맥판막하 막상협착증의 수술요법)

  • No, Jun-Ryang;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.165-173
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    • 1986
  • During the 4 year period from 1982 through 1985, twelve patients have undergone operations for discrete subaortic stenosis with good short-term clinical result at Department of Thoracic and cardiovascular Surgery, S.N.U.H. According to the cineangiographic and operative findings, nine of the 12 patients were classified as Deutsch type I, the other 3 as type II, and eleven of the 12 had one or more associated anomalies of the cardiovascular system such as PDA[5], VSD[5], left SVC[2], MS[1], COA[1], supramitral membrane[1], DORY[1], right aortic arch[1], DCRV[1], and TOF[1] [one with Shone`s complex], and three of them had secondary cardiac disorders such as aortic regurgitation[3],mitral regurgitation[2], and tunnel shaped dynamic obstruction of left ventricular outflow tract[2]. We have performed membrane resection via oblique aortotomy with retraction of the aortic cusps in 7 cases and via VSD from right cardiac chamber in 5 cases with large VSD and have also performed the operations on the correctable associated anomalies. There was only one operative death in patient with associated TOF due to neurologic complication and no other postoperative difficulties except in one patient with transient heart block resolved spontaneously on postoperative 3rd day. To our knowledge, this article is the first report of operation for discrete subaortic stenosis in Korean literature.

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Thoracic Aortic Aneurysm (흉부 대동맥류)

  • Kim, Su-Hyeon;Lee, Jeong-Cheol;Han, Seung-Se
    • Journal of Chest Surgery
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    • v.25 no.8
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    • pp.877-884
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    • 1992
  • From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

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Idiopathic Cystic Medial Necrosis -A Case Report- (특발성 낭포성 중층 괴사 -1례 보고-)

  • 장병철
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.183-190
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    • 1979
  • A 23-year-old male patient complained dyspnea on exertion and orthopnea since December 1977. On examination, he was tall and slender. There was grade IV/VI to-and-fro murmur on the left sternal border especially on Erb`s point. The liver was descended 2 fingers breadth below right costal margin. There were no signs of Marfan`s syndrome. Echocardiography demonstrated partial closure of aortic valve and dilated aortic root with enlargement of ascending aorta. Left heart cardiac catheterization revealed moderately elevated pulmonary wedge pressure and right ventricular pressure. The left ventricular end diastolic pressure was markedly elevated to 26 mmHg. On aortography, the aortic regurgitation was severe and it was belonged to angiographically Grade IV. The aortic valve was replaced with Carpentier-Edwards valve without excision and replacement of ascending aorta, under the impression of rheumatic valvular heart disease. After closure of aortotomy, blood pressure was transiently elevated and bleeding from the site of inserting air vent needle of ascending aorta was developed. The bleeding was not controlled by any means. On postmortem microscopic study, the histologic changes were strikingly limited to the ascending aorta from the region of the aortic valve ring.

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