• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.36-44
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• 2000

Objective : The heart diseases are known as a major cause of sudden death, as well as a cause of poor life-quality of school-age children. But there have been few mass screening of heart diseases in these children in Korea. This study was done to estimate the prevalence of heart diseases of these population. Methods : We screened all elementary students(grade 1) in 12 cities and 16 counties(Gun) in Kyonggi province from 1992 to 1955. The first screening was done by auscultation of doctors and simultaneously by checking using 'auto-interpreter of EKG-cardiac sound' (Fukuda Densi ECP 50A). We conducted luther examinations to whom classified as being abnormal condition in first screening, by using EKG, chest x-ray, doppler echocardiograpy(if needed). Results : The total number of examined students was 161,308(92% of the population), the male were 83,238 and female were 78,070. The congenital heart diseases(CHD) patients were 290(18 per 10,000) - male 155(18.6 per 10,000) and female 135(17.3 per 10,000). The most frequent disease was ventricula septal defect(VSD, 45.5%), Atrial septal defect(ASD, 14.8%), Tetralogy of Follot(TOF, 11.7%), and Patent Dutus Arteriosis(PDA, 7.6%) in order. In female, the order was VSD(48.1%), ASD(13.3%), TOF(11.1%), and PDA(10.4%). The total number of EKG abnormality were 433(62.7 per 10,000) among 69,056 screened children in 1995. The complete right bundle branch block(CRBBB) and paroxymal ventricular contraction(PVC) were frequent(26.6%, 26.3% in each), and incomplete right bunddle branch block(IRBBB, 14.6%), paroxymal atrial contraction(PAC, 6.7%), abnormal Q(5.8%), Wolf-Pakinson-White syndrom (5.5%) in order. In female, the most frequent abnormality was PVC(29.8%), and CRBBB(19.9%) in order. Conclusion : We could present the stable prevalence of the rare heart disease. The prevalence of congenital heart diseases was 18.0 per 10,000 and of EKG abnormality was 62.7 per 10,000 among school children.

• Clinical and Experimental Pediatrics
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• v.56 no.4
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• pp.176-181
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• 2013

Purpose: Apical muscular ventricular septal defects (MVSDs), especially in small infants, can be difficult to manage using surgical and percutaneous closure. An intraoperative perventricular procedure is a good option for closing apical MVSDs in small children with or without associated cardiac anomalies. We evaluated the results of hybrid perventricular closure of apical MVSDs performed using an Amplatzer duct occluder (ADO). Methods: We retrospectively reviewed the medical records of 5 patients who underwent hybrid perventricular closure of MVSDs with ADOs, from March 2006 to May 2011. The median patient age at the time of the procedure was 12 months (range, 25 days to 25 months), and the median body weight was 9.1 kg (range, 4.3 to 15 kg). Two patients had multiple ventricular septal defects (VSDs; additional perimembranous VSD in 1 patient and multiple MVSDs in the other) and 3 patients had associated cardiac anomalies; complete transposition of the great arteries in 1 patient and an atrial septal defect in 2 patients. All the procedures were performed on beating hearts, exception in 1 case. The ADO selected for the aortic side was at least 1 to 2 mm larger than the largest VSD in the left ventricle side. Results: The procedure was successful in all patients and each device was well positioned. During the median follow-up of 2.4 years, a small residual VSD was noted in 2 patients who had multiple VSDs and no leakage was seen in the other 3 patients. Conclusion: Perventricular closure of MVSD with an ADO is a good option for patients with apical MVSD. However, careful manipulation is important, especially in the case of small infants.

• Journal of Genetic Medicine
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• v.9 no.2
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• pp.98-100
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• 2012

Holt-Oram syndrome (HOS) is the most common heart-hand syndrome, which is inherited in an autosomal dominant manner, but most cases are sporadic. This condition is characterized by upper-extremity malformations involving radial-ray, thenar, and carpal bones, and congenital heart malformations including atrial septal defect and ventricular septal defect. It is caused by mutations in the TBX5 gene. In this report, a Korean case with HOS is described, which is inherited from her father. A novel nonsense mutation, $p.Glu294^*$, was identified. This is the first Korean case with HOS confirmed by genetic testing.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.250-258
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• 1986

From Aug. 1984 to May 1986, 116 cases of cardiovascular surgery including 85 cases of open heart surgery were performed at Korea Veterans Hospital. There were 108 congenital anomalies and 8 acquired valvular heart diseases. Among 108 congenital malformations 92 operations were done for acyanotic group, and 16 operations for cyanotic group. Thirteen cases of open heart surgery for infants or small children under 10kg of body weight were performed, which occupied 15.3 percent of total open heart surgery done in the same period. Common congenital cardiovascular anomalies were ventricular septal defect [40.7%], patent ductus arteriosus [29.6%], tetralogy of Fallot [12.[%], atrial septal defect [11.1%], and pulmonary stenosis [1.9%] in order of frequency. Valve replacement using lonescu-Shiley or Carpentier-Edwards valve was performed for 8 cases of acquired mitral valve disease, and valve replacement using St. Jude valve was done for a case of patent ductus arteriosus with severe mitral insufficiency. There was no mortality in acyanotic congenital malformations and acquired valve lesions, and 5 cases of mortality in cyanotic congenital malformations. Overall mortality was 4.3 percent for total cases and 5.9 percent for 85 cases of open heart surgery.

• 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.32 no.6
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• pp.584-587
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• 1999

The DiGeorge syndrome is a rare congenital abnormality consisting of aplasia or hypoplasia of the thymus and parathyroid glands resulting from malformation of the third and fourth pharyngeal pouches. This syndrome usually includes congenital cardiac anomalies and abnormal facial features. We experienced a case of congenital cardiac anomaly associated with DiGeorge syndrome. The patient was 1 month old boy weighing 3.5 kg. The congenital cardiac anomalies included ventricular septal defect, atrial septal defect, coactation of aorta, and patent ductus arteriosus. We performed one-stage operation with two separate incisions for these cardiac anomalies. Postoperative course was uneventful and the patient at 6 months of follow up is doing well.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.63-68
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• 1973

Two patients operated upon for tricuspid atresia by Glenn operation are presented. They were five years old and four years old females who were cyanotic shortly after birth, and remained cyanotic. On physical examination, cyanosis on digits and lips, clubbing of fingers, thrill and grade III systolic murmur on 4th I.C.S. along left sternal border were noted. In the first case, chest roentgenograms showed normal pulmonary markings, and the electrocardiogram was interpreted as showing left ventricular hypertrophy with left axis deviation and peaked P-wave in lead IL Right heart catheterization showed high pressure in right atrium and the catheter tip was easily inserted into the left atrium through septal defect. In the second case, chest roentgenograms showed cardiomegaly with sparse pulmonary vascular markings and narrowed vascular pedicle, and the electrocardiogram showed left ventricular hypertrophy with some element of right atrial hypertrophy. Angiocardiogram showed changes characteristic of tricuspid atresia, including "right ventricular window" The findings of right heart catheterization were similar to those of first case. On the basis of these observations, they were diagnosed as tricuspid atresia, and Glenn operation was performed. Normal position of great vessels combined with ventricular septal defect and pulmonary stenosis were noted on the first case, and on second case, transposition of great vessels was additional finding. Postoperative course was uneventful and favorable outcome was obtained.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.122-128
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• 1993

This series compromised 31 patients with pulmonary hypertension of 282 patients of ventricular septal defect(VSD) who underwent operation at the department of Thoracic and Cardiovascular Surgery in Chonnam University Hospital, from January, 1986 to December, 1991. Pulmonary hypertension was noted in 59 of 280 cases of VSD. Of them, 31 cases underwent cardiac catheterization on postoperative 8th to 77th month. Age at operation was ranged from 10 months to 29 years (mean 9.13 years). 17 patients were male and 14 patients were female. Results of follow-up studies were as follows: Cardiothoracic ratio was decreased from 0.59${\pm}$0.04 to 0.54${\pm}$0.03 (p=NS). Postoperative systolic pulmonary arterial pressure (PAPs), mean pulmonary arterial pressure (PAPm), and systolic right ventricular pressure (RVPs) were decreased significantly (p<0.001). And also Rp/Rs was decreased from 0.37${\pm}$0.21 to 0.14${\pm}$0.06 (p<0.02). However, systemic arterial pressure (SAP), right atrial pressure (RAP), and pulmonary capillary wedge pressure (PCWP) were changed insignificantly. There were significant relations of follow-up period with the decrement of PAP(p<0.005). In contrary, ther were no relations between the decrement of PAP and the age at operation. These data suggested that the long-term hemodynamic changes remained to be determined in some of the patients, even though they Were asymptomatic, with pulmonary hypertension.

• Journal of Chest Surgery
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• v.14 no.2
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• pp.144-152
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• 1981

The effect of cardiopulmonary bypass procedures on the blood components were studied through the measurements of several serum enzymes, SGOT, SGPT, CPK and LDH with its isozymes in the patients who had surgery for their heart diseases. They wre 85 patients: 40 Males and 45 Females. Their ages ranged widely between one and fifty-six. They were divided into 5 groups: Group I.patent ductus arteriosus without extracorporeal circulation, Group II-atrial septal defect, Group III-ventricular septal defect, Group IV-tetralogy of Fallot, and Group V-valve replacement. Generally serum enzymes revealed the increased values after surgery and the tendency returning toward preoperative levels. With the high total serum LDH levels seen uniformly after operation which persisted long in patients with replaced valves, the changes of LDH-isozymes were further analyzed. The isozymes, especially LDI and LDs increased their activities postoperatively, and the other fractions varied little. And $LD_1$/$LD_2$ ratios also showed similar rises and falls while the elevated values lasted longer in the patients with cardiac valve replacement. The significant values of LDH-isozymes in predicting the hemolysis occuring after extracorporeal circulation and in following the patients whose valves were replaced have been further discussed with the special stress placed on the $LD_1$/$LD_2$ratios.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.186-188
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• 2011

Ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction. The event occurs 2~8 days after an infarction and often precipitates cardiogenic shock. Post myocardial infarction VSR is known for difficult to repair. Especially, Transmural myocardial infarction involved in the posterior VSD area, exposure of the affected site is difficult and postoperative mortality rate is high. We have experienced a case of a 75-year-old female patient who suffered posterior VSD due to acute myocardial infarction, and attained good result by approaching the lesion through right atrial incision and repaired the defect by using patch closure technique.