• Title/Summary/Keyword: atrial septal defect

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Clinical Study of Ventricular Function Following Open Heart Surgery by Radionuclide Angiocardiogram - left ventricular ejection fraction by ECG gated blood pool scan - (방사성 동위원소를 이용한 개심술 전후의 심실기능 변화에 관한 연구: ECG gated blood pool scan을 이용한 ejection fraction 검사)

  • Lee, Jeong-Cheol;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.25-34
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    • 1986
  • Recently, radionuclide angiocardiogram is one of the most common procedure for assessment of ventricular performance due to its distinctive advantages such as safety, accuracy, and ease of repeated studies. Also, measurement and comparison between pre and postoperative left ventricular ejection fraction [LVEF] are meaningful for assessing the severity of myocardial damage which occurred during open heart surgery and the status of myocardial recovery. We obtained pre and post operative LVEF using radionuclide angiocardiogram on 30 patients composed of atrial septal defect, ventricular septal defect, cyanotic congenital heart disease, and valvular heart disease who undergone the open heart surgery from March to august 1984. The study revealed that ventricular septal defect and mitral valvular heart disease showed 8.1% and 6.2% decreases of postoperative LVEF, respectively. But, there are little increases of postoperative LVEF in the atrial septal defect and cyanotic congenital heart disease. In ventricular septal defect, each group of Qp/Qs over 2.0 and systolic pulmonary artery pressure over 50mmHg showed significant 17% and 14.7% decreases of postoperative LVEF, respectively. Considering the duration of the aortic cross clamping times and closing methods of VSD, each group of duration over 30 min. and of patch closure showed 13.9% and 14.2% decreases of LVEF between pre and postoperative status respectively which was significant finding statistically.

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Surgical Repair of Isolated Secundum Atrial Septal Defect - Clinical features, hemodynamic function, early and late results according to age at operation - (이차공형 심방중격결손증의 외과적 치료;연령에 따른 혈류학적 상관관계에 관한 고찰)

  • Lee, S.;Choi, B.C.;Ahn, W.S.;Hur, Y.;Kim, B.Y.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1318-1326
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    • 1992
  • Backgroud. To determine the influence of age at operation upon surgical outcome in patients with isolated secundum atrial septal defect, retrospective clinical analysis was done. Material and method. From June, 1976 to December, 1991, 146 patients, 63 male and 83 female patients ranging in age from 13 months to 56 years, were operated on for isolated secundum atrial septal defect. The patients were divided into 3 groups according to their age at operation: Group I [<20 years old], 91 patients[62.3%]; Group II [21 to 40 years old], 44 patients[30.1%]; GroupIII[>41 years old], 11 patients[7.6%]. Significant differences in clinical features, hemodynamic function, early and late results between age groups were speculated. Results. One hundred thirty-one patients[89.6%] were symptomatic at the time of operation, the most common symptoms being dyspnea on exertion, recurrent respiratory infection, palpitation and chest pain. Patients in NYHA class III or IV were 3.3% in group I, 25% in groupIII, and 54.5% in group Ill. Hemodynamic data was available for 138 patients [94.5%]. Significant pulmonary hypertension [MPA systolic pressure $^3$ 40mmHg] was noted in 22 patients [15.9%]. Patients with pulmonary vascular disease [Rp/Rs>1.25] were 2% in group I, 7.3% in group Il, and 9.1% in groupIII. But there were no significant differences between the age groups in the size of the shunt or the ratio of pulmonary to systemic flow. Atrial septal defects were closed with direct suture in 144 patients and patch repair was performed in 2 patients with high defect. Atrial arrhythmia [8.2%] was the most common postoperative complication. The mean [LSD] duration of follow-up in all patients was 16$\pm$22 months [range, 1~96 months]. Functional result was excellent regardless of the age groups. During follow-up period, late cardiovascular events were arrhythmia [7 cases], reoperation for recurrent ASD [2 cases], and premature late death due to bacterial endocarditis [1 case]. Incidence of preoperative and late atrial fibrillation was significantly higher in older age group. Conclusion. Age at operation is one of the most important predictor of early and late surgical outcome with its impact on the following factors : 1] hemodynamic alterations and ventricular dysfunction due to longstanding volume and pressure overload, 2] pulmonary vascular disease, and 3] atrial arrhythmia including atrial fibrillation as a result of atrial dilatation. Therefore, among patients with surgically repaired atrial septal defects, those operated on over the age of 20 require careful supervision on the long-term basis.

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Arterial Switch Operation for Transposition of The Great Arteries with Ventricular Septal Defect and for Double Outlet Right Ventricle with Subpulmonary Venricular Septal Defect (심실중격결손증을 동반한 대혈관 전위증 및 양대동맥 우심실 기시증에 대한 동맥전환술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1118-1127
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    • 1990
  • Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

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Surgical Treatment of Atrioventricular Septal Defect (방실중격결손증의 외과적 치료)

  • 이광숙
    • Journal of Chest Surgery
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    • v.22 no.6
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    • pp.990-995
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    • 1989
  • Since 1984, 24 patients underwent repair of atrioventricular septal defect. Nineteen had a partial defect and 5 had a complete atrioventricular septal defect. There were 9 men and 15 women, ranging in age from 1 to 50 years [mean age, 13.3 years]. Four patients had a Downs syndrome. Additional congenital heart defects were present in 11 patients. One patient had palliative operation prior to total correction. In partial defects, the primum atrial septal defect was closed with Xenomedica patch and the mitral valve was repaired with simple closure of the septal commissure. Central incompetence from annular dilatation was repaired by a local annuloplasty. In complete defect, the septal defects were closed with two patches except one. Operative mortality was 5% in partial defects and 60% in complete defects and low cardiac output was the commonest etiology. In a mean follow-up period of 27.9 months [range, 4 to 63 months] there were no late death and no instances of late-onset complete heart block. One patient required reoperation [MVR] for residual mitral regurgitation. The majority of patients were asymptomatic and mean postop. NYHA functional class was 1.2.

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Ebstein anomaly, right-to-left atrial septal defect, and cor triatriatum dexter in a cat: a case report

  • Soolyi Park;Wonseok Oh;Daye Lee;Seunggon Lee
    • Korean Journal of Veterinary Research
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    • v.64 no.1
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    • pp.5.1-5.6
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    • 2024
  • A 6-month-old male Ragdoll cat presented with exercise intolerance. On physical examination, there was a grade 2/6 systolic murmur at the right apex. Diagnostic tests, including SpO2 measurement, blood tests, radiography, echocardiography, contrast echocardiography, and electrocardiography, were performed. Severe right atrial dilation, tricuspid valve leaflets and orifice displacement, right ventricular atrialization, septal leaflet adherence, anterior leaflet tethering, and right atrioventricular junction dilation were noted on echocardiography, alongside a right-to-left atrial septal defect. Cor triatriatum dexter and left ventricular aneurysm were observed. We diagnosed this case as having Ebstein anomaly with rare congenital heart deformities; which is rare in cats.

Robotic Assisted Surgery in Adult Patient with Congenital Ventricular Septal Defect (내시경 수술 보조 로봇을 이용한 성인 심실중격결손 교정술)

  • Park, Il;Lee, Jong-Tae;Kim, Gun-Jik;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.931-933
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    • 2006
  • Robotic assisted surgery in adult patient with congenital ventricular septal defect Since December in 2005, we have done minimally invasive surgeries in selected cases of mitral valve diseases, tricuspid valve diseases, atrial septal defects and atrial fibrillations with the $AESOP^{TM}$ robotic arm. We have had a better surgical view and skill, according to accumulation of the experience of this procedure. Recently, we performed robotic assisted surgery in a 47-year-old female with congenital perimembranous ventricular septal defect.

A Clinical Evaluatuin on Open Heart Surgery of Congenital and Acquired Heart Disease (선천성 및 후천성 심질환의 개심술)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.33-42
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    • 1979
  • The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

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Transitional Atrioventricular Septal Defect in a Dog

  • Hwang, Tae-sung;Choi, Moon-yeong;Yoon, Young-min;Kim, Jae-hwan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.286-289
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    • 2018
  • A 4-year-old castrated male Maltese was referred to our hospital with heart murmur. The client did not recognize any symptoms. Auscultation revealed systolic murmur located at the left heart base. Radiographs showed right-sided cardiomegaly with the main pulmonary artery bulging and enlargement of pulmonary vessels. Echocardiogram revealed a small ventricular septal defect and a large atrial septal defect. There was also a common atrioventricular valve. Based on diagnostic imaging studies, the dog was diagnosed with transitional atrioventricular septal defect.

Partial Anomalous Pulmonary Venous Drainage Associated with Septal Defect in Dextrocardia (우심증에서 부분 폐정맥 이상환류를 동반한 심방중격결손 -1례 보고-)

  • Chang, M.;Chang, B.C.;Cho, B.K.;Hong, S.N.
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.30-32
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    • 1979
  • Partial anomalous pulmonary drainage is frequently accompanied by an atrial septal defect. The anomaly is entirely compatible with life and the clinical findings are dependent primarily on the proportion of the pulmonary venous return to the right atrium. The anomaly is frequently missed even with complete diagnostic study. In this report we are presenting a case of anomalous pulmonary venous drainage combined with atrial septal defect and dextrocardia and the treatment of this condition.

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