• Title/Summary/Keyword: cardiac approach

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Intracardiac Foreign Body by Penetrating Cardiac Injury (관통성 손상에 의한 심장내 이물 - 수술 치험 1례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.929-935
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    • 1990
  • Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

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Minimal Invasive cardiac Surgery ; Small Submammary Incision (유방하 횡절개를 이용한 최소침습 심장수술)

  • 정승혁;신용철;임용택;김병일;이정호
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.96-98
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    • 2000
  • A cosmetic incision for minimal invasive cardiac surgery is described. Through a small submammary skin incision combined with partial low sternotomy some kinds of cardiac operations are possible without extra-difficulty but with excellent cosmetic effect, No special instruments nor techniques are required. By this method routine cannulations for cardiopulmonary bypass as well as aortic cross clamping bicaval snaring and venting of cardiac chambers are possible, We performed 5 cases of open heart surgeries using this approach which includes two cases of atrial septal defect closure one case of ventricular septal defect closure one case of pulmonic valvotomy and one case of mitral valve replacement.

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Patient-Specific Mapping between Myocardium and Coronary Arteries using Myocardial Thickness Variation

  • Dongjin Han
    • International journal of advanced smart convergence
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    • v.13 no.2
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    • pp.187-194
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    • 2024
  • For precise cardiac diagnostics and treatment, we introduce a novel method for patient-specific mapping between myocardial and coronary anatomy, leveraging local variations in myocardial thickness. This complex system integrates and automates multiple sophisticated components, including left ventricle segmentation, myocardium segmentation, long-axis estimation, coronary artery tracking, and advanced geodesic Voronoi distance mapping. It meticulously accounts for variations in myocardial thickness and precisely delineates the boundaries between coronary territories according to the conventional 17-segment myocardial model. Each phase of the system provides a step-by-step approach to automate coronary artery mapping onto the myocardium. This innovative method promises to transform cardiac imaging by offering highly precise, automated, and patient-specific analyses, potentially enhancing the accuracy of diagnoses and the effectiveness of therapeutic interventions for various cardiac conditions.

Left-Side Surgical Approach to Mitral Valve in Dog Cadaver Study

  • Moon, Jeong-hyeon;Hwang, Byungmoon;Kim, Daesik;Jung, Sunjun;Ha, Yongsu;Lee, Kicahng;Kim, Namsoo;KIM, Min-su
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.10-12
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    • 2018
  • Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

Integrated Quantitative Phosphoproteomics and Cell-Based Functional Screening Reveals Specific Pathological Cardiac Hypertrophy-Related Phosphorylation Sites

  • Kwon, Hye Kyeong;Choi, Hyunwoo;Park, Sung-Gyoo;Park, Woo Jin;Kim, Do Han;Park, Zee-Yong
    • Molecules and Cells
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    • v.44 no.7
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    • pp.500-516
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    • 2021
  • Cardiac hypertrophic signaling cascades resulting in heart failure diseases are mediated by protein phosphorylation. Recent developments in mass spectrometry-based phosphoproteomics have led to the identification of thousands of differentially phosphorylated proteins and their phosphorylation sites. However, functional studies of these differentially phosphorylated proteins have not been conducted in a large-scale or high-throughput manner due to a lack of methods capable of revealing the functional relevance of each phosphorylation site. In this study, an integrated approach combining quantitative phosphoproteomics and cell-based functional screening using phosphorylation competition peptides was developed. A pathological cardiac hypertrophy model, junctate-1 transgenic mice and control mice, were analyzed using label-free quantitative phosphoproteomics to identify differentially phosphorylated proteins and sites. A cell-based functional assay system measuring hypertrophic cell growth of neonatal rat ventricle cardiomyocytes (NRVMs) following phenylephrine treatment was applied, and changes in phosphorylation of individual differentially phosphorylated sites were induced by incorporation of phosphorylation competition peptides conjugated with cell-penetrating peptides. Cell-based functional screening against 18 selected phosphorylation sites identified three phosphorylation sites (Ser-98, Ser-179 of Ldb3, and Ser-1146 of palladin) displaying near-complete inhibition of cardiac hypertrophic growth of NRVMs. Changes in phosphorylation levels of Ser-98 and Ser-179 in Ldb3 were further confirmed in NRVMs and other pathological/physiological hypertrophy models, including transverse aortic constriction and swimming models, using site-specific phospho-antibodies. Our integrated approach can be used to identify functionally important phosphorylation sites among differentially phosphorylated sites, and unlike conventional approaches, it is easily applicable for large-scale and/or high-throughput analyses.

Right Anterolateral Thoracotomy for Cardiac Surgery in the Adult (성인에서의 우전외측 개흉술을 이용한 개심술)

  • Lee, Sang-Gwon;Kim, Sang-Pil;Song, Hyun;Kim, Jong-Ook;Song, Meung-Gun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.722-725
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    • 1999
  • Background: To secure a rapid and safe approach which is at the same time cosmetically appealing, we employed the right anterolateral thoracotomy incision for repair of atrial septal defects and valvular heart diseases in the adult. Material and method: Between October 1989 and June 1998, 44 adult patients underwent open heart surgery through right anterolateral thoracotomy at our institution. Operative time, cardiopulmonary bypass time, aortic cross clamp time, blood loss until chest tube removal, length of ICU stay, days to discharge, and survival were compared with those that received cardiac surgery via conventional sternotomy. Result: No significant differences were observed between the two groups. There was no death and no additional morbidity directly related to this approach. Cosmetically satisfying results were obtained with safety using the right anterolateral thoracotomy approach. Conclusion: Our data show that the right anterolateral thoracotomy approach is a safe alternative to conventional median sternotomy as it offers excellent exposure and aesthetically more acceptable wounds while not adding on to the operative risks.

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Practical stepwise approach to rhythm disturbances in congenital heart diseases

  • Huh, June
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.680-687
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    • 2010
  • Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

The Correlation between Cardiac Catheterization Data and Defect Size in Ventricular Septal Defect (심실중격결손증에서 술전 심도자검사치와 결손크기의 상관관계에 대한 연구)

  • 정상조
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.430-437
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    • 1990
  • We clinically evaluated 121 cases of ventricular septal defect which we operated from April, 1986 to December, 1989 at Inha General Hospital, Seong-Nam, Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University. These patients were occupied 54.8% of all congenital heart diseases operated on its same period. Of the 121 patients, 63 patients were male[52.1%] and 58 patients were female[47.9i]. The two most common symptoms were frequent upper respiratory infection and dyspnea on exertion. By Kirklin s anatomical classification, type I constituted 34.7%, type II 61.98%, type III 0.03% and type IV not occupied. Associated cardiac anomalies were found in 34 cases, and PDA was most common associated anomaly, occupied in 22 cases. On the cardiac catheterization data, there were statistically significant correlation between VSD size[cm2 /BSAm2] and systolic pulmonary arterial pressure[sPAP], pulmonary to systemic flow ratio[Qp/Qs] & pulmonary to systemic pressure ratio[Pp/Ps] respectively, Type II [r=0.53, p<0.01] was more correlated than type I [r=0.49, p<0.05] between VSD size and Qp /Qs. We could not found the correlationship between age and Qp/Qs [Type I; r=0.16, Type II; r=-0.15] All cases were operated under cardiopulmonary bypass and 58 cases[46.3%] were operated through the right atrial approach, and 34 cases[28.1%] through the pulmonary arterial approach. Operative mortality rate was 4.13%[5 cases].

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Wearable Approach of ECG Monitoring System for Wireless Tele-Home Care Application

  • Kew, Hsein-Ping;Noh, Yun-Hong;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.05a
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    • pp.337-340
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    • 2009
  • Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.

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Effects of an Individualized Cardiac Rehabilitation Education Program on Knowledge about Coronary Artery Disease, Compliance of Sick Role, and Vascular Health Status in Patients of Percutaneous Coronary Intervention (개별 심장재활 교육프로그램이 관상동맥중재술을 받은 환자의 질병관련지식, 환자역할이행과 혈관 건강상태에 미치는 효과)

  • Lee, Kyung Sim;Sung, Kyung Mi
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.2
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    • pp.135-144
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    • 2015
  • Purpose: This study was conducted to examine the effects of an individualized cardiac rehabilitation education program on knowledge about coronary artery disease (CAD), compliance of sick role and vascular health status in patients with percutaneous coronary intervention (PCI). Methods: Quasi-experimental design-based nonequivalent control group pretest-posttest design was employed. Using convenience sampling, data were collected from 60 patients who underwent PCI at S Hospital in S City from September 2014 to February 2015. For examining the effects of an individualized cardiac rehabilitation education program, knowledge about CAD, compliance of sick role and vascular health status were measured. Results: The experimental group showed statistically significant differences in knowledge about CAD (t=24.21, p<.001), compliance with sick role (t=20.81, p<.001) and vascular health status (t=15.07, p<.001) compared to the control group. Conclusion: The individualized cardiac rehabilitation education program is effective in improving knowledge about CAD, compliance of sick role and vascular health status in patients who underwent PCI. Based on the findings of this study, nursing intervention programs focusing on individualized approach will be useful for patients undergoing PCI.