• Journal of Chest Surgery
• /
• v.53 no.1
• /
• pp.16-21
• /
• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Journal of Chest Surgery
• /
• v.56 no.6
• /
• pp.414-419
• /
• 2023

Background: The recurrence of ventricular arrhythmias (VAs) in patients who have already undergone treatment with antiarrhythmic medication, catheter ablation, and the insertion of implantable cardioverter defibrillators is not uncommon. Recent studies have shown that bilateral cardiac sympathetic denervation (BCSD) effectively treats VAs. However, only a limited number of studies have confirmed the safety of BCSD as a viable therapeutic option for VAs. Methods: This single-center study included 10 patients, who had a median age of 54 years (interquartile range [IQR], 45-65 years) and a median ejection fraction of 58.5% (IQR, 56.2%-60.8%), with VAs who underwent video-assisted BCSD. BCSD was executed as a single-stage surgery for 8 patients, while the remaining 2 patients initially underwent left cardiac sympathetic denervation followed by right cardiac sympathetic denervation. We evaluated postoperative complications, the duration of hospital stays, and VA-related symptoms before and after surgery. Results: The median hospital stay after surgery was 2 days (IQR, 2-3 days). The median surgical time for BCSD was 113 minutes (IQR, 104-126 minutes). No significant complications occurred during hospitalization or after discharge. During the median follow-up period of 13.5 months (IQR, 10.5-28.0 months) from surgery, no VA-related symptoms were observed in 70% of patients. Conclusion: The benefits of a short postoperative hospitalization and negligible complications make BCSD a safe, alternative therapeutic option for patients suffering from refractory VAs.

• Journal of Chest Surgery
• /
• v.28 no.6
• /
• pp.606-609
• /
• 1995

We have experienced ten cases of emergent operation for the complications of cardiac catheterization during the period from 1985 to September 1994.Catheterization was done for the evaluation of the cardiac or vascular problem in 8 cases and 2 cases of neurosurgical problem. The extracardiac injection of contrast material have occurred in 3 cases[primum ASD,Trilogy,VSD . Six cases were unable to remove the catheter from femoral artery or vein. The catheters were knotted, coiled, impacted or broken. An embolectomy was done 40 years old man who suffered from chronic left subclavian artery obstruction a day after angiography. Open heart surgery was performed in 5 cases of cardiac perforation,impacted catheter in left inferior pulmonary vein and broken catheter of VSD. Arteriotomy was done in 4 cases to remove the knotted and coiled catheter. There was no complication or mortality for the emergent operation.

• Journal of Chest Surgery
• /
• v.40 no.5 s.274
• /
• pp.376-379
• /
• 2007

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair He had no problem after this event. He complained of dyspnea that stalled 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.

• Journal of Chest Surgery
• /
• v.15 no.2
• /
• pp.194-203
• /
• 1982

In this investigation we undertook to evaluate the utility of radionuclide cardiac angiography in the detection of cardiac shunts before and after surgical correction. Time-activity curves of ventricles and lungs were evaluated after bolus intravenous injection of 99mTc-human serum albumin in 512 preoperative patients and 551 post-operative patients. Omitting 31 cases of technical failure due to poor bolus, we detected shunts in 459 cases of 481 preoperative evaluations, so the detectability was 95.4%. The cases which couldn`t be detected by this method had small amount of shunt. Also the degree of shunt detected by radioisotope methods were well correlated with oxymetry method. [r=0.89, p<0.01 ] In postoperative evaluations, 18 out of 411 patients with left to right shunt and 10 out of 140 right to left shunt were found to have remnant shunts with radionuclide cardiac angiography. Of the 28 cases with failed operation, 2 were confirmed in reoperation, 2 by cardiac catheterization, 2 by two -dimensional echocardiography. All except one .f these patients had membranous ventricular septal defects and those with left to right shunts had moderate to severe pulmonary hypertension and shunt amount. Also those had larger septal defects than control group. We consider that radionuclide cardiac angiography is a simple and noninvasive method which can show the preoperative diagnosis and postoperative follow up of cardiac shunts.

• Journal of Chest Surgery
• /
• v.47 no.2
• /
• pp.145-148
• /
• 2014

Here, we present a rare case of cardiac parasitic infection found in an adult female patient who had the symptoms of dyspnea upon exertion. She was diagnosed with a double-chambered right ventricle due to infundibular hypertrophy confirmed by transthoracic echocardiography and cardiac computed tomography. We performed surgery of infundibulectomy around the pulmonary valve. In the end, histopathological findings of the resected infundibular muscle demonstrated trichinellosis, a type of roundworm infection.

• Journal of Chest Surgery
• /
• v.54 no.6
• /
• pp.532-534
• /
• 2021

This study examined a rarely seen benign heart tumor that was found incidentally on a chest X-ray. Radiological images were taken of a 42-year-old patient with no symptoms of a heart condition, showing a thick-walled left lung cavity that appeared after prior inflammation and concomitant enlargement of the cardiac shadow. A large subepicardial lipoma in combination with a chronic abscess on the left lung was revealed on chest computed tomography. The treatment consisted of simultaneous surgical removal of both the lung and heart lesions using video-assisted thoracoscopic surgery.

• Journal of Korean Academy of Nursing
• /
• v.50 no.2
• /
• pp.159-177
• /
• 2020

Purpose: This study aimed at identifying factors related to persistent postoperative pain after cardiac surgery and estimating their effect sizes. Methods: The literature search and selection was conducted in four different databases (CINAHL, Cochrane Library, PubMed, and PQDT) using the Preferred Reporting Items for Systematic Review and Meta-Analysis Statement. A total of 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, R was used to analyze 30 effect sizes of for both individual and operative factors as well as publication biases from a total of nine studies. Results: The meta-analysis revealed that persistent postoperative pain after cardiac surgery was related to one individual factor (gender) and two operative factors (acute postoperative pain and use of the internal mammary artery). Operative factors (OR=5.26) had a larger effect size than individual factors (OR=1.53). Conclusion: Female gender, acute pain after surgery, and use of the internal mammary artery are related factors to persistent postoperative pain. The development of interventions focusing on modifiable related factors, such as acute postoperative pain, may help to minimize or prevent PPP after cardiac surgery.

• Journal of Chest Surgery
• /
• v.31 no.4
• /
• pp.398-401
• /
• 1998

A 56-year-old female with a permanent unipolar pacing(VVI) system underwent elective coronary bypass surgery and mitral valve replacement. Because the unipolar sensing is subject to considerable nonmyocardial electrical noise, the pacing function may be disturbed by the use of electrocautery. Temporary atrial and ventricular bipolar epicardial leads and external generator were used for maintaining A-V sequential pacing during the use of electrocautery. Before aortic cross-clamp was released after cardiac operation, regular cardiac rhythm could spontaneously be resumed with an integrated cardioplegic strategy, avoiding the use of defibrillator

• Journal of Chest Surgery
• /
• v.49 no.5
• /
• pp.356-360
• /
• 2016

Background: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results: No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion: The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.