• Title/Summary/Keyword: cardiac surgery

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The Changes of Serum and Urine Potassium after Extracorporeal Circulation in Open Heart Surgery (개심술환자에서 체외순환후 혈중 및 요중 포타시움의 변화)

  • Ju, Hong-Don;Im, Seung-Pyeong
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.951-959
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    • 1991
  • The level of serum potassium concentration is very important aspect in postoperative cardiac patients The postoperative cardiac arrhythmia and digitalis intoxication are known to be closely related with hypokalemia and also to cause the irreversible cardiac dysfunction. In this study, the changes of the level in serum and urine concentrations during, after extracorporeal circulation[EGG], Predict and Postdict periods are analyzed and compared statistically with postoperative cardiac patients 46 persons according to divided 8 groups. 1. There was no difference significantly in concentrations of serum and urine potassium in each period according to age, sex and disease types. 2. There was no difference significantly in concentrations of serum and urine potassium in each period according to the use of normothermia and hypothermia. 3. There was no difference significantly in concentrations of serum and urine potassium in each period according to the length of extracorporeal circulation time and aortic cross clamping time. 4. There was no difference significantly in concentrations of serum and urine potassium in each period according to the amount of the infused cardioplegic solution and level of Hct.

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Colchicine Derivatives Allows Prolonged Survival of Cardiac Allograft in the Rat (백서에서의 동종이형의 심장이식후 Colchicine 변형 물질 투여군의 장기 변존)

  • Kim Young-Hak;Lee Hyung-Chang;Chung Won-Sang;Kang Jung-Ho;Kim Hyuck;Chon Sun-Ho;Shin Sung-Ho
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.595-600
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    • 2005
  • Background: Colchicine with its immunosupressive properties has been used with benefcial effects in autoimmune disease, such as Gout, etc. Whether colchicine, by virtue of the above property, could attenuate the process of cardiac allograft rejection in the rats is investigated in this report. Material and Method: We compared the untreated group (Control, n=6), Cyclosporin A group (10 mg/kg, daily, n=20), and Colchicine derivative group (Colchicine 40 ${\mu}g$/kg, n=20) of cardiac allografts in the rats. Result: In the untreated control group (n=6), all of 6 rats showed rejection within 3 weeks after cardiac allograft. In the cyclosporin A group (n=20), cyclosporin A (10 mg daily oral dose) was administered at a 10 mg daily oral dose and promoted long-term survival (over 100 days). The cyclosporin A group had one mortality at the 18th post-operative day due to infection. Furthermore, in the Colchicine derivatives group (n=20) with a daily IP (Intra Peritoneum) dose (40 ug/kg/day), we observed long-term survival.(> 100 days), except for one rat that died of an anesthetic problem (respiratory failure) at the 9th post-operative day. Conclusion: Experiments have also been performed to evaluate whether the effect of colchicine derivatives allowed prolonged survival of cardiac allografts compared with the cyclosporin A administration group in the rats.

Cardiac Surgery : A report of 1640 cases (심장질환의 외과적 치료 -1640 수술예 보고-)

  • 이영균
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.92-99
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    • 1980
  • From 1958 up to the end of April 1980, during the period of 12 years 1640 cardiac surgery cases including 1069 open heart surgery and 304 valve replacement cases, were operated in this Department. There were 1070 congenital anomaly and 570 acquired disease cases. In 1070 congenital anomaly cases 673 acyanotic and 397 cyanotic anomaly patients were noted. In acquired diseases 94 pericardial and 456 valvular cases were found. Among 456 valve cases 189 mitral stenosis, 133 mitral insufficiency, 30 aortic valve lesion, 97 double valve, and 7 triple valve lesion patients were noted. Among 304 valve replacement cases 209 mitral, 34 aortic, 5 tricuspid, 34 aortic with mitral, 20 mitral with tricuspid, and 2 triple valves were replaced. Annual increase `of open heart surgery cases and decrease of operative deaths were remarkable in recent years. In recent years Shiley** oxygenator in pump-oxygenator set up and Ionescu** bovine pericardial xenograft bioprosthesis were used for valve replacement mainly.

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Therapy for Postoperative Cardiac Arrhythmia in Patient with Mitral Valve Surgery (승모판막 수술 환자에서 발생한 부정맥의 치료)

  • 조건현
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.672-677
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    • 1992
  • This is a clinical review of the results from electric cardioversion and pharmacological therapy used in our hospital for reverting cardiac arrythmia in patients with mitral valve surgery between Jan. 1990 and Jun. 1991. Of 62 evaluated patients, 16 patients had regular sinus rhythm and the other 46 had arrhythmias [42; atrial fibrillation 1; atrial flutter 1; premature ventricular contraction] preoperatively. In 2 of patients with sinus rhythm, atrial fibrillation newly developed after surgery and was converted into sinus rhythm soon by intravenous administration of digoxin. Remaining 14 patient resumed sinus rhythm spontaneously. In patients with preoperative arrythmia, 3 patients reverted into sinus rhythm from atrial fibrillation by electric cardioversion at operative field, 1 patient by lidocain and mexiletine, 4 patients by combined use of digoxin and verapamil, 4 patients by 2 times of oral quinidine and 9 patient by long term use of oral amiodarone. Throughout this consecutive trials of anti-arrhythmic drugs and electric cardioversion, Conversion into normal sinus rhythm occurred in 48% of patients with arrhythmia developed after mitral valve surgery.

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Valve Sparing Aortic Root Replacement in Children with Loeys-Dietz Syndrome

  • Sim, Hyung-Tae;Seo, Dong Ju;Yu, Jeong Jin;Baek, Jae Suk;Goo, Hyn Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.272-276
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    • 2015
  • Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.

Clinical report of 131 cases of open heart surgery in 1985 (1985년도 연간개심술 131예 보고)

  • 김규태
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.399-406
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    • 1986
  • 131 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1985. There were 116 congenital cardiac anomaly and 15 acquired heart diseases. Out of 116 congenital cardiac anomaly, 73 cases of acyanotic group and 43 cases of cyanotic group were noted. In 73 cases of acyanotic group, 17 ASD, 52 VSD and 4 other acyanotic anomaly were noticed. In 43 cases of cyanotic group, 4 Trilogy of Fallot, 34 TOF, 1 Pentalogy, 3 DORV and 1 DCRV were included. Of the 15 acquired valvular heart disease cases, individual incidence was in mitral valve 10, double valve 3, and simple aortic valve 2 cases. Total number of valve replaced was 16, and 13 for mitral, 2 for aortic, and 1 for tricuspid in position, including 1 cases of double valve replacement. Overall operative mortality for 131 cases of open heart surgery was 4.5%, and the operative mortality was 5.5% in congenital acyanotic group, 2.3% in congenital cyanotic group, 0% in TOF group and 6.7% in acquired group.

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Biventricular Repair after Bilateral Pulmonary Artery Banding as a Rescue Procedure for a Neonate with Hypoplastic Left Heart Complex

  • Yun, Jae Kwang;Bang, Ji Hyun;Kim, Young Hwee;Goo, Hyun Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.107-111
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    • 2016
  • Hypoplastic left heart complex (HLHC) consists of less severe underdevelopment of the left ventricle without intrinsic left valvular stenosis, i.e., a subset of hypoplastic left heart syndrome (HLHS). HLHC patients may be able to undergo biventricular repair, while HLHS requires single ventricle palliation (or transplant). However, there is no consensus regarding the likelihood of favorable outcomes in neonates with HLHC selected to undergo this surgical approach. This case report describes a neonate with HLHC, co-arctation of the aorta (CoA), and patent ductus arteriosus (PDA) who was initially palliated using bilateral pulmonary artery banding due to unstable ductus-dependent circulation. A postoperative echocardiogram showed newly appearing CoA and progressively narrowing PDA, which resulted in the need for biventricular repair 21 days following the palliation surgery. The patient was discharged on postoperative day 13 without complications and is doing clinically well seven months after surgery.

Comparative Analysis of Thoracotomy and Sternotomy Approaches in Cardiac Reoperation

  • Kim, Dong-Chan;Chee, Hyun-Keun;Song, Meong-Gun;Shin, Je-Kyoun;Kim, Jun-Seok;Lee, Song-Am;Park, Jae-Bum
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.225-229
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    • 2012
  • Background: Reoperation of cardiac surgery via median sternotomy can be associated with significant complications. Thoracotomy is expected to reduce the risk of reoperation and to enhance the surgical outcomes. We retrospectively analyzed two operative approaches (thoracotomy vs. sternotomy) in cardiac reoperation. Materials and Methods: From September 2007 to December 2010, 35 patients who required reoperation of the mitral valvular disease following previous median sternotomy were included. Average age of patients was $45.8{\pm}15.4$ years (range, 14 to 76 years) and male-to-female was 23:12. Interval period between primary operation and reoperation was $135.8{\pm}105.6$ months (range, 3.3 to 384.9 months). Results: Comparative analysis was done dividing the patient group into two groups that are thoracotomy group (22 patients) and sternotomy group (13 patients). Thoracotomy group was significantly lower in operative time ($415.2{\pm}90.3$ vs. $497.5{\pm}148.0$, p<0.05), bleeding control time ($108.0{\pm}29.5$ vs. $146.4{\pm}66.8$, p<0.05) and chest tube drainage ($287.5{\pm}211.5mL$ vs. $557.3{\pm}365.5mL$, p<0.05) compared to sternotomy group. Conclusion: The thoracotomy approach is superior to sternotomy in some variables, and it is considered as a valid alternative to repeat median sternotomy in patients who underwent a previous median sternotomy.

A Cardiac Surgeon from the USA who had Worked in Korea a Half Century Ago - Dr. George Schimert - (반세기 전 한국에서 근무하였던 한 미국흉부외과 의사 - Dr. George Schimert -)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.189-201
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    • 2008
  • Dr. George Schimert, born in 1918 in Switzerland, received his medical degrees from universities in Hungary and in Germany. After immigration to the United States, he continued medical training at several hospitals. In 1956, for pursuit of cardiac surgery, he had joined the group headed by Dr. Walt Lillehei at the University of Minnesota. During this period, in 1958, he joined Seoul National University Hospital as a overall medical adviser and adviser in surgery for 15 months in partnership with the University of Minnesota Medical School. During his stay in Korea, in addition to the works in the medical administration and education, he contributed to the early establishment of thoracic surgery program. In August 6, 1959, he performed open heart surgery using cardiopulmonary bypass for an ASD patient at Seoul National University Hospital. However, the patient died 6 hours after the operation. In 1960, after returning to the United States, he began his career at Buffalo General Hospital as the first director of its cardiac surgery program. In 1985, the Dr. George Schimert Lectureship and Medical Conference was established to honor his contributions and achievements. He died December 7, 2002.

Outcomes of Coronary Artery Bypass Grafting after Extracorporeal Life Support in Patients with Cardiac Arrest or Cardiogenic Shock

  • Kim, Younghwan;Cho, Yang-Hyun;Yang, Ji-Hyuk;Sung, Kiick;Lee, Young Tak;Kim, Wook Sung;Lee, Heemoon;Cho, Su Hyun
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.70-77
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    • 2019
  • Background: Extracorporeal life support (ECLS) is used as a bridge to revascularization in high-risk patients with ischemic heart disease. We reviewed our experiences of coronary artery bypass grafting (CABG) after ECLS in patients with cardiac arrest or refractory cardiogenic shock. Methods: We retrospectively reviewed 4,616 patients who underwent CABG at our institution between May 2006 and February 2017. We identified patients who underwent CABG following ECLS for cardiogenic shock or cardiac arrest. Twenty-three patients (0.5% of all CABG cases) were enrolled in the analysis. Their median age was 65 years (Q1-Q3, 58-77 years). Nine patients (39.1%) were diagnosed with ST-elevation myocardial infarction. Mechanical complications after acute myocardial infarction, including acute mitral regurgitation, left ventricular rupture, and ventricular septal defect, occurred in 9 patients (39.1%). Results: The median time from cardiopulmonary resuscitation to ECLS initiation was 25 minutes (Q1-Q3, 18.5-28.5 minutes). Conventional CABG was performed in 10 patients (43.5%) who underwent concomitant intracardiac procedures. Postoperative ECLS was required in 16 patients (69.5%). The rate of successful ECLS weaning was 91.3% (n=21). There were 6 early mortalities (26.1%). Conclusion: CABG after ECLS was very rare in real-world circumstances. Although the early mortality rate was high, the risk of mortality may be acceptable under such devastating circumstances.