• Title/Summary/Keyword: cardiac surgery

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Clinical Experience of Open Heart Surgery - Review of 134 Cases - (개심술 134례의 임상적 고찰)

  • Lee, Jong-Tae;Yu, Byeong-Ha;Park, Do-Ung
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.641-648
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    • 1988
  • Between April 9, 1986 and September 2, 1987, 134 patients underwent open heart surgery with hypothermic cardiopulmonary bypass and cold blood cardioplegia. There were 65 patients[48.5%] of acyanotic congenital cardiac anomalies, 19 patients[14.2%] of cyanotic congenital cardiac anomalies, and 50 patients[37.3%] of acquired heart diseases, which included 49 valvular diseases and 1 myxoma. In 84 congenital cardiac anomalies, 44 patients were male and 40 patients were female ranged in age from 2 years to 57 years. In 50 acquired heart diseases, 18 patients were male and 32 patients were female ranged in age from 10 years to 65 years. The common congenital defects operated were VSD in acyanotic cardiac patients, and Tetralogy of Fallot in cyanotic cardiac patients. Among 50 acquired heart diseases, 49 patient underwent operation for cardiac valvular lesions. 33 patients had mitral valve replacement and 7 patients had aortic valve replacement. 1 patient underwent aortic valvuloplasty and 8 patients had double valve replacement. The operative mortality rate was 3.1%[2 out of 65 patients] in acyanotic cardiac patients, 5.3%[1 out of 17 patients] in cyanotic cardiac patients, and 12.0%[6 out of 50 patients] in acquired cardiac patients, with overall mortality rate of 6.7%[9 out of 134 patients].

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A Postoperative Thrombotic Thrombocytopenic Purpura in a Cardiac Surgery Patient: A Case Report

  • Choi, Eun Jin;Lee, Sub
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.220-222
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    • 2013
  • Although thrombotic thrombocytopenic purpura (TTP) is a rare disease, when it develops in a post-cardiac surgery patient, it may have a fatal outcome. Since the frequency of early-onset thrombocytopenia in post-cardiac surgery patients is high, platelet concentrates are commonly transfused during postoperative management. However, when TTP is the likely diagnosis, platelet transfusion is not recommended. We experienced a postoperative TTP in a cardiac surgery patient and discovered the importance of identifying the etiology of postoperative thrombocytopenia. Here, we report the case with a brief review of the literature.

Successful Surgical Treatment of Cardiac Complication of Graves Disease

  • Min, Jooncheol;Kim, Woong-Han;Jang, Woo Sung;Choi, Eun Seok;Cho, Sungkyu;Choi, Kwang Ho
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.294-297
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    • 2014
  • Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.

COR-KNOT-Induced Leaflet Perforation: How It Happens and How to Prevent It: A Case Report

  • Michael Salna;Jack Shanewise;Alex D'Angelo;Isaac George
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.96-98
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    • 2024
  • The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

Cardiac Myxoma (심장 점액종)

  • Youm, Wook;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.98-106
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    • 1982
  • Cardiac Myxoma is a most frequent benign tumor in primary cardiac tumors. About 75% occur in the left atrium & 20% in the right atrium, ventricular Myxoma is a very rare one among the cardiac myxoma. They may cause severe and progressive disease resembling valvular heart disease. With the advent of various diagnostic modalities, especially real time bidimensional echocardiography enabled us more accurate diagnosis of cardiac myxoma noninvasively and preoperatively. From April 1977 to Sept. 1981, 16 cases of cardiac myxomas were operated in Seoul National University Hospital using cardiopulmonary bypass. There were 13 cases of left atrial myxomas and each of a case was right atrial and right ventricular and left ventricular one. In all cases tumors were resected successfully & were discharged in healthy state. Follow up results of each patient was excellent.

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Cardiac Resuscitation in the Uperating Room (술중 심정지에 대한 심소생 치료)

  • Kim, Kong Soo
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.55-62
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    • 1976
  • This is a report of 8 cases cardiac arrest developed in the operating room at Jeonbug university Hospital from January 1973 to October, 1975. Four patients of cardiac arrest developed during the elective operation, 3 during the emergency operation and the remaining one, bronchoscopy for foreign body removal under the general anesthesia. Immediate closed chest cardiac massage was performed in the 7 patients and the remaining one underwent open chest cardiac massage. Five of 7 patients with the closed chest cardiac massage regained consciousness and restored respiration, but 3 patients of these survived to be discharged. Two patients who underwent pneumonectomy for multiple lung abscess and open drainage for liver abscess, were resuscitated but did survived. The Latter died from bleeding due to rupture of the liver that developed during the closed chest cardiac massage. One patient who had open chest cardiac massage survived to be discharged without any sequele. Unsuccessful resuscitation was observed in two patients, one had a complication of malignant hyperthermia with muscle rigidity during gastrectomy for ulcer perforation and another had not firm support on the back during massage.

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Left atrial myxoma -Two cases report- (좌심방 점액종 -2예 보고-)

  • 한병선
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.429-432
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    • 1986
  • Cardiac myxoma is most significant benign tumors constituting nearly 50% of all primary cardiac tumors. Its diagnosis is important because prognosis is excellent by surgical therapy and is usually fatal if unrecognized and untreated. Recently the development of diagnostic procedure and cardiac surgery increased the accuracy of diagnosis and the opportunity of successful treatment. Two cases of left atrial myxoma removed successfully were presented.

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Cardiac Surgery Via Lower Partial Sternotomy Lower Partial Sternotomy (부분 하흉골절개술을 이용한 심장수술)

  • 권혁면;정태은;이정철;한승세;이동협
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.729-733
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    • 2000
  • Background: Recent trends suggest that minimally invasive cardiac surgery reduces postoperative morbidity and offers a cosmetic benefit. This study was performed to evaluate the CPB time, ACC time, OP time, ICU stay and postoperative hospital stay following a lower partial sternotomy and those of the median sternotomy. Material and Method: A group of 26 adult patients who underwent cardiac surgery through lower partial sternotomy from August 1997 to July 1999(A group) were compared to 45 adult patients who underwent cardiac surgery through median sternotomy from January 1996 to July 1997(B group). The mean ages(46.4$\pm$14.6 years, A group and 46.8$\pm$13.2 years, B group) were similar. Operations were performed with central cannula and antegrade/retrograde blood cardioplegia. Result: There was no death in each group. No differences were found in CPB time, ACC time, OP time, ICU stay and postoperative hospital stay. Postoperative complications were sternal splitting in a patient in group A and a patient with bleeding that required reoperation and a patient with delayed wound closure in group B. Conclusion: The lower partial sternotomy offered a cosmetic benefit, but does not significantly reduced the length of operative time and hospital stay. Minimally invasive cardiac surgery will be applied increasing because of the suggested advantage and choosing a proper operative technique will be helpful.

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Cardiac Resynchronization Therapy Defibrillator Treatment in a Child with Heart Failure and Ventricular Arrhythmia

  • Kim, Hak Ju;Cho, Sungkyu;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.292-294
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    • 2016
  • Cardiac resynchronization therapy (CRT) is a new treatment for refractory heart failure. However, most patients with heart failure treated with CRT are adults, middle-aged or older with idiopathic or ischemic dilated cardiomyopathy. We treated a 12-year-old boy, who was transferred after cardiac arrest, with dilated cardiomyopathy, left bundle-branch block, and ventricular tachycardia. We performed cardiac resynchronization therapy with a defibrillator (CRT-D). After CRT-D, left ventricular ejection fraction improved from 22% to 4 4% assessed by echocardiogram 1 year postoperatively. On electrocardiogram, QRS duration was shortened from 206 to 144 ms. The patient's clinical symptoms also improved. For pediatric patients with refractory heart failure and ventricular arrhythmia, CRT-D could be indicated as an effective therapeutic option.

Effects of changing position on cardiac output & on patient's discomforts after cardiac surgery (개심술을 받은 환자의 체위에 따른 심박출량 및 불편감에 관한 연구)

  • Yu Mi;Kwon Eun-Ok;Choi Yun-Kyoung;Kang Hyun-Ju;Oh Se-Eun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.256-270
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    • 2000
  • Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows : 1) Changes in cardiac output were absent in different angle positions, 0, 30. 45 degrees(F=.070, P=.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(P>.05). 2) Changes in central venous pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(P>.05), diastolic PAP(P>.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(P>.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.

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