• Journal of Chest Surgery
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• v.29 no.1
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• pp.95-98
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• 1996

We report a case of primary cardiac fibroma which is a rare cardiac neoplasm and arising most frequently from right ventricular free wall and interventricular septum. A 2-month-old male infant with cyanosis was admitted for evaluation and treatment. Echocar-diographic lEnding was a cardiac mass. Successful nearly total removal of the tumor was performed. The pathologic result was compatible with fibroma. The postoperative course was not eventful, and have been in good condition upto now.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1261-1263
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• 1992

Primary cardiac fibroma of the left ventricular myocardium is a rare tumor of the heart which is usually located within the anterior wall and /or septum of the left ventricle and is the second most common cardiac tumor in infant and children. Although the tumor is benign histologically, it may cause severe cardiac dysfunction and sudden death. A 30-day-old neonate with a huge intramural fibroma involving the posterolateral wall of the left ventricle underwent it`s partial resection under extracorporeal circulation on April 1992.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.168-170
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• 2011

Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.760-765
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• 1989

Cardiac injury remains one of the most spectacular injuries which the present day cardiac surgeon is called upon to treat. Eight consecutive patients with penetrating or blunt injury to the heart underwent operation at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from April 22 88 to April 6 89. l. Among the 8 cases of cardiac injured patients, 7 cases were penetrating injury [stab injury] and one case was blunt injury [traffic accident]. 2. The site of cardiac injury was LV mainly and the next RV, SVC-RA junction in order. 3. The all patients were admitted to our hospital via ER and most of cases, CVP was elevated above 15 cmH2O and 7 of 8 cases were shock state. 4. In 6 of 8 cases revealed cardiomegaly in simple chest X * ray. 5. 7 cases were operated through the median sternotomy, 1 case the right anterolateral thoracotomy. 6. Associated injuries in penetrating cardiac injury were hemothorax, pneumothorax, sternal fracture, lung laceration, LAD transaction in blunt injury, hemoperitoneum.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.92-95
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• 2009

Sarcoidosis is a systemic inflammatory disease with granulomatous lesions, and cardiac involvement occurs in 20~60% of patients. Isolated cardiac sarcoidosis is extremely rare, and heart transplantation can be performed, if indicated, contingent upon the absence of systemic manifestations of the disease. We present a case of isolated cardiac sarcoidosis with progressive heart failure, which was successfully managed by heart transplantation.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.206-212
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• 2023

Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

• Journal of Chest Surgery
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• v.56 no.5
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• pp.346-352
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• 2023

Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08-0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.205-212
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• 2024

Background: Postoperative atrial fibrillation (A-fib) is a serious complication of cardiac surgery that is associated with increased mortality and morbidity. Traditional 24-hour Holter monitors have limitations, which have prompted the development of innovative wearable electrocardiogram (ECG) monitoring devices. This study assessed a patch-type wearable ECG device (MobiCARE-MC100) for monitoring A-fib in patients undergoing cardiac surgery and compared it with 24-hour Holter ECG monitoring. Methods: This was a single-center, prospective, investigator-initiated cohort study that included 39 patients who underwent cardiac surgery between July 2021 and June 2022. Patients underwent simultaneous monitoring with both conventional Holter and patchtype ECG devices for 24 hours. The Holter device was then removed, and patch-type monitoring continued for an additional 48 hours, to determine whether extended monitoring provided benefits in the detection of A-fib. Results: This 72-hour ECG monitoring study included 39 patients, with an average age of 62.2 years, comprising 29 men (74.4%) and 10 women (25.6%). In the initial 24 hours, both monitoring techniques identified the same number of paroxysmal A-fib in 7 out of 39 patients. After 24 hours of monitoring, during the additional 48-hour assessment using the patch-type ECG device, an increase in A-fib burden (9%→38%) was observed in 1 patient. Most patients reported no significant discomfort while using the MobiCARE device. Conclusion: In patients who underwent cardiac surgery, the mobiCARE device demonstrated diagnostic accuracy comparable to that of the conventional Holter monitoring system.

• Journal of Chest Surgery
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• v.52 no.2
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• pp.112-115
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• 2019

We describe aortic arch endarterectomy performed concomitantly with on-pump cardiac surgery in 2 patients with grade V arch atherosclerosis. In both patients, transesophageal echocardiographic findings led to the diagnosis of severe arch atherosclerosis associated with a mobile atheromatous plaque in the aortic arch. The severe arch atherosclerosis was managed with endarterectomy under deep hypothermic circulatory arrest. In patients with severe grade V atherosclerosis in the aortic arch, performing endarterectomy simultaneously with primary cardiac surgery may be justified as a way to reduce the risk of peripheral embolism, including cerebrovascular accidents, with minimal additional surgical risk.

• The Journal of the Korean life insurance medical association
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• v.32 no.2
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• pp.28-32
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• 2013

We studied trends of cardiac valve surgery using insurance data. 368 persons were included our study. We studied whether there are frauds or not. Only 4 cases were done at less than 1year from an insurance contract. We reviewed medical records of all persons. We could find the type of valve disease in 211 cases. The findings are atrial valve 40.1%, mitral valve 34.6% and others 25.3%. When we divided by materials of surgery, mechanical valves were used in 68.8% of men and 70.6% of woman. The main causes of valve disease were infection(55.1%). And degenerative valve disease 32% and congenital valve disease were 13%. We cannot find definite evidence of insurance frauds in the cardiac valve surgery. But there are some limitation in data analysis.