• 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].

• Journal of Chest Surgery
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• v.24 no.2
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• pp.161-170
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• 1991

Clinical results with the Mechanical cardiac valves were reviewed for 261 patients who underwent cardiac valve replacement from September, 1985 to July, 1990. of the Mechanical valves used, 156 were Carbomedics, 109 Duromedics, 52 St. Jude and 11 Bjork-Shiley. Overall hospital mortality was 14 out of 261[5,36%]: 9 out of 159[5.66%] for MVR, 1 out of 35[2.86%] for AVR and 4 out of 67[5.96%] for DVR[AVR+MVR]. Two hundred and forty seven operative survivors were followed up for a total 466.8 patient-years, ranged from 1 month to 4.9 years [a mean 1.8 years] and the follow up was 96.0%. There were 12 valve-related complications: three from thromboembolism, three from valve thrombosis, three from prosthetic valve endocarditis, two from paravalvular leak and the other one from hemorrhage. Actuarial rate free from all valve-related complication at 4.9 years was 96$\pm$1.3%. There were 11 late deaths: two from thromboembolism, one from valve thrombosis, one from prosthetic valve endocarditis, one from hemorrhage and the others 6 from non-valve-related complications. Actuarial survival rate at 4.9 years was 94$\pm$2.0%. 96$\pm$3.0% for MVR, 94$\pm$4.2% for AVR and 91$\pm$3.7% for DVR[AVR+MVR]. And there are 7 reoperations: three from paraprosthetic leak, two from prosthetic valve endocarditis and two from valve thrombosis. Actuarial rate free from reoperation at 9 years was 96$\pm$2.9%. On the basis of this 4.9 years of experience, the pyrolytic carbon mechanical valves appears to be an excellent mechanical prosthesis for cardiac valve replacement, in terms of hemodynamic performance, low mortality and low thrombogenecity.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.178-181
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• 2019

Prosthetic valve endocarditis with aortic root abscess is a serious condition requiring urgent surgical intervention. We present a case caused by an infected Bentall mechanical valve conduit after cardiac surgery in a patient who was referred for a suprasternal pulsatile mass. The patient also had 1 episode of sentinel haemorrhage.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.678-686
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• 1984

Between Jan. 1978, and Dec. 1983, a total and consecutive 117 patients have undergone cardiac valve replacement using various artificial tissue valve. Out of 117 patients, single valve surgery was 78 consisted of MVR 74, AVR 3 and AVR & supracoronary ascending aorta replacement 1. Multiple valve surgery was 39 cases consisted of MVR+TAP 20, MVR+AVR 13 and so on. Early death with 30 days after operation was 12 cases [early mortality 10.3%] and causes of death were cardiac origin 5, technical problem 4, and others 3. The 105 early survivors were followed-up for a total of 190.5 years over a period of 2 to 64 months [Mean\ulcornerD:21.9\ulcorner4.9 months]. During follow-up, 7 cases died [late mortality:6.7%]. The rate of thromboembolism was 2.1% episodes per patient-year and bleeding due to anticoagulant was 3.1% episodes per patient-year and valve failure was 1.6% episodes per patient-year. Actuarial analysis of late results indicated an expected survival rate at 5 years of 84.6% for patients with single valve surgery and 82.1% for patient with multiple valve surgery and overall was 83.8%. Symptomatically, 86.7% of patients were in NYHA class I or II at the end of follow-up.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.643-647
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• 2000

From March 1988 to June 1994, 275 CarboMedics cardiac valve prostheses(199 mitral, 70 aortic and 3 tricuspid) were implanted in 226 consecutive patients(mean age 39 years, male/female 90/136) by one surgical team operating on adult cardiac patients at Kyungpook University Hospital. Total follow up represented 16,848 patient-months(mean 76 months) and follow up rate was 96%. One hundred and forty-nine patients(66%) wer in NYHA functional class III or IV preoperatively, and 204 patients(99.5%) were in class I or II postoperatively. Early mortality was 4.9% and late death was 9.3%. The actuarial survival at 81 months was 86.l2$\pm$3.1%. The linearized incidence of valve-related death, prosthetic valve thrombosis, anticoagulation-related hemorrhage, non-structural dysfunction and reoperation were 0.71%, 0.43%, 0.07%, 0.21%, and 0.14% respectively. The 81-month rate of freedom from all valve related complications and deaths including hospital mortality was 88.1$\pm$2.5%. Thee facts suggest that the CarboMedics cardiac valve has excellent result, low incidence of valve-related complications and no structureal deterioration.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.164-168
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• 1988

Between November, 1984, and May, 1986, 93 patients underwent combined valvular and coronary artery operation. They were 70 male and 23 female, the age ranging from 29 to 82. From this population 89 patients underwent single valve replacement and 4 patients underwent double valve replacement. Patients with mitral valve disease were in the majority present in the age group between 50 till 70, where as in the group after 60 years, patients with aortic valve disease were dominant. The main indication for aortic valve replacement was aortic stenosis and the indication for mitral valve replacement was equal between mitral stenosis and mitral incompetence, the later was due to papillary dysfunction after myocardial infarction. Dyspnea was a very frequent symptom and it was found in nearly all patients. 28 patients had a previous myocardial infarction and severe left ventricular dysfunction. The grafts were placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. It is our opinion that simultaneous valve replacement and myocardial revascularization does not increase the risk of cardiac valve replacement substantially.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1324-1336
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• 2023

Purpose This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype. Materials and Methods This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium. The aortic valves were classified into fused and two-sinus types. The diagnostic accuracy of cardiac CT and TTE was calculated using a reference standard for intraoperative inspection. Results CT demonstrated significantly higher sensitivity, negative predictive value, and accuracy than TTE in detecting BAV (p < 0.001, p < 0.001, and p = 0.003, respectively). The TTE sensitivity tended to decrease as valvular calcification increased. The error rate of TTE for CT was 10.9% for the twosinus type of BAV and 28.3% for the fused type (p = 0.044). Conclusion Cardiac CT had a higher diagnostic performance in detecting BAV than TTE and may help diagnose BAV, particularly in patients with severe valvular calcification.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1122-1131
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• 1995

One hundred eighty-eight patients[August.23,1988,through July.30,1994 underwent aortic[AVR , mitral[MVR , or double [DVR valve replacement with the St.Jude Medical prosthesis. The author analyzed 100 patients with valvular heart disease,who underwent valve replacement with the St.Jude Medical prothesis from 1990 to 1994, at Hanyang University hospital Cardiovascular department. Information on volume and functional change of the heart chamber can be obtained by cardiac echocardiography and cartheterization. Out of 100 patients, 40 patients were male[40% and 60 patients were female [60% . Age ranged from 13 years to 68 years, with mean age of 42.6 years. Mean height was 160.3cm and mean body weight was 54.9Kg. According to NYHA functional classification, class III is most frequent and 60 patients could be classfied under it. MVR [involved Redo MVR was performed in 40 patients, AVR [involved Redo AVR was performed in 18 patients, and DVR [involved Redo DVR was performed in 42 patients. Warfarin [Coumadin anticoagulation was recommended for all patients. Life long warfarin anticoagulation was necessary to all patients who underwent valve replacement with St.Jude Medical prosthesis. Ideal prothrombin time was maintained about 30% during warfarinization. There were no case of mechanical failure. It followed a comparison of echocardiography before and after valve replacement at Hanyang University hospital [30 patients and a preoperative evaluation of cardiac catheterization and angiography [64 patients . The St.Jude Medical cardiac valve is a viable alternative in the surgical therapy of valvular heart disease.

• Journal of Cardiovascular Imaging
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• v.30 no.2
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• pp.140-141
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• 2022

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1117-1123
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• 1988

Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.