• Title/Summary/Keyword: cardiopulmonary

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Off-pump CABG for Unstable Angina Complicated With COPD (만성폐쇄성 폐질환을 동반한 불안정성 협심증환자에서 off-pump 관상동맥우회술)

  • 곽기오
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.186-189
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    • 2000
  • In an attermpt to aviod the deleterious effects of cardiopulmonary by pass such as pulmonary complication neurologic complication and renal failure off-pump CABG has been rediscovered and developed. We experienced off-pump CABG in 2 cases with unstable angina complicated with COPD and report herein the cases with review of literature.

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Postcardiotomy Ventricular Assist Device (개심술후 심실 보조장치)

  • 나찬영
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.390-393
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    • 1994
  • 의료기술의 발달로 오늘날의 개심술은 대부분 성공적으로 시행되고 있지만 극히 일부분은 아직도 개심술후 심한 심실기능의 저하로 사망하는 겨우가 있다. 1960년대 중반 Spencer와 DeBakey에 의해 개심술후 심한 심실기능이 저하된 환자에게 심실보조장치를 이용하여 성공적으로 치험한 이후로 많은 발전을 거듭해 왔다. 저자들은 4개월 (6.5Kg)된 남아에서 개심술후 심한 저심박출증으로 인공심폐기의 제거를 못하여 좌심실 보조장치(Centrifugal Biopump)를 사용하여 성공적으로 치험하였기에 보고하는 바이다.

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Aortopulmonary Window -Report of A Case- (폐동맥 대동맥 중격결손증 1례 보고)

  • 박기진
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.721-725
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    • 1995
  • One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

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Leiomyosarcoma of the Pulmonary Artery (폐동맥에 발생한 평활근육종)

  • 안병희
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.166-169
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    • 1994
  • Primary malignant tumors originating in the pulmonary artery are extremely rare. Recently, We experienced a case of primary leiomyosarcoma occurred on the main pulmonary artery and extended into the Rt and Lt pulmonary artery. The patient was 44 year-old woman and the chief complaint was severe exertional dyspnea. Emergency pulmonary arteriotomy to relieve the pulmonary artery obstruction was performed on cardiopulmonary bypass. The tumor was 6 x6 x4 cm in size and infiltrated into the main pulomary artery. The tumor in the pulmonary artery was removed without any difficulties. The patient was recovered without any specific problems. The tumor was confirmed to be leiomyosamoma histopathologically.

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Surgical Treatment of Congenital Coronary Arteriovenous Fistula -A report of three cases- (선천성 관동정맥루 -수술치험 3례-)

  • 하현철
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.700-704
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    • 1994
  • Congenital coronary arteriovenous fistula is relatively rare congenital heart disease which has formation of fistula between coronary artery and cardiac ventricle, atrium, or pulmonary artery, but that can be repaired with simple surgical procedure. We experienced three cases of congenital coronary arteriovenous fistula, which were repaired surgically under cardiopulmonary bypass, so we report these cases with review of the literatures.

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A case of rescuing a patient with acute cardiovascular instability from sudden and massive intraoperative pulmonary thromboembolism by extracorporeal membrane oxygenation

  • Kim, Won Jin;Kang, Jin Gu
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.477-482
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    • 2018
  • Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

A Study on the Actual State of Instruction for Emergency Medical Technician(EMT) in Cardiopulmonary Resuscitation(CPR) in Hospitals (병원 내에서 응급구조사의 심폐소생술에 대한 교육 실태에 관한 연구)

  • Park, Sang-Sub;Kim, Jin-Woo;kim, Gwang-Seok;Lee, Chang-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.129-138
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    • 2007
  • Purpose : This is a study on the actual state of instructing in cardiopulmonary resuscitation(CPR) in hospitals, so lays its purpose on providing basic materials for instructing in CPR by understanding the actual state of instruction in CPR for paramedics or first aide persons in hospitals. Result : 1. As a result of examining the actual state of instruction in CPR operation during the past 3 months, 89.3% of the subjects answered that they receive regular instruction. 2. As the number of CPR instruction during one year, the majority of them, 96.0% answered that they have instruction more than one time a year. 3. As answers to their desired first-aid instruction to receive by allowing duplicated responses with 4 items, instruction in CPR and respiratory obstruction for adults was 18.2% occupying the highest proportion followed by instruction in first-aide treatment for traumas with 17.7% and in how to use the AED with 16.3%. Suggestion : First, it is thought that instruction in CPR should be conducted on a continuous basis and the number of instruction should increase. Second, one should provide first-aide persons with proper instruction in CPR operation by developing time tables and protocols for instructional programs, and also make it possible that they can learn various skills by increasing the number of instruction.

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Bloodless Cardiac Surgery in a Neonate Weighing 2.8 kg (2.8 kg 신생아에서 시행한 무혈 개심술)

  • Choi, Jin-Ho;Kim, Woong-Han;Nam, Jin-Hae;Lee, Young-Ok;Min, Byoung-Ju;Lim, Hong-Gook
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.721-724
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    • 2010
  • Despite increased interest in bloodless cardiac surgery, its use has been mostly confined to adult patients. Especially, bloodless pediatric cardiovascular surgery using cardiopulmonary bypass has been avoided mainly due to hemodilution. Authors recently experienced a case of bloodless cardiac surgery in a 2.8 kg-weighing neonate whose parents were Jehovah's Witness.

Risk Factors of On-Pump Conversion during Off-Pump Coronary Artery Bypass Graft

  • Yoon, Sung Sil;Bang, Jung Hee;Jeong, Sang Seok;Jeong, Jae Hwa;Woo, Jong Soo
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.355-362
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    • 2017
  • Background: Off-pump coronary artery bypass grafting (OPCABG) procedures can avoid the complications of an on-pump bypass. However, some cases unexpectedly require conversion to cardiopulmonary bypass during OPCABG. The risk factors associated with a sudden need for cardiopulmonary bypass were analyzed. Methods: This retrospective study included 283 subjects scheduled for OPCABG from 2001 to 2010. These were divided into an OPCABG group and an on-pump conversion group. Preoperative, operative, and postoperative variables were compared between the 2 groups. Results: Of the 283 patients scheduled for OPCABG, 47 (16%) were switched to on-pump coronary artery bypass grafting (CABG). The mortality of the both the OPCABG and on-pump conversion groups was not significantly different. The major risk factors for conversion to on-pump CABG were congestive heart failure (CHF) (odds ratio [OR], 3.5; p=0.029), ejection fraction (EF) <35% (OR, 4.4; p=0.012), and preoperative beta-blocker (BB) administration (OR, 0.3; p=0.007). The use of intraoperative (p=0.007) and postoperative (p=0.021) inotropics was significantly higher in the conversion group. The amount of postoperative drainage (p<0.001) and transfusion (p<0.001) also was significantly higher in the conversion group. There were no significant differences in stroke or cardiovascular complications between the groups over the course of short-term and long-term follow-up. Conclusion: Patients who undergo OPCABG and have CHF or a lower EF (<35%) are more likely to undergo on-pump conversion, while preoperative BB administration could help prevent conversions from OPCABG to on-pump CABG.

Outcomes of Extracorporeal Membrane Oxygenation in Children: An 11-Year Single-Center Experience in Korea

  • Kim, Hongsun;Yang, Ji-Hyuk;Cho, Yang Hyun;Jun, Tae-Gook;Sung, Kiick;Han, Woosik
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.317-325
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    • 2017
  • Background: Extracorporeal membrane oxygenation (ECMO) has become an important treatment modality in pediatric patients with cardiopulmonary failure, but few studies have been conducted in Korea. Methods: We conducted a retrospective review of pediatric patients younger than 18 years who were placed on ECMO between January 2004 and December 2014 at Samsung Medical Center. Results: We identified 116 children on ECMO support. The overall rate of successful weaning was 51.7%, and the survival to discharge rate was 37.1%. There were 39, 61, and 16 patients on ECMO for respiratory, cardiac, and extracorporeal cardiopulmonary resuscitation, respectively. The weaning rate in each group was 48.7%, 55.7%, and 43.8%, respectively. The survival rate was 43.6%, 36.1%, and 25.0%, respectively. Sixteen patients on ECMO had functional single ventricle physiology; in this group, the weaning rate was 43.8% and the survival rate was 31.3%. Ten patients were on ECMO as a bridge to transplantation (8 for heart and 2 for lung). In patients with heart transplantation, the rate of survival to transplantation was 50.0%, and the overall rate of survival to discharge was 37.5%. Conclusion: An increasing trend in pediatric ECMO utilization was observed. The outcomes were favorable considering the early experiences that were included in this study and the limited supply of specialized equipment for pediatric patients.