• Title/Summary/Keyword: dyspnea on exertion

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Surgical Treatment of Mitral Valvular Disease (승모판막질환의 외과적 요법)

  • 홍종완
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.270-275
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    • 1988
  • The results of the clinical observations on the 76 cases of the mitral valvular heart disease treated in the Department of Thoracic and Cardiovascular Surgery, Chung-nam National University Hospital during the period of 3 years from June, 1983 to July, 1986, are as follows: l. Of 76 cases, 43 were male and 33 were female with sex ratio of 1.3:1. 2. The age of the patient varied widely from 12 years of the youngest to 60 years of the oldest. 3. The main clinical symptoms on admission were dyspnea on exertion[100%], palpitation[42%], generalized weakness[29%], indigestion[18%], hemoptysis[16%]. 4. The preoperative functional levels according to NYHA classification were class II, III, IV in 9%, 63%, 28% respectively. 5. All 76 patients were operated on under direct vision using extracorporeal circulation, open mitral commissurotomy was done in 15 cases, mitral valve replacement in 37 cases, mitral valve replacement and aortic valve replacement in 11 cases, mitral valve replacement and tricuspid annuloplasty in 8 cases. 6. The operative mortality was 11.8% and results of the operation were good and excellent in 65 cases of survivors.

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Correction of Funnel Chest: A Report of 4 Cases (누두흉의 수술교정)

  • 노준량
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.153-162
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    • 1974
  • Four patients with funnel chest deformity corrected in the Department of Thoracic Surgery, Seoul National University Hospital are presented. The first case was a 21-year old female with cyanosis, clubbed fingers and systolic murmur on the left infrascapular region on physical examination associated with agenesis of the right lung. The deformity was of asymmetrical funnel chest, in which the left hemithorax was more sunken. She was corrected by the method of Funnel Costoplasty of Wada. The second case was a three years old boy whose anterior chest wall was symmetrically deformed, and he was corrected by the method of Ravitch using Adkins strut under the sternum. The third was a 22-year old man with symmetrical deformity, and was corrected by the method described by Shannon in 1973. The last patient was a 22-year old man and he had dyspnea on exertion, palpitation and apical systolic murmur with symmetrical funnel chest deformity. He was also corrected by Ravitch operation, All of them has excellent result.

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Coronary Artery Fistula Associated with Atrial Septal Defect - Report of a Case - (심방중격결손증을 동반한 관상동맥루 치험 1례)

  • 표현인
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.758-763
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    • 1990
  • A congenital fistulous communication between the coronary artery and the cardiac chamber or the pulmonary artery is a rare condition, but increasing cases with this anomaly are being recognized with wide spread use of cardiac catheterization and coronary arteriography. Recently we experienced one case of right coronary artery fistula which was associated with atrial septal defect. The patient was a 24 year old female who was admitted because of cardiac murmur, palpitation and dyspnea on exertion after pregnancy. Cardiac catheterization and selective coronary arteriography revealed that a fistulous communication, forming a large aneurysm, was noted from the right coronary artery emptied into the right ventricle. On the operation field, the right coronary artery was curved and markedly dilated from the aorta to the middle segment at acute margin of the right ventricle. The egg-sized aneurysm of dilated right coronary artery was noticed on right ventricle. The aneurysm was incised longitudinally and both the proximal opening and the termination site of the fistula were closed directly with aneurysmectomy. The right atrium was also opened to evaluate the fistulous termination site and repaired only small interatrial septal defect. Postoperative course was uneventful and she was discharged without problems

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Rastelli Operation In Congenitally Corrected Transposition Of Great Arteries (I.D.D.) -A Case Report- (Rastelli 씨 수술을 이용한 선천성 교정형 대동맥 전치증 (I.D.D.) ; 1예 보고)

  • 조범구
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.215-224
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    • 1979
  • Corrected transposition of great arteries associated with dextrocardia [I.D.D.] is a very rare congenital cardiac malformation in which the atria and ventricles are in discordant relation, as are the ventricles and great arteries, but the aorta is to the right of the pulmonary artery. A 13 year old male patient who complained cyanosis and dyspnea on exertion for 8 years, was diagnosed as congenitally corrected transposition of great arteries associated with dextrocardia [I.D.D.], large ventricular septal defect, patent foramen ovale and pulmonary stenosis. He was operated on Nov. 22 1978. The ventricular septal defect was closed with Teflon felt and the pulmonary hypoplasia was corrected with Rastelli operation successfully. On 34th postoperative days, complete heart block was occurred and permanent epicardial pacemaker was implanted with good result.

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Ebstein`s Anomaly A Case Report of Plication and Tricuspid Annuloplasty (Ebstein 심기형 수술치험 1례 보고)

  • 이종수
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.391-397
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    • 1985
  • Ebstein`s anomaly is a rare congenital cardiac malformation and characterized by downward displacement of an abnormal tricuspid valve cusps. But until now, the ideal surgical correction is still controversial. We present a case of Ebstein`s anomaly experienced lately. The patient was 13 year old girl with the complaints of dyspnea on exertion, fatigability and cyanosis. Echocardiography revealed downward displacement of septal leaflet of tricuspid valve and atrialized right ventricle. Cardiac catheterization and cineangiography revealed ASD and large right atrium. During operation, the atrialized right ventricle was plicated and tricuspid annuloplasty was done. And the two secundum type ASD`s were closed by direct suture closure. The patient`s postoperative course was uneventful and discharged on the 24th postoperative days.

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A Case Report of Lipomatosis in the Pleura (흉막에 발생한 다발성 지방종의 치험 1례)

  • Kim, Jun-U;Kim, Su-Cheol;Jo, Gyu-Seok
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.885-887
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    • 1994
  • Lipomatosis is a condition containing multiple lipomatous masses.Lipoma is a benign neoplasm composed of adult adipose tissue, and occur most often in the fifth or sixth decade and rarely in the pleura. Pleural lipomas are usually asymptomatic and revealed as an incidental roentgenographic findings. The patient was 59 year-old male and admitted because of dyspnea-on-exertion for 30 years. Chest CT revealed right pleural mass abutting on the chest wall, measuring minus 80 hounsfield units. The mass was resected with calcified pleural plaque and confirmed to be lipomatosis with collagenous fibrosis arising from viserai pleura.

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Surgical treatment of primary heart tumor -Report of 22 cases- (원발성 심장 종양의 수술적 치료)

  • 강면식
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.116-122
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    • 1989
  • During 22-year period ending in June 1988, operation was performed on 22 patients with primary heart tumor at Yonsei University College of Medicine. Mean age was 38.8*3.03[mean \ulcornerEM] ranging from 14 to 63 years old. Twenty cases were myxomas. Others were fibromyxoma and rhabdomyosarcoma. All patients complained of dyspnea on exertion. Nine cases had palpitation. Other constitutional symptoms were weight loss [7 cases], headache [4 cases], generalized edema [3 cases] and cough [3 cases]. Five cases had neurological symptoms and signs preoperatively. Preoperative NYHA Class was poor [Class II; 8 cases, III; 9 cases and IV; 5 cases]. The most common site of tumor origin was fossa ovalis limbus [16 cases; 72.8%]. Because of severe mitral regurgitation and of recurrent myxoma, 2 cases were reoperated for mitral valve replacement. Postoperative complications were postoperative mitral regurgitation [5 cases; 22.8%] and arrhythmia [4 cases; 18.2%], one of which was supra-His bundle block. All patient survived operation. Follow-up of 15 patients [mean 28.95*8.3 months] was good as functional class 1[8 cases] or II [7 cases]. More effective adjuvant therapy will be necessary to improve long-term prognosis for malignant primary heart tumor.

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Myocardial Hamartoma Involving the Interventricular Septum (심실중격을 침범한 심근이형종)

  • 이정렬;황호영;배은정;김종재
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.277-279
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    • 2003
  • A 15 year-old boy was referred to us because of mild dyspnea on exertion and incidentally found heart murmur. On echocardiography, a mass involving mainly interventricular septum and causing left ventricular outflow tract obstruction was detected. Cardiac catheterization demonstrated a transaortic pressure gradient of 20 mmHg. Partial excision of the septal mass was performed via aortotomy under cardiopulmonary bypass. The pathologic diagnosis revealed myocardial hamartoma. The lesion was mainly composed of mature, severely hypertrophic myocytes and intervening fibrosis. During the 5 year of follow-up after the surgery, no evidence of arrhythmia or tumor recurrence was documented.

Chronic Traumatic Femoral Arteriovenous Fistula after Gunshot Vascular Injury - A case report - (총상 후 발생한 만성 외상성 대퇴동정맥루의 치험 -1예 보고 -)

  • Kim, Sang-Ik;Kim, Byung-Hun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.120-123
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    • 2008
  • A 60-year-old man with a history of gunshot vascular injury on the right inguinal area, and this happened in the military service 40 years ago, was admitted to our hospital with claudication and dyspnea on exertion. The patient was diagnosed with a chronic traumatic femoral arteriovenous fistula. The patient underwent a successful operation for arteriovenous fistula closure with bovine pericardium and for femoropopliteal bypass with using a right greater saphenous vein graft. The patient is well at 14 months after the operation.

Coronary Arteriovenous Fistula (관상동정맥루 -수술치험 1례-)

  • 라찬영
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.829-833
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    • 1989
  • Congenital coronary arteriovenous fistula is relatively uncommon, but with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Recently we experienced one case of congenital coronary artery fistula which originated from the right coronary artery. The case was 25 year-old-male, who complained of dyspnea on exertion and continuous murmur was heard, and diagnosed as right coronary artery fistula by the cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated from aorta to the middle segment at acute margin of the right ventricle, which the hen-egg sized aneurysm was noticed. The dilated coronary ostium and fistular site were obliterated with several horizontal mattress sutures. And the dilated tortuous right coronary artery with aneurysm was excised. Postoperative course was uneventful and discharged without problem.

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