• Journal of Chest Surgery
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• v.33 no.9
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• pp.723-728
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• 2000

Background: Minimally invasive techniques for open heart surgery are widely accepted in these days. There are minimally invasive approaches by the right or left parasternal incision and another approaches by mini-sternotomy of upper or lower half or sternum. We report the safety and efficacy of minimally invasive technique with right parasternal incision compared with the routine full sternotomy. Material and Method: From April 1997 through February 1999, 20 patients(Group A) underwent minimally invasive cardiac operations. We chose 41 patients(Group B) whose preoperative diagnosis were the same and general conditions were similar and who underwent routine full sternotomy before April 1997. We compared A group and B group in many aspects. We performed routine full median sternotomy in B group but we did a minimally invasive technique through a small right parasternal incision in A group. Result: mean age was 36.1 years in both groups. In disease entities, there were 11 cases of ASD, 9 cases of mitral valve disease in group A, and 16 cases of ASD, 25 cases of mitral valve diseases in group B. In ASD, operation time, cardiopulmonary bypass time of aortic occulusion time were 263 min, 82 min, and 41 min in group A and 180 min, 53 min, and 32 min in group B. In mitral valve disease, operation time, cardiopulmonary bypass time and aortic occlusion time were 267min, 106 min, and 70min in A group and were 207 min, 82 min, and 69 min in group B. There were significant differences in operation time, CPB time, and ACC time between group A and group B. There was a significant difference in the amount of bleeding in postoperative day 1 between group A and group B of mitral diasease. However, there was no significant difference in the amount of bleeding in other comparisons. Mean length of incision was 8.7 cm in group A. There was no significant difference in postoperative complications between A group and B group. There was no mortality in either group. Conclusion: We conclude that this minimally invasive technique with right parasternal incision is cosmetically excellent but it is not effective in reducing operative time and there was no significant difference in recovery time and postoperative complications compared with routine full sternotomy.

• Journal of the Korean Society of Safety
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• v.31 no.6
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• pp.25-31
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• 2016

This paper has analyzed the structure, applicable regulations and the resistance characteristics of insulation ring type of CSST (Corrugated Stainless Steel Tubing for Gas). With the flammability test conducted in accordance with KS C IEC 60811-1-1, the evaluation of insulation resistance, temperature characteristics, and reliability has been conducted. An insulation ring type CSST consists of protective coating, tube, nut, insulation ring, packing, socket, and ball valve. Connecting an insulation ring type CSST to gas tubings for gas appliance is not permitted, moreover, the product shall be installed inside a sleeve pipe in case of buried installation such as the ceiling. Damages on protective coating and tube were detected when fire was applied to the test sample with a portable torch for 60 seconds. The insulation resistance of a normal product was $49.59M{\Omega}$, while that of the product completed the flammability test reduced to $9.21M{\Omega}$. The mean insulation resistance within the confidence Interval of 95% using the mini tap program 17 was $49.59M{\Omega}$ and the mean insulation resistance within the confidence interval reduced to $9.21M{\Omega}$. In the normal distribution analysis of 95% confidence interval, the value-P of the normal product was stable at 0.075 and AD(Anderson-Darling) statistic value was turned out to be 0.063, which is very normal, and the standard deviation was analyzed as 0.2586. The value P of the product completed the flammability test resulted in 0.005, the AD was 1.355 and the standard deviation reduced to 0.07908.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.568-572
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• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.