• Journal of Chest Surgery
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• 제11권2호
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• pp.199-212
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• 1978

One hundred cases of cardiac valve replacement were done at this Department in the period from June 1968 to May 15, 1978. Seventy-one cases of mitral, 12 aortic, and one tricuspd valve were replaced. There were 16 cases of double valve replacement, 10 aortic with mitral and 6 mitral with tricuspid valve replacement. Prosthetic valves-Beall, Bjoerk-Shiley, Starr-Edwards, Wada-Cutter, Magovern-Cromie, and Smeloff-Cutter valves-were used. But in recent years bioprosthetic valves-Hancock, Carpentier-Edwards, and Angell-Shiley valves-were used mainly due to the difficulties of postoperative anticoagulation, especially for the rural Korean patients. Over all operative mortality was 2896, 26.2% for single and 37.5% for double valve replacement cases. There were 4 postoperative thrombo-embolism cases with 2 deaths. Four postoperative subacute bacterial endocardities cases with 2 deaths were noted. Three cases of postoperative congestive heart failure succumbed. Two cases of peri valvular leakage, one of which needs reopration, were found. There were 28 operative and 9 late deaths, leaving 63 long-tel m survivors, who showed marked improvements.

• Journal of Chest Surgery
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• 제48권1호
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• pp.7-12
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• 2015

Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients with Marfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy for these patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgery for mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47 months (range, 3 to 140 months) and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years). Mitral valve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanical prosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two months after repair. The four patients who underwent mitral valve replacement did not experience any complications related to the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfan syndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasible treatment option for these patients.

• Journal of Chest Surgery
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• 제11권2호
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• pp.213-226
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• 1978

One hundred cases of open heart surgery were done at this Department in 1977. There were 65 congenital anomaly and 35 acquired diseases. Out of 65 cases of congenital malformation 35 acyanotic and 30 cyanotic cases were found. Fifteen cases of ventricular septal defect and 29 tetralogy of Fallot were noted eight patients expired out of 65 congenital anomaly [12.3%] , 4 out of 35 acyanotic [11. 4%] and 4 among 30 cyanotic anomaly[13.3%]. Among 35 cases of acquired heart disease 3 atrial myxoma [2 left and one right] and 32 valvular lesions were noted. In two cases open mitral commissurotomy, and in 30 valve replacement were done. Twenty-two single valve and 8 double valve replacement were done. Seven patients expired out of 30 patients [23.3%]. Among 22 single valve replacement cases 2 and among 8 double valve 5 died. ~ In eighteen mitral valve replacement cases 2 deaths occurred. One mitral insufficiency patient who expired suffered from severe pulmonary` hypertension [PA=120/67mmHg], tricuspid insufficiency and a large ventricular septal defect. The patient underwent mitral valve replacement, tricuspid annuloplasty and patch closure of ventricular septal defect. Over all mortality rate for 100 open heart surgery cases was 15%. Since 1977 open heart surgery cases were done routinely in this institution and cases are increasing rapidly. With present rapid improvement of economical status and introduction of medical insurance system, open heart surgery will be firmly established in Korea in the very near future.

• 대한영상의학회지
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• 제81권2호
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• pp.290-301
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• 2020

최근 들어 승모판(mitral valve) 질환에 대해 승모판 성형술(mitral valvuloplasty) 또는 중재 시술을 통하여 인공판막을 넣어주는 시술(transcatheter mitral valve replacement)이 발전하고 있다. 이러한 치료 계획을 위해서는 승모판의 해부학적인 정보를 수술자 혹은 시술자의 관점에서 조금 더 자세하게 알려줄 필요가 있다. 본 리뷰에서는 승모판의 보존 수술 및 중재적 시술의 치료 전 계획을 위한 승모판의 해부학 및 CT를 이용한 승모판막 주변의 평가 방법에 대해 다루고자 한다.

• 대한한의학회지
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• 제43권3호
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• pp.164-180
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• 2022

Objectives: The purpose of this study was to evaluate the effects of shenfu injection on myocardial protective effects after mitral valve replacement surgery. Methods: We searched four international databases (PUBMED, Embase, Web of Science and CNKI) and three domestic electronic databases (OASIS, RISS and NDSL) for relevant studies. We used following keywords 'shenfu', 'valve replacement', 'mitral valve' at PUBMED, Embase and Web of Science; '二尖瓣', '参附注射液', '瓣膜' at CNKI and '이첨판', '판막', '삼부' at domestic databases. The search range included randomized controlled trials. When appropriate, meta-analyses were performed. Results: Seven randomized controlled trials were selected. All studies used Shenfu injection after mitral valve replacement surgery. We analyzed myocardial damage, cardiac function, patients' recovery rate, with various evaluation indicators. We also used meta-analysis for CK-MB, cTnI, MDA and voluntary recovery of heartbeat. CK-MB was analyzed in two subgroups: 8 hours and 24 hours after surgery. Std was -2.34(95% CI -4.10, -0.58) for 8 hours and -1.95(95% CI -4.79 to 0.88) for 24 hours. 8 hours showed statistically significant difference. cTnI appeared significant decrease with Std of -2.13(95% CI -2.60, -1.66). MDA showed significant decrease with Std of -0.95(95% CI -1.43 to -0.47). Voluntary recovery of heartbeat significantly increased with the odd ratio of 4.34(95% CI 1.76, 10.70). Conclusions: We suggest that Shenfu injection after Mitral valve replacement surgery may have significant myocardial protective effects in terms of reducing myocardial damages, reactive oxygen species, increasing cardiac function and patients' recovery after surgery. However, the evidence is limited, further research is required.

• Journal of Chest Surgery
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• 제30권4호
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• pp.423-427
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• 1997

객혈은 승모판막협착증의 영향으로 흔히 발생되지만,많은 양으로 지속적이며 치명$\boxUl$101 곤출친으 확 실히 드물다. 한양대 학교 흉부외과학교실에서는 지속적인 대량 폐출혈로 응급이중판막 재치환술 시행받은 30대 여자의 예를 보고하고자 한다. 환자는 1984년 류마치스성 승모판막 폐쇄부전증으로 판막치환술을(lonescu Shilcy 27mm) 받았으며, 그후 2년후에 삼첨판윤 성형술(Carpcntier's ring 30mm)을 받았다. 1995년 12월 26일 환자는 대량 객혈과 심한 호흡곤란으로 입원하였다. 객혈에 대한 동맥색전술을 포함한 내과적 치료를 시행 받았지만 효과는 없었다. 환자는 응급 이중판막 재치환술(승모판 : St. Jude 29mm, 삼첨판; St. Jude 33mm)을 시 행 받았으며. 술후 24시간이 경과된 후 객혈은 극적으로 조절되었다.

• Journal of Chest Surgery
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• 제48권2호
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• pp.126-128
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• 2015

A 75-year-old woman who had previously undergone a double valve replacement was admitted to Asan Medical Center because of severe bioprosthetic mitral valve dysfunction and tricuspid regurgitation. Under hypothermic fibrillatory arrest without aortic cross-clamping, minimally invasive mitral and tricuspid valve surgery was performed via a right minithoracotomy.

• Journal of Chest Surgery
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• 제27권10호
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• pp.838-845
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• 1994

From April, 1982 to December, 1992, multiple valve replacement was performed in 100 patients. Mitral and aortic valve replacement were done in 86 patients, 9 underwent mitral and tricuspid valve replacement, 4 patients underwent triple valve replacement and 1 patient underwent aortic and tricuspid valve replacement. Of the valve implanted, 100 were St. Jude, 64 Duromedics, 19 Carpentier-Edwards, 13 Bj rk-Shiley, 6 Ionescu-Shiley, and 2 Medronics.The hospital mortality rate was 15%[15 patients] and the late mortality rate was 7%[7 patients], the mortality rate was high in early operative period but decreased with time[20% at 1986, 18.2% at 1987, 9.5% at 1988, 11.1% at 1989, 12.5% at 1990, 11.8% at 1991, 0% at 1992]. The causes of death were low cardiac output in 8, sudden death in 3, CHF in 3, bleeding in 2, cerebral thromboembolism in 1, leukemia in 1, multiorgan failure in 1 and so on. The actuarial survival rate excluding operative death was 73% at 10 years.

• Journal of Chest Surgery
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• 제27권6호
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• pp.444-450
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• 1994

From June 1984 to February 1994, cardiac valve replacement was performed in 108 patients. The distribution of patients was ranged from 13 to 64 year-old age[mean 39.48 1.24] and 51 patients were male, 57 patients were female [male:female=1:1.1]. 64 patients had mitral valve replacement, 27 patients underwent aortic valve replacement and 17 patients were performed double[mitral & aortic] valve replacement. Total 125 artificial cardiac valves were used, mechanical valves were 51 valves and tissue valves were 74 valves. The duration of follow-up was 473.41 patient-year[mean 4.79 3.29 patient-year] and the information of follow-up was available for 99 patients[92%]. The actuarial survival rates including the operative mortality was 89.5% & 88.3 at postoperative fourth & ninth year. The probability of freedom from overall valve failure, thromboembolism and bacterial endocarditis were 77.5%, 89.2% and 95.6% at ninth year after cardiac valve replacement.

• Journal of Chest Surgery
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• 제54권5호
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• pp.419-421
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• 2021

Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.