• Journal of Chest Surgery
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• 제21권5호
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• pp.948-953
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• 1988

A technique applicated for physiologic correction of complex congenital cardiac disease suitable for Fontan procedure in which drainage of left superior vena cava and hepatocardiac vein to left atrium combined is described. We made one systemic venous baffle from left hepatocardiac vein to left superior vena cava and another systemic venous baffle from right inferior vena cava to the right superior vena cava with rigid prosthetic material[0.5mm thickness PTFE patch]. And then we anastomosed directly between the right sided atrial appendage and right pulmonary artery, and left-sided atrial wall beneath the appendage and left pulmonary artery. We believe that this procedure is superior to the method using intraatrial tube graft to divert the left hepatocardiac venous blood to right atrium, and applicable for physiologic correction of any complex congenital cardiac disease suitable for Fontan-type procedure in which anomalies of systemic venous drainage combined.

• Journal of Chest Surgery
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• 제18권1호
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• pp.7-12
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• 1985

The frequency of intraventricular conduction disturbance [IVCD] following right ventriculotomy and right atriotomy approach for ventricular septal defect [VSD] closure was compared in various conditions. Of the 170 isolated VSD patients, 114 patients were repaired via right ventriculotomy and 56 patients were repaired via right atriotomy. The results were as follows; 1. The frequency of IVCD was 45.6% in right ventriculotomy, and 21.2% in right atriotomy group [P<0.01]. The frequency of IVCD following transverse ventriculotomy and vertical ventriculotomy was not significantly different. 2. The frequency of IVCD in subarterial VSD following right ventriculotomy and right atriotomy was not significantly different. But the frequency of IVCD in perimembranous VSD was 50.8% in right ventriculotomy and 27.5% in right atriotomy group [P<0.01]. 3. The frequency of IVCD was higher in groups with larger VSD and it was more significant in right ventriculotomy group. 4. The frequency of IVCD was higher in patch graft closure and it was more significant in right ventriculotomy group. 5. Overall frequency of IVCD was lower in right atriotomy than right ventriculotomy group.

• Journal of Chest Surgery
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• 제17권3호
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• pp.448-455
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• 1984

Coarctation of the Aorta is a congenital constriction of aorta of varying degree, usually located at or near the aortic ismuth with frequent associations of other cardiac anomalies. Various modes of surgical corrections, such as resection and end-to-end anastomosis, graft interposition, angioplasty using prosthetic patch or subclavian flap have been used according to the status of coarctation and age of the patient. We have experienced two cases of surgically treated coarctation of the aorta, one of which was preductal coarctation with hypoplastic aortic arch and ventricular septal defect in a 4 year old boy, and the other case was juxtaductal type with aortic regurgitation. Subclavian flap angioplasty with additional pulmonary artery banding procedure was done in the first case and wedge resection with end-to-end anastomosis and aortic valve replacement [St. Jude valve, 23mm] 20 days later of first operation in the other case. The first case developed massive tarry stool on 3rd POD, probably due to mesenteric arteritis with resultant bowl ecrosis, and expired the next day. Recovery was uneventful with the second case.

• Journal of Chest Surgery
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• 제17권3호
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• pp.488-491
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• 1984

Vascular injuries from gun shot wound is rare in these days, in Korea. A Case of false aneurysm of the right common carotid artery due to penetrating injury to the neck by carbine. The confirmatory diagnosis was made by right carotid angiogram which revealed bean-sized aneurysmal sac at the mid-portion of the right common carotid artery. Despite of no symptoms, emergency false aneurysmectomy and reconstruction with on-lay vein patch graft using left greater saphenous vein for threat of rupture and embolization from mural thrombi. During repair of common carotid artery, cerebral circulation was maintained with internal shunt. The postoperative course was uneventful except limit of motion of right upper extremity due to initial injury.

• Journal of Chest Surgery
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• 제23권5호
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• pp.968-975
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• 1990

An aortobronchial fistula is a rare complication of aneurysm of the aorta. The fistula starting from a chronic traumatic aortic aneurysm is exceptionally rare. Our observation concerns a patient of 26 with previous chest trauma who had atelectasis of left lung following dyspnea and hemoptysis. Aortography and surgical intervention revealed that this was a chronic traumatic aortic aneurysm of descending thoracic aorta, which developed a fistula in the bronchus. She underwent left posterolateral thoracotomy and the surgical repair of the aneurysm was performed with a woven Dacron patch graft using a temporary external bypass between the ascending and the descending aorta. The fistula in the bronchus was closed with simple interrupted sutures. In the immediate postoperative period, double vision, headache, and hoarseness developed but returned normal.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1263-1269
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• 1990

Two patients with uncorrectable cyanotic cardiac anomalies underwent total cavopulmonary shunt[modified Fontan operation]. Case I was a 14 years old male with dyspnea and cyanosis after birth. Aortogram showed TGA combined with overriding of aorta, pulmonary stenosis, complete atrioventricular septal defect, interruption of inferior vena cava, and situs inversus totalis. We had performed total cavopulmonary shunt using with 16 mm Gortex Graft in single atrium to bypass the hepatic vein to pulmonary artery. Postoperatively, patient sustained low PaCO2 and low cardiac output and then expired at 19th postoperative day. The cause of death of the patient would be low cardiac output. Case II was a 6 years old female with dyspnea and cyanosis after birth. Aortogram showed tricuspid atresia[Type IIb], transposition of great arteries, atrial septal defect, ventricular septal defect and pulmonary stenosis, We had performed total cavo-pulmonary shunt using intraatrial baffle[tunnel] with Goretex patch. The postoperative course of this patient was good without event.

• Journal of Chest Surgery
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• 제28권6호
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• pp.623-629
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• 1995

Rupture of ventricular septum following myocardial infaction is one of the serious complication of coronary artery disease. The characteristic manifestations are sudden appearance of a harsh systolic murmur, precordial pain, cardiovascular collapse and permit early diagnosis. We report two cases of successful repair of postinfaction ventricular septal defect. The infarcted area was anterior wall of ventricle and VSD was placed near apex of heart in two cases all. VSD was closed with pledgetted Dacron patch and incised wall was sutured with Teflon felt and concomitant coronary artery bypass graft was done respectively .Postoperative courses were uneventful.

• Journal of Chest Surgery
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• 제23권4호
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• pp.769-775
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• 1990

Congenitally corrected transposition of the great arteries is defined as the anomaly of atrioventricular and ventriculoarterial discordance. Although this condition is compatible with longevity, it is usually associated with other congenital cardiac anomalies, which result in a greatly shortened life span. This report describes a 2 years old female patient who had congenitally corrected transposition of the great arteries associated with ASD, VSD and pulmonary stenosis. The ASD was closed directly through the right atriotomy and the VSD was closed using Dacron patch through right ventriculotomy and the pulmonary[valvular, supra and subvalvular] stenosis was repaired with the use of a valved conduit woven Dacron vessel graft between the pulmonary ventricle and the main pulmonary artery.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1238-1241
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• 1991

Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

• Journal of Chest Surgery
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• 제27권3호
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• pp.234-237
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• 1994

We report a case of double orifice mitral valve complicating a partial atrioventricular septal defect.The preoperative diagnosis was suggested by a characteristic angiographic and echocardiographic findings but the correct diagnosis of double orifice mitral valve itself was proven by open heart surgery. The smaller accessory mitral orifice was located in the left lateral leaflet and was left untouched. The A-V septal defect was closed with Gore-Tex patch and localized tricuspid annuloplasty was done using Gore-Tex tubular graft for correction of severe tricuspid regurgitation. The anterior mitral cleft left intact had mild mitral regurgitation on postoperative echocardiography.Postoperative course was uneventful and the patient was discharged 2 weeks later.