• Journal of Chest Surgery
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• 제26권7호
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• pp.543-547
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• 1993

Cor triatriatum is a rare entity of congenital heart disease characterized by the presence of a fibrousmuscular diaphragm that subdivides the left atrium into a proximal or "accessory" chamber and a distal or "true" left atrial chamber. In the other hand, cor triatriatum is a variant of abnormal connection between the pulmonary vein and true left atrium which is separated from accessory left atrium receiving pulmonary venous blood flow by fibromuscular diaphragm. We experienced two cases of cor triatriatum. One of them was classical, and the other case was combined with atrial septal defect and all pulmonary veins were drained into the " common pulmonary venous chamber " which connected with right atrium and there was no direct communication between the accessory chamber and true left atrium. The abnormal diaphragms were excised and the atrial septal defect was repaired with pericardial patch in case II. The postoperative courses were not eventful and the patients were discharged with good result, and have been in good condition upto now.n good condition upto now.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1448-1454
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• 1992

Between July, 1990 and July, 1992, 6 male patients of truncus arteriosus, whose age ranged from 2 months to 18 months, underwent total surgical correction without a extracardiac conduit. Their anatomic types were type I in 3, type II in 2 and III, in one by the Collett-Edwards classification. Surgical techniques were similar to the first description by Lecompte except for the fact that distal pulmonary arterial stumps were approximated to ventriculotomy site without Lecompte maneuver in all cases. Also in all cases, mon-ocusps were placed using glutaraldehyde fixed autologous pericardial patch directly in right ventricular outflow tract. Three patients died postoperatively and the causes of death were myocardial failure, pulmonary hypertensive crisis and pulmonary complication due to progressive pulmonary vascualr obstructive disease respectively. The three survivors have been followed up for 6~10 months with good functional results.

• Journal of Chest Surgery
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• 제24권7호
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• pp.732-738
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• 1991

Membranous obstruction of the inferior vena cava[IVC] is a rare congenital anomaly that may present clinical features of Budd-Chiari syndrome caused by chronic obstruction of hepatic drain. We have experienced a case of IVC obstruction caused by hour-glass constriction and membrane in its center. Operative correction was accomplished using profound hypothermia [20%] and total circulatory arrest of 26 minutes. This technique permitted resection of membrane with direct vision and removal of thrombus of IVC and hepatic vein. After then constricted IVC was repaired with autologous pericardial patch. Total circulatory arrest was used intermittently for good visual field. Postoperative course was smooth and postoperative angiography showed unobstructed flow through the IVC in spite of slight constriction of cavoatrial junction and nearly complete disappearance of collateral vessels.

• Journal of Chest Surgery
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• 제35권6호
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• pp.487-490
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• 2002

65세 여자 환자가 호흡곤란을 주소로 내원하였다. 환자는 과거력상 뇌수술과 기관절개술후 반복되는 흡인으로 인하여 기관전환수술을 시행 받았다. 응급 3차원 나선형 기관단층 촬영술에서 하부기관의 협착이 나타났다. 수술은 정중 흉골절개술을 통하여 글루타르알데하이드에 담근 심막을 이용한 전방기관성형술을 실시하여 좋은 결과를 보았다. 저자들은 이를 치험 하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1119-1122
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• 1999

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.

• Journal of Chest Surgery
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• 제28권7호
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• pp.704-707
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• 1995

The use of the patient`s pulmonary valve for replacement of the patient`s diseased aortic valve was introduced and developed by Mr. Donald Ross. The long term benefits of having a normal, fully viable, trileaflet semilunar valve in aortic position was demonstrated. A 38 year old male had histories of failures of previously implanted aortic prosthetic valves twice and evidence of progressive heart failure. At operation, aortic root abscess was found; the abscess extension to adjacent structures and partial valve dehiscence had occurred. The patient underwent replacement of the aortic root with autologous pulmonary valve, autologous pericardial patch repair of left ventricuar outflow tract and recontruction of the right ventricular outflow tract and pulmonary artery with prosthetic valved conduit. Postoperatively, the patient recovered well. Postoperative doppler echocardiography demonstrated minimal central regurgitation in new aortic valve. Aortic root replacement with pulmonary autograft in a patient of recurrent aortic root abscess and false aneurysm of left ventricuar outflow tract was experienced and reported with follow up echocardiography.

• Journal of Chest Surgery
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• 제30권1호
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• pp.88-91
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• 1997

복잡 심 기 형을 동반한 선천성 기관협착증은 일반적으로 치명적 인 질환으로 간주되고 있다. 본 논문에서는 수술전에 예상하지 못한 선천성 기도 협착을 동반한 복잡 심기형 환자에서, 체외순환하에 동시 교정술을 성공리에 수행하였기에 보고하고자 한다. 환아는 3개월된 여자로 대동맥 교약증, 심실중격결손증 및 동맥관 개존증의 진단으로 전신마취 유도 후 예상치 못한 기관내 삽관의 어려움으로 선천성 기도협착이 있음을 알게 되었고, 자가심낭을 이용한 전방 기관 성형술 및 대동맥 교약증, 심실중격결손증 및 동맥관개존증의 일차 완전 교정술을 체외순환 하에 동시에 시행하게 되었다. 환아는 술후 2년 1개월이 지난 현재 합병증의 증상없이 순조로운 술후경과를 보이고 있다.

• Journal of Chest Surgery
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• 제32권1호
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• pp.75-79
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• 1999

Budd-Chiari syndrome은 하공정맥에서 우심방으로의 혈류장애로 인한 간부전증이다. 본 증례의 남자 45세 환자는 1987년 선천적인 막의 하공정맥 폐쇄로 인한 하공정맥 폐색막 제거와 확장술을 자가심낭으로 이용하여 수술을 받았다. 술후 10년이 경과한 후 하공정맥이 재협착되어 비침습적인 방법인 Gianturco stent 확장술을 받았으나 치료적인 효과를 얻지 못하였다. 재수술은 Gore-Tex 인조 혈관의 일부를 오각형으로 재단하여 하공정맥의 협착 부위를 절개한후 부착 봉합후 손가락 두행지가 통과할수 있도록 확장하였다. 수술후 출혈이나 합병증없이 양호한 경과를 보였으며 항응고제 사용없이 수술 2주 경과후 퇴원 하였다. Gore-Tex 인조혈관을 일부 제단한 patch를 수술에 사용하여 좋은 결과를 얻었으며 Budd-Chiari syndrome의 재수술의 경우로 인공심폐기하에도 수술시야에 심한 출혈이 발생 하므로 신속하고 정확한 지혈 수기가 요구된다고 할수 있다.

• Journal of Chest Surgery
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• 제28권3호
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• pp.268-273
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• 1995

Budd- chiari syndrome resulting from a membranous obstruction of the inferior vena cava[IVC is a rare congenital anomaly. From January 1989 to December 1993, 8 cases of IVC obstruction was treated in Kyung Hee Univ. Hospital. There were 2 male and 6 female patients between 34 and 66 years of age[mean 47.3$\pm$11.9 years of age . 4 patients were treated with angioplasty by balloon catheter and 4 patients were treated with operative correction using cardiopulmonary bypass, profound hypothermia and total circulatory arrest. These 4 patients were repaired the constricted IVC with autologous pericardial patch. In surgically treated patients, all of the specimens were confirmed to be membranous web histopathologically. Postoperative outcome in operative correcting patients was uneventful and postoperative angiography showed unobstructed flow through the IVC with filling of the hepatic veins.The above 8 patients were followed up from 10 months to 56 months [ mean 36.43 17.24 months and recurrent IVC obstruction or stenosis was not seen.

• Journal of Chest Surgery
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• 제40권12호
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• pp.859-862
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• 2007

심장 판막엽에 발생하는 혈관종은 극히 드문 질환으로 최근까지 문헌에 보고된 것은 총 5례가 전부이며 아직까지 국내문헌에는 보고된 바가 없다. 건강하던 46세 여자가 갑자기 발생한 좌측 안면마비와 수부 감각이상을 주소로 내원하였다. 신경학적 검사에서는 이상 소견이 없었으며 심장초음파에서 승모판막 전엽에 위치한 종괴가 발견되어 종괴를 포함한 승모판막 전엽의 일부를 절제한 후 자가심낭을 이용하여 승모판막성형을 시행하였다. 병리조직 검사상 승모판막 전엽에 발생한 혈관종으로 판명되어 문헌고찰과 함께 보고하는 바이다.