• Journal of Chest Surgery
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• v.29 no.9
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• pp.977-982
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• 1996

Cardiac valve implantation was performed in 107 patients from September, 1988 to May, 1995. There were 3) men and 74 women, whose ages ranged from 19 to 75 years(mean 42.6$\pm$11.7). Mitral valve was implanted in 61 patients, double(mitral & aortic) valve were Implanted in 28 patients and aortic valve was implanted in 18 patients. Follow up was 100% complete, with 345.6 patient-years and a mean fo low up of 41 months(from 1.5 to 84 months). The total mortality was 14.9%(16 patients). The early mortality was 5.6%(6 patients) and the late mortality was 9.3%(10 patients). The overall actuarial survival was 92.6 $\pm$ 2 6% at 2 years, 88.6$\pm$3.8% at 6 years. The probability of freedom from valve failure, thromboembolism and bacterial endocarditis were 388.6 $\pm$ 3.8, 88.3 $\pm$3.9, 89.5 $\pm$3.7 at 6 years, respectively.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.282-293
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• 1993

From Sep. 1985 to Dec. 1992, total 1000 cases of open heart surgery [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College Of Medicine, Inje University.Among the total 1,000 cases of OHS, there were 823 cases with congenital heart diseases [CHD] and 177 cases with acquired heart diseases [AHD]. The age distribution was 9 days [4.0 kg] to 49 years in CHD and 11 to 64 years in AHD, In the 823 cases of CHD, there were 763 acyanotic cases and 60 cyanotic cases. The CHD cases consisted of 520 VSD [63.2 %], 177 ASD [21.5 %], 60 TOF[7.3 %], 27 PS [3.3 %], 17 ECD [2.1%], 7 Valsalva sinus rupture [0.9 %], 4 TGA [0.5 %], 3 Ebstein`s anomaly [0.4%], 3 DORV[0.4%], and others. The corrective operations were applied for congenital heart disease with the result of 2. 8 % hospital mortality. In the 177 AHD, 168 cases were valvular heart diseases, 7 cases were cardiac tumors and one LA thrombus and one annuloaortic ectasia. In the 168 valvular heart diseases, there were 115 single valve replacement cases [16 AVR, 99 MVR], 20 cases of double valve replacement[AVR & MVR], 15 cases of MVR with TVA, and 10 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 199`. In MVR, 66 of St. Jude Medical valves, 78 ofCarpentier-Edward valves, and 5 of Ionescu-Shiley valves were used. In AVR, 38 of St. Jude Medical valves and 12 of Carpentier-Edward valves were used.The hospital operation mortality rate of congenital acyanotic, cyanotic, and acquired heart diseases were 1.6%, 18.3 % and 3.4% respectively. The overall mortality rate was 2.9 % [29/1000].

• Journal of Chest Surgery
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• v.18 no.1
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• pp.46-53
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• 1985

A single aortic valve replacement using the lonescu-Shiley bovine pericardial xenograft valve was performed in 66 consecutive patients during the period from February, 1979 to June, 1984. They were 49 males and 17 females with ages ranging from 9 to 61 [mean, 31.113.1] years, and 9 of them were children younger than 15 years of age. Twenty-seven patients [40.9%] required the combined operative procedures to either other valvular lesions or congenital defects. There were 9 early deaths within 30 days of surgery [operative mortality rate, 13.6%] and 2 late deaths thereafter [late mortality rate, 3.0%; or 1.75%/patient-year]. The 57 early survivors were followed for a total duration of 114.2 patient-years [mean, 24.016.0 months]. Four patients experienced thromboembolic complication with no death [3.50%/patient-year]; one died from intracranial bleeding related to anticoagulation [0.88%/patient-year]; one recovered from prosthetic valve endocarditis [0.88%/patient-year]; and four developed aortic regurgitant murmur with none or minimal cardiac symptoms and they were classified into cases of tissue valve failure [3.50%/patient-year]. The actuarial survival rate was 82.34.7% at 6 years, and the actuarial probabilities of freedom from thromboembolism and valve failure were 93.33.9% and 89.15.8% at postoperative 6 years respectively Symptomatic improvement was excellent in most late survivors at the follow-up end with the mean of NYHA Classes of 1.040.19 while the one was 2.290.67 at the time of operation. Excluding the higher operative mortality rates, these clinical results are fully comparable with the ones of reports from the major institutions using the porcine aortic or the bovine pericardial tissue valves and warrants the continued use of the xenograft valve in the aortic position. The importance of more detailed preoperative evaluation of the myocardial function and the need of improved myocardial preservation during surgery for the improved early clinical results were discussed.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.249-255
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• 2013

Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.83-92
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• 2020

In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.826-830
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• 2002

Prosthetic valve thrombosis(PVT) may be a life-threatening complication requiring prompt intervention. This is a case report of thrombolytic therapy for thrombosis of prosthetic mitral valve. A 47 year-old male admitted to the emergency room for abrupt onset of dyspnea. He had undergone mitral valve replacement(On-Ⅹ valve, 29mm) for mitral stenosis 8 months ago. The patient's international normalized ratio(INR) on admission was 1.09. The mechanical clicks were muffled and rales were heard in both lung fields. A transesophageal echocardiography(TEE) revealed prosthetic valve thrombosis with increased transvalvular pressure gradient(34 mmHg). The patient's condition needed to intubation for mechanical ventilation due to hemodynamic compromise, however his wife and relatives refused the surgical intervention due to financial problems. The patient was transferred to the cardiac care unit and we decided to perform thrombolytic therapy. A bolus of 1,500,000 IU of urokinase was given, followed by a drip of 1,500,000 IU for 1 hour. The patient did not improved hemodynamically; therefore, we gave 100 mg of tissue plasminogen activator(t-PA) for over 2 hours. During that time mechanical clicks were audible and hemodynamics of the patient improved progressively. A TEE showed disappearance of thrombus and decreased pressure gradient(1.7 mmHg) after 6 hours of thrombolytic therapy. The patient was recovered without any neurologic sequale and was discharged with administration of warfarin.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.630-636
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• 2013

During the past decade, the use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has become highly predictable and successful. SPT(Supportive Periodontal Therapy) identified as regular visits to the therapist for periodontal control and maintenance in a well-organized scheme, the number of appointments per year following a pre-designed subject-tooth/implant-site risk assessment method. Peri-implant disease was a frequent finding in subjects having natural healthy dentition and in subjects without periodontitis. Supportive periodontal program were found to be strongly related to implant survival. This study demonstrates that regular maintenance reduces the risk for peri-implant inflammation significantly as compared with irregular maintenance. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications. It is highly recommended to maintain implant patients under a strict supportive periodontal treatment protocol that might contribute to implant survival, and regular maintenance reduces the risk for periimplant inflammation significantly as compared with irregular maintenance. Ideally, patients may be informed on the beneficial effect of a regular patient-related post-therapy care before implant insertion.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.467-470
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• 2017

Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova S OLO; LivaNova PLC, London, UK). Postoperative echocardiography showed that the prosthetic valve was in the correct position and there were no paravalvular leaks. A bailout open transcatheter valve implantation can be considered a safe and effective option in selected cases with an extensively calcified mitral valve.

• Journal of Chest Surgery
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• v.24 no.11
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• pp.1074-1080
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• 1991

A total and consecutive 62 patients between 13 and 58 years of age receiving biological prosthetic heart valves at the Korea University Hospital from January 1978 through October 1983 were analyzed. Out of 71 valves replaced, 64 were Carpentier-Edwards valves, 4 were Ionescu-Shiley valves, 2 were Angell-Shiley valves, 1 was Hancock valve. Early mortality within 30 days after operation was noted in 4 cases[6.4%]. There were no cases of valve-related early death. The 58 early survivors were followed-up for a total 387 patient-year over a period of 3 years to 12 years[Mean$\pm$S.D: 6.37$\pm$2.51 years] at the follow-up end of April 1991. During follow-up, seven patients died and late mortality rate was 12%. There were two major late complications: the one is thromboembolism[1.6% /patient-year], the other is primary tissue failure[2.76% /patient-year]. Ten patients underwent re-replacement of 13 tissue valves because of primary tissue failure[nine Carpentier-Edwards, two Ionescu-Shiley, two Angell-Shiley]. There was operative mortality. The probabilities of freedom from primary tissue failure were 95.4% and 75.3% at 5 and 10 years after operation respectively, The actuarial survival rates were 86.2% and 81.8% at 5 and 10 years after initial surgery respectively.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.300-308
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• 1987

Clinical and pathologic data were reviewed in 20 patients who had have surgery for isolated aortic valvular heart disease between April 1978 and April, 1987. Hospital mortality was 10%, with no additional late mortality during a mean follow-up period of 24.1 months. Prosthetic valve failure developed in 3 patients and two had reoperation. Niety four percent of the survivors who were in NYHA Funtional class III or IV before operation are now in class I or II. Ninety percent of all patients are still alive at a maximum follow up of 9 years. The clinical histories, gross and histologic examination of valves estabilished the causes for isolated aortic valve disease: 3 rheumatic, 2 congenital bicuspid, 2 hypertention, 2 aortitis and each one case of floppy valve, medial cystic necrosis of aorta, bacterial endocarditis. But etiology was unknown in 8 cases. Sixteen patietns had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucosaccharides and cystic changes. Myxoid degeneration was also the primary pathologic abnormality in the patients with 2 hypertention, 2 rheumatic, 1 aortitis, 1 bacterial endocarditis, 1 floppy valve, 1 congenital bicuspid. The patients with myxoid degeneration of uncertain origin were 8. Histologic finding of all of them revealed nonspecific patients with myxoid degeneration of uncertain orgin were 8. Histologic finding of all of them revealed nonspecific chronic valvulitis with myxoid degeneration. This finding may indicate that the etiology w uld be infectious.