• Journal of Chest Surgery
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• 제25권4호
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• pp.429-434
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• 1992

We experienced a rare case of traumatic ventricular septal defect by penetrating stab injury The patient was 26-year-old women who got stab wound at the left anterior third intercostal space and left sternal border with a knife. seven hours after admission, the patient was undertaken an emergency thoracotomy due to hypovolemic shock caused by massive bleeding from transected left internal mammary artery, vein, and right ventricular outflow tract. On postoperative second day, the patient was suffered from moderate dyspnea, and arterial blood gas analysis and chest X-ray revealed hypoxemia and pulmonary edema. Right heart cardiac catheterization with Swan-Ganz Cathater showed oxygen step-up between right atrium and main pulmonary artery and a 1.6:1 ratio of pulmonary to systemic blood flow. At operation, harsh systolic thrill was palpable along right ventricular outflow tract. Through small vertical right ventriculotomy, the linear ventricular septal laceration on infundibular septum was noticed, and its size was 1.5cm with sharp margin This defeat was repaired by three interrupted matress sutures using Prolene 4-O with pledget. Her postoperative course was uneventful, and she discharged with good physical condition.

• Journal of Chest Surgery
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• 제20권1호
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• pp.71-80
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• 1987

Twenty six patients were operated a total correction of tetralogy of Fallot between Jan., 1984 and July, 1985 at the Dept. of thoracic and cardiovascular surgery, Chonnam University Medical School, and a comparison between the survived group [n = 18] and the dead group [n = B was performed to detect factors influencing laboratory data, cineangiographic findings, operative findings and methods, and pump time. Following results were obtained, 1. There was no significant difference between two groups in the preoperative P.O2 and hematocrit level. 2. The size of the interventricular defect was not related to the operative mortality. 3. There was a significant difference in mortality rate between combined type of stenosis of pulmonary artery, valve and infundibulum and other types of right ventricular outflow tract stenosis. 4. There was a significant difference in mortality rate between the transannular patch reconstruction and other types of operative procedure. 5. There was no significant difference between two groups in total bypass time and aortic time. 6. There was no significant difference between two groups in left ventricular end diastolic volume and right ventricular end diastolic volume. 7. The operative mortality was related to the ratio of the diameter of the pulmonary valve annulus or each pulmonary artery to the ascending or descending aorta in cineangiographic findings, but there was no statistical significance of which probably is due to the lack of the total number of patients.

• Journal of Chest Surgery
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• 제28권8호
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• pp.754-758
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• 1995

Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.

• Journal of Chest Surgery
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• 제12권2호
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• pp.119-126
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• 1979

This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

• Journal of Chest Surgery
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• 제37권8호
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• pp.707-710
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• 2004

다리기관지는 상당히 드문 기관지 기형으로 종종 슬링좌폐동맥과 동반되며 대부분 영아에서 진단되거나 부검에서 발견된다. 본 증례는 29세 여자 환자로 과거력상 특이병력이 없었으며 2년 전 폐결핵을 치료한 뒤 최근 한 달간의 발열, 기침, 가래를 주소로 내원하여 시행한 기관지내시경 및 흉부 전산화단층촬영 검사에서 다리기관지와 이와 동반된 무기폐로 진단되었다. 다리기관지는 좌측 주기관지에서 기시하여 종격동을 지나 우중엽과 우하엽과 연결되어 있었으며 동반된 폐동맥이상은 없었다. 수술은 우중엽 및 하엽 이엽절제술을 시행하였다.

• Journal of Chest Surgery
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• 제28권1호
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• pp.18-22
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• 1995

From January 1989 to December 1993, cardiac catheterization and open heart surgery for ventricular septal defect closure were performed in 115 pediatric patients who were selected as meeting the criteria for elective closure of restrictive ventricular septal defect. These criteria included age greater than 1 year and less than 15 years, no evidence of congestive heart failure, Qp/Qs 2.0, pulmonary artery systolic pressure 35mmHg, and no associated cardiac anomalies. Mean age of patients was 5.25$\pm$ 3.53, and 72 patients were male, 43 patients were female[male:female=1.9:1 . Mean systolic pulmonary artery pressure was 19.66$\pm$4.79mmHg, and mean pulmonary to systemic flow ratio was 1.27$\pm$ 0.28. Aortic cusp prolapse was present in 30 patients [26% , aortic insufficiency was present in 1 paient, and 1 patient had prior bacterial endocarditis. There were no instances of complete atrioventricular dissociation, reoperations for bleeding, or reoperations for recurrent ventricular septal defect, but wound infection was present in 1 patient, and there were 7 patients who had the hemodynamically insignificant remnant shunt. There were no early or late deaths or major morbidity.

• Journal of Chest Surgery
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• 제30권8호
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• pp.747-751
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• 1997

폐동맥협착을 시행한 환아에서 수술직후 변화하는 혈역학에 대응하기 위하여 피하조직에 위치시켜 쉽게 조절할 수 있는 기구를 개발하였다. stainless steel wire를 이용하여 스프링을 만든후 이것의 표면을 PTFE로 덮은 형태로 제작하였으며 스프링 내부로 wire를 통과시켜 이것을 올가미 형식으로 죄는 방법으로 협착을 할 수 있게 하였으며 협착의 정도를 피하조직으로 통하는 투명한 tube에 1mm간격으로 표시하여 알수 있게 하였다. 6마리의 개의 하행대동맥에 협착을 시행하였다. 수술후 1,2일째에도 이완과 협착을 효과적으로 유도 할수 있었으며 3개월후 어느정도의 혈관손상은 있었으나 큰 협병증 없이 유지함을 보였다. 비록 실험적인 연구이지만 인체에 삽입할수 있는 재료로 쉽게 기구제작이 가능하며 앞으로 피하를 열고 조절가능한 폐동맥협착술에 이용할 수 있으리라 생각된다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.739-747
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• 1989

Between September 1986, and August 1989, eight infants underwent operation for repair of coarctation of the aorta in the first year of life. The patients included 7 males and 1 female ranging in age 19 days and 9 months. Weights ranged from 3.5 Kg to 7 Kg [mean 5 Kg]. All patients had preductal coarctation of the aorta. Each infant had associated cardiac anomalies, including ventricular septal defect [7 infants] and patent ductus arteriosus [5 infants]. All had intractable congestive heart failure, despite aggressive medical therapy. Pressure gradient across the coarctation ranged from 10 mmHg to 60 mmHg. Operative techniques were subclavian flap aortoplasty in five cases, Gore-Tex patch aortoplasty in three cases. In addition to coarctation repair, six infants had concomitant banding of the pulmonary artery. Four infants required ventilator support for several days. There was no operative death. Complications developed in two. One infant had tracheal stenosis after a tracheostomy. Another infant had restenosis of the aorta revealed by cardiac catheterization 30 months after surgery. The pressure gradient was 30 mmHg, necessitating balloon dilatation aortoplasty. Results were satisfactory. During follow up, we performed total correction procedures [patch closure of the ventricular septal defect, infundibulectomy, pulmonary valvotomy and pulmonary artery angioplasty] in one case. Continuing follow-up finds all patients in good condition.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.146-151
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• 2015

Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

• Clinical and Experimental Pediatrics
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• 제46권1호
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• pp.86-90
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• 2003

Alagille 증후군은 간내 담도 형성 부전으로 인한 만성 담즙 정체, 말초 폐동맥 협착, 골격 이상, 눈의 이상, 특징적인 얼굴 모양 등을 주요 증상으로 하는 상염색체 우성 유전 질환으로 말초 폐동맥 협착 이외에도 여러 말초 혈관 병변들이 동반된다. 관련된 유전자로 20번 염색체 위에 존재하는 JAG1이 발견되었고, 이 유전자의 결손으로 인한 Notch 신호전달체계의 결함이 혈관형성에 영향을 미친다고 생각되고 있다. Alagille 증후군에서 만성 뇌동맥 폐색질환인 moyamoya병이 발생한 예들이 보고된 바 있는데, Alagille 증후군의 혈관병증의 또 다른 한 발현으로 이해되어야 할 것이다. 저자들은 생후 2개월에 Alagille 증후군을 진단받고 추적 관찰 중에 갑자기 편측 마비가 발생하여 뇌혈관 조영술을 통해 moyamoya병을 진단받은 25개월 여아를 경험하였기에 이를 보고하는 바이다.