• 제목/요약/키워드: repaired patch

검색결과 136건 처리시간 0.021초

흉부 둔상에 의한 삼첨판 역류를 동반한 심실 중격 결손증 (Ventricular Septal Defect with Tricuspid Regurgitation due to Blunt Chest Trauma -A Case of Report-)

  • 이장훈;류한영
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.559-563
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    • 1996
  • We have experienced a patient, 16 year-old male, with ventricular septal defect with tricuspid recur- gitation due to blunt chest trauma. He suffered from congestive heart failure after the trauma. Echocardiogram and cardiac catheterization revealed left to right shunt at the ventricular level (muscu- far portion of interventricular septum) and tricuspid regurgitation. At the time of the operation, marked systolic thrill was palpable over the rlght ventricle near the apex and a chorda tendina was seen sharply ruptured just near the medial papillary muscle. We repaired the ventricular septal defect with a Dacron patch and chordal reconstruction with autologous pericardium. The postoperative course was uneventful and the patient was discharged in good condition.

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비관통성 외상에 의한 심실중격결손증 -수술치험 1례- (Traumatic Ventricular Septal Defect Secondary to Nonpenetrating Chest Trauma -A Case Report-)

  • 홍기표
    • Journal of Chest Surgery
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    • 제27권2호
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    • pp.161-165
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    • 1994
  • We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

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복합재 패치 보강 평판의 균열선단 진전거동 해석 (Analysis of fatigue crack growth behavior in composite-repaired aluminum place)

  • 이우용;이정주
    • Composites Research
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    • 제17권4호
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    • pp.68-73
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    • 2004
  • 본 논문에서는 한 쪽 면만 복합재 패치로 보강한 알루미늄 균열평판의 피로균열 진전거동을 해석적인 방법으로 고찰하였다. 한쪽 면 보강 시, 균열선단은 비대칭성과 면 외 굽힘의 효과로 인하여 초기의 직선형태에서 경사곡선형태로 진전한다는 사실을 이전의 연구견과에서 확인할 수 있다. 따라서 정확한 피로거동을 고찰하기 위하여는 이와 같은 균열선단의 변화과정을 예측하고, 이론 해석에 반영하는 것이 필수적이라 하겠다. 본 연구에서는 균열선단 전개형상을 고려한 한쪽 면 보강시의 피로해석을 수행하기 위하여 선형탄성 파괴역학개념을 적용한 3차원 순차적 유한요소 해석기법을 적용하였는데, 이를 통하여 진전하는 균열선단 형상을 단계적, 반복적으로 추적하고 해석모델에 반영하였다. 이와 같은 해석기법을 적용함으로써 패치보강 평판의 피로수명은 물론 균열선단 진전과정도 정확히 예측할 수 있었다. 해석으로 얻어진 균열선단 진전거동 및 피로수명은 상응하는 실험결과와 잘 일치함을 확인하였다.

복잡 심기형에서의 동맥 전환술에 대한 연구 (Arterial Switch Operation in Complex Congenital Heart Diseaes (Application, procedure analysis,risk assessment,and results))

  • 김용진
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.237-246
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    • 1995
  • Between March 1989 and December 1994, one-stage repair was performed for correction of the intracardiac malformations associated with aortic coarctation in 34 patients or interrupted aortic arch in 8 patients via median sternotomy. There were 26 male and 16 female patients, and their body weight ranged from 1.8 to 8 kg [mean weight, 4.0 1.4 kg . The age at the operation ranged from 7 days to 18 months [mean age, 3.1 $\pm$ 3.8 months . The repair of aortic coarctation or interrupted aortic arch was performed using extended end-to-end anastomosis in most of the patients [86%, 36/42 , and six patients underwent ductal tissue excision and patch aortoplasty. Intracardiac defects were corrected concomitantly through the right atrium unless the anatomy dictated otherwise. Obstructive outlet septum was resected whenever necessary. There were seven early deaths [16.8 % , and three late deaths with a mean follow-up period of 25 months [range from 1 to 65 months . Three patients were reoperated upon residual subaortic stenosis, stenosis at the RPA origin, and subacute bacterial endocarditis respectively. None showed any significant residual or anastomotic stenosis postoperatively. One stage repair of the aortic coarctation and interrupted aortic arch associated with intracardiac defect leaves no native coarctation shelf tissue or residual hypoplasia in the repaired segment, has low incidence of recurrent or residual stenosis, minimizes reoperation and incisions, and manages arch hypoplasia easily. We concluded that surgical results of one-stage repair for the intracardiac malformation associated with aortic coarctation or interrupted aortic arch are reasonable.

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하공정맥 막성폐쇄에 의한 Budd-Chiari증후군의 치료 (Budd-Chiari Syndrome Resulting from a Membranous Obstruction of the Inferior Vena Cava -8 Case Report-)

  • 김동원;김준우;박주철
    • 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.

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승모판막 전엽에 발생한 심장혈관종 - 1예 보고 - (Cardiac Hemangioma of the Anterior Mitral Valve Leaflet - A case report -)

  • 최재성;김응중
    • 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.

부분심내막상 결손증의 교정수술치험 1 (Surgical correction of partial endocardial cushion defect: one case report)

  • 기노석
    • Journal of Chest Surgery
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    • 제17권2호
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    • pp.244-249
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    • 1984
  • Surgical treatment of partial endocardial cushion defect was accomplished in Feb. 1984 in this department. The 5 year old male patient had history of frequent upper respiratory tract infection and since his age of 3 years dyspnea on exertion and palpitation were noted but there were no cyanosis and clubbing. A thrill was palpable on the apex and grade IV/IV harsh systolic ejection murmur and diastolic murmur was audible on it. Liver was palpable about 3 finger breadths and no ascites. Chest X-ray revealed increased pulmonary vascularity, moderate cardiomegaly [C-T ratio; 0.69], and enlarged left atrium. EKG showed first degree heart block, RVH, LVH, and LAD. Echocardiogram showed paradoxical ventricular septal movement and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted left to right shunt [Qp:Qs:2.1:1 ] and moderate pulmonary hypertension [60/40 mmHg]. Left ventriculogram showed mitral regurgitation [Grade III/IV] and filling of left atrium and right atrium nearly same time. Operative findings were: 1.Primum type atrial septal defect [3x2 cm] 2.Cleft on the anterior leaflet of mitral valve. 3.No interventricular communication and cleft of tricuspid valve leaflet. The mitral cleft was repaired with 4 interrupted sutures. The primum type atrial septal defect was closed with Dacron patch intermittently at endocardial cushion and continuously remainder. The post operative course was uneventful and discharged on 22nd postoperative day in good general conditions.

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좌측 상공정맥을 동반한 삼심방증 1례 보고 (Cor triatriatum with left superior vena cava[Report of a case])

  • 박병순
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.293-298
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    • 1985
  • Cor triatriatum is a rare congenital malformation of the heart in which a septum stretches in a transverse plane through the left atrium, thus creates two left atrial subchambers. The upper one connects with the pulmonary veins, and the lower connects with the left ventricles. Due to the rarity of, and difficulty in diagnosing car triatriatum, data on the surgery of the disease are of necessity and very limited. A case of cor triatriatum combined with atrial septal defect and persistent left superior vena cava was experienced in November, 1984 in Chonnam University Medical School. There was a transverse septum in the left atrium below atrial septal defect, all pulmonary veins were drained into the upper chamber of the left atrium which connected with the right atrium via atrial septal defect and the lower chamber via an oval opening[8mm] in the abnormal septum and the lower chamber was connected with the left atrial appendage, and the left ventricle via mitral valve. There was persistent left superior vena cava drained to left atrium and coronary sinus. The abnormal transverse septum within the left atrium was completely excised and the atrial septal defect was repaired with Woven Dacron patch. The post-operative course was not eventful and the patient was discharged to home with good result on the 15th postoperative day, and has been in good condition upto now.

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인터넷 기반의 항공기용 복합재의 보수 (Internet-based Repair for Aircraft Composites)

  • 추원식;안성훈
    • 한국항공우주학회지
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    • 제30권5호
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    • pp.48-55
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    • 2002
  • 항공기용 복합재의 보수를 보조하는, 보수 제안 서비스 (Repair Advisory Service, RAS)라는 인터넷 기반의 소프트웨어가 개발되었다. 웹 브라우저를 유저인터페이스로 하는 RAS는 보수된 복합재의 파괴하중 계산, 구조 보수 지시서 (SRM) 제공 및 검색 등을 보수 엔지니어에게 거리에 제약을 받지 않고 제공한다. 본 논문에서는 RAS의 기능을 겹치기 기술(lap repair)에 의해 보수된 복합재의 파괴하중을 계산하는 모델을 예로 보여준다. 이 모델은 기초복합재와 보수층에 있는 각 복합재 층의 이방성을 고려하여 개발되었고, 기초복합재와 보수복합재 사이의 경계층의 비탄성을 고려하였다. 모델에 의한 파괴하중은 실험결과와 유사한 결과를 보여준다.

좌심실에 발생한 진성심실류 (2례 보고) (Left ventricular aneurysm (Two cases report))

  • 이철세
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.175-183
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    • 1983
  • Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

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