• Title/Summary/Keyword: thrombus

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Transvenous proximal closure of large congenital coronary arteriovenous fistula using the single Amplatzer vascular plug in a 3-year-old girl

  • Jang, Hae In;Choi, Young Earl;Cho, Hwa Jin;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.56 no.2
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    • pp.90-93
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    • 2013
  • Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.

BEHCET DISEASE WITH SUPERIOR VENA CAVA THROMBUS IN A PATIENT PRESENTING DELAYED FACIAL WOUND HEALING : A CASE REPORT (단순안면열상환자에서 발생한 창상치유지연 및 상대정맥혈전증을 동반한 베체트병 : 증례보고)

  • Choi, Sun-Mi;Ha, Joo-Hyo;Kim, Sun-Ae;Choi, Mi-Ra;Jung, Su-Jin;Lee, Hyen-Soo;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.2
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    • pp.198-204
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    • 2008
  • Behcet Disease is a multisystem inflammatory disorder of unknown orign. It is characterized by recurrent oral ulcer, genital ulcer, skin lesions and ocular inflammation, and which may involve the joints, skin, central nervous system and gastrointestinal tract. Because Behcet Disease dose not have any specific symptoms and laboratory findings, the diagnosis is made on the basis of the criteria proposed by the the International Study Group for Behcet Disease. Behcet Disease is affecting both arteries and veins, and clinically manifest large vessel involvement occurs in between 7 and 49% of patients. Superior vena cava thrombosis is a rare but well-recognized manifestation of Behcet disease. We report a case of a Behcet Disease with superior vena cava thrombosis in a patient presenting delayed facial wound healing.

Characteristics of the Sealing Pressure of a Magnetic Fluid Shaft Seal for Intra-Cardiac Axial Flow Blood Pumps (심장 내 이식형 축류 혈액 펌프용 자성 유체 축봉의 내압 특성)

  • KIM, Dong-Wook;Mitamura , Yoshinori
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.51 no.10
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    • pp.477-482
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    • 2002
  • One of the key technologic requirements for rotary blood pumps is the sealing of the motor shaft. A mechanical seal, a journal bearing, magnetic coupling, and magnetic suspension have been developed, but they have drawbacks such as wear, thrombus formation, and power consumption. A magnetic fluid seal is durable, simple, and non power consumptive. Long-term experiments confirmed these advantages. The seal body was composed of a Nd-Fe-B magnet and two pole pieces; the seal was formed by injecting magnetic fluid into the gap (50${\mu}m$) between the pole pieces and the motor shaft. To contain the ferro-fluid in the seal and to minimize the possibility of magnetic fluid making contact with blood, a shield with a small cavity was attached to the pole piece. While submerged in blood, the sealing pressure of the seal was measured and found to be 31kPa with magnetic fluid LS-40 (saturated magnetization, 24.3 KA/m) at a motor speed of 10,000 rpm and 53kPa under static conditions(0mmHg). The specially designed magnetic fluid seal for keeping liquids out is useful for axial flow blood pumps. The magnetic fluid seal was incorporated into an intra-cardiac axial flow blood pump.

Numerical Simulation of Flow in a Total Artificial Heart (인공심장내의 혈류유동의 컴퓨터 시뮬레이션)

  • ;K.B
    • Journal of Biomedical Engineering Research
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    • v.13 no.2
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    • pp.87-96
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    • 1992
  • In thIns paper, a numerical simulation of steady laminar and turbulent flow in a two dimensional model for the total artificial heart is'presented. A trlleaflet polyurethane valve was simulated at the outflow orifice while the Inflow orifice had a trileaflet or a flap valve. The finite analytic numerical method was employed to obtain solutions to the governing equations in the Cartesian coordinates. The closure for turbulence model was achieved by employing the k-$\varepsilon$-E model. The SIMPLER algo rithm was used to solve the problem in primitive variables. The numerical solutions of the slulated model show that regions of relative stasis and trapped vortices were smaller within the ventricular chamber with the flap valve at the Inflow orifice than that with the trileaflet valve. The predicted Reynolds stresses distal to the inflow valve within the ventricular chamber were also found to be smaller wlth the flap valve than with the trlleaflet valve. These resu1ts also suggest a correlation be- tween high turbulent stresses and the presence of thrombus In the vicinity of the valves in the total artificial hearts. The computed velocity vectors and trubulent stresses were comparable with previ ously reported in vitro measurements in artificial heart chambers. Analysis of the numerical solo talons suggests that geometries similar to the flap valve(or a tilting disc valve) results in a better flow dynamics within the total artificial heart chamber compared to a trileaflet valve.

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Long Term Results of Open Mitral Commissurotomy (개방성 승모판 교련 절제술의 장기 성적)

  • 김효윤
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.521-525
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    • 1993
  • Sixty-three patients who underwent open mitral commissurotomy at Sejong General Hospital during last 10 years from the August, 1983 to June, 1993 were reviewed There were fifty-one women and twelve men, and the mean age was 34.2 years. According to the NYHA classification, the distribution of patient preoperatively was as follows: class I, 5 patients ; class II, 26 patients ; class III, 30 patients ; class IV, 2 patients, and mean duration of symptome was 4.5 years. The mean mitral valvular area measured with echocardiogram preoperatively was 0.92cm2. All patients underwent open mitral commissurotomy and 41 patients required additional procedures for relief of subvalvular stenosis or other valvular disease. There were no operative death. 63 patients had three different types of mitral stenosis : type I, mobile cusps without subvalvular change [21 patients] ; typeII, thickened cusps with subvalvular change [34 patients] ; type III, rigid cusps with severe subvalvular change [8 patients]. The valvular calcification was seen in 11 patients [17%] and 15 patients [24%] had left atrial thrombus. The duration of follow-up was from 1 month to 168 months [mean, 39.6 months] and there were no late death. Six patients required reoperation and one patient had embolic episode. Conclusively,the open mitral commissurotomy represents a safe surgical precedure for treating mitral stenosis, allowing a complete removal of atrial thrombosis if present, and even when associated with subvalvular changes.

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Intramuscular Sinusoidal Hemangioma of the Masseter Muscle with Organizing Thrombus Preoperatively Mimicking Coincidental Parotid Sialolithiasis (이하선 타석증 병발로 오인된 교근 내 혈관종 1예)

  • Seo, Young Wook;Shin, Seung Ho;Seo, Ja Yeong;Byeon, Hyung Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.79-83
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    • 2017
  • Hemangioma is the most common benign tumor in neonatal and infant stage. In the head and neck region, the lesion mostly occurs in the masseter, trapezoidal or sternocleidomastoid muscle. Due to its rarity and non-specific symptoms, it is difficult to diagnose precisely. Intramuscular hemangioma can be misdiagnosed as sialolithiasis of the parotid gland. There are several treatment options for hemangiomas such as sclerotherapy, radiotherapy, embolization, and surgery. Of all these, definitive surgical resection is considered most effective in preventing future recurrence. Here we report a case of intramuscular hemangioma that was detected in the patient's right masseter muscle which was initially misdiagnosed as parotid sialolithiasis and was consequently managed with surgical resection.

Antithrombotic Compounds form the Leaves of Ligularia stenocephala M.

  • Yoon, Min-Ho;Cho, Chong-Woon;Lee, Jae-Won;Kim, Young-Shin;An, Gil-Hwan;Lim, Chi-Hwan
    • Natural Product Sciences
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    • v.14 no.1
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    • pp.62-67
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    • 2008
  • The leaf extract of Ligularia stenocephala showed the highest anti-platelet aggregating activity in large numbers of edible and herbal plants. The active fraction fractionationed from L. stenocephala extract by using preparative HPLC inhibited the platelet aggregation up to above 80% and its blood coagulating time (PT and APTT) also showed similar effect to aspirin (0.2 ${\mu}g/mL$), known as an anti-thrombus compound. Two antithrombus active compounds were purified and identified as 3,5-dicaffeoylquinic acid and 3,4-dicaffeoylquinic acid, respectively, on the basis of NMR and FAB-MS spectroscopic data. Two active compounds has not only antiplatelet aggregating activity, but also has anticoagulating activity.

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

  • 이철세
    • Journal of Chest Surgery
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    • v.16 no.2
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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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Early and Late Clinical Results of Cardiac Valvular Surgery (심장판막질환의 수술성적)

  • 김형묵
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.247-253
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    • 1981
  • A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

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The Study on Electrocardiographic Changes after Mitral Valvular Replacement (승모판막 수술에 따른 심전도 변화)

  • Yeo, Seung-Dong;Im, Seung-Pyeong
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.421-427
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    • 1991
  • Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

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