• Title/Summary/Keyword: valve defect

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Coarctation of the aorta: report of 2 cases (대동맥 축착증 -2례 보고-)

  • Kim, Byeong-Ju;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.448-455
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    • 1984
  • Coarctation of the Aorta is a congenital constriction of aorta of varying degree, usually located at or near the aortic ismuth with frequent associations of other cardiac anomalies. Various modes of surgical corrections, such as resection and end-to-end anastomosis, graft interposition, angioplasty using prosthetic patch or subclavian flap have been used according to the status of coarctation and age of the patient. We have experienced two cases of surgically treated coarctation of the aorta, one of which was preductal coarctation with hypoplastic aortic arch and ventricular septal defect in a 4 year old boy, and the other case was juxtaductal type with aortic regurgitation. Subclavian flap angioplasty with additional pulmonary artery banding procedure was done in the first case and wedge resection with end-to-end anastomosis and aortic valve replacement [St. Jude valve, 23mm] 20 days later of first operation in the other case. The first case developed massive tarry stool on 3rd POD, probably due to mesenteric arteritis with resultant bowl ecrosis, and expired the next day. Recovery was uneventful with the second case.

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Right Ventricular Outflow Tract Reconstruction with Bovine Jugular Venous Valved Conduit. (소경정맥 판막도관을 이용한 우심실 유출로 재건술)

  • 박형주
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.830-833
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    • 2000
  • Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.

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Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum without Extracorporeal Circulation - Report of One Case - (심실중격결손이 없는 폐동맥페쇄증 환아에서 체외순환 없이 시행한 고식적 수술치험 1례)

  • Park, Cheol-Hyeon;Lee, Sin-Yeong;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.24 no.7
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    • pp.719-724
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    • 1991
  • A case of pulmonary atresia with intact ventricular septum was presented in a 10-month-old cyanotic female patient, which was congenitally rare. Infant with pulmonary atresia and intact ventricular septum usually require urgent surgical intervention. Angiogram showed the pulmonary atresia at the level of the pulmonary valve, the hypoplasia of tricuspid valve and atrial septal defect without patent ductus arteriosus. We performed the pericardial patch graft on the right ventricular outflow tract and pulmonary artery after ventriculotomy using pacemaker wire as electrical saw and main pulmonary arteriotomy and then modified Waterston shunt from the ascending aorta to patch on the right ventricular outflow tract without extracorporeal circulation. Patient was postoperatively good condition.

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Interim palatal lift prosthesis as a constituent of multidisciplinary approach in the treatment of velopharyngeal incompetence

  • Raj, Neerja;Raj, Vineet;Aeran, Himanshu
    • The Journal of Advanced Prosthodontics
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    • v.4 no.4
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    • pp.243-247
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    • 2012
  • The velopharynx is a tridimensional muscular valve located between the oral and nasal cavities, consisting of the lateral and posterior pharyngeal walls and the soft palate, and controls the passage of air. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to a lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy; though optimal results often require a multidisciplinary approach for the restoration of both anatomical and physiological defect. We report a case of 56 year old male patient presenting with hypernasal speech pattern and velopharyngeal insufficiency secondary to cleft palate which had been surgically corrected 18 years ago. The patient was treated with a combination of speech therapy and palatal lift prosthesis employing interim prostheses in various phases before the insertion of definitive appliance. This phase-wise treatment plan helped to improve patient's compliance and final outcome.

CT Diagnosis of Paradoxical Embolism via a Patent Foramen Ovale in a Patient with a Pulmonary Embolism and Prominent Eustachian Valve (난원공개존증과 거대 유스타기오밸브를 가진 환자에서 기이색전증의 CT 진단)

  • Min Ji Son;Seung Min Yoo;Charles S White
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.435-439
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    • 2021
  • While there is a high prevalence of patent foramen ovale in adults, paradoxical embolism via a patent foramen ovale is rare. Previous echocardiographic studies indicated that paradoxical embolism might only occur in patients with high-risk features of patent foramen ovale (i.e., large defect size, presence of a Eustachian valve, and high right atrial pressure). Here, we present a case of patent foramen ovale with high-risk CT features for paradoxical embolism.

Aortic Valve Papillary Fibroelastoma - Report of 1 Case- (대동맥판막에 위치한 유두상 섬유탄력종)

  • Kim Jae Hyun;Oh Sam Sae;Lee Chang-Ha;Baek Man Jong;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.316-318
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    • 2005
  • Papillary fibroelastomas are benign, and they are the second most common primary cardiac tumors usually involving the cardiac valve. Papillary fibroelastoma attached to the free margin of right coronary cusp of the aortic vlave was found incidentally during the work-up of a 51-year-old woman, who was presented with palpitation and dyspnea. During the operation, the tumor mass was excised without leaving defect on the aortic valve leaflet.

Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report (삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보)

  • Kim, Chi-Gyeong;Na, Beom-Hwan;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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Valve-Sparing Neo-Aortic Root Replacement for Neo-Aortic Root Dilatation 20 Years after Arterial Switch Operation for Transposition of the Great Arteries: A Case Report

  • Sangjun Lee;Chan Hyeong Kim;Jae Hong Lee;Jae Gun Kwak
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.445-448
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    • 2023
  • A 25-year-old man returned to Seoul National University Children's Hospital with mild dyspnea on exertion. He had undergone an arterial switch operation at 1 month after birth to correct a complete transposition of the great arteries and a ventricular septal defect. When the patient was 15 years old, dilatation of the neo-aortic sinus and annulus was first identified; since then, it had gradually increased. Given the young age of the patient and the degree of aortic regurgitation (AR), which was mild to moderate, we opted to perform a valve-sparing neo-aortic root replacement with aortic valve repair. Postoperative echocardiography showed successful reductions in the sizes of the aortic sinus and annulus, with only mild AR remaining.

Open Heart Surgery Through other than Full Sternotomy in Adults (성인에서 최소절개를 이용한 개심술)

  • 이재원;송명근
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.576-580
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    • 1998
  • This study is to clarify the results of atrial septal defect(ASD) repair and mitral valve surgery through right anterolateral thoracotomy since 1989, and those of more generalized application of minimal invasive cardiac surgery since August 1997. We retrospectively analyzed the results of open heart surgery(OHS) through other than full sternotomy carried out until October 1997. There were 28 cases of OHS done through right anterolateral thoracotomy(17 cases of ASD, 4 cases of mitral valve repair, 6 cases of mitral valve replacement, and 1 redo mitral and tricuspid valve repalcement) which has demonstrated no surgical mortality or morbidity except only 1 case of reoperation for bleeding. During the period between August and October 1997, we performed near routine application of upper sternotomy or transverse sternotomy in aortic valve cases and routine application of minimal incision in cases with ASD and there was no evidence of early and late complications associated with this approach. We conclude that OHS with the use of minimal incisions is very safe, cosmetically excellent, and superior in terms of the amount of bleeding. The indication for minimal incision, therefore, should be extended afterwards.

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Zebrafish Crip2 Plays a Critical Role in Atrioventricular Valve Development by Downregulating the Expression of ECM Genes in the Endocardial Cushion

  • Kim, Jun-Dae;Kim, Hey-Jin;Koun, Soonil;Ham, Hyung-Jin;Kim, Myoung-Jin;Rhee, Myungchull;Huh, Tae-Lin
    • Molecules and Cells
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    • v.37 no.5
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    • pp.406-411
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    • 2014
  • The initial step of atrioventricular (AV) valve development involves the deposition of extracellular matrix (ECM) components of the endocardial cushion and the endocardialmesenchymal transition. While the appropriately regulated expression of the major ECM components, Versican and Hyaluronan, that form the endocardial cushion is important for heart valve development, the underlying mechanism that regulates ECM gene expression remains unclear. We found that zebrafish crip2 expression is restricted to a subset of cells in the AV canal (AVC) endocardium at 55 hours post-fertilization (hpf). Knockdown of crip2 induced a heart-looping defect in zebrafish embryos, although the development of cardiac chambers appeared to be normal. In the AVC of Crip2-deficient embryos, the expression of both versican a and hyaluronan synthase 2 (has2) was highly upregulated, but the expression of bone morphogenetic protein 4 (bmp4) and T-box 2b (tbx2b) in the myocardium and of notch1b in the endocardium in the AVC did not change. Taken together, these results indicate that crip2 plays an important role in AV valve development by downregulating the expression of ECM components in the endocardial cushion.