• Title/Summary/Keyword: valve defect

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A study on surgical significance of angiographic pulmonary arterial size in tetralogy (활로 4 징증에서 술전 폐동맥 크기에 대한 연구)

  • Jo, Jae-Il;Kim, Jong-Hwan
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.40-48
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    • 1983
  • Tetralogy of Fallot is characterized by the interventricular septal defect associated with obstruction of the right ventricular outflow. The importance of the latter anatomic malformation was clinically evaluated according to the angiographic measurements of the pulmonary arteries along with the pulmonary valve annulus. Seventy of a total 76 patients operated on during a whole year of 1981 were the patients for clinical evaluation. Fifteen patients died within 1 month after operation with the operative mortality of 21.4%. The young age and the severity of pulmonary arterial hypoplasia were ones among the surgical risk factors at a total corrective surgery of tetralogy. Preoperative angiographic measurements of the pulmonary arteries to speculate the expected postoperative ratio between the left ventricular and the right ventricular pressures were retrospectively calculated according to the formula. The predicted values of P RV/LV greater than 0.5 carried apparenliy higher complication and mortality rates than the group of P RV/LV less then 0.5. The selection of the candidates for either a total correction or the staged operation In tetralogy of Fallot can be evaluated on the preoperative angiographic measurements and the expected Improvements of the clinical results were discussed.

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Cor triatriatum associated with partial anomalous pulmonary venous drainage: one case report (폐정맥 환류이상을 동반한 삼중방심 치험 1)

  • Kim, Yeong-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.381-388
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    • 1984
  • Cor triatriatum is rare congenital cardiac anomaly first described by Church in 1868. The anomaly consists of an abnormal partitioning of the left atrium by a fibromuscular membrane that divides the atrium into an upper chamber, which receives the pulmonary veins, and a lower chamber, which contains the atrial appendage and the mitral valve. The upper and lower chambers communicate through a stenotic fenestration in the membrane, which has the hemodynamic consequence of pulmonary venous obstruction. Recently we experienced cot triatriatum associated with partial anomalous pulmonary drainage to right atrium. The upper chamber was connected to right atrium through a sinus venous type of ASD and received left superior and both inferior pulmonary vein, whereas the lower chamber so called true left atrium communicated with right atrium through foramen ovale type of ASD, left atrial appendage and mitral orifice. And the anomalous membrane has no fenestrations which permit blood flow. The operation was made right atrial approach under the CPB. We excised completely the anomalous septum and reconstructed atrial septal defect with pericardial patch to drain the right upper pulmonary vein to the left atrium. The postoperative course has been good during follow up.

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Left Ventricular Pseudoaneurysm after Surgery for Infective Endocarditis with Annular Abscess - A case report - (판막륜 농양을 동반한 감염성 심내막염 수술 후 발생한 좌심실 가성류 - 치험 1예 -)

  • 황호영;김기봉
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.273-276
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    • 2003
  • We report a surgical case of 39-year-old male with a pseudoaneurysm of the left ventricle. Four years ago, the patient underwent aortic and mitral valve replacements with mechanical valves and abscess removal for infective endocarditis with annular abscess. Recent echocardiography demonstrated a communication between left ventricle and abscess pocket, and the size of pocket increased further at the follow-up echocardiography. The patient underwent patch closure of the defect between left ventricle and pseudoaneurysm located at the aortomitral fibrous continuity, under the cardiopulmonary bypass and cardioplegia. The postoperative course was uneventful and the patient was discharged on the 9th postoperative day.

Study on Laser Welding of Automotive Modular Steering Gear Housing by using Multi-Axis Control (다축제어를 이용한 모듈형 조향장치 하우징의 레이저용접에 관한 연구)

  • Kim, Jung-Do;Lee, Chang-Je
    • Journal of Welding and Joining
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    • v.26 no.6
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    • pp.59-66
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    • 2008
  • Recently, automobile parts progress with modularization, which a great many allied products are modularized. Therefore, the purpose of this study is to develope modular housing for modularization of steering gear. Generally, steering gear housing is composed of valve housing and rack housing, it is important to combine two housings. However, housing having the pipe shape is very sensitive to welding distortion, and welding trajectory is very complicated. In order to solve this subject, cooperative control by using robots was constructed. Further, we developed the dedicated system to suit modular housing based on it, and applied laser welding to there. Moreover, welding speed was controlled in the rapid curve section so that the defect in trajectory of housing was reduced to obtain sound weldment. Accordingly, produced housing by this way is presented enough withstanding pressure to $100kg/cm^2$, and roundness and straightness are measured about 10/100 and 0.9/100 respectively.

Cor Triatriatum with Coronary Artery Disease in an Old Man -A case report- (고령환자에서 관상동맥 질환을 동반한 삼심방심의 수술치험 -1예 보고-)

  • 천종록;이응배;조용근;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.58-61
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    • 1999
  • Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

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An Evaluation of Fatigue Properties on Dissimilar Friction Weld of Heat-Resisting Steels Used in Vehicle Valves (차량 밸브용 내열강재 이종 마찰용접부의 피로특성 평가)

  • 이동길;이상열;정재강
    • Transactions of the Korean Society of Automotive Engineers
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    • v.10 no.2
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    • pp.186-192
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    • 2002
  • The fatigue crack propagation characteristics were investigated on dissimilar friction weld of two kind of heat-resisting steels (STR3 and STR35) commonly used in valve materials for vehicles. A small circular artificial defect was machined to induce fatigue crack at bonded line, heat affected zone and base metal of the weld on the surface of the specimens. From the results of the experiment, the fatigue limits of the materials STR3 and STR35 were obtained to be 429.0MPa and 409.4MPa respectably. The STR35 base metal and 1.0mm HAZ specimens showed 190% and 82% higher fatigue life than STR3 base metal. And the fatigue life of 1.0mm HAZ specimen was shown 99% on STR3 and 29% on STR35 higher than that of their base metal. But the fatigue life of weld interface specimen was shown 18% on STR3 and 72% on STR35 lower than that of their base metal because of the weld interface separation.

Percutaneous Transcatheter Closure of Congenital Ventricular Septal Defects

  • Jinyoung Song
    • Korean Circulation Journal
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    • v.53 no.3
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    • pp.134-150
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    • 2023
  • Ventricular septal defects (VSDs) are the most common kind of congenital heart disease and, if indicated, surgical closure has been accepted as a gold-standard treatment. However, as less-invasive methods are preferred, percutaneous device closure has been developed. After the first VSD closure was performed percutaneously by Lock in 1988, both techniques and devices have developed consistently. A perventricular approach for closure of muscular VSD in small patients and the closure of perimembranous VSD using off-label devices are key remarkable developments. Even though the Amplatzer membranous VSD occluder (Abbott) could not be approved for use due to the high complete atrioventricular conduction block rate, other new devices have shown good results for closure of perimembranous VSDs. However, the transcatheter technique is slightly complicated to perform, and concerns about conduction problems after VSD closure with devices remain. There have been a few reports demonstrating successful closure of subarterial-type VSDs with Amplatzer devices, but long-term issues involving aortic valve damage have not been explored yet. In conclusion, transcatheter VSD closure should be accepted as being as effective and safe as surgery but should only be performed by experienced persons and in specialized institutes because the procedure is complex and requires different techniques. To avoid serious complications, identifying appropriate patient candidates for device closure before the procedure is very important.

Study on the Damage Pattern Analysis of a 3 Phase 22.9/3.3kV Oil Immersed Transformer and Judgment of the Cause of Its Ignition (3상 22.9/3.3kV 유입변압기의 소손패턴 해석 및 발화원인 판정에 관한 연구)

  • Choi, Chung-Seog
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.60 no.6
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    • pp.1274-1279
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    • 2011
  • The purpose of this paper is to present the manufacturing defect and damage pattern of a 3 phase 22.9/3.3kV oil immersed transformer, as well as to present an objective basis for the prevention of a similar accident and to secure data for the settlement of PL related disputes. It was found that in order to prevent the occurrence of accidents to transformers, insulating oil analysis, thermal image measurement, and corona discharge diagnosis, etc., were performed by establishing relevant regulation. The result of analysis performed on the external appearance of a transformer to which an accident occurred, the internal insulation resistance and protection system, etc., showed that most of the analysis items were judged to be acceptable. However, it was found that the insulation characteristics between the primary winding and the enclosure, those between the ground and the secondary winding, and those between the primary and secondary windings were inappropriate due to an insulating oil leak caused by damage to the pressure relief valve. From the analysis of the acidity values measured over the past 5 years, it is thought that an increase in carbon dioxide (CO2) caused an increase in the temperature inside the transformer and the increase in the ethylene gas increased the possibility of ignition. Even though 17 years have passed since the transformer was installed, it was found that the system's design, manufacture, maintenance and management have been performed well and the insulating paper was in good condition, and that there was no trace of public access or vandalism. However, in the case of transformers to which accidents have occurred, a melted area between the upper and the intermediate bobbins of the W-phase secondary winding as well as between its intermediate and lower bobbins. It can be seen that a V-pattern was formed at the carbonized area of the transformer and that the depth of the carbonization is deeper at the upper side than the lower side. In addition, it was found that physical bending and deformation occurred inside the secondary winding due to non-uniform pressure while performing transformer winding work. Therefore, since it is obvious that the accident occurred due to a manufacturing defect (winding work defect), it is thought that the manufacturer of the transformer is responsible for the accident and that it is lawful for the manufacture to investigate and prove the concrete cause of the accident according to the Product Liability Law (PLL).

Fate of Regurgitation of Left Atrioventricular Valve Following Repair of Atrioventricular Septal Defect (완전 방실중격결손증의 수술적 교정 후 잔존 좌측 방실판막부전에 대한 장기적 임상 경과 관찰)

  • 김시호;박한기;장병철;조범구;방정희;박영환
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.961-969
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    • 2003
  • The purpose of this study was to evaluate the fate of left atrioventricular valve regurgitation(LAVVR) following repair of complete atrioventricular septal defects (AVSDs). Material and Method: Between July 1984 and March 2002, repair of complete AV defects were performed in 77 patients. Mean age at surgery was 30.23$\pm$69.11 months (range 1 to 456). Echocardiograms of all survivors after isolated AVSDs correction were reviewed. LAVVR were evaluated with color doppler echocardiography in 64 survival periodically. On each study, LAVVR severity was graded on a 1 to 4 scale, based upon the size of the regurgitated jet. Result: Mild deterioration of LAVV function was fairly common. LAVVR severity increased by >1 grade in 19 patients (30.2%) during the course of the study. However, the deterioration in LAVVR function occurred primarily between 12 and 24 months postoperatively. After the initial 24 postoperative months, LAVVR worsened on only 8 occasions and in each instance worsened by only 1 grade. Deterioration more than 3+ LAVVR occurred in only 3 patients. And deterioration to 4+ LAVVR was not observed after the initial 24 postoperative months but one. Survival curve analysis predicted a 88.2% of ten-year freedom rate from development of 4+ LAVVR after initial operation of complete AVSDs. Conclusion: Postoperative LAVVR remains fairly stable following AVSDs repair, Serious deterioration is rare after 24 postoperative months, especially after the initial 48 postoperative months. But serial follow-up study with echocariogram was need till 24 postoperative months after repair of complete AVSDs.

Clinic Analysis of Heart Surgery -110 cases- (심장수술 110례 임상고찰)

  • Chang, Hoon;Shin, Sung-Aia;No, Joong-Kee;Rho, Jun-Ryang
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.597-603
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    • 2001
  • Background: The purpose of writing this article is to get better clinical results and further clinical improvement based on subject to 110 cases of cardiac surgery which were performed and clinically analyzed. Material and Method: Since January 1995, the patent ductus arteriosus surgery had started in our hospital. In February 1999, an open heart surgery had started and up to September 2000, total of 110 cases were performed as of double ligation of patent ductus arteriosus(10 cases) and open heart surgery(100 cases). Result: Among the patients, Korean-Chines was 74(67.3%) and Han-Chinese was 35(31.8%). Congenital heart disease was 95 cases and acquired valvular heart disease was 15 cases. 83 cases of acyanotic congenital heart disease consisted of ventricular septal defect(VSD) with associated anomaly(45 cases), atrial septal defect(ASD) with associated anomaly(20 cases), patent ductus arteriosus(PDA) with associated anomaly(11 cases), cogenital aortic stenosis(5 cases), double chamber right ventrical(1 case) and Ebstein's anomaly(1 case). Among the 12 cases of cyanotic congenital heart disease, 11 cases of tetralogy of Fallot underwent total correction. Among the 15 cases of acquired valvular heart disease, valvular replacement(7 cases), double valve replacement (3 cases), mitral valve replacement(3 cases) and aortic valve replacement(1 case) were performed. And 8 cases of valvuloplasty were performed by using of commissurotomy, chordal plasty, plasty of papillary muscle, ring type annuloplasty, repair of leaflet. Conclusion: on cogenital heart disease, short term results of surgery for acyanotic cogenital heart disease was good. Among the cyanotic congenital heart disease, tetralogy of Fallot showed a little difference of recovery according to the surgery method so that further follow up observation was needed for long term result. On acquired valvular heart disease, especially, in terms of short term result of valvuloplasty, was relatively good, but further follow up observation was also needed for long term result. There wasn's any operative mortality.

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