• 제목/요약/키워드: valve detachment

검색결과 13건 처리시간 0.022초

Emergency Quadrido-Bentall Procedure for Aortic Rupture in a Patient with Behcet's Disease

  • Park, Sung Jun;Lee, Jeong-woo;Kim, Joon Bum
    • Journal of Chest Surgery
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    • 제48권5호
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    • pp.364-367
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    • 2015
  • Cardiovascular involvement in cases of Behcet's disease is a rare but life-threatening condition, and prosthetic valve detachment is a frequent and serious complication attributable to Behcet's disease following the surgical repair of aortic regurgitation. We report the case of a patient with Behcet's disease presenting with contained aortic rupture around the aortic root. The patient had previously undergone aortic valve surgery three times due to recurrent prosthetic valve detachment. An emergency operation was performed, consisting of aortic root replacement (ARR) using a composite valved conduit and the replacement of the hemiarch. ARR may be an appropriate surgical option for patients with Behcet's disease in order to prevent recurrence of the disease.

삼첨판막절개아 심실중격결손증의 수술 이후의 삼첨판막의 기능에 대한 연구 (A Study of Electrocardiographic Change and Tricuspid Competence after Temporary Detachment for Closure of Ventricular Septal Defect)

  • 정성운;박준호;김종원
    • Journal of Chest Surgery
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    • 제36권9호
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    • pp.633-637
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    • 2003
  • 일시적인 삼첨판 절개법은 좋은 시야를 제공하고 심실을 열지 않고 심실중격결손의 폐쇄수술을 할 수 있다. 그러나 대부분의 외과의는 삼첨판막의 폐쇄부전의 염려로 주저하게 된다. 특히 최근의 교과서에서는 일시적인 삼첨판 절개법은 장기성적의 발표가 예외적인 방법으로만 기술되어 있고 더 이상의 분석이나 기술이 되어 있지 않다. 대상 및 방법: 1985년부터 1994년까지 수술받은 11명으로부터 술 전의 자료, 술 후 경과, 최근 심초음파와 심전도를 토대로 후향적 연구를 시행하였다. 결과: 심초음파에서 삼첨판폐쇄부전은 없는 경우가 9명, 미세한(trivial) 경우가 2명이었고, 심전도상 의미있는 심전도블록은 없었다. 결론: 삼첨판 절개법은 심실중격결손의 폐쇄수술을 시행하는 데 안전하며 향상된 시야를 제공하는 데 효과적인 방법이며, 삼첨판 이상이나 심전도상에 나쁜 영향을 끼치지 않는다.

베체씨 병에서의 동종 이식편을 이용한 대동맥 근위부 치환술 - 1례 보고 - (Aortic Root Replacement with Homograft in Behcet's Disease -A Case Report-)

  • 문현종;안혁
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.92-96
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    • 1997
  • 구강 생식기의 궤양, 안구와 피부 병변을 특징으로 하는 베체씨 병의 예후는 중추 신경계, 위장관, 혈 관계의 합병증에 의존된다. 심장의 병변 특히 대동맥 판막 폐쇄부전증은 매우 드물고, 일반적으로 혈역 학적 불안정성은 개심술을 통하여 치료된다. 그러나 많은 환자에서 인공 판막의 이탈, 판막 주변 누출. 전도 장애, 가성 동맥류 등의 심각한 합병증이 보고되어 왔다. 이런 합병증을 막기 위하여 많은 노력이 있었으며 그중 하나는 동종 이식편읜 사용이었다. 서울대학교병원 흉부외과에서는 베체씨 대동맥염으로 인해 인조 판막 이탈이 있었던 39세 남자 환자에서 동종 이식편을 이용한 대동맥 근위부 치환술을 시도하여 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

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대동맥판막 재이식술 -1예 보고- (Redo AVR: One Case Report)

  • 성상현;성숙환;이영균
    • Journal of Chest Surgery
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    • 제15권2호
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    • pp.254-258
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    • 1982
  • We have experienced one case of Redo AVR which was performed 13 months after initial operation. The patient had received AVR [Bjork-Shiley disc valve] and MVR [Ionescu-Shiley tissue valve] because of ASI and MSI at March, 1981. During follow up through the OPD, he complained exertional dyspnea and progressive jaundice with hemolytic anemia was also noticed since 1 month prior to readmission. Cardiac catheterization and angiography revealed periaortic valvular leakage due to partial detachment of previously replaced prosthetic aortic valve. Re-replacement of prosthetic aortic valve with Ionescu-Shiley valve was performed and the patient was discharged at 17th POD without any complications.

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인공판막 치환수술 재수술에 대한 임상적 고찰 -12예보고- (Clinical Analysis of Reoperation for Prosthetic Valve Replacement Report of 12 cases)

  • 장진우;이연재
    • Journal of Chest Surgery
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    • 제30권4호
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    • pp.390-395
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    • 1997
  • 1986년 5월부터 1996년 5원까지 총 269명(조직판막70례, 금속판막 232례)의 판막 치환술 환자중 판막의 재치환술이 필요했던 12례를 분석 하였다. 승모판 재치환술이 9례, 대동맥 판막 치환이 3례로 연령범 위는 16세에서 68세까지로 50대 이후가 가장 많았다. 초인공판막치환후 재 수술이 필요했던 숭모판막의 경우 평균 87.6개월, 대동맥판막의 경우 36.7개월로서, 대부분의 경우 운동시 호흡곤란이 주증상이었으며 원인으로서는 판막자체의 구조적 실패 5례, 심내막염 2례였으며 재치환술에 사용된 판막은 기계판막 11례, 조직판막 1례로 수술후 사망률은 17% (2/12)였고 술후 심내막염 및 폐렴에 의한 호흡부전으로 사망하였다.

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압력 비평형형 유압 베인 펌프의 토출 압력 맥동 특성 연구 (A Study on the Discharge Pressure Ripple Characteristics of the Pressure Unbalanced Vane Pump)

  • 장주섭
    • 한국정밀공학회지
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    • 제26권4호
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    • pp.55-63
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    • 2009
  • This paper reports on the theoretical and experimental study of the pressure ripples in a pressure unbalanced type vane pump which have widespread use in industry. Because they can infinitely vary the volume of the fluid pumped in the system by a control. Pressure ripples occur due to the flow ripples induced by geometry of side plate, leakage flow, reverse flow from the outlet volume produced by pressure difference between pumping chamber and outlet volume when the pumping chamber connected with the outlet volume. In this paper, we measured the pressure variation of a pumping chamber, reaction force on a cam ring, the mathematical model for analyzing the pressure ripples which included vane detachment and fluid inertia effects in notch area has been presented, and was applied to predict the level and the wave form of the pressure ripples according to operating conditions.

총동맥간증의 교정수술 (Corrective surgery of truncus arteriosus)

  • 조형곤
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.457-463
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    • 1986
  • Truncus Arteriosus is uncommon, accounting for 0.4%-2.8% of all congenital cardiac malformations. Truncus arteriosus has a poor prognosis in early infancy and defined as "a single arterial trunk that leaves the heart by way of a single arterial valve and that gives rise to the coronary, systemic and one or both pulmonary arteries directly." Through antemortem study of patients with truncus arteriosus the development of surgical techniques for palliation and correction was established. Recently we had surgical experience of truncus arteriosus - Collett '||'&'||' Edwards type 2. The main pulmonary artery was originated from truncus at right posterolateral aspect. Truncal valve was tricuspid with good coaptation. Ventricular septal defect was subarterial type of 2.0 cm in diameter. After detachment of the main pulmonary artery from truncus, truncus was repaired directly. Ventricular septal defect was closed with Dacron patch. Extracardiac valved conduit [Carpentier-Edwards: 16mm] was employed for making continuity between right ventricular outflow tract and pulmonary artery. Postoperatively, incomplete right bundle branch block on electrocardiogram was continued. Patient was died due to respiratory failure in postoperative 40 days.s.

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저밀도 세라믹 필터의 고온 여과 성능시험에 관한 연구 (A Study on the High Temperature Filtration Performance Test of Low Density Ceramic Filters)

  • 이동섭;홍민선;최종인
    • 한국대기환경학회지
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    • 제17권1호
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    • pp.75-84
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    • 2001
  • Hot gas filtration method via using ceramic filters is an evolving technology applicable to numerous industrial and air pollution control processes. Alumino silicate, organic and inorganic binders were the major raw materials in manufacturing ceramic filters. In this work, disc type ceramic filters(50$\phi$$\times$10t) were manufactured by vacuum forming processes using ceramic raw materials. The porosity and bulk density of disc type ceramic filers ranged from 86 to 89% and from 0.27 to 0.36 g/㎤, respectively. In this work disc type ceramic medium were tested utilizing coupon experimental apparatus. Disc type filters showed high collection efficiencies over 99.96% with Darchs law coefficients of 4.1$\times$10(sup)10~9.63$\times$10(sup)10/$m^2$ depending on mean pore sizes. In addition, filtration and detachment of ceramic filters turned out to be performed effectively using 10 cm/sec face velocity, 5 minutes filtration cycle, 100msec pulse jet valve opening time and 3 bar pulsing pressure.

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성인 활로씨 4징증 수술치험 101예 보고 (Surgical Correction of Tetralogy of Fallot in Adults - 101 Cases Report -)

  • 조범구
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.649-655
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    • 1988
  • One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

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