• Journal of Chest Surgery
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• v.42 no.4
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• pp.543-559
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• 2009

Dr Lillehei (1918$\sim$1999) pioneered cardiac surgery with his landmark operations using cross-circulation in 1954 and 1955. With his dedications to open heart surgery, he is generally considered to be the father of open heart surgery by many medical historians. Dr Lillehei expanded his contributions to cardiac surgery with training 134 cardiothoracic surgeons at the University of Minnesota Hospital and he trained an additional 20 surgeons at the Cornell Medical Center. Dr Lillehei's trainees came from all over the world and Dr YK lee (1921$\sim$1994) of Seoul National University was among them. He joined the University of Minnesota Hospital in 1957 as a part of the Minnesota project. During his stay for two years, in addition to experimental research, he learned clinical cardiac surgery as part of Dr Lillehei's team. In 1959, after returning to Korea, Dr Lee began his career as. a full-time cardiac surgeon with establishing the Division of Cardiac Surgery at Seoul National University. Hospital. Yet he encountered many difficult barriers in the process. During that time, Dr Lillehei was willing to share his experience and he provided many valuable resources for cardiac operations. With Dr Lillehei's kind help, the open heart surgery program was gradually and successfully established at Seoul National University Hospital. These two surgical titans from across the Pacific Ocean died in 1994 (Dr Lee) and 1999 (Dr Lillehei). They are gone, yet the proud Korean people have not forgotten them.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.4
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• pp.1728-1736
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• 2013

The purpose of this study is to identify prognostic predictors of postoperative acute renal failure(ARF) for the patient undergoing cardiac surgery. Retrospectively review the electronic hospital database at a A hospital from Jan 2008 to Dec. 2011. 483 patients were included in this study. They were divided into a occurrence of ARF group(n=59) and a non occurrence of ARF group(n=424). ARF occurred in 59 cases (12.2%). Multi-variable logistic regression analysis identified that preoperative risk factors include creatinine(OR 3.92, p=<.001), advanced age(OR 2.142, p=.015), female(OR 2.165, p=.015), hypertension(OR 2.513, p=.005), NYHA(New York Heart Association) class II(OR 3.081, p=.003), and III(OR 6.759, p=.004), and intraoperative risk factor includes blood transfusion(OR 3.753, p=<.001), and postoperative factors include bilirubin(OR 4.541, p=.028), creatine(OR 8.554, p=.003), and cardiac output(OR 0.214, p=.033) as a prognostic predictors. The development of postoperative ARF could be a reason for increase in rate of complication and mortality after cardiac surgery. therefore the prevention of ARF is of paramount importance and treatment strategies are urgently needed.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.1-6
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• 1998

Total body water is increased after cardiopulmonary bypass resulting in tissue edema and organ dysfunction. Ultrafiltration has been used to reduce this accumulation of water. We have carried out a prospective randomized study in 17 children undergoing open heart surgery, comparing modified ultrafiltration(MUF) with nonfiltered controls. MUF was carried out for about 10 minutes after completion of cardiopulmonary bypass to a hematocrit 36∼42%. Blood loss, blood transfused, hemodynamics, and laboratory data were recorded for 24 hours postoperatively. The results were analyzed using Mann-Whitney U test, comparing controls(n=7) to ultrafiltered(n=10). There was no death in each group. The mean filtrate volume(ml/kg) was 42(30∼68). Blood loss(ml/kg/24hr) was 14.5 mean(4.0∼26.6) in controls versus 12.1 mean(6.0∼21.5) in MUF(P＞0.05) ; blood transfused(ml/kg/24hr) was 9.4 mean (6.0∼36.3) in controls versus 3.4 mean(0∼11.4) in MUF(P<0.05). There was rise in arterial blood pressure during MUF. Percent rise of systolic blood pressure was 4.2(0∼11.7) in controls versus 19.8(7.0∼36.9) in MUF(P=0.001). Percent rise of diastolic blood pressure was 10.0(1.6∼20.8) in controls versus 30.6(5.8∼73.3) in MUF(P<0.05). Platelet count, fibrinogen, and oncotic pressure rose after MUF. No complications directly attributable to the ultrafiltration were observed. Conclusively, MUF is safe, effective means of removing body water and beneficial to hemodynamics.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.305-307
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• 1989

Cold agglutinins are a potential danger to patients who must be subjected to hypothermia. A patient with a cold agglutinin of moderate titer but broad thermal amplitude was to undergo hypothermia during double valve replacement. She was managed preoperatively with plasmapheresis 5 times. There was no complication during and after operation.

• Proceedings of the KTCVS Conference
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• 1998.10a
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• pp.9-9
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• 1998

• Proceedings of the KTCVS Conference
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• 1993.06a
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• pp.14-14
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• 1993

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.237-240
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• 2005

Improved operative, anesthetic, and cardiopulmonary bypass (CPB) techniques have significantly reduced postoperative complications; however, neurologic disorders remain a serious complication after open heart surgery. Possible explanations for neurologic complications are microembolism from CPB, decreased cerebral pefusion pressure due to intraoperative hypotension and unexpected metabolic changes. Amomg these, seizure has low incidence and Todd's paralysis after open heart surgery is extremely rare. Todd's paralysis is a complication of a seizure due to neuronal exhaustion mimicking large cerebral infarction after open heart surgery.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.256-258
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• 2009

A 63-year-old man who had a permanent pacemaker placed 17 years ago presented to us with local inflammatory signs on his chest. The skin was opened to remove the permanent pacemaker. However, the pacing wire was not easily removed. So, the permanent pacemaker was removed from the chest with leaving the remnant wire inside. However, the local infection recurred because of the remnant wire. Right thoracotomy was performed and cardiopulmonary bypass was started. After total circulatory arrest, the right atrium was opened and the wire was completely removed.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.65-73
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• 2011

Purpose: This study was to develop and evaluate stability and effects of an early exercise program for patients with open heart surgery. Methods: The subjects of this study were 30 patients who had either a coronary bypass surgery or a valvular heart surgery at a tertiary hospital in Seoul. The data was collected by observation and measurement from October 1, 2004 to November 15, 2004. Results: The early exercise program developed for this study consisted of range of motion exercise and walking. Intensity of walking was 1~3 METs and increased progressively to daily target distance. During exercise, the subjects were monitored heart rate, blood pressure and RPE (Rating of Perceived Exertion). The mean FIM (Functional Independent Measurements) score of subjects was significantly improved after the early exercise program. However, several complaints such as dizziness or pain were also reported. Most complaints were associated with chest tube and RPE. Conclusion: The early exercise program can help to recover patients' physical activities after surgery, and can be applied to most patients. Patients' RPE, dizziness and pain was possible limitations, therefore, active pain control and prevention of accidents for patients would be needed.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.364-367
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• 1999

Background: The efficacy of the hemostasis of prophylactic aprotinin after cardiac valve replacement was evaluated from January 1994 to December 1996 at Pusan National University Hospital. Material and Method: In a randomized study, 20 patients received aprotinin(2${\times}$106 KIU as a loading dose for 30 minutes after anesthesia, 1${\times}$106 KIU for priming and 5${\times}$105 KIU/hr as a maintenance dose from the completion of loading dose till skin closure) and another 20 untreated patients served as controls. Result: Aprotinin produced a significant reduction in postoperative blood loss compared with controls and significantly decreased total exposure to allogenic blood products compared with the control group(p<0.05). Conclusion: We conclude that aprotinin effectively reduces postoperative blood loss and trasfusion in patient undergoing cardiac valve replacement.