• Journal of Chest Surgery
• /
• 제29권5호
• /
• pp.495-503
• /
• 1996

The bidirectional cavopulmonary shunt may be useful as an intermediate procedure before Fontal oper- ation in high-risk patients, because it provides adequate relief of cyanosis and relief of ventricular volume overload. But there are no established theory about the effects of bidirectional cavopulmonary shunt on pulmonary arterial development. The purpose of this article is a study of changes of pulmonary artery size after bidirectional cavopulmonary shunt. Ca diac catheterization and angiography procedures were done on 19 patients who underwent bidirectional cavopulmonary shunt from February 1992 to July 1994, their results were reviewed. Preoperative cardiac catheterization and angiography procedures were performed at a mean interval of ).8 $\pm$4.8($\pm$SEM) months before surgery and following catheterization at a mean postoperative interval of 19.6 $\pm$4.8 months. Pulmonary arterial sixte measurement were standardized for body surface area(Pulmon- arty artery index), and for diameter of descending thoracic aorta(McGoon ratio). Patient's age, body stir- face area, pulmonary angioplasty, preoperative McGoon ratio and follow-up intervals were considered as variables. Before bidirectional cavopulmonary shunt, patient's mean age, body surface area, arterial 02 saturation, diameter of right pulmonary artery, diameter of left pulmonary artery, pulmonary artery Index, McGoon ratio were 13.7$\pm$15.6 months, 0.40$\pm$0.12m2, 71.4$\pm$12.4m2, 7.1$\pm$1.7mm, 6.2$\pm$1 , 191.8$\pm$82.7mm21m2, 1.73 $\pm$0.49, respectively. After bidirectional cavopulmonary shunt, the values were changed to 39.9 $\pm$ 16.2 months, 0.58$\pm$0.07 m2, 83.0$\pm$3.8m2, 9.0$\pm$ 1.5 mm, 7.7$\pm$2.0, 197.3$\pm$57.1 mm2/m2, 1.76$\pm$0.32, respect- ively With patients'development (age, body surf'ace area), diameters of pulmonary arteries were increased, but pulmonary artery indices and McGoon ratios were not changed. And there were no effects of age, body surf'ace area, amount of increased 02 saturation, pulmonary angiography and follow-up duration on the increment of pulmonary ar- tery size. But when the McGoon ratio was as low as 1.2, there were significant increase in postoperative pulmonary artery sizes. There was a significant correlation between preoperative pulmonary artery index (PAI) and McGoon ratio (MGR) ; PAI : MGRxl18.0-12.4 In conclusion, bidirectional cavopulmonary shunt provides adequate increment of arterial 02 saturation and does not increase the pulmonary artery size. Further investi ation is mandatory to evaluate the effect of pulsatile bidirectional cavopulmonary shunt on pulmonary artery growth.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
• /
• pp.38.1-38
• /
• 1981

Currently in the otologic field, there are various methods of special audiometric examinations, such as, tone decay, SISI, and impedance audiometry and only a few studies has been done in these fields sporadically in Korea. The purpose of this paper is to establish norms of various special audiometric tests, so we have performed the special audiometric tests on 100 male medical students in good physical condition and the follow results were obtained. 1. All cases showed over 90% of PB scores. The mean and its 2 S.D. were 98$\pm$4.9% in the right ear and 97$\pm$5.6% in the left ear. 2. The mean and its 2 S.D. of MCL(most comfortable level) were 45$\pm$15.4 dB in the right ear and 46$\pm$17.9 dB in the left ear, and its range was 12$\pm$12.2 dB in the right ear and 13$\pm$12.6 dB in the left ear. 3. The mean and its 2 S.D. of UCL (uncomfortable level) were 102$\pm$7.9 dB in the right ear and 102$\pm$7.9 dB in the left ear and about an half in cases showed over 106 dB of UCL. 4. In 95% of cases, SISIs(short increment sensitivity index) at 1, 000 Hz and 4000 Hz was below 45% in the right ear in both frequencies and below 55% and 75% in the left ear, respectively. 5. In 95% of cases, tone decays at 2, 000 Hz and 4, 000 Hz was below 10 dB in both ears. 6. The difference between SRT and PTA (speech reception threshold minus pure tone average) was 4$\pm$9.2 dB in the right ear and 4$\pm$10.0 dB in the left ear. 7. The dynamic range(uncomfortable level minus speech reception threshold) was 98$\pm$13.5 dB in the right ear and 99$\pm$13.5 dB in the left ear. We had trouble in estimating the dynamic range in about an half in cases, in which we couldn't estimate the UCL with our conventional audiometry. 8. The results of impedance audiometric tests were as follow: A. In the tympanogram, all cases were of A type with one exception of B type in the left ear. The mean and its 2 S.D. of its peak level were 22.8$\pm$32.94mm $H_2O$ in the right ear and 23.9$\pm$29. 81mm $H_2O$ in the left ear. B. The mean and its 2 S.D. of the compliance were 0.6$\pm$0.54cc in the right ear and 0.6$\pm$0.53cc in the left ear. C. The results of stapedial reflex: a. The mean and its 2 S.D. of the controlateral stapedial reflex at 500Hz, 1, 000Hz, 2, 000Hz, 4, 000Hz were 99$\pm$17.7 dB, 87$\pm$14.4 dB, 79$\pm$13.7 dB, 77$\pm$20.0 dB in the right ear and 99$\pm$15.9 dB, 88$\pm$13.9 dB, 79$\pm$13.7 dB, 77$\pm$21.3 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wasn't generated in 6 cases in the right ear and 11 cases in the left ear. b. The mean and its 2 S.D. of the ipsilateral stapedial reflex at 1, 000Hz, and 2, 000Hz were 89$\pm$16.3 dB, 82$\pm$15.9 dB in the right ear and 89$\pm$18.0 dB, 83$\pm$18.9 dB in the left ear. Depending on the tested frequencies, the stapedial reflex wans't generated in 1 case in the right ear and 2 cases in the left ear. 9. Eustachian tube function using with impedance audiometry was malfunctioned in21 cases depending on the tested pressure and the range of peak level of tympanogram was 14$\pm$26.9mm $H_2O$(tested pressure:+250mm $H_2O$), 8$\pm$21.9mm $H_2O$ (tested pressure:-250mm $H_2O$) in the right ear and 11 cases depending on the tested pressure and the range of the peak level of tympanogram was 12$\pm$22.5mm $H_2O$ (tested pressure: +250 mm $H_2O$, 9$\pm$17.3mm $H_2O$(tested pressure: -250mm $H_2O$) in the left ear.