• Title/Summary/Keyword: 대동맥판막, 협착

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Supravalvular Aortic Stenosis with Aortic Regurgitation (대동맥판막 폐쇄부전증을 동반한 대동맥판막 상부 협착증)

  • 김정태;이철주;소동문;한정선
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.591-594
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    • 1999
  • Supravalvular aortic stenosis is an uncommon, congenital narrowing of the ascending aorta which originates just distal to the level of the ostium of the coronary artery. We conducted a successful surgical treatment in a 39 year- old female patient with a congenital supravalvular aortic stenosis and aortic regurgitation who did not show signs of William's syndrome. After we performed an inverted Y-shaped aortotomy toward the noncoronary sinus and right coronary sinus, pantaloon shaped prosthetic patch(Vascutek, Ino, USA) was used to repair the narrowing sinotubular junction. The aortic valve was replaced concommittently using Sorin Bicarbon 19mm. Her postoperative course was uneventful. The patient discharged at 9th postoperative day in good health.

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Aortic Valvuloplasty in Pediatric Age (소아연령군에서의 대동맥판막성형술)

  • 임홍국;박천수;황호영;김웅한;이정렬;노준량;김용진
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.652-659
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    • 2004
  • Background: In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. Material and Method: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1$\pm$61.5 (1∼223) months. The mean follow up was 50.8$\pm$30.2 (3∼121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0$\pm$33.0 mmHg, and the mean grades of AR were 3.1$\pm$0.9. Result: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5$\pm$21.0 mmHg (p < 0.05), and AR improved with mean grades of 1.9$\pm$0.8 (p < 0.05). At mean follow up of 35.0$\pm$23.0 months, AS maintained with mean peak pressure gradients of 31.5$\pm$24.0 mmHg, but AR progressed with mean grades of 2.8$\pm$1.3 (p < 0.05). Reoperation was required in 6 patients 38.3$\pm$21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9$\pm$3.1%, 79.5$\pm$5.5%, and 56.8$\pm$11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR. Conclusion: Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.

Classificatin of Normal and Abnormal Heart Sounds Using Neural Network (뉴럴네트워크를 이용한 심음의 정상 비정상 분류)

  • Yoon, Hee-jin
    • Journal of Convergence for Information Technology
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    • v.8 no.5
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    • pp.131-135
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    • 2018
  • The heart disease taking the second place of the cause of the death of modern people is a terrible disease that makes sudden death without noticing. To judge the aortic valve disease of heart diseases a name of disease was diagnosed using psychological data provided from physioNet. Aortic valve is a valve of the area that blood is spilled from left ventricle to aorta. Aortic stenosis of heart troubles is a disease when the valve does not open appropriately in contracting the left ventricle to aorta due to narrowed aortic valve. In this paper, 3126 samples of cardiac sound data were used as an experiment data composed of 180 characteristics including normal people and aortic valve stenosis patients. To diagnose normal and aortic valve stenosis patients, NEWFM was utilized. By using an average method of weight as an feature selection method of NEWFM, the result shows 91.0871% accuracy.

Aortic Valve Replacement with Pulmonary Autograft in Patient with Congenital Aortic Stenosis : Ross Procedure without Homograft -one case report - (선천성 대동맥판 협착증에서 폐동맥판 자가이식편을 이용한 대동맥판 교체술:동종판막을 쓰지 않는 Ross술식)

  • 이은상;윤태진;서동만
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.303-306
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    • 1999
  • This is a genuine case report of the Ross operation without the use of homografts or heterografts in reconstruction of the right ventricular outflow tract. A 8-year-old boy with congenital aortic stenosis underwent aortic valve replacement with a pulmonary autograft and right ventricular outflow tract reconstruction with a pericardial conduit bearing autologous aortic monocusp. The postoperative echocardiography and cardiac angiography revealed good ventricular function and competent neoaortic valve. He has been followed up for 19 months.

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Congenital Quadricuspid Semilunar Valve - A case report - (선천성 사엽성 반월형 판막 - 1예 보고 -)

  • Seo, Min-Bum;Seo, Hong-Joo
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.361-363
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    • 2009
  • A 17-year-old male patient was referred with symptoms of dyspnea. Multi-detector computerized tomography (MDCT) and echocardiography evaluation revealed quadricuspid aortic and pulmonary valves, an atrial septal defect (ASD), and pulmonary stenosis. We closed the ASD using a bovine patch and performed a commissurotomy of the pulmonary valve. Quadricuspid semilunar valves are very rare congenital abnormalities that are reported to occur nine times more frequently in the pulmonic valve than in the aortic valve. According to the Hurwitz Roberts classification, the aortic valve was type A, and the pulmonic valve was type B. The aortic valve normal function, but the pulmonic valve was stenotic and had abnormal function.

Fibrocalcific Embolism of Right Coronary Artery Combined with Aortic Valvular Stenosis (대동맥판협착증에 동반된 우관상동맥의 석회성 색전증)

  • 장성욱;박정옥;김영권;이명용;류재욱;박성식;서필원;김삼현
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.858-861
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    • 2003
  • The main cause of ischemic heart disease combined with aortic valve disease is the systemic atherosclerotic process. Coronary artery embolism by a particle from the calcified aortic valvular tissue is very rare. A 73-year-old female patient was admitted due to chest tightness of recent onset. Two dimensional echocardiogram showed severe calcific aortic valve stenosis. Preoperative coronary angiogram exhibited a stenotic lesion at the distal right coronary artery, which seemed to be embolic in origin. The coronary embolus was removed through the coronary arteriotomy and then the arteriotomy site was repaired by onlay patch angioplasty technique. Aortic valve was replaced by a bioprosthetic valve. The embolus was reported as a fibrocalcified particle of diseased valve.

Aortic Stenosis in Systemic Lupus Erythematosus Syndrome (전신성 흥반성 낭창에 동반된 대동맥 판막 협착증의 수술 1에)

  • 최주원;김우식;고행일;강윤경;김용인
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.613-616
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    • 2004
  • Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.

Influence of Prosthesis Size on Change in Left Ventricular Hypertrophy Following Aortic Valve Replacement (대동맥판막협착증 환자에서 판막치환 후 좌심실 심근비후의 변화에 대한 판막크기의 영향)

  • 이희성;지현근;김건일;홍기우;신윤철
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.57-63
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    • 2001
  • 배경: 대동맥판막협착증 환자는 판막질환으로 인한 만성적인 후부하의 증가에 대한 보상성 좌심실 심근비후가 일어나게 된다. 대동맥 판막 치환 후 좌심실 심근 비후의 감소가 이루어지는 것으로 알려져 있으나 21mm이하의 작은 인공판막으로 치환시 좌심실 심근 변화에 대해 논란이 있다. 대상 및 방법: 1994년 9월부터 1998년 7월까지 한림대학교 강동성심병원 흉부외과에서 대동맥판막협착증으로 진단받고 판막치환술을 시행한 20명을 대상으로 하였다. 환자는 남녀 각각 13명, 7명이며 평균나이 61$\pm$13.8세 체표면적은 평균 1.57$\pm$0.14m$m^2$이었다. 환자의 추적관찰은 수술 전, 수술 후 초기(평균 10.4일) 및 수술 후 만기(평균 29.9개월)에 심초음파로 시행하였다. 환자들은 사용된 판막에 따라 2개의 군(1군;21mm 이하, 2군;23mm이상)으로 나누었다. 결과: 모든 군에서 NYHA Functional class의 유의한 감소가 있었다. 좌심실 구추률은 수술 전후 1군은 유의한 차이가 없었으나 2군에서는 유의한 차이가 있었다. 그러나 수술 전 좌심실 구출률이 2군에서 1군에 비해 유의하게 감소되어 있었다(p=0.044). 좌심실근량지수는 1군은 수술후 초기에 유의한 감소가 없었으나 수술후 만기에는 유의한 감소를 보여주었다. 그러나 2군은 수술후 초기와 만기에 모두 유의한 감소를 보여주었다. 결론: 21 mm이하 군과 23 mm이상 군 모두 임상적 호전이 있었다. 그러나 19 mm판막군이 2례로 적어 19 mm 판막의 사용시 환자의 나이와 체표면적, 운동량을 고려하여 신중한 판막선택이 고려된다.

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Aortic Valve Replacement in a Patient with Aortic Arch Syndrome Secondary to Takayasu's Arteritis -One case - (Takayasu씨 동맥염에 의한 대동맥궁 증후군 환자에서 대동맥판막 치환술 - 1예 보고 -)

  • 최종범;양현웅;이삼윤
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.88-91
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    • 2004
  • Aortic regurgitation is not a rare complication of Takayasu's disease. Aortic regurgitation may aggravate cerebral ischemic syndrome like syncope in patients with stenotic or occlusive lesions in cerebral branches of aorta secondary to acute or progressive inflammation. In a 34-yrs-old male patient who complained of syncope and exertional dyspnea with occlusion of both carotid arteries and severe stenoses of both subclavian arteries, occlusion of right coronary artery, and aortic regurgitation, his symptom was improved with perioperative aggressive steroid therapy, stent insertion in both subclavian arteries, and aortic valve replacement.

Surgical treatment of Supravalvular Aortic Stenosis (판막상부 대동맥협착증의 외과적 요법)

  • 장우익;오삼세;이정렬;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.763-769
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    • 1998
  • Background: Supravalvular aortic stenosis is a rare form of congenital cardiac anomaly involving ascending aorta distal to coronary orifice. Materials and methods: We operated 12 cases of supravalvular aortic stenosis between July 1986 and March 1997. Age ranged from 4 to 17(mean 10.2) years and 11 of them were male. Nine patients had clinical features of Williams syndrome. We experienced two types of supravalvular aortic stenosis, including 10 hour glass type and 2 diffuse type. Results: Preoperative transaortic pressure gradient ranged from 40 to 180(mean 92) mmHg by cardiac catheterization. Pulmonary stenosis was associated in 5 and 2 of them required angioplasty. Operative techniques included 6 standard aortoplasty with elliptical patch, 4 extended aortoplasty with inverted Y shaped patch, and 2 modified Brom's repair. There were no operative deaths. Postoperative echocardiographic evaluation was done at a mean interval of 12 months. Grade I or II aortic regurgitation was found in 3 cases. Postoperative cardiac catheterization revealed a mean transaortic pressure gradient of 26 (range 0 to 75) mmHg. A mean pressure drop was 78(range 30 to 114) mmHg. All patients were followed up for a mean of 40(range 1 to 67) months with uneventful clinical course. Conclusions: Our data proved the low mortality and excellent hemodynamic improvement after surgical relief of supravalvular aortic stenosis in children.

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