• Journal of Chest Surgery
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• v.37 no.9
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• pp.793-795
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• 2004

Modified Norwood procedure with maintaining cardiac beat was done in a 30-day-old neonate. Procedure was done with regional perfusion of innominate and coronary artery. Postoperative course was uneventful. Second-stage operation (bi-directional cavopulmonary shunt) was done 4 months later. The diameter of ascending aorta was more than 5 mm, Norwood procedure can be done in beating hearts.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.63-66
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• 2010

Apical muscular ventricular septal defects (VSDs) are relatively rare conditions among all the different types of VSDs. Apical VSDs are difficult to treat because of they are difficult to visualize through a trans-atrioventricular approach, and especially in infants. Treatment by left ventriculotomy is associated with long-term ventricular dysfunction. Catheter-based intervention still shows less than satisfactory results and this type of intervention may not be possible in small infants. This report describes the benefits of right apical ventriculotomy in terms of successful closure of the lesion without harming the ventricular function.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.263-269
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• 1997

From April 1987 to May 1996, 13 infants underwent a Norwood operation for complex congenital heart diseases including hypoplastic left heart syndrome (n : 7), mitral stenosis with small VSD and subaortic stenosis (n : 1), mitral atresia with ventricular septal defect, coarctation of aorta, and subaortic stenosis (n = 1), interrupted aortic arch with ventricular septal defect and subaortic stenosis (n : 1), tricuspid atresia with transposition of the great arteries (n = 1), and complex double-inlet left ventricle (n : 2). All patients without hypoplastic left heart syndrome were associated wit hypoplasia of ascending aorta and arch. Age at operation ranged from 3 days to 8.7 months (mean 60.6 $\pm$ 71.6 days, median 39 days). The operative mortality( < 30 days) was 46% (6 patients). Late mortality was 15% (2 patients). All operative deaths occured during the Erst 24 hours after the operation as a result of cardiopulmonary bypass weaning failure (5 patients) and sudden hemodynamic instability postoperatively (1 patient). Late death was due to aspiration pneumonia in two cases. There are 5 long-term survivals (39%). Three of them have undergone a two-stage repair with a modified Fontan operation in two and total cavopulmonary shunt in one at 12, 17, 4.5 months after Norwood procedure with no mortality. Two patients have entered a three-stage repair strategy by undergoing a bidirectional cavopulmonary shunt at 3 and 5.5 months after initial operation with 1 operative death. The actuarial survival rate for all patients at the first-stage operation, including hospital deaths and ate death was 30.8% at 1 year. In conclusion, the operative mortality of Norwood operation was relatively high compared to other operation for major cardiac anomalies, continuing experience will lead to an improvement in result.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1024-1027
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• 1997

Anomalous origin of left coronary artery from pulmonary artery(ALCAPA) is a rare fatal congenital anormaly that needs early surgical intervention. Many reports say that the choice of operative procedure is reimplantation of the left coronary artery into the ascending aorta. We experienced the surgical management of a case of the ALCAPA. The patient was 44 days old and 3.45 kg weighed female baby who had a symptom of congest ve heart failure. She underwent implantation of coronary artery on the aorta with cardiopulmonary bypass and recovered without any complications.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.509-512
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• 2009

Ebstein's anomaly is a complex congenital defect of the tricuspid valve and right ventricle. Various surgical methods to repair the regurgitant tricuspid valve have been reported, and most of them depend on monocuspidalization with using the anterior leaflet. We report here on our first experience with Ebstein's anomaly in a 31-year-old female patient who underwent cone reconstruction of the tricuspid valve with using three leaflets.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.892-899
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• 1995

Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.14 no.2
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• pp.153-160
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• 1981

Within the group of congenital cardiac anomalies manifesting dextrocardia and double-outlet right ventricle, ventricular non-inversion [S.D.L] is extremely rare. Recently, a 5 year-old boy underwent a successful surgical correction of dextrocardia associated with double-outlet right ventricle, ventricular non-inversion [S.D], ventricular septal defect, pulmonary stenosis, and patent foramen ovale. The operation consisted of construction of an internal baffle connecting the left ventricle to the aorta through the large ventricular septal defect [subaortic]. The pulmonary stenosis was managed by infundibulectomy and patch enlargement of the right ventricular wall. The patient`s postoperative recovery has been uneventful, and 2 months after the operation, he is doing well.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.99-106
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• 2004

Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.609-614
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• 2002

Purpose : The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. Methods : We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos $2500^{(R)}$) from subcostal long and short axis views. Results : There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm-six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. Conclusion : We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.499-503
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• 2008

Berry syndrome (a distal aortopulmonary window and a right pulmonary artery originating from the ascending aorta, an intact ventricular septum, a patent ductus arteriosus and an interrupted aortic arch) is a rare complex congenital cardiac malformation. We describe a case of one stage repair with using an autologous arterial flap in a 19-day-old neonate who was suffering with this malformation, and we report on the development of postoperative right pulmonary artery stenosis and its successful management with performing multiple balloon angioplasties.