• Title/Summary/Keyword: 선천성 심질환

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Clinical Study of 459 Cases of Cardiovascular Surgery (심혈관 수술 459례에 대한 임상적 고찰)

  • Ryu, Han-Young;Jung, Tae-Eun;Park, Yee-Tae;Han, Sung-Sae
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.101-110
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    • 1988
  • Between April, 1984 and September, 1988, 459 patients underwent cardiovascular surgery at the Yeungnam University Hospital. Of these, 355 cases were open heart surgeries and 104 cases were non-open heart surgeries. There were 237 patients of acyanotic congenital cardiac anomalies, 40 patients of cyanotic congenital cardiac anomalies, and 85 patients of acquired heart diseases. The sex ratio of cardiovascular diseases was represented as 1:1.3 in male and female. The age distribution was ranged from 1 day to 65 years old. The common congenital cardiovascular anomalies were ventricular septal defect(38.7%), patent ductus arteriosus(25.5%), atrial septal defect(20.7%), Tetralogy of Fallot(8.3%), and pulmonary stenosis(2.4%) in order of frequency. Among 87 acquired cardiovascular diseases, 81 patients underwent operation for cardiac valvular lesions. 51 patients had mitral valve replacement and 13 patients had aortic valve replacement and 17 patients had double valve replacement. The overall mortality of cardiovascular surgery was 3.3% and mortality of open heart surgery was 3.9%.

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Anomalous systemic arterial supply to lung without sequestration in an infant who has congenital heart disease : a case report (선천성 심장질환을 가진 영아에서 발견된 폐 격리증을 동반하지 않은 폐의 이상 체 동맥 기시 1례)

  • Jang, Yeon Woo;Choi, Duck Young
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.895-897
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    • 2006
  • Systemic arterial supply from the aorta to the lung is a rare congenital anomaly within the spectrum of bronchopulmonary sequestration according to Pryce's terminology. We describe our experience of this anomaly in an infant with congenital cardiac disease confirmed by multidetector CT scan. We found a systemic arterial supply from the aorta to the right lower lobe of lung without right lower lobar pulmonary artery and bronchopulmonary sequestration. This combination of congenital anomaly is most rare form.

Child Rearing Experience Among Mothers of Children with Severe CHD (중증 선천성 심질환 아동 어머니의 양육경험)

  • Cho, Kyung-Mi
    • Child Health Nursing Research
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    • v.13 no.4
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    • pp.454-466
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    • 2007
  • Purpose: To explore the experiences of parenting from the mothers of children with severe CHD and to develop a grounded theory about their experiences. Method: Grounded theory method guided the data collection and analysis. A purposeful sample of 16 mothers of children with severe CHD participated during the period 2003. The data were collected by semi-structured individual interviews. Results: "Raise with dignity" emerged as the core phenomenon. 'Powerlessness' came up as the central concept. The causal conditions working on powerlessness was 'living with a bomb in the heart': uncertainty and the context were 'confronting people's eyes', 'developing child's adaptability'. An intervening condition was 'forming a support system' and consequences for coping with powerlessness were 'overcome' or 'ambivalence' using the strategies for mother's positive personality, care role perception, accepting, acknowledgement, and managing the body and mind. Conclusions: In the results of this study, the mothers of children with severe CHD are continue to struggle with life during children's growth and repeated attacks of disease. They need to be provided with skills to cope with physical and mental problems in rearing the children with expertized information for the entire period of growth.

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Treatment of Pulmonary Hypertensive Crisis Using ECMO - A Case Report - (성인의 선천성 심질환 수술 후 발생한 폐동맥 고혈압 위기증에서 체외막 산소화 장치를 이용한 치험 - 1례 보고 -)

  • 최재성;김기봉
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.664-667
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    • 2002
  • Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies (소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술)

  • Kwak, Ju Yuong;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.137-142
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    • 2005
  • Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

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Surgical Treatment of Atrial Septal Defect in Adult - Clinical Review of 31 Cases - (성인의 선천성 심방중격결손증의 외과적 치료)

  • 장운하;오태윤;배상일
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.770-775
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    • 1998
  • Background: Atrial septal defect (ASD) is the most common congenital cardiac anomaly, accounting for 30 percent of congenital heart disease detected in the adult. Many patients with ASD are well tolerated and reach adult without significant symptoms. The patients with ASD die 4th and 5th decades, but prolonged survival is not uncommon. In general, the survival depends on whether pulmonary hypertension develops during adulthood or not. The most common cause of death in the patients with ASD is right ventricular failure or arrhythmias. Materials and methods: From January 1988 to June 1997, 33 cases of ASD underwent open heart surgeries in our hospital. Among them, 31 cases were adult ASD, and 2 tricuspid regurgitation, 1 pulmonic stenosis, 1 mitral regurgitation, 1 tricuspid regurgitation, and 1 coronary artery disease were combinded. All of the patients underwent surgical repair using autologus pericardial patch or direct closure. Results: The postoperative course was smooth and uneventful. Most of the patients showed significant improvement in ECG finding, hemodynamic profile, radiologic finding, and echocardiography, after surgery. Conclusions: Conclusively, most of the ASD should be closed even in patients over the age of 60 years, and early surgical repair must be done to prevent pulmonary hypertension, right ventricular failure, and arrythmias.

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Statistical Analysis of Patients Referred to Pediatric Cardiology Clinic for Diagnosis of Heart Disease (심장질환의 진단을 위해 의뢰된 환아들에 대한 자료 분석)

  • Choi, Kwang-Hae;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.49-54
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    • 2000
  • Background: Echocardiography is rapidly establishing itself as the primary diagnostic technique for investigation of children with heart diseases, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analyzed data on the patients referred to the pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. Methods: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. Results: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(67 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6% (26R cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral ed to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia01.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia. 13 cases(3.0%); normal heart. 144 cases(33.6%). Conclusion: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patients were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Therefore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

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Transplantation of an Extremely Oversized Heart after. Prolonged Extracorporeal Membrane Oxygenation Assistance in a 3-month-old Infant with Congenital Heart Disease (선천성 심질환을 가진 3개월 소아에서 장기간의 체외 막형 산소화 보조 후 몸무게 차이가 큰 공여자-수용자간 심장 이식)

  • Cho, Hyun-Jin;Seo, Dong-Man;Jhang, Won-Kyoung;Park, Chun-Soo;Kim, Young-Hwee
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.630-634
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    • 2009
  • According to the 2007 International Society for Heart and Lung Transplantation (ISHLT) report, a congenital diagnosis, infantile transplantation and being on extracorporeal membrane oxygenation (ECMO) at the time of transplant are risk factors for mortality for the patients who undergo a heart transplant, and a large body weight ratio also increases the risk of mortality. The patient of this case underwent a Ross operation and mitral valve repair due to left ventricle outflow track obstruction and mitral regurgitation. But the baby was treated with ECMO due to heart failure after the operation. When he was 3-months-old and had been. on 30 days of ECMO, he underwent a heart transplant with a heart that had a high donor-recipient weight ratio (4.42). We present this case from a technical standpoint and we include a review of the relevant literature.

DENIAL TREATMENT OF THE CHILD WITH CONGENITAL HEART DISEASE (선천성 심장질환 환아의 치과치료)

  • Kim, Jae-Gon;Lee, Yong-Hee;Kim, Mi-Ra;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.208-215
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    • 2000
  • Patient with congenital heart disease are susceptible to infective endocarditis, and bacteremia following dental procedures may lead to infective endocarditis is these patients. Therefore prophylactic antibiotics are recommended for patients with congenital heart disease who are undergoing dental procedures that are associated with infective endocarditis. In 1997 American Heart Association revised guidelines for a prophylaxis against infective endocarditis. The new American Heart Association recommendations for the prevention of infective endocarditis represent a substantial departure from past guidelines. Major change involve the indications for prophylaxis, antibiotic choice and dosing that may reduce bacteremic risk. Previously, antibiotic prophylaxis was suggested for dental procedures associated with any amount of bleeding. Now only those that are associated with significant bleeding are recommended for prophylaxis as dictated by clinical judgement. Recommended antibiotic prophylaxis regimens now consist of a single preprocedural dose, no second dose is recommended. This report presents three cases of dental treatment of patients with congenital heart disease under the most recent American Heart Association recommendations for antibiotic prophylaxis.

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