• Title/Summary/Keyword: 선천심장병

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건강관리 성공사례담-꺼져가는 생명에 불을 당긴 사람들

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.10 no.4 s.89
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    • pp.2-8
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    • 1986
  • 조재희 학생은 선천적으로 심장병을 앓고 나서 수술비 부족으로 인하여 수술을 못하고 있었던바, 한국건강관리협회 경상남도지부에서 원호 가족임을 알고 무료혜택 수술을 단행했다

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Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease (조직 도플러 영상을 이용한 선천성 심장병 수술 전후의 단기 심기능 평가)

  • Lee, Jun-Hwa;Kim, Yeo-Hyang;Hyun, Myung-Chul;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.476-483
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    • 2007
  • Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

Open Heart Surgery for Congenital Heart Disease in Adult (성인 선천성 심장기형의 개심수술)

  • 구본원;허동명
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.940-944
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    • 1996
  • Patients over 15 years of age who have undergone a surgical correction of congenital heart disease at Kyungpook University Hospital during the period of January 1990 through October 1994 have been reviewed . One hundred forty three, 22.4 % of 628 operations, which have repaired congenital heart diseases during this period were adult patients. There were 23 patients under 20 years of age, 58 between 20∼29 years, 34 between 30∼39 years, 18 between 40∼49 years, and 10 between 50∼59 years. The most common defects were atrial septal defects which accounted for 73 cases (51.1 %) and other common anomalies were ven- tricular septal defects (57 cases, 39.9 %), tetralogy of Falloffs(4 cases, 2.8%) in order of incidence. There were 10 non-fatal operative complications (6.9 %) but there was no operative mortality. This study shows the incidence of operable congenital heart diseases in adults and the fact that it could be corrected surgically with low mortality and morbidity.

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선천성(소아)심장병이란?

  • Yun, Yong-Su
    • 건강소식
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    • v.10 no.2 s.87
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    • pp.20-23
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    • 1986
  • 이 세상의 모든 생명체들, 대를 이어 가면서 태어나는 모든 새 생명들이 빠짐없이 잘 자라고 성숙기를 지나 자연사를 하는 것은 아니다. 우리 인간도 이 범위를 벗어날 수 없어서 갓 태어난 애기가 심한 기형을 동반하는 수가 있다. 그 중에서도 심장의 기형은 빈도가 자그마치 출생신생아의 거의 1%에 해당하고 있으며 그대로 방채했을 경우에는 치명적인 경우가 많다.

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Personal Resource and Parenting Stress of Mothers of Children with Congenital Heart Disease (선천성 심장병을 가진 아동의 어머니의 개인적 자원과 양육스트레스)

  • Lee, Sun-Hee;Yoo, Il-Young
    • Child Health Nursing Research
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    • v.13 no.1
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    • pp.73-80
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    • 2007
  • Purpose: As a result of dramatic advances in the medical and surgical management of congenital heart disease (CHD), many babies born with cardiac anomalies today can expect to reach adulthood. The main purpose of this study was to examine the relationship between parenting stress and personal resources of mothers of children with CHD. Method: Fifty-one mothers of children with CHD were recruited at the pediatric cardiac outpatient clinic from July 14th to September 25th 2006. Abidin's parenting stress index/short form (PSI/SF) and Brandt and Weinert's personal resource questionnaire (PRQ) were used. PSI has 3 sub-concepts; parental role distress, dysfunctional parent-child interaction, and difficult child. PRQ has 4 sub-concepts; intimacy, social integration, worth, and assistance. Data were analyzed using SPSS 13.0 version. Results: Correlation analysis showed that parenting stress was significantly related to 'intimacy', 'social integration', and 'worth' of mothers. Multiple regression analysis showed that parenting stress was significantly related to personal resource of mother and information by internet. Conclusion: Mothers who felt they had supportive friends and family, high self esteem, and social integration reported lower parenting stress. Also, internet may be an effective method to provide information and share experience for mothers of children with CHD.

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Vasopressin in Young Patients with Congenital Heart Defects for Postoperative Vasodilatory Shock (선천성 심장병 수술 후 발생한 혈관확장성 쇼크에 대한 바소프레신의 치료)

  • 황여주;안영찬;전양빈;이재웅;박철현;박국양;한미영;이창하
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.504-510
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    • 2004
  • Background: Vasodilatory shock after cardiac surgery may result from the vasopressin deficiency following cardio-pulmonary bypass and sepsis, which did not respond to usual intravenous inotropes. In contrast to the adult patients, the effectiveness of vasopressin for vasodilatory shock in children has not been known well and so we reviewed our experience of vasopressin therapy in the small babies with a cardiac disease. Material and Method: Between February and August 2003, intravenous vasopressin was administrated in 6 patients for vasodilatory shock despite being supported on intravenous inotropes after cardiac surgery. Median age at operation was 25 days old (ranges; 2∼41 days) and median body weight was 2,870 grams (ranges; 900∼3,530 grams). Preoperative diag-noses were complete transposition of the great arteries in 2 patients, hypoplastic left heart syndrome in 1, Fallot type double-outlet right ventricle in 1, aortic coarctation with severe atrioventricular valve regurgitation in 1, and total anomalous pulmonary venous return in 1. Total repair and palliative repair were undertaken in each 3 patient. Result: Most patients showed vasodilatory shock not responding to the inotropes and required the vasopressin therapy within 24 hours after cardiac surgery and its readministration for septic shock. The dosing range for vasopressin was 0.0002∼0.008 unit/kg/minute with a median total time of its administration of 59 hours (ranges; 26∼140 hours). Systolic blood pressure before, 1 hour, and 6 hours after its administration were 42.7$\pm$7.4 mmHg, 53.7$\pm$11.4 mmHg, and 56.3$\pm$13.4 mmHg, respectively, which shows a significant increase in systolic blood pressure (systolic pressure 1hour and 6 hours after the administration compared to before the administration; p=0.042 in all). Inotropic indexes before, 6 hour, and 12 hours after its administration were 32.3$\pm$7.2, 21.0$\pm$8.4, and 21.2$\pm$8.9, respectively, which reveals a significant decrease in inotropic index (inotropic indexes 6 hour and 12 hours after the administration compared to before the administration; p=0.027 in all). Significant metabolic acidosis and decreased urine output related to systemic hypoperfusion were not found after vasopressin admin- istration. Conclusion: In young children suffering from vasodilatory shock not responding to common inotropes despite normal ventricular contractility, intravenous vasopressin reveals to be an effective vasoconstrictor to increase systolic blood pressure and to mitigate the complications related to higher doses of inotropes.

Early postoperative arrhythmias after open heart surgery of pediatric congenital heart disease (소아 선천성 심장병 개심술 후 발생한 조기 부정맥)

  • Choi, Hee-Joung;Kim, Yeo-Hyang;Cho, Joon-Yong;Hyun, Myung-Chul;Lee, Sang-Bum;Kim, Kyu-Tae
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.532-537
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    • 2010
  • Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.

Congenital Intrapericardial Left Atrial Appendage Aneurysm Presenting with an Embolic Stroke - A case report - (뇌졸증을 병발한 선천성 심낭내 좌심방이류 - 1예 보고 -)

  • Suh, Jong-Hui;Kim, Yong-Hwan;Jeon, Hui-Kyung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.643-646
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    • 2008
  • Congenital intrapericardial left atrial appendage aneurysms (LAAA) are very rare. Most cases are asymptomatic and this malady is generally incidentally diagnosed in older patients. LAAAs are usually accompanied with supraventricular arrhythmias and life-threatening systemic embolism. Complete surgical correction is recommended immediately after the diagnosis to prevent significant complications, and even for the asymptomatic patients. We report here on the case of a 45-year-old man who presented with cerebral embolism due to LAAA. The patient was successfully treated with a resection of the aneurysm.

The Surgical Case Analysis of Congenital Heart Disease -A review of 1,060 Cases (선천성 심장병의 외과적 고찰)

  • Jo, Sam-Hyeon;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1316-1322
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    • 1996
  • From May 1977 to December 1994, 1.060 cases of open heart surge y for congenital heart disease were performed under cardiopulmonary bypass in Chonnam University Hospital They were divided into two groups; group A(677 cases, from May 1977 lo December 1989), group B(38B cases, from January 1990 to December 1994), to be compared and analized. Of the 1, 060 cases, there were 889 acyanotic (83.9%) and 171 cyanotic(16.1%). The operative mortality was 7.8% in group A and 5.7% in group B (total : 6.6%). The operative mortality for group A was 25% in cyanotic disease and 3.7% in acyanotic disease, respectively in group B, it was 23.8%, 3.2%. There were 19 patients (3.8%) and 78 patients(20.4%) with body weight under 10kg in group A and group B respectively. The operative mortality for these patients were 31.6% in A group and 16.1% in B group. In result, increasing trend in congenital heart disease in patients under 10 kg of body weight has been noted, whereas mortality has decreased. The operative mortality of tetralogy of Fallot has decreased in group B t an group A. These results suggest that the operative result have improved in recent years.

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