• Journal of Chest Surgery
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• v.32 no.9
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• pp.781-789
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• 1999

Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.285-291
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• 1996

We have reviewed 157 cases of coarctation of aorta in the age of infancy and children from March 1973 to december 1994. Patients were 9) males and 64 females, and their age ranged from one month to fifteen years (23.8 $\pm$ 41.6months) with 113 infant cases. In the infantile age, congestive heart failure was the most common chief complaint (781113), and above that age, asymptom was most common (15/44). Isolated coarctation was present in 31 patients, and 9 patients had additional atrial septal defect (group I), 73 patients had associated ventricular septal defect (group II), and 44 patients had associated complex intracardiac lesions(group III). Aortic arch hypoplasia was present in 17 patients. , The operations perf'ormed were subclavian flap angioplasty in 71 patients, resection and anastomosis in 32 patients, patch aortoplasty in 26 patients, resd extended end-!o-end anastomosis in 27 patients, and direct angioplasty with resection of web in 1 patient. The early mortality was 17.2% (27/157) and re-coarctation rate was 18.0% (281157). The most common complication was respiratory problem in infants and postoperative hypertension in children.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.10-17
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• 1983

Valve replacement in children, aging up to 15 years [Mean 11.g years], has been done at Seoul National University Hospital over the past 14 years since 1968. Fifty-one patients have received 59 artificial valves: 55 bioprosthetic and 4 prosthetic valves. Thirty-one patients [60.8%] had rheumatic heart disease and the remainder [39.2%] had congenital heart disease. Forty-two patients [82.4%] survived operation: 9 patients [17.7%] died within one monfi3 postoperatively and 4 patients [7.8%]during the follow-up period with the overall mortality rate of Thromboembolic complication occurred in 3 patients with 2 deaths: 5.9% embolic rate or 4.68% emboli per patient-year. One patient who had been on coumadin anticoagulation died from cerebral hemorrhage. One mitral Ionescu-Shiley valve failed 19 months after first replacement and this was successfully re-replaced with the same kind of valve. Actuarial survival rate was 59.9% at 4 years after surgery. Thromboembolism-free and valve failure-free survivals were 80.0% and 93.1% respectively. These clinical results in the pediatric age group suggested that valve replacement in children was a serious undertaking with a higher mortality rate than in adults. However, the main superiority on the low thrombogenecity of the xenograft valve over the mechanical one warrants its continuing use until the question of its durability would otherwise be answered by a further study of clinical follow-up.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.498-504
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• 2002

Purpose : The purpose of this study was to evaluate the perioperative myocardial damage in pediatric congenital heart disease with the cardiac specific protein of cardiac troponin I(cTpn-I). Methods : All 25 pediatric patients who were diagnosed with tetralogy of Fallot or double outlet right ventricle were classified as group A(acyanotic, $SaO_2$ >90%), group B(mildly cyanotic, $SaO_2$ >80-90%) and group C(moderately cyanotic, $SaO_2$ <80%). The control group D was consisted of 10 patients with ventricular septal defects who were operated in the same period. We measured preoperative hemoglobin, preoperative and postoperative(24 and 72 hour) arterial oxygen saturation, cTpn-I and creatine kinase(CK-MB). Results : Total 25 patients were subdivided into 6 of group A, 12 of group B and 7 of group C. The concentrations of preoperative cTpn-I were $0.23{\pm}0.12ng/mL$ in group A, $0.25{\pm}00.12 ng/mL$ in group B, $0.26{\pm}0.13ng/mL$ in group C. And the concentrations of cTpn-I in postoperative 24 hour were $10.04{\pm}5.28ng/mL$ in group A, $12.50{\pm}6.86ng/mL$ in group B, $12.55{\pm}9.90ng/mL$ in group C. Which revealed cTpn-I in group C was higher than that of the another less cyanotic groups. In addition, the concentration of cTpn-I of group C in postoperative 72 hour was higher than any other groups. The concentration of cTpn-I in postoperative 72 hour was statistically correlated with that in postoperative 24 hour and preoperative arterial oxygen saturation(P=0.001). Conclusion : Preoperative chronic cyanosis can influence on the postoperative concentration of cTpn-I in pediatric cardiac patients, which means impairment on the postoperative myocardial recovery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.65-69
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• 2008

A two-month-old baby had acholic stool, neonatal hyperbilirubinemia and congenital heart disease. Atresia of the hepatic duct was confirmed by open cholangiography, which showed a non-opacified intrahepatic bile duct. Liver biopsy and the Kasai operation were performed. Because the liver biopsy pathology revealed a paucity of intrahepatic bile ducts, the patient was diagnosed with the Alagille syndrome. We report the case of an infant diagnosed with the Alagille syndrome with atresia of the hepatic duct.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.959-962
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• 2004

Pleuropulmonary blastoma is a rare malignant neoplasm which originates from either the lungs or pleura. Pleuropulmonary blastoma usually develops in the first decade of life, mostly younger than 5 years old and shows aggressive biological behavior. Pleuropulmonary blastoma is discriminated from classic pulmonary blastoma of adulthood by its morphological features like primitive mesenchymal and sarcomatous component without carcinomatous portions. To our knowledge, report of pleuropulmonary blastoma in adulthood is very rare. Our case support the possibility that primitive neoplasm recognized as pediatric tumors can develop in adulthood. We report a case of surgical experience of pleuropulmonary blastoma which developed in 21 years old man with literature review.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.804-807
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• 2010

Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion， ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.47-55
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• 2014

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.319-323
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• 2008

Edward's syndrome is a genetic disorder of 18th chromosomal trisomy. Main clinical features of this syndrome include systemic conditions, such as mental retardation, growth retardation, dyspnea, congenital heart disease, and orthopedic disorders, such as flexion deformity and rocker-bottom feet. The characteristics of fetal abnormality are hydramnios, small placenta, common umbilical artery. Infants with Edward's syndrome have very low survival rate. Almost half of them die during fetal stage. Fifty percent of them survive 2 months, and 5 to 10 percent of them survive about 1 year. A 3-year and 7 month old girl visited our dental hospital for the treatment of dental caries. Considering her systemic disease, low body weight, medical history of cardiac surgery, and difficulty in airway management, dental procedure was performed under general anesthesia. We report this case with review of literatures.

• Journal of Korean Academy of Nursing
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• v.44 no.2
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• pp.228-236
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• 2014

Purpose: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. Methods: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. Results: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (${\chi}^2$=1.15, p=.283). Conclusion: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.