• Title/Summary/Keyword: 승모판막

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Mitral and Aortic Valce Replacement with Patch Enlargement of Narrow Aortic Annulus (협소한 대동맥판윤의 첨포확대후 대동맥 및 승모판막 대치술 치험 1예)

  • 강면식
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.56-60
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    • 1979
  • Replacement of the aortic valve in a normal or large aortic root can be accomplished with ease and safety in most instances. The presence of a narrowed aortic annulus remains a problem in that the replaced smaller prosthetic valve has a significant resting pressure gradient across the orifice. This narrowing causes not only technical difficulties, but also increased mortality and post-op. complication. Therefore this problem deserves special attention. This report presents our experience with a case of a small aortic root caused by rheumatic heart disease [AI and MS]. This is the method of enlargement of the aortic annulus with a woven Dacron patch and replacement of a larger prosthetic aortic valve combined with mitral valve replacement.

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Mitral Valve Replacement: Report of Two Cases (승모판막 이식수술: 2례 보고)

  • 장순명
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.195-202
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    • 1973
  • Two patients were admitted with chief complaints of exertional dyspnea and palpitation respectively. Physical examination showed Grade III and Grade II to III systolic rumbling murmur at apex in each case. Chest X-ray and EKG findings were compatible with mitral insufficiency in both cases. The diseased valves were replaced with Beall mitral valve prosthesis under cardiopulmonary bypass using hemodilution technic. The first patient died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation and the 2nd patient was discharged in good condition one month after operation-Autopsy of the 1st patient showed no thrombus formation, no disc variance, and good epithelization of valve cuffs. In the second case clinical improvement was remarkable with decreased heart size.

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A Clinical Study for Pre- and Intraoperative Risk Factors of Hospital Mortality after Mitral Valve Replacement (승모판막 치환술후 조기사망의 술전 및 술중 위험인자에 대한 임상적 고찰)

  • 박승규
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.236-244
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    • 1990
  • To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

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Early Results of Mitral Valve Replacement - Clinical analysis of 158 cases - (승모판막 치환의 조기 성적;158 임상보고례)

  • 김한용
    • Journal of Chest Surgery
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    • v.25 no.9
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    • pp.976-981
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    • 1992
  • The results of the clinical observations on the 158 cases of the mitral valvular heart disease treated at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from June, 1986 to December, 1991 were as follows; 1. There were 50 men and 108 women with sex ratio 1: 2.2. 2. The age of patient varied widely from 13 years to 65years. 3. The preoperative functional level accoridng to the NYHA classification were class II, III, IV in 18%, 67%, 15%. 4. All 158 patients were operated on under direct vision using extracorporeal circulation, mitral valve replacement in 118 cases, mitral and aortic valve replacement 40 cases. 5. The follow up period was between 2 months and 65 months postoperatively. [mean 30.1 months] 6. The early operative motality was 5.7%[9 cases], late motality was 4%[6 cases]. 7. The cardiothoracic ratio in the chest X-ray decreased at the 6th month postoperation. [pre-op: 0.60$\pm$0.07, post-op: 0.56$\pm$0.06 p<0.01]

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Left Ventricular Rupture after Mitral Valve Replacement - 3 cases report - (승모판막 치환술후 합병한 좌심실 파열의 외과적 고찰 - 3례 보고 -)

  • 유환국
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.987-993
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    • 1990
  • An unusual but often lethal complication of mitral valve replacement is rupture of the left ventricle. From March 1977 through June 1990, 424 mitral valve replacements were performed as isolated or combined procedures. Rupture of the posterior wall of the left ventricle was observed in 3 patients. Their was one type I and two type II rupture. Once the diagnosis was made, all of the patient were connected to the heart-lung machine again and total cardiopulmonary bypass is re-established. Repair was attempted in all of them from the outside of the heart. One of them was successively repaired but two were failed due to myocardial ischemia by circumflex coronary artery injury and failure of adequate closure of the ruptured site. From this results, we concluded that prevention is the best solution. But if we encountered this condition, early diagnosis and rapid treatment may improve the patient`s chances for survival.

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Protamine Induced Anaphylactic Reaction after Cardiopulmonary Bypass -A case report- (체외순환 후 에 의해 유발된 아나필락시스 반응 - 1예 보고-)

  • 백종현;한승세;이정철;정태은;이장훈;이동협
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.606-608
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    • 2004
  • Anaphylactic reaction to protamine sulfate, which is used widely to reverse the anticoagulative effect of heparin after cardiopulmonary bypass, is very rare. But the result of anaphylactic reaction can be very fatal and the mechanism of it is still not clear. We report. a. case of severe anaphylactic reaction to protamine sulfate following the replacement of the mitral valve and .Maze procedure using microwave in a non-diabetic 57-year-old female patient.

Therapy for Postoperative Cardiac Arrhythmia in Patient with Mitral Valve Surgery (승모판막 수술 환자에서 발생한 부정맥의 치료)

  • 조건현
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.672-677
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    • 1992
  • This is a clinical review of the results from electric cardioversion and pharmacological therapy used in our hospital for reverting cardiac arrythmia in patients with mitral valve surgery between Jan. 1990 and Jun. 1991. Of 62 evaluated patients, 16 patients had regular sinus rhythm and the other 46 had arrhythmias [42; atrial fibrillation 1; atrial flutter 1; premature ventricular contraction] preoperatively. In 2 of patients with sinus rhythm, atrial fibrillation newly developed after surgery and was converted into sinus rhythm soon by intravenous administration of digoxin. Remaining 14 patient resumed sinus rhythm spontaneously. In patients with preoperative arrythmia, 3 patients reverted into sinus rhythm from atrial fibrillation by electric cardioversion at operative field, 1 patient by lidocain and mexiletine, 4 patients by combined use of digoxin and verapamil, 4 patients by 2 times of oral quinidine and 9 patient by long term use of oral amiodarone. Throughout this consecutive trials of anti-arrhythmic drugs and electric cardioversion, Conversion into normal sinus rhythm occurred in 48% of patients with arrhythmia developed after mitral valve surgery.

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Postoperative Hemodynamic Changes in the Mitral Valvular Disease with Pulmonary Hypertension (폐고혈압을 동반한 승모판막 질환의 술후 혈역학적 변화에 대한 연구)

  • 박도웅
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.659-666
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    • 1990
  • We evaluated 68 patients with mitral valve disease who underwent mitral valve replacement from April, 1986, to December, 1988. Among them 20 patients showed increased systolic pulmonary arterial pressure greater than 60 mmHg and postoperative hemodynamic data were obtained in 19 patients average 13 months after mitral valve replacement. The results were as followings. 1. Average pulmonary systolic pressure decreased from 84.8$\pm$4.5 preoperatively to 33. 0$\pm$1.9mmHg postoperatively[P<0.001]. 2. Average pulmonary vascular resistance index decreased from 1425$\pm$148 preoperatively to 287+35.8 dyne * sec * cm2 * m postoperatively[P<0.001]. 3. Average cardiac index rose from 1.927$\pm$0.169 preoperatively to 2.625$\pm$0.159 L/min/m2 postoperatively [P <0.005]. This study shows that pulmonary hypertension and the increased pulmonary vascular resistance index due to mitral valve disease can regress significantly after mitral valve replacement.

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Result of open mitral commissurotomy (개방성 승모판막 교련부절개술의 결과)

  • Park, Pyo-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.387-393
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    • 1982
  • A total of 18 open mitral commissurotomy were performed at Seoul National University Hospital between January 1975 and August 19. Thirteen patients had open mitral commissurotomy alone and five had additional cardiac procedure. Six patients were men and twelve were women. The mean age was 33 years. According to the NYHA classification, the distribution of patients preoperatively was as follows; Glass II, 2 patients; class III, 14 patients; class IV, 2 patients. Three patients had emboli preoperatively, all of whom were in atrlal fibrillation. There was no operative death. The patients were followed from 2 to 86 months [mean 26 months]. There was no late death and no embolic episode. Mitral valve replacement was required in one patient due to mitral restenosis after 4 years.

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Clinical Analysis of Mitral Valvular Disease (승모판막 질환의 임상적 고찰)

  • 김창수
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.382-389
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    • 1991
  • The clinical observations on the 63 cases of the mitral valvular heart disease treated in the department of Thoracic and Cardiovascular Surgery, Kosin medical college, during the period of 5 years from January, 1986 to December, 1989, are as follows. 1. Total 63 cases, 23 were male and 40 were female with sex ratio of 1: 1.7. 2. The age distribution was widely varied from 7 years of the youngest to 65 years oldest, average age was 35.3 year old. 3. The main clinical symptom and sign were D.O.E, general weakness, fatigability, palpitation, chest pain, hepatomegaly, pitting edema and both neck vein distension. 4. The preoperative N.Y.H.A functional classification were class II, III, IV in 28%, 54%, 16%. 5. The preoperative diagnosis were MS - 6.3%, MR - 53.9%, MSR - 36.5%, MVP - 3.1%. 6. All 63 patients were operated on the under direct vision using extracorporeal circulation, MVR in 18 cases, MVR and Tricuspid annuloplasty in 24 cases, DVR in 3 cases, DVR and Tricuspid annuloplasty in 5 cases, TVR in 1 case, Mitral annuloplasty in 4 cases, mitral valvuloplasty in 7 cases and mitral commissurotomy in 2 cases 7. The operative mortality was 7.9%, and 5 years actuarial survival rate was 89%.

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