• Title/Summary/Keyword: 심낭액

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Subxiphoid Pericardial Drainage of Pericardial Effusions (심낭삼출액에 대한 검상하 심낭배액술)

  • 오삼세;장우익
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.693-700
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    • 1997
  • To assess the effectiveness of subxipoid pericardial drainage for the treatment of pericardial effusion, we reviewed 80 cases of subxiphoid pericardial drainage between January 1986 and December 1995. There were 39 males and 41 females with ages ranging from 20 to 80 years. The diagnosis of pericardial effusion was made by echocardiography. The procedure was carried out under general anesthesia in 50(62.5%) and under local anesthesia in 30 patients(37.5%). Among the 33 p tients with malignant pericardial effusion, cytology was positive .in 14 of 31(45%), and pericardial biopsy showed malignancy in 7 of 29 patients(24%). Among the 27 patients with tuberculous pericardial effusion, the diagnosis was confirmed by histology of pericardial biopsy in 12 patient or bacteriologic culture in 1 patient. The operative mortality was 17.5% (14180 patients) and all the mortality occurred in the malignant group. There were no operation-related mortality Sixty six patients were followed from 9 days to 5 years; mean follow-up was 452 days. Recurrent pericardial effusions, necessitating further surgical intervention, occurred in 6 (7.5%) patients. Constrictive pericarditis developed later in 4 patients(5%) and two of them had undergone complete pericardiectomy. In summary, subxiphoid pericardial drainage allowed safe and efficient drainage of pericardial effusions with sampling for cytology and pericardial biopsy, and had an acceptable morbidity and mortality.

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Primary Pericardial Fibrosarcoma Presenting as Cardiac Tamponade - A case report - (심낭압전으로 발견된 원발성 심낭 섬유육종 - 1예 보고 -)

  • Lim, Ju-Yong;Sung, Kyu-Wan;Kang, Gil-Hyun;Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.574-577
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    • 2007
  • Primary malignant neoplasm of the pericardium is very rare, Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.

Analysis of Pericardial Fluid in Patients with Cardiac Disease (심장질환환자에서 심막액의 분석)

  • 김종원;황수희
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1354-1359
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    • 1996
  • Few observation have been made on the pericardial pressure and little is known about the composition of he pericardial fluid. So we studied the basic qualitative and quantitative analysis of the pericardial fluid in the patients with cardiac disease either congenital heart diasese(group A) or acquired heart disease(group B). The pressure of the pericardial cavity was measured by the method of open tipped water filled small polyethylene catheter connecting to the standardized monitor, which was introduced into pericardium of the patients who were performed pericardial incision for the heart or pericardial surgery. All of the data was compared to the simultaneously checked hematologic value of the same patient. The mean pressure of the pericardial cavity was 2.4mmHg and the amount of the pericardial fluid was 13cc/m2 of body surface for the group A and 17.7cc for the group B. And the cell count was 138$\pm$l16/1 in group A and 230$\pm$135/1 in group B and the pH was 7.83$\pm$0.40 in group A. 7.80$\pm$0.52 in group B. Pericardial fluid revealed satisfactically significant alkaline pH than plasma. The fundamental electrolyte, Wa+, K+, Cl and glucose were identical to the hematologic values of the same patient, but the protein concentration was 2.Bg/dL for group A and 3.Ig/dL for group B heart disease and those were remarkable low concentration compared to the hematologic value of the same patient. LDH and amylase were identical to the value of the serum of the same patient, but the concentration of LDH of group B was slightly higher than that of the group A.

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Waffle Procedure in Chronic Constrictive Epicarditis Patient with Pericardial Effusion . -A Case Report- (심낭 삼출액을 동반한 교액성 심장외막염 환자에 적용된 Waffle Procedure -1례 보고-)

  • 전희재;김기봉;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.307-310
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    • 2002
  • The purpose of this presentation is to demonstrate a good results of a second operation, the Waffle procedure, in a patient who did not improve following pericardiectomy. Incomplete parietal pericardiectomy, myocardial fiber atrophy, and unexpected restrictive cardiomyopathy can be considered when the patient\`s symptom does not improve after pericardiectomy is carried out. Constrictive epicarditis is always ruled out. In our case, the patient having constrictive pericarditis combined with pericardial effusion received a pericardiectomy. However, hemodynamics and symptoms of the patient following the operaltion did not improve. However, we experienced a good result following a second operation., the Waffle procedure.

Successful Treatment of Left Atrial Auricular Abscess -A case report - (좌심방이-농양의 수술적 치료 -치험 1예 -)

  • 이정렬;김준성;배은정;노정일;안규리
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.272-274
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    • 2004
  • We report an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics and mediastinal irrigation. A 9-year-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located within the left atrial auricular wall with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed. Pathologic examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis. She discharged on the 21st postoperative day without complication.

Comparison of the Uniaxial Tensile Strength, Elasticity and Thermal Stability between Glutaraldehyde and Glutaraldehyde with Solvent Fixation in Xenograft Cardiovascular Tissue (이종심혈관 조직에 대한 글루타알데하이드 및 용매를 첨가한 고정방법에 따른 장력, 탄력도 및 열성 안정성 비교연구)

  • Cho, Sung-Kyu;Kim, Yong-Jin;Kim, Soo-Hwan;Park, Ji-Eun;Kim, Wong-Han
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.165-174
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    • 2009
  • Background: With the advances of cardiac surgery, the demand for an artificial prosthesis has increased, and this has led to the development and utilization of diverse alternative materials. We conducted this research to improve an artificial prosthesis by examining the changes of the physical qualities, the pressure related tensile strength, the change in elasticity and the thermostability of a xenograft valve (porcine) and pericardium (bovine, porcine) based on the type of fixation liquid we used. Material and Method: The xenograft valves and pericardium were assigned into three groups: the untreated group, the fixed with glutaraldehyde (GA) group and the glutaraldehyde with GA+solvent such as ethanol etc. group. The surgeons carried out each group's physical activities. Each group's uniaxial tension and elasticity was measured and compared. Thermostability testing was conducted and compared between the bovine and porcine pericardium fixed with GA group and the GA+solvent group. Result: On the physical activity test in the surgeon's hand, no significant difference between the groups was sensed on palpation. For suture and tension, the GA+solvent group was slightly firmer than the low GA concentration group. In general, the circumferential uniaxial tension and elasticity of the porcine aortic and pulmonary valves were better in the fixed groups than that in the untreated group. There was no significant difference between the GA and GA+solvent groups (p>0.05). Bovine and porcine pericardium also showed no significant difference between the GA group and the GA+solvent group (p>0.05). When comparing between the groups for each experiment, the elasticity tended to be stronger in most of the higher GA concentration group (porcine pulmonary valve, porcine pericardium). On the thermostability testing of the bovine and porcine pericardium, the GA group and the G+solvent group both had a sudden shrinking point at $80^{\circ}C$ that showed no difference (bovine pericardium: p=0.057, porcine pericardium: p=0.227). Conclusion: When fixing xenograft prosthetic devices with GA, adding a solvent did not cause a loss in pressure-tension, tension-elasticity and thermostability. In addition, more functional solvents or cleansers should be developed for developing better xenografts.

Cardiac Metastasis of Malignant Melanoma - A case report - (심장으로 전이된 악성 흑색종 - 1례 보고 -)

  • 김오곤;홍종면;이석재;홍장수
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.840-843
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    • 1999
  • We report a case of a resection of very large intracavitary metastatic malanoma causing obstruction of the right ventricular inflow and outflow tract of the heart. A 49-year-old woman with dyspnea and generalized edema was seen. Echocardiography reveal an intra cavitary mass occupying the entire right ventricle and pericardial effusion. The lesion was palliatively resected using a cardiopulmonary bypass and was confirmed as a malignant melanoma. The patient is alive and improved symptomatically 30days after the operation.

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