• Title/Summary/Keyword: 심내막상 결손

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Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age (경증의 폐동맥 고혈압을 동반한 고령에서의 심내막상 결손 환자 치험 1예)

  • Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.633-636
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    • 2006
  • The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Postoperative Follow up Study in ECD (심내막상 결손증 술후 추적 관찰에 관한 연구)

  • 류지윤
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.196-201
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    • 1994
  • Endocardial cushion defect is a rare congenital heart disease. From September 1985, we experienced 20 cases of endocardial cushion defects and postoperative follow up was taken.We reviewed preoperative clinical data, echocardiography, cardiac cath data, operative method & time. After operation, we performed echocardiography and examined mitral valve function & integrity of patch closure sites. Postoperative follow up was taken regularly & follow up period was from 2 month to 91 months. Several postoperative complications were overcome with adequate treatment. There were 3 cases of early death and mortality rate was 15% [3/20].

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Operation of Tricuspid Valve Endocarditis with Pulmonary Infarction - Lobectomy with Open Heart Surgery (폐경색을 동반한 삼천판막 심내막염의 수술치험 -폐엽 절제술과 개심술의 동시 수술-)

  • 김성완;김덕실;조준용;전상훈;이응배;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.776-779
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    • 2003
  • An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10 x 6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.

Partial Endocardial Cushion Defect with Unusual Clinical Course (부분 심내막상 결손증의 치험 1예)

  • 이철주
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.237-242
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    • 1980
  • This is a case report of spontaneous regression of elevated pulmonary vascular resistance after the age of 6 years in a patient with partial endocardial cushion defect. The patient was first evaluated and considered to be highly risky for surgical correction because of obstructive type of pulmonary hypertension and presisting congestive heart failure at the age of 6 years, during which time medical treatment for congestive heart failure and sufferring from respiratory infection were only provided. Finally the patient was reevaluated at the age of 16 years, in January of 1980 when cardiac catheterization was revealed markedly reduced pulmonary vascular resistance and pulmonary hypertension as well. The patient was operated upon with uneventful postoperative recovery. So we report this case with review of the literatures regarding natural history regarding natural history of partial endocardial cushion defect.

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Clinical study of Endocardial Cushion Defect [7 Cases Report] (심내막상 결손증의 임상적 고찰7례 보고)

  • 김승철
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.283-287
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    • 1985
  • Seven patients had undergone repair of endocardial cushion defect from Jan. 1977 to Dec. 1984 at National Medical Center. Most patients had no associated anomalies except one who had PFO, and mortality case was absent. Five patients had partial ECD and two had complete ECD [Rastelli type A]. In P-ECD patients, the atrial septal defect was closed with patch in all cases and mitral cleft was approximated with 2-3 direct stitches. In two cases of C-ECD, atrial and ventricular septal defect was closed with single patch in one case and atrial septal defect was closed with patch but ventricular septal defect was closed with patch but ventricular septal defect was closed it direct suture in the other case. Atrioventricular cleft was approximated with 2-3 direct sutures. Postop. transient A-V block was noted in 2 cases but returned to regular sinus rhythm after 2 to 6 months.

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Correlation between Reverse Redistribution and Subendocardial Myocardial Infarction Observed in Myocardial Contrast Echocardiography (역재분포 소견과 심근조영 심초음파에서 보인 심내막하경색과의 관계)

  • Kim, Sung-Eun;Choe, Won-Sick;Kwan, Jun
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.228-233
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    • 2000
  • Purpose: The aim of this study is to better understand the pattern and nature of reverse redistribution (RR) in myocardial perfusion imaging. Materials and Methods: In consecutive 20 acute myocardial infarction (MI) patients, frequency of RR was correlated with that of subendocardial MI that was detected by myocardial contrast echocardiography (MCE). RR was judged to be present when there was more than one grade of worsening in perfusion at 24 hr delayed images compared with the initial rest images. MCE evaluated the significant lack of opacification in the subendocardial myocardium relative to the subepicardial myocardium to suggest the subendocardial MI. Kendall's nonparametric correlation coefficiency was calculated. Results: Concordant cases were 15 of 20 (75%) and correlation was statistically significant (p=0.0285). Conclusion: Our results suggested that RR was correlated with MCE-detected nontransmural MI.

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Surgical Treatment of Prosthetic Valve Endocarditis after Reconstruction of the Intervalvular Fibrous Trigon -A case report- (판막간 섬유체 재건을 시행한 후 발생한 인공판막 심내막염의 수술적 치유 -1예 보고-)

  • Choi, Seon-Uoo;Kim, Wook-Sung;Min, Ho-Ki;Kang, Min-Woong;Lee, Young-Tak;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.755-758
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    • 2008
  • We report here on a case of performing a redo-operation for a 65-years-old male patient who had prosthetic endocarditis after reconstruction of the fibrous skeleton due to infective endocarditis 8 years earlier. An aortic annular abscess with a 1cm sized subvalvular abscess and mobile mitral valve vegetation with destruction of the fibrous skeleton was shown on the preoperative echocardiography. An emergency operation was performed due to heart failure. Reconstruction of both the aortic and mitral annuli and the fibrous skeleton was done by using two separate bovine pericardial patches and then mechanical valves were implanted. The postoperative echocardiography shows no paravalvular leakage. The patient has been followed up with no symptoms.

Left Ventricular Pseudoaneurysm after Surgery for Infective Endocarditis with Annular Abscess - A case report - (판막륜 농양을 동반한 감염성 심내막염 수술 후 발생한 좌심실 가성류 - 치험 1예 -)

  • 황호영;김기봉
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.273-276
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    • 2003
  • We report a surgical case of 39-year-old male with a pseudoaneurysm of the left ventricle. Four years ago, the patient underwent aortic and mitral valve replacements with mechanical valves and abscess removal for infective endocarditis with annular abscess. Recent echocardiography demonstrated a communication between left ventricle and abscess pocket, and the size of pocket increased further at the follow-up echocardiography. The patient underwent patch closure of the defect between left ventricle and pseudoaneurysm located at the aortomitral fibrous continuity, under the cardiopulmonary bypass and cardioplegia. The postoperative course was uneventful and the patient was discharged on the 9th postoperative day.

Clinical study of endocardial cushion defect: 37 cases report (심내막상 결손증에 대한 임상고)

  • Jo, Jae-Il;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.657-665
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    • 1984
  • Thirty-seven patients had undergone repair of a endocardial cushion defect between 1977 and Aug. 1983 in Seoul National University Hospital. Twenty eight had a partial defect, one intermediate defect and eight complete endocardial cushion defect. Tricuspid cleft was found in 4 cases and mitral cleft was in all p-ECD. Seven patients were of type C anatomy in c-ECD. Four patients had associated major anomalies, including three TOF in c-ECD, one coarctation in p- ECD. In p-ECD patients, the septal defect was closed with patch in all cases and the atrioventricular valvular insufficiency was corrected with MVR in 4 cases, TVR in 1 case and simple interrupted sutures in remainders. In c-ECD patients the septal defect was closed with single patch except one case. The atrioventricular valve was repaired with simple interrupted sutures except one MVR and TVR case. The operative mortality was 14.2% in p-ECD, 44.4% in c-ECD, but recent 3 years [1980-1983] mortality was 8.7% in p-ECD, 20% in c-ECD. More than grade III systolic regurgitant murmur was oted postoperatively in 4 cases of c-ECD and 3 cases of p-ECD. The operative risk factors were preoperative NYHA classification, cyanosis, Rp/Rs, systolic pressure of main pulmonary artery and the degree of regurgitation of atrioventricular valves. The causes of death were low cardiac output syndromes, pulmonary complications and arrhythmias.

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