• Title/Summary/Keyword: 심방중격결손

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Surgical Management for Chronic Atrial Fibrillation (만성 심방세동에 대한 외과적 치험 4례)

  • 강경훈;김철환;김병열
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.59-65
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    • 1998
  • Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.

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Anatomical Repair of Congenitally Corrected Transposition with Apicocaval Juxtaposition - 1 case report - (심첨과 대정맥이 동측에 있는 수정대혈관전위의 해부학적 교정)

  • 김웅한;이택연;김수철;전홍주;한미영;김수진;이창하;정철현;이영탁
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.749-752
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    • 1999
  • Over the past several years, a number of centers have reported favorable results of anatomical repair for the congenitally corrected transpositions. However, there have been subsequent problems related mainly to the results of atrial switch procedures in patients who had small atriums because of venoatrial obstructions or supraventricular arrhythmias, especially in patients with apicocaval juxtaposition. Cavopulmonary shunt may be a useful addition to the double switch operation in certain circumstances as a means of avoiding potential atrial complications. Herein, we describe the successful anatomical repair of congenitally corrected transposition of the great artery with pulmonary atresia, ventricular septal defect, and cavo apical juxtaposition with this modification.

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The Effects of Right Anterolateral Thoracotomy in Cardiac Surgery (개심술시 우전측방흉부절개술의 효과)

  • Gwak, Mong-Ju;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.986-990
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    • 1997
  • Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect; 1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective me hod to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.

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A case of Congenital Cardiac Anomaly Associated with DiGeorge Syndrome (DiGeorge증후군에 동반된 선천성 심장기형 치험 1례)

  • 손영상;김태식;황재준;김학제;박선화
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.584-587
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    • 1999
  • The DiGeorge syndrome is a rare congenital abnormality consisting of aplasia or hypoplasia of the thymus and parathyroid glands resulting from malformation of the third and fourth pharyngeal pouches. This syndrome usually includes congenital cardiac anomalies and abnormal facial features. We experienced a case of congenital cardiac anomaly associated with DiGeorge syndrome. The patient was 1 month old boy weighing 3.5 kg. The congenital cardiac anomalies included ventricular septal defect, atrial septal defect, coactation of aorta, and patent ductus arteriosus. We performed one-stage operation with two separate incisions for these cardiac anomalies. Postoperative course was uneventful and the patient at 6 months of follow up is doing well.

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A Case of Congenital Extra Hepatic Portocaval Shunt (Abernethy Malformation Type 2) with a very Large Liver Mass and an Atrial Septal Defect (거대 간 종괴와 심방 중격 결손을 동반한 Abernethy 기형 2형 1예)

  • Lee, Hae-Jeong;Lee, Jee-Hyun;Huh, June;Kang, I-Seok;Lee, Heung-Jae;Suh, Yeon-Lim;Yoo, So-Young;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.56-59
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    • 2008
  • Extrahepatic portosystemic shunts, known as Abernethy malformations, were first reported by John Abernethy in 1793. They are classified into two types: Type I refers to a congenital absence of the portal vein and Type II refers to a shunt involving a side-to-side anastomosis with reduced portal blood flow into the liver parenchyma. This malformation is so rare that less than 100 cases have been reported in the medical literature. We report the case of a 13-month-old boy who had a congenital extrahepatic portocaval shunt with a hypoplastic portal vein. This case was complicated with an atrial septal defect and a large hyperplastic nodule in the liver. The patient was diagnosed with a Type II Abernethy malformation. We planned on surgical occlusion of the extrahepatic portocaval shunt. However, six months later, the patient had a sudden onset of a fever of unknown origin and developed hepatic encephalopathy. Although he underwent a liver transplantation, he died of acute hepatic failure.

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Successful Conversion Arterial Switch Operation after Palliative Senning Operation (고식적 심방 전환술 후 시행한 전환 대혈관 치환술)

  • Kim Joon Bum;Park Jeong-Jun;Chung Sung Ho;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.140-144
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    • 2006
  • Six year-old female having TGA, VSD with severe PHT which was considered inoperable for anatomical correction, received palliative Senning procedure. During follow-up, she was given prostacyclin and at the age of 21, she received Senning takedown, arterial switch and VSD closure after a reevaluation of the hemodynamic status. Significant reduction in PHT was found and she is doing well without complication 3 months after the operation.

Trilogy of Fallot in a Dog (개에서 발생한 팔로삼징)

  • Choi, Ran;Ahn, Hyo-Jin;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.404-407
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    • 2012
  • A 3 years-old female mixed dog (weighing 5.3 kg) was referred to veterinary teaching hospital of Kangwon National University with primary complaints of syncope, severe exercise intolerance, depression and lethargy. Diagnostic studies revealed polycythemia, right sided cardiac enlargement on thoracic radiography and right-to left atrial septal defect, severe pulmonary stenosis (~5 m/s of peak velocity) and right ventricular hypertrophy. Based on diagnostic findings, the dog was diagnosed as trilogy of Fallot. To improve clinical condition of this dog, diltiazem and enalapril were prescribed with weekly phlebotomy. To author's best knowledge, this is the first case of trilogy of Fallot in Korea.

Myocardial Protective Effect of Histidine-Tryptophan-Ketoglutarate Solution and Cold Blood Cardioplegic Solution in Pediatric Cardiac Surgery (소아 개심술에서 Histidine-Tryptophan-Ketoglutarate 용액과 냉혈심정지액의 심근보호 효과)

  • Jung, Tae-Eun;Lee, Dong-Hyup;Han, Sung-Sae
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.19-25
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    • 2006
  • Background: There is limited data on comparisons between the effect of histidin-etryptophan-ketoglutarate (HTK) solution and cold blood cardioplegic (CBC) solution in pediatric cardiac surgery. The purpose of this study was to compare the myocardial protective effect of HTK solution and CBC solution in patients undergoing pediatric cardiac surgery. Materials and Methods: We selected 49 patients with ventricular septal defect and atrial septal defect. HTK solution was used in 21 patients and CBC solution was used in 28 patents. HTK solution was given as a single dose, whereas CBC solution was used in the usual multi-dose method. The incidence of EKG change and concentration of Troponin T and CK-MB were compared for the evaluation of myocardial damage. Results: There were no significant differences in the incidence of ST, T segment change by EKG and serial cardiac enzyme levels between two groups. Conclusion: These results suggested that the myocardial protective effect of HTK solution was similar to CBC solution in simple pediatric cardiac surgery.

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Partial Anomalous Pulmonary Venous Drainage Associated with Septal Defect in Dextrocardia (우심증에서 부분 폐정맥 이상환류를 동반한 심방중격결손 -1례 보고-)

  • Chang, M.;Chang, B.C.;Cho, B.K.;Hong, S.N.
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.30-32
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    • 1979
  • Partial anomalous pulmonary drainage is frequently accompanied by an atrial septal defect. The anomaly is entirely compatible with life and the clinical findings are dependent primarily on the proportion of the pulmonary venous return to the right atrium. The anomaly is frequently missed even with complete diagnostic study. In this report we are presenting a case of anomalous pulmonary venous drainage combined with atrial septal defect and dextrocardia and the treatment of this condition.

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Incomplete atrioventricular canal associated with tricuspid valve cleft and multiple ASD: report of one case (삼첨판균열과 다발성 심방중격결손을 합병한 Incomplete Atrioventricular Canal 의 치험)

  • O, Sang-Jun;Kim, Sam-Hyeon;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.614-619
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    • 1984
  • Atrioventricular canal is divided into incomplete, intermediate and complete types. In ostium primum ASD [incomplete type] mitral valve cleft is almost always present, but ostium primum ASD with tricuspid valve cleft is a rare congenital anomaly. The patient was a 7 year old female whose complains were palpitation, exertional dyspnea and growth retardation. The chest films showed moderate cardiomegaly [C-T ratio, 61%]. EKG, Echocardiography, cardiac catheterization and left ventriculography were performed. Open heart surgery was done under the impression of incomplete atrioventricular canal. At the time of operation, ostium primum ASD [2x2.5 cm in diameter], secundum type ASD [lxl.5 cm in diameter] and cleft in the septal leaflet of the tricuspid valve were noted. But mitral valve was normal without cleft and VSD was not noted. Each anomalous portion was repaired. The patient made an uneventful recovery and we report this case, review and discuss the literatures.

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