• Title/Summary/Keyword: 심방

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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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Conversion Arterial Switch Operation for Failed Sensing Procedure in TGA with VSD -One Case Report- (심방교체수술을 시행한 대혈관 전위증환자에서의 동맥전환술-1례 보고-)

  • 조유원;서동만
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.86-89
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    • 1996
  • This is a report of successful conversion arterial switch operation for failed Sunning procedure in transposition of the great arteries(TGA) with ventricular septal defect(VSD). A 15 month-male patient was admitted due to intractable congestive heart failure after Sunning operation was done at the age of 8 months. Angiography revealed marked dysfunction of the morphologic right ventricle with tricuspid regurgitation and residual VSD. The pulmonary ventricle 1 systemic ventricle pressure ratio' of 75/85 at catheter study enabled us to do the take down of denning repair, patch closure of VSD and arterial switch without pulmonary artery banding. After the operation, the baby showed good growth with normal ventricular function.

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Completely Port-Accessed Atrial Septal Defect Patch Closure Using the da Vinci System (다빈치 로봇을 이용한 포트 접근에 의한 심방중격 결손 폐쇄 수술)

  • Kim, Gwan-Sic;Lee, Jae-Won;Jung, Sung-Ho;Kim, Joon-Bum;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.409-412
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    • 2010
  • We have experienced five cases of atrial septal defect closure under complete port access using the da Vinci system. We used only six 8∼12 mm ports without thoracotomy or sternotomy for operation.

Primary Left Atrial Myxofibrosarcoma -A case report- (좌심방에 발생한 악성 원발성 점액섬유성육종 -1예 보고-)

  • Yoon, Yoo-Sang;Lee, Cheol-Joo;Kang, Joon-Kyu;Kim, Hyung-Tai;Choi, Ho;Lee, Kyi-Beom
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.422-426
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    • 2003
  • Primary cardiac tumor has very low incidence, especially in cases of malignancy. A 29 year old male patient visited our cardiologic clinic for recent aggrevation of dyspnea on exertion and palpitation. Echocardiography showed a large tumor in the left atrium, which suggested the left atrial myxoma. Urgent open heart surgery was taken. The operative finding was fossa ovalis based a large tumor (35$\times$90$\times$50 mm) that invaded the posterior wall of LA and right superior pulmonary vein directly. The tumor was excised well by simple dissection, and the final pathologic report was malignant myxofibrosarcoma. His postoperative course was smooth and he was discharged in good health. Postoperative radiation and chemotherapy had taken with satisfactory clinical outcome.

Treatment of Acute Pulmonary Thromboembolism with Left Atrial Thrombus via Atrial Septal Defect - A case report- (심방중격결손을 통해 좌심방으로 유입되어 있는 혈전을 동반한 급성 폐동맥 혈전색전증의 치험)

  • 김시욱;최재성;유재현;임승평;이영;나명훈
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1010-1014
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    • 2004
  • Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.

Cor Triatriatum Dexter Complicated with Pulmonic Stenosis and Patent Foramen Ovale in A Pitbull Terrier Puppy (핏불테리어종 자견에서 폐동맥 협착과 난원공 개존증이 합병된우측 삼중심방증)

  • Choi, Ran;Lee, Dong-Guk;Choi, Hyun-Seok;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.112-116
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    • 2014
  • A 2-month-old intact male Pitbull terrier (weighing 1.01 kg) were referred with primary complaints of severe abdominal distension, exercise intolerance, retarded growth, yellow nasal discharge and anorexia. Diagnostic imaging studies found enlarged right atrium partitioned by abnormal membrane, severe pulmonic systolic jets (5.66 m/s of peak velocity) and right-to-left blood shunt at the inter-atrial septum. Based on clinical and diagnostic findings, the case was diagnosed as cor triatriatum dexter complicated with severe pulmonic stenosis and right-to-left shunted patent foramen ovale. Either surgical or interventional therapy has not been attempted, because of unstable patient's condition. Using blood transfusion, oxygen supply and cardiac medications (i.e., sildenafil, spironolactone, enalapril), the dog was recovered.

Modified Starnes Operation for Neonatal Stenotic Ebstein Anomaly (신생아 폐쇄성 엡스타인 기형에 대한 변형 Starnes 술식)

  • Lee Seung Hyun;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.633-636
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    • 2005
  • Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.

Primary Undifferentiated Sarcoma of Left Atrium (좌심방에 발생한 원발성 미분화 육종-1례 보고-)

  • Lee, Seock-Yeol;Lee, Seung-Jin;Lee, Man-Bok;Youm, Wook;Lee, Kihl-Rho;Choi, Doo-Ho;Lee, Dong-Wha
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.811-815
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    • 1998
  • Primar99y cardiac tumors are rare and about 25% of primary cardiac tumors are malignant. A primary undifferentiated cardiac sarcoma, which very rare, is presented as follows: A 28-year old woman at the 32th week of pregnancy was admitted to the hospital because of dyspnea. A large intracardiac (left atrium) tumor was found with cardiac echocardiography and MRI. Emergency operation was performed under the diagnosis of left atrial myxoma. After Cesarean section, LA-tomy was done under the cardiopulmonary bypass. Tumor removal including endocardium of left atrium was done and final pathologic diagnosis was primary undifferentiated laft atrial sarcoma. After adjuvant radiotherapy, she has been followed up in out patient bases without problems up to now.

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Surgical Treatment of Atrial Septal Defect in Adult - Clinical Review of 31 Cases - (성인의 선천성 심방중격결손증의 외과적 치료)

  • 장운하;오태윤;배상일
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.770-775
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    • 1998
  • Background: Atrial septal defect (ASD) is the most common congenital cardiac anomaly, accounting for 30 percent of congenital heart disease detected in the adult. Many patients with ASD are well tolerated and reach adult without significant symptoms. The patients with ASD die 4th and 5th decades, but prolonged survival is not uncommon. In general, the survival depends on whether pulmonary hypertension develops during adulthood or not. The most common cause of death in the patients with ASD is right ventricular failure or arrhythmias. Materials and methods: From January 1988 to June 1997, 33 cases of ASD underwent open heart surgeries in our hospital. Among them, 31 cases were adult ASD, and 2 tricuspid regurgitation, 1 pulmonic stenosis, 1 mitral regurgitation, 1 tricuspid regurgitation, and 1 coronary artery disease were combinded. All of the patients underwent surgical repair using autologus pericardial patch or direct closure. Results: The postoperative course was smooth and uneventful. Most of the patients showed significant improvement in ECG finding, hemodynamic profile, radiologic finding, and echocardiography, after surgery. Conclusions: Conclusively, most of the ASD should be closed even in patients over the age of 60 years, and early surgical repair must be done to prevent pulmonary hypertension, right ventricular failure, and arrythmias.

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Repair of Distal Aortic Arch and Descending Aorta Dissection under Right Atrium-Retrograde Cerebral Perfusion (우심방-역행성 뇌관류 하에 원위 대동맥궁 및 하행대동맥 박리증의 수술)

  • 최종범;양현웅;박권재;임영혁
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.740-744
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    • 2002
  • Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.