• Title/Summary/Keyword: 심실

Search Result 853, Processing Time 0.035 seconds

Medico-Surgical Cooperative Treatment of Pulmonary Atresia with Intact Ventricular Septum (심실중격 결손이 없는 폐동맥 폐쇄의 내과-외과적 협동치료)

  • Kim, Kyeong Sik;Kweon, Byeong Chul;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.3
    • /
    • pp.250-258
    • /
    • 2003
  • Purpose : The actual clinical examples of co-appliance of catheter intervention with surgical procedures in the treatment of pulmonary atresia with an intact ventricular septum(PA/IVS) which we have experienced in our institution are here shown, and the anatomical and hemodynamical profiles between each method is compared. Methods : Medical records of 33 patients with PA/IVS who underwent various treatment from January, 1995 to December, 2000 were reviewed for a retrograde study. Results : In three out of 10 patients who underwent percutaneous balloon pulmonary valvotomy (PPV), residual pulmonary stenosis were observed in their out patient department(OPD) follow-ups, eventually necessitatig balloon pulmonary valvuloplasty(BPV). One out of three patients exhibited deterioration of tricuspid regurgitation after BPV, requiring surgical tricuspid annuloplasty(TAP). Two out of the seven patients who received primarily surgical right ventricle outlet tract(RVOT) repair without any systemic-pulmonary shunt or intervention needed additional intervention employing cardiac catheterization after operation. Two patients received interventional catheterization before surgical RVOT repair. In five out of 11 cases of Fontan type operation, coil embolization of collateral circulation was done before total cavo-pulmonary connection(TCPC), and in three cases, interventional catheterization was needed after TCPC. Conclusion : Both medical and surgical treatment modalities are widely used in management of PA/IVS patients, and recent results prove that medico-surgical cooperative treatment is essential.

A Histological Study on the Heart in the False dace (Pseudorasbora parva) (참붕어(Pseudorasbora parva) 심장의 조직학적 연구)

  • Park, No Kwan;Reu, Dong Suck
    • Korean Journal of Ichthyology
    • /
    • v.27 no.1
    • /
    • pp.26-32
    • /
    • 2015
  • The histological structure of the heart in Pseudorasbora parva was investigated by light microscope. The heart consisted of four consecutive chambers, the sinus venosus, atrium, ventricle and bulbus arteriosus. The wall of the sinus venosus was divided into endocardium, myocardium and epicardium, and the walls of the atrium and ventricle were divided into endocardium, subendocardium, myocardium, subepicardium and epicardium, and the wall of the bulbus arteriosus was divided into endocardium, subendocardium (ridge tissue), middle layer, subepicardium and epicardium. The valves were observed in the sinoatrial, artrioventricular and bulboventricular junctions. The sinus venosus wall was mostly made up of collagen. The rings of tissue were observed at the sinoatrial junction. The atrium was composed of a spongy trabeculate myocardium surrounded by an external rim of thin myocardium, and collagens were distributed in the subepicardium and trabeculae. The ventricle was a spongy myocardium with vessels in subepicardium. In the subepicardium and trabeculae of the ventricle, collagens were distributed. In the bulbus arteriosus, the diameter and length of the ridges were differed. The endocardial cells were convex and the non-clustered subendocardial cells showed irregular shapes. The cells of the middle layer were arranged into incomplete layers that showed different orientations. The subepicardium was formed by cells of different morphology. Collagens and elastins were demonstrated in the subendocardium, middle layer and subepicardium of the bulbus arteriosus. The epicardium was a single layer composed of flattened cells.

Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD) (만성폐쇄성폐질환 환자의 호흡곤란 평가에서 우심실 박출계수의 의의)

  • Lee, Jung Eun;Min, Bo Ram;Park, Jae Seok;Park, Hun Pyo;Jun, Mi Jung;Won, Kyung Sook;Choi, Won Il
    • Tuberculosis and Respiratory Diseases
    • /
    • v.60 no.6
    • /
    • pp.631-637
    • /
    • 2006
  • Background: Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient. Methods: The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively. Results: The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate $160{\pm}27$, severe $210{\pm}87$, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group ($25{\pm}8$) than in the moderate group ($35{\pm}6$). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02). Conclusion: This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function.

Single-Stage Repair of Coarctation of the Aorta and Ventricular Septal Defect in Infants Younger than 6 Months (생후 6개월 이하 환아에서 대동맥 축착증과 심실중격결손의 일차 완전교정)

  • 백만종;김웅한;이영탁;한재진;이창하
    • Journal of Chest Surgery
    • /
    • v.34 no.10
    • /
    • pp.733-744
    • /
    • 2001
  • Background: The optimal therapeutic strategies for patients with coarctation of the aorta(CoA) and ventricular septal defect(VSD) remain controversial. This study was undertaken to determine the outcome and the need for reintervention following single-stage repair of coarctation with VSD in infants younger than 6 months. Material and Method: Thirty three consecutive patients who underwent single-stage repair of CoA with VSD, from January 1995 to December 2000, at Sejong General Hospital were reviewed retrospectively. Mean age and body weight at repair were 54$\pm$37 days(12 days-171 days) and 3.9$\pm$1.1 kg(1.5~6 kg), respectively. The surgical repair of CoA was performed under deep hypothermic circulatory arrest(CA) in the early period of the study and under regional cerebral perfusion through a direct innominate arterial cannulation without CA in the later period. The technique used in the repair of the CoA was resection and extended end-to-end anastomosis(EEEA; n=16) and extended side-to-side anastomosis(ESSA; n=2) in the early period, and resection and extended end-to-side anastomosis(EESA; n= 15) in the later period. The simultaneous closure of VSD was done with a Dacron patch(n= 16) and autologous pericardium(n=17). Aortic arch hypoplasia was present in 29 patients(88%) and its types were distal(n=18), complete(n=5), and complex(n=6)

  • PDF

Transaortic Closure of Ventricular Septal Defect in Corrected Transposition of the Great Arteries (심실중격 결손 및 폐동맥협착이 동반된 선천성 교정형 대혈관 전위증 - 대동맥 절개를 통한 심실중격 결손의 봉합 치험 1례 -)

  • 전예지
    • Journal of Chest Surgery
    • /
    • v.23 no.4
    • /
    • pp.764-768
    • /
    • 1990
  • Congenitally corrected transposition of great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. A 8-year-old girl had congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary valvular stenosis. By transaortic approach, ventricular septal defect was closed and pulmonary valvotomy was performed by transpulmonary approach. No heart block or aortic insufficiency developed postoperatively.

  • PDF

One-stage Repair of Interrupted Aortic Arch with Ventricular Septal Defect and Valvular Aortic Stenosis - A case report- (심실 중격 결손과 대동맥 판 협착을 가진 대동맥 궁 단절의 일차 완전 교정술 -1예 보고-)

  • Cho, Joon-Yong;Jeong, Young-Kyun;Lee, Jong-Tae;Kim, Kyu-Tae;Chang, Bong-Hyun
    • Journal of Chest Surgery
    • /
    • v.38 no.12 s.257
    • /
    • pp.856-859
    • /
    • 2005
  • A male neonate was referred to our hospital with facial cyanosis and tachypnea at 19 days of age. Two-dimensional echocardiography showed type B interrupted aortic arch, posterior malalignment ventricular septal defect and valvular aortic stenosis. A new surgical repair was done with biventricular repair and neo-aortic arch reconstruction. Left ventricular outflow track (LVOT) was consisted of aortic valve and pulmonic valve. Right ventricular outflow (RVOT) track was reconstructed with extracardiac conduit. Postoperative two-dimensional echocardiography showed no stenosis and turbulency flow on LVOT and RVOT.

The Use of Rapid Ventricular Pacing to Facilitate Stent Graft Deployment in the Distal Aortic Arch (빠른 심실유도를 이용한 흉부대동맥류의 혈관 내 스텐트 그라프트 치료)

  • Kong, Joon-Hyuk;Koo, Yang-Hee;Lee, Yoon-Ji;Hur, Jin;Kim, Duk-Sil;Kim, Sung-Wan
    • Journal of Chest Surgery
    • /
    • v.43 no.6
    • /
    • pp.769-773
    • /
    • 2010
  • Systemic hypotension has been traditionally used to facilitate deployment of thoracic stent grafts. Decreasing blood pressure with vasodilating agents further increases cardiac output and, consequently, the cardiac output-mediated windsock effect during deployment. Use of rapid ventricular pacing reduces the windsock effect during stent graft deployment and allows the graft to appose to the aortic wall under zero cardiac output, thus minimizing aortic wall shear stress. In this case we report the use of transvenous rapid ventricular pacing, a safe and reproducible technique to allow precise deployment of a Valiant Captivia stent graft in the distal thoracic arch for a saccular thoracic aneurysm.

Antipsychotic Drugs Induced Torsade de Pointes - A Case Report - (항정신병약물들에 의해 유발된 Torsade de Pointes 1례)

  • Shin, You-Ho;Oh, Dong-Jae;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
    • /
    • v.1 no.1
    • /
    • pp.124-128
    • /
    • 1994
  • We report a case of antipsychotics induced torsade de pointes in a 42-year-old female schizophrenic patient. The patient had taken perphenazine 20 mg/day, chlorpromazine 100 mg/day, and trifluoperazine 15 mg/day irregularly for about 8 years. She experienced syncope and a few difficulties in breathing. On EKG(electrocardiography), QT interval was delayed and polymorphic QRS complexes and ventricular tachycardia were observed. Following a switch of the antipsychotics to haloperidol, known to have fewest effects on the cardiac rhythms among antipsychotics, the arhythymias disappeared. However after discharge, as dose of haloperidol was increased, the symptoms such as chest discomforts and syncopes reappeared. We concluded that the torsade de pointes was developed by antipsychotics. The most common cause of sudden death in patients receiving antipsychotic treatment appears to be ventricular tochycardia. Therefore, clinician should be well aware of the possible side effects of antipsychotics and be cautious in prescribing such drugs to their patients.

  • PDF

Double Outlet Right Ventricle in a Maltese Dog (말티스견에서 발생한 양대혈관 우심실기시)

  • Lee, Jong-Sung;Choi, Ran;Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
    • /
    • v.27 no.6
    • /
    • pp.735-739
    • /
    • 2010
  • An 8 month old female Maltese (body weight 3.6 kg) was referred with primary complaints of dyspnea and exercise intolerance. Diagnostic imaging studies revealed marked cardiomegaly and prominent main pulmonary trunk dilation on thoracic radiography, abnormally arisen aortic roots (toward right ventricle) with left-to right shunted perimembraneous ventricular septal defect located underneath of aortic root, aortic root was located to predominantly to the right ventricle and pulmonary regurgitation (peak velocity 4.7 m/s, pressure gradient ~88 mmHg) from pulmonary over-circulation and hypertension on echocardiography, indicating double outlet right ventricle (DORV). The dog was treated with furosemide (1 mg/kg, BID) for reducing volume overload at right ventricle, spironolatcone (1 mg/kg) and enalapril (0.5 mg/kg) for minimizing deleterious cardiac remodeling, and sildenafil (1 mg/kg) for lessening pulmonary over-circulation and hypertension. The clinical condition of this dog was improved after 1 week of medical treatment. The dog is currently survived and regularly monitored.