• Title/Summary/Keyword: 심실

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Aortic Translocation for Complete Transposition of the Great Arteries with a Ventricular Septal Defect and Pulmonic Stenosis (심실 중격 결손과 폐동맥 협착을 동반한 완전 대혈관 전위에서 대동맥 전위술)

  • Jeong, In-Seok;Lee, Chang-Ha;Lee, Cheul;Lim, Hong-Gook;Kim, In-Sub;Youn, Hyo-Chul
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.476-479
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    • 2008
  • The Rastelli operation has been a standard procedure for repairing complete transposition of the great arteries combined with a ventricular septal defect and pulmonary stenosis. Yet this procedure has several shortcomings, including the risk of incurring left ventricular outflow tract obstruction on long-term follow-up. In this regard, aortic translocation has recently been regarded as a potent alternative to Rastelli's operation. We report here on a case of complete transposition of the great arteries that was combined with an inlet-extended perimembranous ventricular septal defect and pulmonary stenosis in a 2-year-old boy. All the problems were successfully repaired using the aortic translocation technique. Postoperative echocardiography showed a straight and wide left ventricular outflow tract.

Blood Flow and Pressure Evaluation for a Pulsatile Conduit-Shaped Ventricular Assist Device with Structural Characteristic of Conduit Shape (관형의 구조적 특징을 갖춘 박동형 관형 심실보조장치의 혈류, 혈압 평가)

  • Kang, Seong-Min;Choi, Seong-Wook
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.11
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    • pp.1191-1198
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    • 2011
  • The use of a ventricular assist device (VAD) can raise the one-year survival rate without cardiac transplantation from 25% to 52%. However, malfunction of the VAD system causes 6% of VAD patients' deaths, which could possibly be avoided through the development of new VADs in which VAD malfunctions do not affect the patient's heart movement or hemodynamic state. A conventional VAD has an impeller or vane for propelling blood that can allow blood to regurgitate when the propelling force is weaker than the aortic pressure. In this paper, we developed a new pulsatile conduit-shaped VAD that has two valves. This device removes the possibility of blood regurgitation and has a small stationary area even when the pumping force is extremely weak. We estimated the characteristics of the device by measuring the outflow and the pressure of the pump in in-vitro and in-vivo experiments.

Biventricular Repair of Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect by Arterial Switch -Report of 1 case - (비상관성 심실중격결손증을 동반한 양대혈관우심실기시증 환자에서의 동맥전환술을 이용한 양심실성 교정 - 1예 보고 -)

  • Kim, Jae-Hyun;Kim, Woong-Han;Chang, Yun-Hee;Na, Chan-Young;Oh, Sam-Se;Baek, Man-Jong;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Jo, Won-Min;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.687-690
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    • 2003
  • Although surgical options for double outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) are vary in accordance to the morphological characteristics, it is very difficult to use biventricular repair technique when there is tricuspid chordae originating from conal septum or when the distance between the tricuspid valve and the pulmonic valve is too short. We report our clinical experience of biventricular repair of DORV with non-committed VSD by VSD rerouting to the pulmonary artery and arterial switch in case of a presence of conal tricuspid chordae and short distance between the tricuspid valve and the pulmonic valve.

Surgical Treatment of Traumatic Ventricular Septal Defect by Penetrating Chest Injury (흉부관통상으로 인한 심실중격결손의 치료)

  • 김시욱;한종희;강민웅;나명훈;임승평;이영;최시완;유재현
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.999-1002
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    • 2004
  • Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.

A Study on Ventricular Fibrillation Prediction through neurologic and multi-morphic analyze of intra-cardiac database and Implementation of Simulator (체내 심전도 데이터의 신경학적 분석 및 다형성 판별을 통한 심실세동 예측에 관한 연구 및 시뮬레이터 구현)

  • Shin, K.S.;Kim, J.K.;Park, H.C.;Lee, C.K.;Lee, M.H.
    • Proceedings of the KIEE Conference
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    • 2008.10b
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    • pp.489-490
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    • 2008
  • 본 고에서는 체내 심실신호를 농하여 신경학적 분석 및 다형성의 측면에서 심실세동이 일어나는 것을 예측하는 분석 알고리즘을 설계하였다. 신경학적 측면에서는 시계열 신호의 Peak to Peak Interval을 예측법과 0.15Hz를 기준으로 HRV 신호의 AR Burg 모델링을 통하여 고주파성과 저주파성을 나누어 교감신경과 부교감신경의 활동성 통한 신경학적 예측법을 제시하였으며 또한 체내 심실신호의 비선형적 특성을 고려한 Fractal Dimension을 생성시킴으로서 주기성의 특성과 다형성 통한 예측법을 제시하였다. 체내 심전도를 기반으로 Simulation 하였으며 각 분석별 조합을 통하여 최적의 예측 구조를 찾고자 하였다. 의학적 의미가 있는 민감도와 특이도를 판별하였으며 예측을 위한 수행시간을 실험하였다. 이를 통하여 자율신경 활성도와 다형성 판별을 조합한 방법이 심실세동 예측을 위한 민감도의 측면에서 가장 우수함을 나타내었고 시뮬레이션을 위만 시뮬레이터(Simulator) UI(User Interface)를 제시하였다.

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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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Subvalvular Aortic Stenosis Developed after Patch Closure of VSD in A Child -Case Report (소아에서의 심실중격 결손증 수술 후 발생한 대동맥 판막하 협착증 -증례 보고-)

  • Kim, Yong-In;Lee, Gun;Kim, Bum-Shik;Choi, Suk-Min;Park, Chung-Hyun
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1125-1127
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    • 1997
  • Subvalvular aortic stenosis developed after patch closure of perimembranous'VSD is rarely reported. A 18-month-old, 8 kg child with this complication after VSD closure 8 months ago in other hospital has been treated medically and was admitted to this hospital because of severe cardiomegaly and sign of heart failure. Cardiac catheterization revealed 55 mmHg of pressure gradient between aorta and LV cavity. We report one successful redo case of surgically relieved subvalvular aortic stenosis in a child after patch closure of perimembranous VSD.

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Prediction of Improvement of Hibernating Myocardium after Coronary Artery Bypass Grafting -The role of dobutamine stress echocardiography- (동면심근을 가진 관상동맥 환자의 수술 후 기능회복의 예측에 대한 임상적 고찰 - Dobutamine 심초음파의 역할 -)

  • 유경종;강면식;이교준;김대준;임세중;정남식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.776-780
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    • 1998
  • Background: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular(LV) function after surgical revascularization. Materials and methods: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography(DSE) (dobutamine: baseline, 5, 10, 20$\mu$g/kg/min) before coronary artery bypass grafting(CABG) and underwent echocardiography at least 2 months after CABG. Results: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8(50%) of 16 patients in DSE. Among them, 6 patients(75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients(38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments(74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments(23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.

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Effect of Surgical Closure of Ventricular Septal Defect on Ventricular Systolic Time Intervals (심실중격결손 교정술 전후의 심실 수축기 시간 간격 (Ventricular Systolic Time Interval)의 변화)

  • 이현경;이영환;이장훈;김도형;백종현;이동협;이정철;한승세;정태은
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.511-516
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    • 2002
  • Background: This study was undertaken in infant patients with isolated ventricular septal defect(VSD) to determine the effect of surgical closure on ventricular systolic time interval, as a parameter for ventricular performance, by echocardiography. Material and Method: Thirty patients were enrolled. Mean age of patients at operation was 6.5$\pm$3.2 months and all patients had non-restrictive VSD. We checked the left atrium/aorta(LA/Ao) ratio, left ventricle ejection fraction(EF), left ventricular systolic time interval(LVSTI), and right ventricular systolic time interval(RVSTI). Echocardiographic studies were done before surgical correction and postoperative periods(postopl: within 2 weeks, postop2: between 4 and 6 months, postop3: between 1 and 2 years). Result: LA/Ao ratio decreased significantly at immediate postoperative period compared to preoperative period and sustained during further follow-up period(from 1.74$\pm$0.37 to 1.36$\pm$0.24*, 1.32$\pm$0.22*, and 1.27$\pm$0.19*, p<0.01). LV EF had not changed during follow-up periods(from 65.1$\pm$7.0 to 62.3$\pm$9.5, 62.8$\pm$5.7, and 64.1$\pm$6.9). LVSTI decreased significantly at postop2 and sustained during further follow-up period (from 0.46$\pm$0.13 to 0.46$\pm$0.11, 0.37$\pm$0.08*, and 0.34$\pm$0.07*, p<0.01). RVSTI decreased significantly at postop3(0.33$\pm$0.08 to 0.32$\pm$0.08, 0.31$\pm$0.07, and 0.27$\pm$0.05*, p<0.01). Conclusion: We found that right and left ventricular systolic time intervals had decreased over the period of 1 year after surgical correction of VSD. Therefore, it is necessary to observe the change of ventricular function during that period.