• Journal of Chest Surgery
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• v.31 no.9
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• pp.899-902
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• 1998

Recent advances in understanding the anatomy of complete atrioventricular septal defect have led to alternative methods of repairing these defects. Here we report two cases of complete atrioventricular septal defect repair by direct closure of the ventricular element of the defect. Follow-up for average of 3 months suggests that, when direct closure can be performed, the results can be comparable with those of the standard technique. Our initial success with this approach is encouraging; however, longer follow-up and more experiences are required to establish whether it will be broadly applicable.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.463-466
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• 2002

We present a case of coronary artery fistula originating from the proximal left anterior descending artery draining into the main pulmonary artery, which was associated with atrial septal defect. The patient was a 56 year old male who was admitted for exertional dyspnea and abdominal distension. Echocardiogram and selective coronary arteriogram revealed a atrial septal defect and fistulous connection. The patient underwent surgery under the cardiopulmonary bypass with fibrillating heart. The pericardial patch closure of atrial septal defect and internal obliteration of the fistula termination site in the main pulmonary artery were performed. Postoperative hospital courses were uneventful without any specific complication and the patient was discharged without problem.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.168-172
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• 1998

Inferior sinus venosus defect is a rare lesion in which there is a large interatrial communication adjacent to the atrial connection of the inferior caval vein. The defect is located posteriorly and inferiorly, outside the confines of the true atrial septum, and partial anomalous pulmonary venous connections are the rule. We underwent surgical repair in four patients with inferior sinus venosus defect and partial anomalous pulmonary venous return. There were three males and one female with an age range from four months to 25 years. A cross- sectional echocardiogram and cardiac catheterization had been performed preoperatively in all patients, but the correct diagnosis had been made in only one case. Surgical repair was indicated due to congestive heart failure, and one patient of 4-month-old needed urgent operation. The repair was accomplished by suturing a untreated autologous pericardial patch to the right of the pulmonary veins, so that the defect was closed and all the pulmonary venous blood was directed to the left atrium. The preoperative knowledge of the unusual anatomy allows the surgeon to repair the anomaly without difficulties. For the patients in whom interatrial communication and anomalous pulmonary venous return are suggested, surgeon has to pay careful attention to the anatomical landmarks to avoid incorrect placement of the patch.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.890-893
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• 2002

Ebsteins anomaly is a rare congenital cardiac malformation that is the downward displacement of the septal and posterior leaflets of the tricuspid valve into the ventricular apex, aresulting in the formation of an atrialized portion of the right ventricle. In most patients, symptoms such as cyanosis and progressive heart failure occur during the adolescence or young adulthood. The associated anomalies include ventricular septal defect, transposition of the great arteries, and malformation of the mitral valve. An 8-months-old male with Ebsteins anomaly, ventricular septal defect, and duplication of the mitral valve orifice successfully underwent operation with VSD patch closure. Postoperatively, cardiac size was significantly reduced and tricuspid regurgitation was trivial in echocardiography He has been doing well without any cardiac medication during the 18 months follow up after operation.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1247-1250
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• 1997

A 13-year-old boy presented with anterior chest wall depression and dyspnea on exertion(NYHA II). He underwent Ravitch operation for pectus excavatum 7 years ago. A preoperative echocardiographic study revealed secundum atrial septal defect. He had no other abnormality of laboratory test, except FVC and FEVI were decreased into 2.03 L(7 %) and 1.82 L(71 %). He underwent repair of secondary anterior chest wall deformity and secundum atrial septal defect. We used unique method, raising sternum at right angle to secure good operative field for open heart surgery. Acute respiratory insufficiency was developed on postoperative day 1. Mechanical ventilation was applied which could be weaned on postoperative day 6 and thereafter hospital course was uneventful without any other sequale. He was discharged on postoperative day 19.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.630-632
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• 2008

Minimally invasive cardiac surgery using AESOP (Automated Endoscope System for Optimal Positioning) offers certain advantages such as better a cosmetic outcome, a shortened post operative recovery time and a shorten hospital stay, and these advantages are not achieved by conventional cardiac surgery. We report here on our first robot-assisted (AESOP) left minithoracotomy surgery in a 26 year-old female with a subarteral ventricular septal defect, and this might have been treated by median sternotomy before the development of AESOP.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.62-65
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• 1999

Infantile lobar emphysema is an uncommon disease affecting newborns and infants with varying degree of respiratory distress, lobar overaeration, mediastinal shift and herniation. Although the etiology of the condition is most commonly idiopathic, there is a clear association with congenital heart disease, particularly in the presence of pulmonary hypertension due to left to right shunt. Sites of predilection are the left main bronchus, the left upper and right middle bronchi. This report describes a two-week-old boy who had right middle lobe emphysema with large ventricular septal defect. At first, patch closure of perimembranous ventricular septal defect was performed. Postoperatively, the patient required continuing assisted ventilation and the lobar emphysema was not improve. One week following the initial operation, right middle lobectomy was successfully performed and the patient was weaned from artificial ventilator on the 5th postoperative day. The patient was discharged with good general condition on the 45th postoperative day.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.630-633
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• 2001

Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system and has a wide variety of manifestations. It is associated with almost any drug given during anesthesia, except neuromuscular relaxants, and treated with the cholinesterase inhibitor physostigmine. The diagnosis of central anticholinergic syndrome is often made when symptoms resolve promptly after the administration of physostigmine. We present a case of a central anticholinergic syndrome diagnosed by treatment with physostigmine, in a patient who received closure of patent foramen ovale associated with stroke.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.516-519
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• 2009

Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

• Journal of Chest Surgery
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• v.29 no.5
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• pp.554-558
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• 1996

A case of distal aortopulmonary septal defect associated with aortic origin of right pulmonary ar- tery, patent ductus arteriosus and hypoplasia of aortic isthmus in a 50-day-old female infant is presented. Ligation of patent ductus arteriosus, resection and end-to-end anastomosis of hypoplasia of aortic isthmus, implantation of rlght pulmonary artery to main pulmonary artery and autologous peri- cardial patch repair of aortopulmonary septal defect were performed under cardiopulmonary bypass as one-stage approach. Deep hypothermic total circulatory arrest was applied during repair of hypoplasia of aortic isthmus. The p stoperative course was uneventful.