• Journal of Chest Surgery
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• v.28 no.6
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• pp.565-570
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• 1995

Seventy-three patients with isolated total anomalous pulmonary venous connection the patients associated with other major cardiac anomalies such as single ventricle, DORV[Double Outlet Right Ventricle and large VSD[Ventricular Septal Defect were excluded were underwent surgical repair from January 1980 through October 1993. There were 45 boys and 28 girls. The mean age at operation was 19.9 months[range 6 days to 24 years and mean body weight was 7.1kg[range 2.6kg to 45kg . The anomalous locations of connection were supracardiac in 38, cardiac in 21, infracardiac in 5, and mixed in 9. In 38 patients[52% , the venous drainage was obstructed. The obstruction ratios according to the connection type were as follows: 53%[28/38 in supracardiac, 52%[11/21 in cardiac, 100%[5/5 in infracardiac, 22%[2/9 in mixed type. The associated cardiac anomalies were persistent left SVC[2 , tricuspid valve regurgitation[3 , cor triatriatum[1 , and mitral cleft[1 . And associated noncardiac anomalies were imperforate anus[1 and Neil Weightman syndrome[1 . The operative mortality was 23%. The causes of death were pulmonary hypertensive crisis, perioperative myocardial failure, pneumonia with sepsis, arrhythmia and etc. The statistically significant factors in postoperative mortality were the pulmonary venous obstruction and age [p<0.01 . The operative mortality was high in groups of age under 1 month and pulmonary venous obstruction. The mean follow-up was 27.1 months. There were two late deaths. The first patient was three months old boy with supracardiac type and severe obstructive symptoms. The postoperative echocardiography was showed anastomotic stenosis and reoperations were performed twice but the patients expired due to pneumonia and sepsis. The second patient was three month old boy with supracardiac type and total correction was done and was doing well postoperatively. Eight years later, he expired suddenly due to arrhythmia. But all the other patients were in NYHA Fc I and received no medications. The 5-year survival rate excluding early expired patients is 97.1 $\pm$ 0.03 %. In conclusion, although the operative mortality of total anomalous pulmonary venous connection was relatively high compared to other major cardiac anomalies, we could expect excellent long-term results by early surgical correction.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.962-967
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• 1990

The anomalous pulmonary venous return of the entire left lung was an extremely rare congenital anomaly. The reported surgical experience with correction of this disorder was limited. The 3-year-old female patient underwent an operation upon the unilateral total anomalous pulmonary venous return from the left lung, in which the left superior pulmonary vein drained into innominate vein and the left inferior pulmonary vein into the coronary sinus, in Yeungnam University Hospital. The symptoms were nonspecific except frequent upper respiratory infection. Cyanosis was not seen. On auscultatory findings, a grade 2/6 systolic ejection murmur was audible over left second intercostal space of left sternal border and second heart sound had an increased pulmonary component which was widely splitted. The electrocardiogram demonstrated a right ventricular hypertrophy and right axis deviation and chest X-ray showed slightly increased pulmonary vascularity and bulged pulmonary conus. The echocardiogram demonstrated increased right atrial, ventricular, and pulmonary arterial dimension, and also secundum atrial septal defect and enlarged coronary sinus. The cardiac catheterization confirmed the left-to-right with a Qp/Qs of 2.0: 1 and oxygen step-up was seen in pulmonary artery, right ventricle, right atrium, and left innominate vein, and the catheter was not been introduced into the left pulmonary vein. A median sternotomy incision was done. Left superior pulmonary vein was drained to the innominate vein through anomalous vertical vein and the left inferior pulmonary vein drained to right atrium through the coronary sinus. The diversion of the left inferior pulmonary vein to posterior wall of left atrium was done after division in the proximity of coronary sinus. The anomalous vertical vein was diverted to base of left atrial auricle and then a atrial septal defect was sutured directly. The postoperative course was uneventful and she was discharged on the eleventh postoperative day. In the postoperative follow-up-2 months, she has been well without specific problems.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.708-712
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• 1997

We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 o 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weatuless(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.421-423
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• 2010

A 52-year-old female presented with pain and swelling owing to recurrent inflammation on a generator pocket. She had undergone a permanent pacemaker implantation (DDD type) 7 years previously. We planned to insert a new pacemaker after removal of the previous generator and wires through a surgical approach. However, she had a history of the left modified radical mastectomy (MRM) with radiation therapy for breast cancer. For this patient, it would be difficult to care for the postoperative wound if we approached via the median sternotomy. Therefore, we decided to use a right atrial approach via a right thoracotomy. We removed the previous pacing wires through an atriotomy and inserted a new pacemaker using epicardial pacing leads without cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.688-691
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• 2002

Takayasu's arteritis is a chronic inflammatory disease of unknown cause. It predominantly affects the aortic arch and its branches. Concomitant involvement of coronary and renal arteries is a rare entity. In this report, we described successful treatment of a patient with Takayasu's arteritis associated with coronary and renal arteries stenosis. A 23-year-old woman was presented with chest pain on exertion. Angiographic studies demonstrated left main coronary, bilateral renal, and left subclavian arteries stenosis. She underwent angioplasty and stenting of bilateral renal artery. After one week, coronary artery bypass grafting using greater saphenous veins and aorto-subclavian bypass with PTFE vascular graft were done simultaneously. She was discharged on the 13th postoperative day without any complications.

• Journal of Chest Surgery
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• v.12 no.2
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• pp.140-144
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• 1979

This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube [$1.3{\times}5$ cm]. After that SVC was decompressed very well. SVC pressure was markedly reduced from 32 cm $H_2O$ in preoperative to 21 cm $H_2O$in postoperative. Mediastinal fibrosis was confirmed by histopathological examination postoperatively. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.594-596
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• 2000

Congenital cystic adenomatoid malformation and Extralobar Pulmonary sequestration are very rare congenital anomalies. We experienced a 4 year-old female patient who had Congenital cystic adenomatoid malformation in her lower lobe of left lung. We accidently found extralobar pulmonary sequestration associated with Congenital cystic adenomatoid malformation at operation field. The resection of the left lower lobe and the extralobar pulmonary sequestration were performed. The arterial supply of the extralobar pulmonary sequestration was one anomalous artery arised from the thoracic aorta. The Venous drainage of expralobar pulmonary sequestration was intercostal vein into the azygous vein. The patient was discharged without any problem.

• Korean Journal of Ichthyology
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• v.27 no.3
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• pp.228-232
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• 2015

The structure of the ventricle in the heart of Hypomesus nipponensis was investigated by light and scanning electron microscope. The heart consisted of four consecutive chambers, the sinus venosus, atrium, ventricle and bulbus arteriosus. The wall of the ventricle was divided into endocardium, myocardium, subepicardium and epicardium. The valves were observed in the artrioventricular and bulboventricular junctions. The ventricular myocardium was an entirely spongy without coronary vessels. The trabecular network was formed with lumina included a central lumen and the trabecula was cylindrical shape. Collagen distribution was apparent in the subepicardium, artrioventricular valve and bulboventricular valve. But in the trabeculae, collagen distribution was observed partly in the base of the ventricle. Especially, the endocardial bridges were observed between trabeculae. These results might be considered that the structure of the ventricle in the heart of pond smelt is adapted to sedentary habit associated with its habitat and lifestyle.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.60-64
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• 2017

Kawasaki disease (KD) is a systemic vasculitis that occurs predominantly in infants and young children. The etiology of KD is unknown and coronary heart disease is a major complication of KD. Acute scrotum is a rare complication of acute KD, and not as well recognized as other manifestations of the disease. We report a 2-month-old boy with acute scrotum in the acute phase of KD. He was treated with intravenous immunoglobulin (total 2 g/kg) and aspirin (50 mg/kg/day). The treatment was effective in resolving his fever and other clinical symptoms, but 2 days after starting treatment he experienced scrotal swelling. Scrotal ultrasound and transillumination were used in the diagnosis of acute scrotum. After 2 months, a follow-up testicular ultrasound revealed a remission of the acute scrotum. Subsequently, he has been followed up for KD.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.791-794
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• 2006

Popliteal artery entrapment syndrome is a rare disorder and lead to claudication and disturbance of blood flow from the results of an abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in a young male population. The specific diagnosis is difficult, In most cases, surgical treatment provides a definitive diagnosis of the lesion and is necessary for the patient's recovery. A 34-years-old male was admitted complaining of claudication and pain on left leg. Ankle-brachial index, vascular sonography, CT-angiogram and MRI revealed an occlusion of proximal popliteal artery of left leg. The patient was confirmed as a popliteal artery entrapment syndrome (type IV) that the popliteal artery was entrapped by a fibrous band around the popliteus muscle in the operative fold. Completely occluded fibrotic popliteal artery was removed, and interposition with ipsilateral greater saphenous vein graft was done. After surgery, symptoms of the patient have improved.