• Title/Summary/Keyword: 심초음파

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Half-turned Truncal Switch Operation for Transposition of Great Arteries, Ventricular Septal Defect and Pulmonic Stenosis (폐동맥 협착과 심실 중격 결손을 동반한 대혈관 전위에서 시행한 반회전 동맥간 전환술)

  • Lim Hong Gook;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Kim Jun Seok;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.145-149
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    • 2006
  • The surgical management of patients with transposition of the great arteries, ventricular septal defect, and pulmonary stenosis remains a challenge. The Rastelli operation or Lecompte operation is the preferred surgical procedure, but its long-term results are not optimal because of a warped left ventricular outflow tract through a space-occupied intraventricular tunnel and a contrived right ventricular outflow tract. We performed a half-turned truncal switch operation as an alternative surgical procedure in a 3-year-old boy (weighing 9.6 kg) with this anomaly. Postoperative echocardiography showed laminar flow through straight and nonobstructive aortic and pulmonary ventricular outflow tracts.

Simultaneous Repair of Secondary Anterior Chest Wall Deformity and Secundum Atrial Septal Defect -1 Case Report- (심방중격결손을 동반한 이차성 전흉벽기형의 동시교정 -1예 보고-)

  • 김용희;정종필
    • 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.

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Primary Pulmonary Artery Osteosarcoma Mimicking Acute Pulmonary Artery Embolism - A case report- (급성 폐동맥 색전증으로 의심된 원발성 폐동맥 골육종 -1예 보고-)

  • 박상현;손정환;지현근;신윤철;유병수;박우정;박혜림;김응중
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.929-932
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    • 2004
  • The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.

Surgical Management for Chronic Atrial Fibrillation (만성 심방세동에 대한 외과적 치험 4례)

  • 강경훈;김철환;김병열
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.59-65
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    • 1998
  • Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.

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Aortic Root Replacement Using Aortic Homograft in Acute Bacterial Endocarditis One Case Report (심내막염 환자의 동종대동맥편을 이용한 대동맥 근부 치환술 - 1례 보고 -)

  • Im, Chang-Yeong;Lee, Heon-Jae
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.819-822
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    • 1997
  • Aortic valve replacement with aortic allograft has been considered a treatment of choice for aortic valve disease secondary to bacterial endocarditis because of its good homodynamic performance and higher resistance to infection. The aortic root replacement technique might be superior to the subcoronary allograft implantation technique with regard to aortic regurgitation. A 46 yea,rs old male patient had acute aortic regurgitation with progressing heart failure secondary to acute bacterial endocarditis. The patient underwent emergent aortic root replacement using 20 mm aortic allograft. At operation, right coronary cusp perforation and heavy calcification of commissure between right and left coronary cusp were observed. The patient recovered well and postoperative echocardiography demonstrated no aortic regurgitation. Inflammatory signs were subsided after 8 weeks of antibiotics therapy. Medically uncontrolled acute bacterial endocarditis was treated successfully by aortic root replacement using aortic homograft.

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Assessment of Regional Myocardial Wall Motion by Gated $^{99m}Tc-MIBI$ Myocardial SPECT (게이트 $^{99m}Tc-MIBI$ 심근 SPECT의 심근 분절 운동 평가능력)

  • Kim, S.W.;Lee, D.S.;Kim, S.H.;Hyun, I.Y.;Chung, J.K.;Lee, M.M.;Lee, M.C.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.473-477
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    • 1995
  • Information about regional wall motion obtained with gated $^{99m}Tc-MIBI$ SPECT was compared in 23 subjects(4 normals) to echocardiography or contrast left ventriculography. Gated SPECT study using 20-30 mCi $^{99m}Tc-MIBI$ were aquired lot 8 frames/RR interval (aqusition time=40min.) and processed with Cine Mode computer protocol. Regional wall motion was assessed by visual analysis. The concordance with echocardiography was 88% and with contrast ventriculography was 78%. We conclude that gated $^{99m}Tc-MIBI$ SPECT was effective in assessing the regional wall motion with the information of regional perfusion in one study.

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Left Ventricular Outflow Obstruction due to a Left Ventricular Myxoma (좌심실 점액종에 의해 발생한 좌심실 유출로 협착증)

  • Park, Jeong-Min;Ahn, Byung-Hee
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.98-101
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    • 2008
  • Once it is diagnosed, immediate surgical extirpation is desirable for treating left ventricle myxoma that's accompanied with stenosis of the left ventricle outflow tract. This is because this condition may potentially induce fatal complications such as cerebral infarction or myocardial infarction that's triggered by myxoma embolus, or even sudden death due to coronary malperfusion. An 18-year-old male with the chief complaint of NYHA class II exertional dyspnea was found to have a $4{\times}3\;cm^2$ sized mass on transthoracic ultrasonography, which was shown to move down the left ventricle outflow tract on the systolic phase. The mass was immediately extirpated by incision of the left ventricle; the mass was finally diagnosed as a myxoma. The patient was discharged on at the 10th day postoperatively without any complications. On the 22-month follow-up observation made at the out-patient clinic after discharge, there have been no noticeable, significant changes seen on physical examination or the cardiac ultrasonography.

Operative Treatment for Cardiac Tamponade with Ventricular Rupture of Post Myocardial Infarction without Cardiopulmonary Bypass - A case report - (급성심근경색 후 발생한 양심실파열로 인한 심장압전에서 체외순환의 사용없이 시행한 수술적 치료 - 1예 보고 -)

  • Choi, Chang-Seock;Kim, Han-Yong;Park, Jae-Hong
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.95-97
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    • 2008
  • Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

Heartworm Extraction in a Pitbull Terrier Dog with Heavy Worm Burden Using A Loop Snare (심한 심장사상충 감염증에 걸린 핏불테리어 개에서 Loop Snare를 이용한 심장사상충 제거술)

  • Kim, Ji-Yoon;Yoon, Won-Kyoung;Yang, Hye-Mi;Choi, Won-Jin;Kim, Hyun-Wook;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.412-416
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    • 2014
  • A 7-year-old intact male Pitbull terrier dog was presented with complaints of marked abdominal distension and severe exercise intolerance. Diagnostic studies found a right-sided cardiomegaly with marked dilation of pulmonary arteries, diffuse interstitial pulmonary infiltration and heavy worm burden in the right atrium and ventricle. Color and spectral Doppler echocardiography also revealed tricuspid and pulmonic regurgitation indicating severe pulmonary hypertension. The 104 heartworms were removed by interventional extraction using a loop snare (Snare, Boston Scientific, USA) through external jugular vein. After heartworm removals, the clinical condition of this dog was remarkably improved. To author's best knowledge, this is the first case of interventional heartworm extraction using a loop snare in Korea.

Repair of Left Ventricular Free Wall Rupture after Acute Myocardial Infarction: Application of Pericardial Patch Covering and Fibrin Glue Compression A case report (급성심근경색 후 발생한 좌심실벽 파열에서 소심낭과 Fibrin Glue 압박을 이용한 치험 - 1예 보고 -)

  • 김상익;금동윤;원경준;오상준
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.363-366
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    • 2003
  • Background: Left ventricular rupture after acute myocardial infarction is a serious complication with high mortality. Emergency operation is usually the only available treatment. A 76-year-old female with persistent chest pain and syncopal attacks was admitted. Transthoracic echocardiography showed the pericardial effusion and generalized hypokinesia of the inferolateral wall of left ventricle. Coronary angiography revealed a total occlusion of the first diagonal branch. After percutaneous transluminal coronary angioplasty with coronary stent and insertion of intraaortic balloon pump, emergency operation was performed. Under cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia, coronary artery bypass graft with saphenous vein, pericardial patch covering on the rupture area with 6-0 polypropylene running sutures, and fibrin glue compression under the patch were performed. We present a case of left ventricular (free wall) rupture after acute myocardial infarction.