• 제목/요약/키워드: 심초음파

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Idiopathic Arterial Thromboembolism(ATE) in a Turkish Angora Cat (터키산 앙고라(Turkish Angora) 고양이에서 발생한 특발성 동맥 색전혈전증(arterial thromboembolism: ATE) 1례)

  • Han, Sung-Kuk;Kim, Jung-Hyun;Jeong, Soon-Wuk;Park, Hee-Myung;Park, Chul;Yoo, Jong-Hyun
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.23-26
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    • 2008
  • A 2-year-old, female, Turkish Angora cat was presented due to hindlimb paralysis with 2-day history of vomiting and depression. Physical examination revealed weak femoral pulse and cyanotic footpads of hind limbs. Chest auscultation, thoracic radiography, and electrocardiogram were no remarkable. Abdominal ultrasonography showed suspected hyperechoic thrombus in abdominal aorta. Underlying causes of the arterial thromboembolism were not found on multiple diagnostic examinations and the cat was diagnosed as idiopathic saddle thromboembolism. Despite 4-week regimen with heparin sodium, aspirin, and diltiazem, the hind limbs were progressively and irreversibly necrotized. Therefore, coxofemoral amputation was performed. After surgery, the clinical condition of this cat returned to normal without further complications.

Trilogy of Fallot in a Dog (개에서 발생한 팔로삼징)

  • Choi, Ran;Ahn, Hyo-Jin;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.404-407
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    • 2012
  • A 3 years-old female mixed dog (weighing 5.3 kg) was referred to veterinary teaching hospital of Kangwon National University with primary complaints of syncope, severe exercise intolerance, depression and lethargy. Diagnostic studies revealed polycythemia, right sided cardiac enlargement on thoracic radiography and right-to left atrial septal defect, severe pulmonary stenosis (~5 m/s of peak velocity) and right ventricular hypertrophy. Based on diagnostic findings, the dog was diagnosed as trilogy of Fallot. To improve clinical condition of this dog, diltiazem and enalapril were prescribed with weekly phlebotomy. To author's best knowledge, this is the first case of trilogy of Fallot in Korea.

A Case of Hepatopumonary Syndrome with Cyanosis (청색증으로 내원한 간폐증후군 1예)

  • Ryu, Dae-Sik;Jung, Bock-Hyun;Jung, Sang-Sik;Kim, Ho-Dong;Yoo, Chul-Hee;Kang, Kil-Hyeon;Kim, Nam-Hyeon;Jung, Seung-Mun;Park, Man-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.420-425
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    • 1999
  • We report a case of hepatopulmonary syndrome defined as a triad of chronic liver disease, increased alveolar oxygen gradient on room air, and intrapulmonary arteriovenous shunting. Chest rediographs showed bilateral, basilar, medium sized reticulonodular opacities. High resolution CT scand showed multiple centrilobular nodules and branching structures in the subpleural lung that suggested dilatation of lung vessels with abnormally large number of visible terminal branches. $^{99m}Tc$-macroaggregated albumin(MAA) perfusion lung scan showed right to left shunt. Contrast echocardiography demonstrated intrapulmonary vascular shunt without intracardiac shunt.

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Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report - (좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Seong, In-Whan
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.490-493
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    • 2001
  • A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.

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Membranous PTEE Monocusp Vlave on the Right Ventricular Outflow Tract (막형 PTEE 단엽판막을 이용한 우심실 유출로 확장수술)

  • 박영환;홍유선;이현성;이종균;조범구
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.322-328
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    • 2001
  • 배경: 우심실 유출로 재건술후에는 폐동맥판막부전이 우심실기능에 나쁜 영향을 미친다. 이를 막기 위해 여러 재료로 판막을 제조하여 사용하는데 가피 형성이 적은 막형 ePTEE(expanded polytetrafluoroethylene, Goretex) 단엽판막의 효과를 알아보고자 연구를 시행하였다. 대상 및 방법; 1996년 3월부터 1997년 2월까지 우심실유출로 재건술을 시행받고 수술 1일까지 우심실 압력을 측정할 수 있었던 47명중 막형 Goretex단엽판막을 사용한 환자(비교군) 19명, 사용하지 않은 환자(대조군) 28명에서 단엽판막의 유용성을 조사하였다. 두 군간에는 나이, 체중 그리고 McGoon ratio 등에는 통계학적 차이가 없었다.(p>0.05) 이전의 수술은 대조군에서 19번, 비교군에서 22번을 시행하였다. 우심실 유출로에 대한 수술은 대조군에서 REV수술 2예, 우심실폐동맥 연결수술 8예, 우심실 유출로 재개건술 2예, 우심실 유출로에 대한 수술은 대조군에서 16예였으며, 비교군에서는 REV 수술 5예, Rastelli 씨 수술 6예, 재우심실 유출로 재건술 5예, 그리고 우심실 재건술 3예였다. 결과: 대동맥 차단 시간이나 총심폐순환시간에는 두군간의 차이는 없었다. 또한 수술직후와 수술후 1일째 측정한 우심실 압력 및 좌심방압력의 차이도 두군간에는 차이가 없었으며 수술후 7일째 시행한 심에코도 결과 ejection fraction., 우심실/ 좌심실 압력비 , 그리고 우심실 유출로의 압력차, 강심제 투여일수, 호흡기 사용 기간 등에서도 두군간의 차이는 없었으나 흉관 삽입기간이 비교군에서 의미있게 짧았다. 추적 조사 기간 중 비교군 1예에서 사망을 하였으나. Goretex 단엽판막에 의한 것은 아니였으며 심초음파검사상 우심실 유출로 압력차이나 재수술은 두군간에 차이는 없었으나 폐동맥 폐쇄부전은 비교군에서 의미 있게 낮은 것을 보이고 있다. 결론; 막형 Goretex 단엽판막의 조기성적은 우수하였으며 폐동맥 폐쇄분전의 정도를 적게 하는 효과를 보이나 앞으로 이들이 성장함에 따라 우심실 유출로에 폐쇄를 일으키는지는 계속적인 추적관찰이 요구된다.

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Video-Assisted Thoracoscopic Surgery for Patent Ductus Arteriosus - 6 cases report - (흉강경을 이용한 동맥관 개존증 수술- 6례 보고 -)

  • Park, Chan-Beom;Kwon, Jong-Bum;Won, Yong-Soon;Park, Kuhn;Park, Kyu-Ho
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.351-355
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    • 2001
  • 개흉술에 의한 수술적 폐쇄방법 및 경도관 동맥관 폐쇄술은 동맥관 개존중의 치료방법으로 발전되어 왔으나, 이러한 술식은 개흉술에 의한 합병증, 지속적인 단락 및 용혈의 가능성, 기구의 이동이나 색전증의 발생, 지속적인 단락시 세균성 심내막염 방지를 위한 지속적인 항생제 사용등의 단점이 있어 저자들은 흉강경을 이용한 수술을 시행하였다. 총 6례의 환자에서 흉강경을 이용한 동맥관 개존증 수술을 시행하였으며. 이중 대동맥 외막(adventitia) 박리중 지형이 잘 되지 않았던 1례에서는 소개흉술(minithoracotomy)로 전환하였다. 술 후 이시행한 이학적 검사상에서 모든 환아에 심잡음이 소실되었음을 확인할 수 있었으며, 흉부 방사선 검사상 점진적인 폐혈관음영의 감소를 관찰할 수 있었으며 수술중 동맥관 파열이나 불완전한 동맥관 폐쇄, 기흉, 애성(hoarseness) 등의 합병증은 발생되지 않았다. 환아들은 술후 평균 3.4일째 퇴원하였으며, 퇴원후 외래추적 관찰검사시 시행한 심초음파 검사상 동맥관의 재개통이나, 잔류단락은 관찰되지 않았다. 본원에서는 개흉술 및 경도관 동맥관 폐쇄술의 단점을 방지할수 있으며, 성공적인 동맥관 폐쇄, 작은 피부절개 반흔에 의한 미용적 효과, 짧은 재원기간등의 장점을 가진 흉강경을 이용항 동맥관 결찰술을 시해앟여 문헌 고찰과 함께 보고하는 바이다.

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Repair of Postinfarct Subacute Left Ventricular Free Wall Rupture Using Fibrin Glue (급성심근경색 후 발생한 아급성형 좌심실파열에서 Fibrin Glue를 이용한 치료)

  • Lee, Jae-Hoon;Noh, Dong-Sub;Kim, Jae-Bum;Park, Nam-Hee;Keum, Dong-Yoon;Choi, Sae-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.448-450
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    • 2007
  • The mortality of left ventricular free wall rupture after acute myocardial infarction is high; however, subactue myocardial rupture can be diagnosed by echocardiogram and the use of the intraaortic balloon pump reduces the incidence of re-rupture. Bleeding from subacute myocardial rupture can be managed by employing fibrin glue and several patches. We report here on a case of successfully managed case of subactue left ventricular free wall rupture after acute myocardial infarction with using the sutureless technique and fibrin glue.

Ebstein's Anomaly in Transthoracic Echocardiography: Two Case Reports (경흉부 심초음파에서 관찰된 엡스타인 기형: 증례보고 2례)

  • Kim, Sung-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.265-269
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    • 2019
  • Ebstein's anomaly is attached to the right ventricle with the tricuspid leaf attached to the lower right ventricle without any attachment to the tricuspid annulus. Most patients in their 20s are alive. Patients older than 25 years of age are similar in the incidence of heart failure and sudden death, and survive approximately 70% from 2 years, and 50% from 3 years, from 5% to over 50 years of age. Through this example, Ebstein's anomaly exists in various forms. A 22 year old case with WPW syndrome and those who survived to 77 years of age are reported. The normal heart structure in the apical four-chamber view should be observed on similar lines, even though the tricuspid annulus is slightly lower than the mitral annulus. If not, there will be some doubt regarding this anomaly. Furthermore, echocardiography plays an important role in the diagnosis and prognosis of congenital heart disease.

Assessment of the Severity of Degenerative Aortic Stenosis: Three Case Reports (퇴행성 대동맥판 협착증의 중증도 평가: 증례보고 3례)

  • Kim, Sung-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.270-275
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    • 2019
  • The incidence of degenerative valve disease also increasing with the increasing life expectancy of the elderly population. Rheumatic valve disease is decreasing gradually and the incidence of calcified degenerative aortic stenosis (AS) is growing. Echocardiography is a very important tool for evaluating the prognosis and treatment method as well as the time of operation and diagnosis of heart valve disease. When evaluating valvular heart disease, 2-dimensional echocardiography, which observes all heart valves in detail, should take precedence. Understanding the clinical findings of degenerative valve disease and performing precise echocardiography are extremely important. In addition, an assessment of the severity of aortic stenosis is necessary to determine the surgical indications. An assessment of the severity by echocardiography was explained with three cases of degenerative aortic stenosis. To perform echocardiography accurately, it is necessary to understand degenerative valve disease and its clinical findings accurately.

Right Atrial Deformation Mechanics in Children with Adenotonsillar Hypertrophy

  • Kang, Soo Jung;Kwon, Yoo Won
    • Journal of Cardiovascular Imaging
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    • v.26 no.4
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    • pp.201-213
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    • 2018
  • BACKGROUND: Children with significant adenotonsillar hypertrophy (ATH) may show right ventricular (RV) dysfunction. We aimed to evaluate RV dysfunction in such children before adenotonsillectomy by evaluating peak longitudinal right atrial (RA) strain (PLRAS) in systole. PLRAS, electrocardiogram (ECG) and conventional echocardiographic parameters were compared to distinguish children with significant ATH with sleep-related breathing disorder (ATH-SRBD) from controls. METHODS: Fifty-six children (23 controls and 33 children with ATH-SRBD without symptoms of heart failure) were retrospectively studied. Preoperative echocardiograms and ECGs of children with ATH-SRBD who underwent adenotonsillectomy were compared to those of controls. Available postoperative ECGs and echocardiograms were also analyzed. RESULTS: Preoperatively, prolonged maximum P-wave duration (Pmax) and P-wave dispersion (PWD), decreased PLRAS, and increased tricuspid annulus E/E' were found in children with ATH-SRBD compared to those of controls. From the receiver operating characteristic curves, PLRAS was not inferior compared to tricuspid annulus E/E', Pmax, and PWD in differentiating children with ATH-SRBD from controls; however, the discriminative abilities of all four parameters were poor. In children who underwent adenotonsillectomy, echocardiograms $1.2{\pm}0.4$ years after adenotonsillectomy showed no difference in postoperative PLRAS and tricuspid annulus E/E' when compared with those of the preoperative period. CONCLUSIONS: Impaired RA deformation was reflected as decreased PLRAS in children with ATH-SRBD before adenotonsillectomy. Decreased PLRAS in these children may indicate subtle RV dysfunction and increased proarrhythmic risk. However, usefulness of PLRAS as an individual parameter in differentiating preoperative children with ATH-SRBD from controls was limited, similar to those of tricuspid annulus E/E', Pmax, and PWD.