• Title/Summary/Keyword: 심초음파

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Bidirectional Cavopulmonary Shunt for Isolated Right Ventricular Endomyocardial Fibrosis (우심실에 생긴 심근내막섬유증에서 시행한 양 방향성 상대정맥-폐동맥 단락 수술)

  • 서영준;이덕헌;박남희;최세영;유영선
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.523-526
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    • 2003
  • A 44-year-old man had been admitted for dyspnea on exertion and abdominal distension. The echocardiography revealed abnormal mass in right atrium and tricuspid valve stenosis with right ventricular obliteration. The operation was performed with mass removal, enlargement of tricuspid valve opening, and right ventricular endocardiectormy. And then, atrial septal defect was made due to inadequate right ventricular volume. The patient's symptom was improved and he discharged without events. The endomyocardial fibrosis was diagnosed with microscopic examination. Eighteen months later, the patient was readmitted due to aggravated dyspnea and cyanosis. The right ventricular obliteration was progressed and pulmonary blood flow was severely decreased in follow up echocardiography. Palliative bidirectional cave-pulmonary shunt was performed due to functional single ventricle. The dyspnea and cyanosis was markedly improved. Bidirectional cavo-pulmonary shunt for advanced and isolated right ventricular endomyocardial fibrosis provided effective palliation at early postoperative period, However, long-term follow up is mandatory.

Laparoscopic Retrieval of Ectopic Adult Heartworms from the Abdominal Cavity of a Dog with Heartworm Infestation (심장사상충 복강내 이소기생 개에서 복강경적 치료 1예)

  • Kang, Min-Hee;Song, Kun-Ho;Lim, Chae-Yung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.595-597
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    • 2011
  • A 5-year-old, intact male Beagle was presented with chronic abdominal pain. The dog was diagnosed with dirofilariasis by positive heartworm antigen detection via ELISA and concurrent microfilaria. Thoracic radiographs revealed cardiomegaly with dilation of the main pulmonary artery. Echocardiography revealed the adult worms in the main pulmonary arteries, but other abnormalities other than heartworm infection were not present. To find the cause of the abdominal pain, exploratory laparoscopy was performed. Ectopic migrating adult heart worms were visualized through exploratory laparoscopy and the clinical sign resolved after removing the heart worm. This report describes removing the ectopic migrating adult heartworms using exploratory laparoscopy in the abdominal cavity.

A Study of Electrocardiographic Change and Tricuspid Competence after Temporary Detachment for Closure of Ventricular Septal Defect (삼첨판막절개아 심실중격결손증의 수술 이후의 삼첨판막의 기능에 대한 연구)

  • 정성운;박준호;김종원
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.633-637
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    • 2003
  • Sometimes temporary tricuspid valve detachment is applied for closure of ventricular septal defect to facilitate good exposure and avoiding ventriculotomy, but most surgeons hesitate to do it in the fear of tricuspid incompetence. Moreover in recent textbooks the technique of temporary tricuspid detachment is only described for exceptional situations and is not further analysed or commented on. Material and Method: Retrospective study was carried out in all 11 patients operated between 1985 to 1994, with preoperative data and postoperative course and recent echocardiographic and electrocardiographic data. Result: On the basis of the area of the color flow jet, tricuspid valvular regurgitation was graded as none in 9 and trivial in 2, and significant electrocardiographic heart block did not developed in any patients. Conclusion: Takedown and attachment of the tricuspid valve is a safe and effective technique that improves exposure for ventricular septal defect, and does not adversely effect tricuspid valve competence and electrocardiography.

Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report- (간농양에 속발한 급성화농성 심 낭염 -1례 보고-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.785-788
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    • 1996
  • Pericardial abscess due to liver abscess is a very rare disease, the result of which is usually fatal when untreated. But a combination of antibiotics therapy and pericardial drainage has broug t good result. A 32-year-old man was admitted to the emergency room because of fever and chilling sensation. Chest X-ray showed cardiomegaly and a mass lesion In the left lobe of liver on ultrasonography. The echocardiography revealed impending cardiac tamponade. Pus drainage of the liver abscess through per- foration of right diaphram and pericardiotomy were performed. The pericardium was thickened and 600 ml of purulent fluid and necrotic debris were drained. Fibrin clots were firmly attached to the undelying myocradium. Histological examination of the pericardium showed acute inflammation with microabsscess and Escherichia soli was cultured from pericardial pus. He was discharged after 4 weeks on antibiotics, but Doppler echocardiograpy revealed a slightly thickened pericardium with a mild constrictive physiology.

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Tricuspid Valve Endocarditis (삼첨판막 심내막염)

  • 문광덕;김대영
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.440-443
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    • 1996
  • Some tricuspid valve endocarditis can be controlled effectively with specific antibiotic treatment. However, surgical intervention Is necessary when there are continuing sepsis, moderate or severe heart failure, multiple pulmonary emboli, and echocardiographycally demonstrated vegitations. We are repoting a 19 year-old male patient who was admitted for the treatment of infective endocarditis. He previously had an operation for ventriculer septal defect (perimembranous type) about 9 years ago . An echocardiogram showed a large vegetation on the anterior cusp area and a left to right shunt through VSD, which was previously closed with dacron patch. A valve replacement in addition to antibiotic therapy was recommended for the patient. The patient underwent on operation : tricuspid valve replacement was done with 51. Jude medical valve prosthesis (33 mm), and in addition to above procedure, removal of vegetation and direct closure of VSD were done Postoperative echocardiogram showed that replaced tricuspid valve functioned well and vegeta ion and shunt flow were not observed. The patient recovered without complication and discharged at Postoperative day 25. Early aggressive surgical intervention is indicated to optimize surgical results, and this case seems to be a typical right sided bacterial endocarditis, which is caused by residual VSD. We are reporting a case of tricuspid valve endocarditis with a review of the literature. (Korean J Thorax Cardiovasc Surg 1996 ; 29: 440-3)

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The Clinical Analysis of Patient with Patent Ductus Arteriosus (동맥관개존증의 임상적 고찰)

  • Kang, Meyun-Shick;Lee, Cheol-Joo;Lee, Dong-Hyup;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.287-292
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    • 1986
  • A clinical analysis was performed on 61 cases of patent ductus arteriosus experienced at Yeungnam University Hospital during 3 years period from Aprial, 1984 to December, 1986. Of the 61 patient of PDA, 13 patient were male and 48 patient were female and age ranged 2 months to 26 years old with the average age of 9.4 years. The chief complaints on admission were frequent URI and dyspnea on exertion. Main diagnostic procedure were Doppler Echocardiogram(in 53 among 61). All of the operations were performed the method of ligation of PDA. Three posterative complication were developed, but there was no operative mortality.

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Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis (가와사끼병 환아에서 발생한 거대관상동맥류 내 혈전의 성공적 용해요법과 장기 치료 및 경과 1례)

  • Moon, Su Jung;Lee, Su Ya;Na, Kyong Hee;Park, Sun Young;Kim, Eun Young;Kim, Kyoung Sim;Kim, Yong Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.302-307
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    • 2003
  • The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess (인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병)

  • Kim, Eu Jin;Lim, Young Su;Yoon, Ji Eun;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.251-255
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    • 2009
  • Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.

Surgical Treatment of Prosthetic Valve Endocarditis after Reconstruction of the Intervalvular Fibrous Trigon -A case report- (판막간 섬유체 재건을 시행한 후 발생한 인공판막 심내막염의 수술적 치유 -1예 보고-)

  • Choi, Seon-Uoo;Kim, Wook-Sung;Min, Ho-Ki;Kang, Min-Woong;Lee, Young-Tak;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.755-758
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    • 2008
  • We report here on a case of performing a redo-operation for a 65-years-old male patient who had prosthetic endocarditis after reconstruction of the fibrous skeleton due to infective endocarditis 8 years earlier. An aortic annular abscess with a 1cm sized subvalvular abscess and mobile mitral valve vegetation with destruction of the fibrous skeleton was shown on the preoperative echocardiography. An emergency operation was performed due to heart failure. Reconstruction of both the aortic and mitral annuli and the fibrous skeleton was done by using two separate bovine pericardial patches and then mechanical valves were implanted. The postoperative echocardiography shows no paravalvular leakage. The patient has been followed up with no symptoms.

Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring (인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료)

  • Son, Kuk-Hui;Son, Ho-Sung;Chung, Jae-Ho;Chung, Won-Jae;Sun, Kyung;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.489-491
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    • 2008
  • A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the tarumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.