• 제목/요약/키워드: 우심실

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소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예 (A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF)

  • 나용준;곽재건;김진현;오세진;이재항;김웅한
    • Journal of Chest Surgery
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    • 제39권11호
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    • pp.854-857
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    • 2006
  • 환자는 8세 여자 환자로 확장성 심근병증을 진단 받은 환자이다. 환자는 심부전으로 인하여 양심실 순환보조를 15일간 시행하였다. 15일 중 후반기 7일은 급성 신부전증이 발생하여 지속적 정맥-정맥간 혈액투석을 시행하였다. 이후 뇌사상태의 A형 혈액형을 가진 심장 공여자에게서 심장을 이식받아 심장이식술을 시행하였다. 면역 억제제는 급성 신부전증을 고려하여 사용하였다. 신부전 상해는 2주간 지속되었고, 심장 이식술 후 약 14일 후 배뇨가 시작되었다. 환자는 수술 후 12일째에 시행한 우심실 조직검사에서 특별한 거부반응의 증거가 없었으며, 면역요법 후 수술 후 52일째에 특별한 문제 없이 퇴원하였다. 환자는 술 후 약 14개월간 조직검사에서 면역 거부반응 없이 외래 경과관찰 중이다.

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

  • 최창석;김한용;박재홍
    • Journal of Chest Surgery
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    • 제41권1호
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    • pp.95-97
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    • 2008
  • 허혈성 좌심실벽 파열은 심근경색 후에 발생하는 치명적인 합병증 중의 하나인 심장파열의 한 유형으로 빠른 진단과 수술이 필요하다. 환자는 내원 15분 전 갑작스런 의식소실을 주소로 내원한 75세 여자로 당시 의식은 반 혼수상태로 얼굴과 상하지에 청색증 소견을 보였으며 응급실에서 시행한 심초음파 검사상 심낭에 약 $1.5{\sim}2\;cm$ 두께로 삼출소견이 관찰되었으며 심장박동 수가 35회/분까지 떨어져 심장마사지 시행하면서 응급수술을 시행하였다 우심실 전벽에 1 cm정도의 파열과 좌심실 벽에 괴사성 출혈반흔을 동반한 파열부위를 확인하고 체외순환 없이 사친스키 겸자를 이용해 출혈부위를 잡은 뒤 봉합하였다. 환자는 수술 후 28일째 약간의 호흡곤란은 있으나 일상생활 가능한 상태로 퇴원하였다.

Ebstein 심기형의 개심술 4례 (삼첨판막 대치이식술 및 우심실 Plication) (The Surgical management of Ebstein's anomaly: A Report of 4 cases of tricuspid valve replacement and plication of the atrialized right ventricle)

  • 임승평;양기민;이영균
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.435-441
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    • 1980
  • Ebstein`s anomaly had been amenable to reparative surgery since 1962. However, neither the role of surgery in Ebstein`s anomaly nor the surgical procedure of choice for its correction are clearly defined. Whether or not the atrialized right ventricle, which plays a major role in the functional abnormalities, should be obliterated in all cases remains unsolved. Four cases of Ebstein`s anomaly treated surgically at Seoul National University Hospital were reported. All had closure of the atrial septal defect, obliteration of the atrialized right ventricle by plication, and insertion of a tricuspid bioprosthesis and an epicardial ventricular pacemaker. One patient had a pulmonic valvotomy due to stenotic bicuspid pulmonic valve also. All but one had discharged with a good result.

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투명도 가중치 혼합방법을 이용한 다중 볼륨 렌더링 기법 (Multi-Volume Rendering using Opacity Weighted Mixing Method)

  • 홍헬렌;김명희
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 1999년도 가을 학술발표논문집 Vol.26 No.2 (2)
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    • pp.568-570
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    • 1999
  • 복잡한 인체기관의 해부학적 형태 및 상대적 관계를 파악하기 위하여 단일 볼륨에 대한가시화 뿐 아니라 다중 볼륨에 대한 가시화가 요구된다. 본 논문에서는 특정기관의 표면을 추출하여 가시화하는 선택적 렌더링 방법과 투명도 가중치 혼합 방법을 이용한 다중 볼륨렌더링 방법을 제안한다. 해부학적 형태로부터 관심부위의 표면을 추출하여 가시화하는 선택적 렌더링 방법은 분할된 외곽선으로부터 거리변환을 통하여 거리볼륨을 생성하고 이를 렌더링하는 방법으로 거리볼륨을 이용함으로써 가시화시간을 가속화시킬 수 있으며, 다중 볼륨 렌더링 방법은 투명도 가중치 혼합방법을 사용한 렌더링 방법으로 심장의 해부학적 형태와 좌심실, 우심실 간의 혼합된 렌더링 결과를 제시한다. 본 제안방법은 단일 볼륨 렌더링의 한계를 극복하여 복잡한 해부학적 형태로부터 관심부위의 형태와 상대적 관계를 효과적으로 나타낼 수 있다.

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심장외 도관을 사용치 않고 시행한 우심실 성형술 (Roconstruction of the Pulmonary Outflow Tract withou Proshetic Conduit)

  • 김진국
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1124-1136
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    • 1988
  • Massive hemoptysis, usually rapid flooding of tracheobronchial tree and asphyxia, is associated with high mortality. We have controlled massive hemoptysis in two cases with use of bronchial artery angiography & selective bronchial artery embolization with Gelfoam particle. One case was inoperable case that was confirmed as TOF c severe pulmonary artery hypoplasia with massive hemoptysis due to hypertrophied bronchial artery and its collaterals. Another case was congenital ASD with pulmonary Aspergillosis, postop. empyema and BPF associated with massive bleeding due to erosion of hypervascular bronchial artery. We experienced dramatic improvement of general condition and cessation of massive hemoptysis for above two cases. No other problems and complication were noted during postop. hospitalization and follow-up period.

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이강 우심실 1례 보고 (Two chambered right ventricle with anomalous trabecular hypertrophy)

  • 곽문섭;이홍균
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.34-39
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    • 1983
  • The syndrome of anomalous muscle bundle dividing the right ventricle into two pressure chambers has been described by many authors. The malformation should not be confused with tetralogy of Fallot itself because the obstructive hypertrophic bands are usually proximal to the right ventricular infundibulum. One case [11 years old male] of double chambered right ventricle due to aberrant muscle bundle with intact ventricular septum is presented. The pressure gradient was 68 mmHg between inflow and outflow tracts of right ventricle on cardiac catheterization. On opening the right ventricle, there noted stenosis of outflow tract by infundibular membrane, hypertrophied anomalous muscle bundle, thickened moderator band & hypertrophied anterior papillary muscle. Open heart surgery was carried out with the aid of extracorporeal support, Anomalous muscle bundle [1.0 cm x 4.0 cm] and infundibular membrane were resected safely. The hypertrophied moderator band was cut at mid-portion and anterior papillary muscle was split vertically. The postoperative course was uneventful and discharged in good condition 2 weeks later.

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우심실 발육부전이 동반된 선천성 심장질환의 치험 2례 보 (Hypoplastic RV: report of 2 cases)

  • 박영식
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.632-635
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    • 1984
  • Hypoplastic RV was rarely combined with various other intracardiac anomalies. We experienced the excellent result after surgical correction in these 2 patients. 1. F/7: Combined anomalies were, [1] Hypoplastic Rt. Coronary art.[2] Hypoplastic RV [3] ASD [secundum] & [4] PS [infundibular & valvular] After CP Bypass, [1] Direct suture of ASD [2] Infundibulectomy [3] Pul valvulotomy & [4] Patch enlargement of RVOT with Pericardial monocusp were done 2. F/14: Combined anomalies were, [1] Hypoplastic RV [2] P5 [infundibular] [3] T5 [4] VSD [Type II] [5] ASD [secundum] & [6] 2\ulcornerA-V Block fter CP Bypass, [1] Infundibulectomy [2] Tricuspid valvulotomy [3] Patch repair of VSD & ASD & [4] Implantation of permanent pacemaker were done. Above operations resulted in marked improvement with disappearance of cyanosis & dyspnea.

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소경정맥 판막도관을 이용한 우심실 유출로 재건술 (Right Ventricular Outflow Tract Reconstruction with Bovine Jugular Venous Valved Conduit.)

  • 박형주
    • Journal of Chest Surgery
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    • 제33권10호
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    • pp.830-833
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    • 2000
  • Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.

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폐동맥 협착증을 동반한 양대혈관 좌심실 기시증에서, 우심실 유출로 첩포 재건술을 이용한 해부학적 완전 교정술 (Anatomical Repair of Double-Outlet Left Ventricle with Ventricular Septal Defect and Pulmonary Stenosis by Reight Ventricular Outflow Patch Reconstruction)

  • 한재진;장지원;원태희;김혜순;손세정
    • Journal of Chest Surgery
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    • 제33권4호
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    • pp.316-319
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    • 2000
  • Double-outlet left ventricle with ventricular septal defect and pulmonary stenosis was conventionally repaired with extracardiac conduit or pulmonary artery translocation. Here, we report an anatomically repaired double-outlet left ventricle without extracardiac conduit or pulmonary artery translocation in an 11 month old patient who had undergone palliative systemic-pulmonary shunt at a nonatal period. The location of ventricular septal defect, both great arteries and coronary arteries made it possible to reconstruct the right ventricular outflow tract using on-lay patch after incision and undercutting the tissue between the ventriculotomy and the pulmonary arteriotomy.

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거대 우심실 점액종 1례 보 (A case report of giant right ventricular myxoma)

  • 박재길;송인성;이홍균
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.470-475
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    • 1983
  • Myxoma of the heart can now be successfully treated but the success is obviously dependent upon the correct diagnosis and treatment prior to development of catastrophic complications such as sudden death, embolism or cardiac failure. The right ventricular myxoma is very rare, and we treated successfully a case of giant right ventricular myxoma, sessile tumor originated from ventricular apex, weighed 175 gm. The tumor base was broad, about 3 cm x 3cm, and it was hardly adhesed to the tricuspid valvular structures, but could remove with the preservation of adequate residual ventricular chamber size and the maintenance of functional tricuspid valve anatomy. The postoperative course was excellent and uneventful.

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