• Title/Summary/Keyword: 인조절

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Changes in the Luminal Surface of the PTFE Graft used in Systemic- pulmonary Shunt Operation (체폐단락술에 사용되었던 PTFE 인조혈관 내면의 변화)

  • Park, Yeong-Hwan;Jang, Byeong-Cheol;Sin, Dong-Hwan;Jo, Beom-Gu
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.836-843
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    • 1996
  • Histologic, and scanning electron microscopic observa ions were made of 12 biopsy specimens from polytetrdiluoroethylene (PTFE) grafts that had been Implanted as systemic-pulmonAry shunt for improving oxygenation of cyanotic congenital heart disease and harvested near the end of pulmonary artery side at the time of redo shunt or tonal correction between 1985 and 1992. The types of shunt operation are modified Blalock-Taussig shunt in 10 cases, Waterston-Cooley shunt in 1 And Potts shunt in 1 case. The 5 mm PTFE graft was used In 10, 4mm in 1 and 6mm in 1 case. The mean duration of implantalion was 0 $\pm$ 14.1 months(rl.on 12 months to 55 months). The plAtelets were aggregated between gaps'of Coretex surface and intimal thickening was noted about 10 to 20 months after implantation. Endothelial cells were found in the 40-months patent PTFE graft by light and scanning electron microscopy. In the specimen of poor flow or zero flow graft, severe intimal hyperplasia and thrombi which was made of platelets were noted . Based on this experience, we think that the patency will be maintained well if the connective tissue could be Hxed firmly over the Inner layer of the Goretex and the endothelial cell layer sllould form over the con- nective tissue and platelet aggregation should be prevented.

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Aortic Arch Aneurysm Repair using a Prosthetic Graft with a Pre-mounted Distal Stent (Frozen Elephant Trunk) (원위부에 스텐트가 포함된 인조혈관 (Frozen Elephant Trunk)을 이용한 대동맥궁 동맥류 수술)

  • Chang, Hyoung-Woo;Chung, Eui-Suk;Choi, Jin-Ho;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.375-379
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    • 2009
  • Difficulty in exposing anastomotic sites is a frequently encountered problem during surgical repair of a distal aortic arch aneurysm via median sternotomy or lateral thoracotomy. Endovascular repair has th limitation that it usually requires surgical rerouting of some of the brachiocephalic branches in order to get sufficient length for proximal fixation of the stent-graft. To take advantage of each approach, we fixed the distal end of the prosthetic graft by means of a pre-mounted metallic stent instead of performing conventional surgical anastomosis during the repair of distal arch aneurysms with using median sternotomy and hypothermic circulatory arrest. We report here on our experience with such 3 patients.

A Study on the chemical analysis of synthesized Li-AGICs with changes of intercalant contents (Intercalant 함량 변화에 따라 합성된 Li-AGICs의 화학적 분석에 관한 연구)

  • Oh, Won-Chun;Shim, Sang-Kyun
    • Analytical Science and Technology
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    • v.10 no.3
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    • pp.209-215
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    • 1997
  • Li-AGICs as a anode of secondary battery were synthesized by high-pressure method as a function of the Li-contents. The characteristics of these prepared compounds were determined from the studies with X-ray diffraction method, UV/VIS spectrophotometric and differential scanning calorimeter(DSC) analysis. From the results of X-ray diffraction, it was found that the lower stage intercalation compounds were formed with increase of Li-contents. The mixed stages in these compounds were also observed. In the case of the $Li_{30wt%}$-AGIC, the compounds in the stage 1 structure were formed predominantly, but the structure of only pure stage 1 for structural defect of artificial graphite is not observed. According to UV/VIS spectrophotometric analysis, $Li_{30wt%}$-AGIC shows distinguishable energy state spectrum with the position of $R(%)_{min}$ values, but the characteristic spectra of almost all Li-AGICs are not observed. The enthalpy and entropy changes of the compounds can be obtained from the differential scanning calorimetric analysis results. From the results, it was found that exothermic and endothermic reactions of Li-AGICs are related to thermal stability of lithium between artificial graphite layers.

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Mitral Valve Repair for Mitral Regurgitation (승모판막폐쇄부전에 대한 승모판막재건술)

  • 최세영;유영선;박기성;최대융;박창권;이광숙
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.221-225
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    • 1998
  • From February 1996 to May 1997, 18 patients underwent mitral valve repair for mitral regurgitation. There were 9 male and 9 female patients aged from 19 to 68 years(mean, 53). Thirteen patients were in New York Heart Association(NYHA) class III and IV. The cause of mitral regurgitation was degenerative in 12 patients, rheumatic in 5 patients and infective in 1 patient. Fifteen patients were in Carpentier's functional classification II, 2 patients in Carpentier's class III and 1 patient in Carpentier's class I. Surgical procedures included prosthetic ring annuloplasty(16 cases), rectangular resection of posterior leaflet(15 cases), chordal shortening(5 cases), triangular resection of anterior leaflet(2 cases), commissurotomy(2 cases), partial transposition of posterior leaflet(1 case). These procedures were combined in most patients. There was no operative death. These patients have been followed from 1 to 15 months, mean of 6.7 months. There was one late death resulted from low cardiac output following mitral valve replacement. The function of the repaired valve in other 17 patients has remained satisfactory during the observed interval. We consider that mitral valve repair is highly satisfactory in patients with mitral regurgitation.

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Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.621-627
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    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

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