• Journal of Chest Surgery
• /
• v.18 no.1
• /
• pp.75-78
• /
• 1985

From April, 1984 to January, 1985, 57 cases of cardiovascular surgeries were performed at Yeung Nam University Hospital consisting 31 cases of open heart surgery and 26 cases of ligating patent ductus arteriosus. Among 31 cases of open heart surgery, all cases are congenital acyanotic heart disease except a case of rheumatic aortic valvular heart diseases taken aortic valve replacement with Bjrk-Shiley 25mm. Only 2 cases of transient hemoglobinuria were complicated. A case of surgical mortality was present died of acute respiratory failure and intractable arrhythmia, which resulting 3.2% of mortality rate.

• Journal of Chest Surgery
• /
• v.57 no.1
• /
• pp.36-43
• /
• 2024

Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

• Journal of Chest Surgery
• /
• v.30 no.8
• /
• pp.819-822
• /
• 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.

• Journal of Chest Surgery
• /
• v.29 no.8
• /
• pp.844-849
• /
• 1996

During the 2 years period, we hav performed acute peritoneal dialysis in twenty two children after cardiopulmonary bypass among 198 patients who underwent surgery due to complicated congenital heart diseAses . were fluid over- load (10 cases), oliguria (9 cases) and hyperkalemia (3 cases). Bypass time greAter than 90 minutes was a predictor of the need for dialysis(p< 0.05). Five neonates (38 %) operated on instituted peritoneal dialysis but it was insignificant determinant factor (p 08). Sixteen patients recovered their renal suction, but 4 patients died due to respirAtory fAilure or sepsis. All the patients which could not recover their renal function, expired although the renal failure was not re- sponsible for the mortality. We think that early peritoneal dialysis is helpful in cases of oliguia, fluid overload or hyperkalemia after cradiopulmonary bypass.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.718-721
• /
• 1998

The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP(unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD(2.0 cm in diameter) with severe pulmonary hypertension(116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.

• Journal of Chest Surgery
• /
• v.44 no.5
• /
• pp.343-347
• /
• 2011

Background: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. Materials and Methods: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicated for mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. Results: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. Conclusion: Emergency operation should be performed when medical treatments are no longer effective.

• Journal of Chest Surgery
• /
• v.27 no.8
• /
• pp.650-655
• /
• 1994

The author analyzed 99patients with VSD weighting less than 10kg of body weight who underwent surgical correction from 1981 to 1992 at cardiovascular department of Hanyang University hospital. Patients occupied 29.3% of total cases who were underwent surgical corrections for congenital heart diseases during that time. Of the 99 patients, 51 patients were male [52%] and 48 patients[48%] were female. Age ranged from 28 days to 36 months with mean age of 13.6 months. Mean body weight was 7.53kg. According to Kirklin`s anatomical classification, type II defect was most common [61.6%]. Associated anomaly was found in 48 patients [48.5%]. Patent foramen ovale was most commonly associated cardiac anomaly [14.1%] and followed by atrial septal defect [12.1%], patent ductus arteriosus [10.1%]. Cardiac catheterization data were analyzed. The most common range of Qp/Qs, Rp/Rs, Pp/Ps were above 3.0, 0.1 - 0.25, and above 0.75 respectively. Among the indications of surgical correction, there were pulmonary hypertention in 69 patients, congestive heart failure in 44 patients, frequent respiratory infection in 47 patients, growth retardation in 33 patients. The most common surgical approach and method for VSD closure were right atriotomy[48.3%] and dacron patch closure[93.3%]. Complication rate was 13.1% [13 cases], and overall mortality was 17.1% [17 cases]. The cause of death consisted of low cardiac output syndrome[11 cases], acute renal failure[3 cases], sepsis[2 cases] and pulmonary insufficiency[1 case] in order of frequency.

• Journal of Chest Surgery
• /
• v.21 no.5
• /
• pp.899-904
• /
• 1988

In Behcet syndrome, cardiac involvements are rare and have been reported pericarditis, myocarditis, right heart endocardial fibrosis, right ventricle mural thrombus with pulmonary embolism, active endocarditis, granulomatous endocarditis, conduction disturbance, acute aortic insufficiency, mitral valve prolapse. Our three patients underwent AVR because of aortic insufficiency and ascending aorta enlargement combined with Behcet syndrome. Two patients had mitral regurgitation too. So one underwent MAP and the other underwent MVR concomitantly. One who underwent AVR have been well for 50 months. Another who underwent AVR+MAP and redo AVR due to aortic paravalvular leakage was died of congestive heart failure. The other who underwent AVR+MVR and repeated AVR three times because of aortic paravalvular leakage is in condition of aortic paravalvular leakage. Paravalvular leakage is considered to recur due to progressive dilatation and fragility of aortic root that is the result of pathologic change of Behcet syndrome in it. If Open heart surgery is needed in Behcet`s syndrome during inflammatory reaction is active, postoperative complications such as paravalvular leakage or suture line rupture may be prevented with pre- and postoperative anti-inflammatory management.

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.977-982
• /
• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• Annals of Clinical Neurophysiology
• /
• v.17 no.2
• /
• pp.73-75
• /
• 2015

A 69-year-old woman presented with a progressive limb weakness. Both clinical and neurophysiological findings were consistent with diagnosis of Guillain-$Barr{\acute{e}}$ syndrome (GBS). Two days after admission, the patient suffered from an acute coronary syndrome without stenosis at coronary arteriography. Echocardiography revealed left ventricular inferior wall and apical akinesia and decreased ejection fraction. A diagnosis of Takotsubo cardiomyopathy was then made. Left ventricular dysfunction and electrocardiography normalized within one month. Takotsubo cardiomyopathy can be developed as a complication of GBS.