• Journal of Chest Surgery
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• 제27권1호
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• pp.57-59
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• 1994

Ebstein`s anomaly, a rare congenital cardiac anomaly, is characterized by downward displacement of abnormal tricuspid valve. Indication for surgical repair and the optimal surgical approach are still controversy. Recently, we experience a case of Ebstein anomaly, which was treated by atrilized right ventricular plication and annuloplasty. The patient was discharged with good result on 17th post-operative day.

• Journal of Chest Surgery
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• 제26권3호
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• pp.191-195
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• 1993

Among 25 consecutive cases having undergone mitral valve surgery between March 1991 and June 1992 in Gill General Hospital, 11 patients[44%] who had undergone mitral valve reconstruction using prosthetic rings is evaluated and presented. Patients` mean age is 43 + 19 years[range:16-72], and they are consisted with 4 males and 7 females. Mitral valve insufficiency is due to degenerative disease in 6 cases[55%] and rheumatic disease in 5 patients[45%]. Carpentier`s functional classification I is 2 cases, II is 6 cases, and III is 2 cases. Surgical techniques include prosthetic ring annuloplasty[11 patients, 100%], chorda shortening[6, 55%], leaflet mobilization[4,36%], new chorda formation[2, 18%], chorda transposition[1, 9%] commissurotomy[3, 27%], and papillary muscle splitting[3, 27%]. Average number of mitral anatomic lesions per patient are 2.7 and we used average 2.8 procedures upon mitral valve apparatus per patient. There were no surgical mortality and no late valve related admission during the mean follow up period of 17 months. The mean functional class[NYHA] is 2.81 preoperatively and improved to 1.10 postoperatively. Doppler echocardiography showed much improvement from grade II MR [1 case], grade III MR [1 case] and 9 cases of grade IV MR to 6 cases of patients showed no MR, only trace MR in 4 cases, and grade I MR was found only in one patient with NYHA functional class II postoperatively. The postoperative mean mitral valve area is $2.10+0.28cm^2$. We conclude that mitral reconstruction is a predictable and stable operation.

• Journal of Chest Surgery
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• 제40권5호
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• pp.376-379
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• 2007

51세 환자가 3개월 전에 심장 자상으로 본원에 입원하여 심장봉합수술을 받았다. 이후 별다른 소견 없이 지내다가 약 2개월 전부터 발생된 호흡곤란을 주소로 내원하였다. 심장초음파상 심한 삼첨판막 페쇄부전이 관찰되었으며 삼첨판막의 건삭치환술과 판윤 성형술을 실시하였다. 이에 저자들은 심장 자상 후에 발생된 삼첨판막 폐쇄부전을 판막성형술로 치료하였기에 증례보고를 하는 바이다.

• Journal of Chest Surgery
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• 제26권12호
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• pp.909-914
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• 1993

Complete and optimal visualization of the mitral apparatus is a prerequisite for accurate repair or replacement of the mitral valve. A vertical left atriotomy just posterior to the interatrial groove is the most commonly used approach. However,exposure can be difficult under certain circumstances,such as small left atrium or reoperation. Other approaches have been advocated to deal with this difficult situations. We used an extended transseptal approach in 10 patients and good clinical results and excellent educational effects were obtained. The extended transseptal approach combines two semicircular atrial incisions circumscribing the tricuspid and mitral annuli anteriorly and superiorly,allowing exposure of the mitral valve by deflecting the ventricular side using stay sutures. The right atrium is opened anteriorly along the atrioventricular sulcus. The atrial septum is incised vertically through the fossa ovalis. Right atrial and septal incisions are joined at the superior end of the interatrial septum and extended across the dome of the left atrium to the left atrial appendage. The mitral valve was replaced in all 10 patients. Four of 10 patients had other simultaneous valve procedure: one had aortic valve replacement: 2 underwent tricuspid annuloplasty: 1 had aortic valve replacement and tricuspid annuloplasty. There was no hospital death and complication. Among the 5 patients who had atrial fibrillation preoperatively,4 had atrial fibrillation postoperatively,1 converted to sinus rhythm. The five patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after replacement. A review of our results with this approach confirms the efficacy and safty of this method. So we recommanded this approach for routine mitral valve procedure,especially difficult situations,such as a small left atrium or the redo operation.

• Journal of Chest Surgery
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• 제32권3호
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• pp.299-302
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• 1999

심한 울혈성 심부전으로 Dopamine을 1개월간 사용해온 10세의 확장성 심근증 환아에서 심장 이식을 시행하려 하였으나, 적절한 크기의 공여 심장이 없었고, 환아의 증상이 악화되어 부분 심실 절제술과 승모판 성형술을 시행하였다. 수술후 환아의 임상 증상은 현저히 호전되었고 수술전과 수술후 3개월, 6개월 1년째의 심장 초음파 검사 소견을 비교하여 추적 관찰한 결과, 좌심실의 심박출 계수는 수술전 17 %에서 수술후 각각 29%, 35%, 36%로 개선되었고 좌심실 확장기말 직경은 수술전 72 mm에서 수술후 각각 59 mm, 61 mm, 61 mm로 변화를 보였다. 부분 좌심실 절제술과 승모판 성형술의 동반 시행은 심장 이식의 기회가 상대적으로 적은 소아의 확장성 심근증에 있어 심장의 부하를 감소시켜 증상 완화를 시킬 수 있는 외과적 방법으로 심장 이식을 시행할 때까지 유지시켜주는 고식적 가치가 크며 아울러 장기적 추적 관찰이 필요하다고 사료 된다.

• Journal of Chest Surgery
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• 제24권9호
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• pp.907-912
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• 1991

Isolated primary tricuspid insufficiency except Ebstein`s anomaly is rare disease. Recently we experienced two cases of isolated primary tricuspid insufficiency and treated successfully with annuloplasty or valve replacement. We could not classify our case as one of the classification of isolated tricuspid insufficiency, because the morphology and microscopic finding did not suggest any similar variety.

• Journal of Chest Surgery
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• 제11권4호
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• pp.428-432
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• 1978

Between Jan. and Oct. 1978, mitral valve Replacement had been performed on eight patients using porcine aortic valve mounted on flexible polypropylene or Egyloil wire and Dacron covered stent. Mitral valve replacement was performed on five, mitral valve replacement with tricuspid valve replacement on two, and mitral valve replacement with tricuspid valve annuloplasty on 1 patient using five Carpentier and five Hancock Xenograft. Overall operative deaths were 2 cases. All other 6 cases did well after surgery and improved. No systemic thromboembolism occurred without anticoagulant-No valve failure took place. The results are satisfactory.

• Journal of Chest Surgery
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• 제21권2호
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• pp.347-350
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• 1988

Recent advances in the managements of chronic renal failure have increased the number of the candidates for cardiac operation in patients with chronic renal disease. There have been reports that the operative mortality of the open cardiac surgery in patients with end stage renal diseases was equal to that of the patients with normal renal function. Aortic valve replacement and mitral annuloplasty was successfully performed in a patient with chronic renal failure, and the pre-and postoperative managements are presented.

• Journal of Chest Surgery
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• 제48권3호
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• pp.228-230
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• 2015

We report a rare case of an extremely large right ventricular myxoma involving the ventricular side of the tricuspid valve. The tumor was excised along with the entire posterior leaflet and part of the anterior leaflet. The tricuspid valve was repaired by sliding valvuloplasty combined with ring annuloplasty.

• Journal of Chest Surgery
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• 제38권12호
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• pp.849-851
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• 2005

Duran ring을 이용하여 승모판막륜 성형술을 시행 받은 두 명의 소아 환자에서 술 후 8년과 5년 뒤에 판누스와 환자의 성장에 기인한 승모판협착이 발생하였다. 판누스와 Duran ring을 제거함으로써 승모판협착증은 호전되었다. 비록 어른에서 사용되는 충분한 크기의 판막륜 성형링이 사용되더라도 성장하는 소아에서는 시간이 지남에 따라 협착이 발생할 수 있다.