• Journal of Chest Surgery
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• 제20권2호
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• pp.416-422
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• 1987

Anomalous origin of a pulmonary artery from the ascending aorta is a rare congenital cardiovascular anomaly which usually involves the right pulmonary artery. For operative reconstruction, the surgical technique of choice used to be a direct end-to-side anastomosis of the ectopic pulmonary artery to the main pulmonary artery. A case of right pulmonary artery arising from the ascending aorta associated with a contralateral patent ductus arteriosus is presented, with description of a new modified surgical technique. The operation was done on cardiopulmonary bypass with deep hypothermia. After closure of PDA, a side-to-side anastomosis between the RPA and MPA, roofed with Gore-Tex patch, was established. The postoperative course was excellent, and the postoperative angiography revealed complete anatomic correction.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1174-1177
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• 1995

We experienced one case of TAPVC patient who was 39 years old man with mild dyspnea on exertion and easy fatigability. He was the oldest patient among TAPVC which was reported in Korea. Preoperative echocardiogram, cardiac catheterization and angiogram revealed supracardiac type TAPVC drained through left innominate vein. An anastomosis between common pulmonary venous trunk and left atrium, pericardial patch closure of ASD and ligation of left vertical vein were performed with extracorporeal circulation. The postoperative course was uneventful and discharged with excellent general condition and has been well during 8 months follow-up.

• Journal of Chest Surgery
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• 제27권1호
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• pp.52-56
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• 1994

This is case report of total anomalous pulmonary venous return with atrial septal defect which were corrected surgically by intracardiac procedure under total cardiopulmonary bypass.Two patients were supracardiac type,cardiac and mixed type was each one.The mixed type was three years old female patient.She was diagnosed as atrial septal defect with partial anomalous pulmonary venous return[right pulmonary vein drains into superior vena cava and right atrium] and corrected as usual.After operation,she underwent exertional dyspnea and frequent tachycardia.Chest x-ray film showed pulmonary congestion.Follow up cardiac cineangiogram revealed that left pulmonary vein also anomalously drained into left innominate vein through vertical vein.Through left thoracotomy,anastomosis was successfully carried between left atrium and vertical vein without cardiopulmonary bypass and there was no sign of pulmonary artery obstruction for two years follow up.The other three patient were corrected successfully without complication and got good result.

• Journal of Chest Surgery
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• 제13권2호
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• pp.110-117
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• 1980

This is a case report of total anomalous pulmonary venous drainage with Atrial septal defect, which was corrected surgically by intracardiac procedure under total cardiopulmonary bypass. This 9 years old girl, she complained mild cyanosis, exertional dyspnea, and frequent upper respiratory infection from 3 months age. The chest X-ray showed cardiomegaly and a "snow man appearance", she has systolic murmur with splitting of S2. The diagnosis was confirmed with right heart catheterization, the catheter was reached to right pulmonic vein passed through right atrium, right superior vena cava, innominate vein, left superior vena cava, and common venous trunk. On 28th, Dec. 1979, an anastomosis between common pulmonary venous trunk and left atrium, Pericardial patch closure of ASD, and ligation of left superior vena cava were performed with Extra-corporeal circulation. The postoperative course was uneventful and discharged with excellent general condition.Total Anomalous Pulmonary Venous Drainage with A.S.D. with A.S.D.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1019-1023
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• 1997

우측 폐동맥이 대동맥에서 이상기시되는 기형은 선천성 심장질환의 드문 형태이고 치명적이다. 주로 동맥관개존과 같이 동반되어 나타나며, 대개 출생후 이른 유아기에 사망한다. 우폐동맥의 이상기시는 좌폐동맥의 이상기시에 비해 더욱 많은 빈도를 나타내며, 비정상적인 우폐동맥은 주로 대동맥판막에 인접한 상행대동맥의 뒤쪽편에서 주로 기시한다.

• Journal of Chest Surgery
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• 제26권3호
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• pp.228-233
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• 1993

Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.

• Journal of Chest Surgery
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• 제32권10호
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• pp.939-942
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• 1999

Partial anomalous pulmonary venous connection is frequently found in any ASD(atrial septal defect) patients. These patients are usually symptomatic, therefore, easily diagnosed as just simple ASD. We experienced a case of a 37-year-old female patient with ASD in which the left upper pulmonary vein was connected to SVC by the left inominate vein. The patient was diagnosed as simple ASD previously. During cardiac catheterization, we found a meaningful oxygen saturation step up between the SVC and its upper portion. Angiogram confirmed PAPVC. The surgical correction of anastomosis of PAPVC with left atrial appendage and direct closure of ASD were done. The patient was discharged 15 days later.

• Journal of Chest Surgery
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• 제19권3호
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• pp.438-442
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• 1986

The case of a 40-year-old male with symptom related to a anomalous right subclavian artery [dysphagia lusorium] combined with thymoma is described. He was treated by removal of the thymoma and resection of the retroesophageal right subclavian artery with anastomosis of its distal end to the ascending aortic arch by Gore-Tex. This procedure relieved the dysphagia and provided the right arm with normal arterial circulation.

• Journal of Chest Surgery
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• 제17권1호
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• pp.48-52
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• 1984

Total anomalous pulmonary venous connection [TAPVC] defines a group of congenital heart disease which have in common the entire pulmonary venous drainage returning directly or indirectly to the right atrium instead of to the left atrium. Although this disorder represents only 1.3% of cases of congenital heart disease, if untreated the resultant mortality is greater than 80% in the 1st year of life. And since there is no satisfactory palliative treatment, correction of TAPVC Is high on the list of indications for open heart surgery in the 1st year of life. This paper describes 10 patients who underwent surgical correction of this disorder at SNUH between 1978 and 1983. 1. 7 were males and 3 females, with ages ranging from 5 months to 24 years. 2. 7 were supracardiac type, 2 cardiac type, and 1 mixed type TAPVC. We didnt experience infracardiac type. 3. All showed some degree of pulmonary hypertension preoperatively. 4. In 4 cases of supracardiac type, total circulatory arrest was used in brief period during anastomosis between common pulmonary venous trunk and left atrium. In the other cases, usual cardiopulmonary bypass with moderate to deep hyperthermia was used. 5. There were 2 cases of mortality; 1 died at operation, and the other at 4 months due to congestive heart failure. 6. Mortality seemed not closely related to age, body weight, or severity of pulmonary hypertension.

• Advances in pediatric surgery
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• 제4권2호
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• pp.100-109
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• 1998

The anomalous pancreaticobiliary duct union (APBDU) might cause the formation of choledochal cyst and malignancies of hepatopancreaticobiliary system. The purpose of this study is to make an experimental animal model of APBDU similar to that of human. One to two-month-old Mongrel dogs (n=12) were divided into two groups; the control group (n=2) had a sham operation performed, and in the experimental group (n=10) the end of distal ' common bile duct (CBD) was anastomosed to the side of the dorsal pancreatic duct making APBDD. Serum was obtained for chemical analysis on the 10th postoperative day. The dogs were sacrificed at the 5th week (n=3), the 6th week (n=3), the 7th week (n=2), the 8th week (n=2) and the 6th month (n=2) after the experimental surgery. With sacrifice, operative cholangiogram was taken, and bile juice was obtained for chemistry and bacterial culture. The en-bloc specimens of the hepatopancreaticobiliary system were removed for microscopic examination. Serum and bile juice amylase levels were elevated in the experimental group(n=10), but not in the control group(n=2). Operative cholangiograms of control group revealed no evidence of bile duct dilatation.. On the other hand, the bile duct in the experimental group was markedly dilated without any evidence of stenosis at the anastomosis site (n=10). Histologic examination of the hepatopancreaticobiliary system in the experimental group resembled the findings of choledochal cyst in human. The APBDU of this animal model can produce bile duct dilatation by pancreaticobiliary reflux. We think that this animal model can be potentially promising for the research about the APBDU associated hepatopancreaticobiliary diseases.