• Journal of Chest Surgery
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• 제39권1호
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• pp.64-67
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• 2006

제1 대각지 단독 폐쇄에 의한 승모판막 전방 유두근의 파열은 매우 드물다. 66세 여자환자가 심근경색에 이은 심인성쇼크로 전원되었는데, 심초음파 및 관상동맥 조영술 결과 제1 대각지의 완전폐쇄와 승모판막 전방 유두근 파열 및 심한 승모판막 폐쇄부전증이 발견되어 응급 승모판막치환술 및 관상동맥 우회술 후 특별한 문제없이 회복하였다.

• 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.

• Anatomy and Cell Biology
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• 제52권1호
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• pp.38-42
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• 2019

This study investigated and classified the various types of moderator band (MB) in relation to the anterior papillary muscle, with the aim of providing anatomical reference information and fundamental knowledge for use when repairing the congenital defects and understanding the conduction system. The study investigated 38 formalin-fixed human hearts of both sexes obtained from donors aged 38-90 years. The MB was evident in 36 of the 38 specimens (94.7%). The morphology of the MB and its connection with the APM took various forms. The MBs that had a distinct shape were classified into three types according to their shape: cylindrical column, long and thin column, and wide and flat column. Types 2 and 3 were the most common, appearing in 15 (41.7%) and 14 (38.9%) of the 36 specimens, respectively, while type 1 was observed in seven specimens (19.4%). Type 3 was divided into subtypes based on their length. The MB usually originated from a single root (91.7%), with the remainder exhibiting double roots. The pairs of roots in the latter cases had different shapes. The originating point of the MB ranged from the supraventricular crest to the apex of the ventricle. The most-common originating point was in the middle (25 of 36 specimens, 69.4%), followed by the upper third (13.9%), the lower third (11.1%), and the top fifth (5.6%) of the interventricular septum. This study has produced fundamental anatomical and clinical information that will be useful when designing cardiac surgical procedures.

• 한국임상수의학회지
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• 제36권3호
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• pp.155-158
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• 2019

Morphologic changes or functional impairments of the papillary muscle (PM) can influence mitral valve competence. The purpose of this study was to investigate PM size and contractile function using two-dimensional and color tissue Doppler echocardiography in normal dogs. 35 unsedated Beagle dogs without cardiovascular disease were examined. The vertical (VD) and horizontal diameter (HD) of the posterior and anterior PM was measured at end-diastole, and compared with the thickness of the left ventricular posterior wall (LVPWd). Longitudinal systolic movement of the PM was quantified as myocardial velocity and strain using tissue Doppler. The VD, HD, and ratios (VD/LVPWd, HD/LVPWd, VD/HD) were significantly greater in the posterior than anterior PM (P < 0.001). The VD and HD of posterior PM and the HD of anterior PM were significantly correlated with LVPWd (r = 0.47, 0.44, and 0.42, respectively). Body weight was significantly correlated with VD of posterior PM (r = 0.37). The peak systolic tissue velocity of the PM was $4.93{\pm}1.25cm/sec$ and peak strain was $-30.83{\pm}11.92%$. PM size and systolic function can be quantitatively assessed using two-dimensional and tissue Doppler. The establishment of these objective PM measurements may be useful to evaluate morphological and functional abnormalities of the canine PM.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.136-140
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• 2021

We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.

• Journal of Chest Surgery
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• 제43권4호
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• pp.413-416
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• 2010

47세 남자 환자가 교통사고로 인한 감속 손상후 흉부 통증 및 호흡곤란을 주소로 내원하였다. 청진시 우 흉골연에서 수축기 심잡음이 들렸고 심전도에서는 분당 120∼130회의 동빈맥을 보였다. 경흉부 심장 초음파에서 삼첨판막의 전엽이 동요하는 형태를 보였고 유두근의 파열과 함께 심한 판막 폐쇄 부전이 관찰되었다. 수술은 통상적인 심폐기하에서 우심방절개를 통해 접근하여, 전엽의 유두근과 후엽의 건삭이 파열되어 있는 것을 확인하였다. 전엽과 후엽에 각각 우심실내의 유두근으로 새로운 인공 건삭을 조성하였다. 또한 De-Vega 판륜 성형술을 병행하여 시행하였다. 저자들은 매우 드물게 발생한다고 알려져 있는 외상후 유두근 파열로 인한 삼첨판막의 기능부전의 수술을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회지
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• 제12권2호
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• pp.31-34
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• 2006

Simultaneous occurrence of medullary and papillary thyroid carcinomas in the same gland is very rare. In fact. there are only 18 cases of simultaneous occurrence of medullary and papillary thyroid carcinomas in the literature. We report a case of simultaneous medullary and papillary carcinoma of thyroid gland. A 67-year-old woman was diagnosed with medullary carcinoma of right lobe of thyroid gland and papillary carcinoma of left lobe of thyroid gland by fine needle aspiration cytology. Total thyroidectomy, anterior neck dissection, bilateral modified radical neck dissection and tracheotomy was undertaken. The tumor metastasized to regional lymph node and extrathyroidal muscle invasion of left papillary carcinoma was also revealed by pathological report. This report describes a case of thyroid carcinoma that demonstrated both medullary carcinoma and papillary components in the thyroid with lymph node metastasis.

• 대한두경부종양학회지
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• 제26권2호
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• pp.221-224
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• 2010

Papillary thyroid carcinoma frequently invades the lymph node, trachea, esophagus and perithyroid tissue. However, direct extension to posterior pharyngeal area is known to be rare. A 64-year-old male was referred to our clinic presenting as posterior pharyngeal mass during gastrofiberscopy. The neck CT scan showed soft tissue mass in retropharynx and lymph node in right level III with calcifications. We performed the total thyroidectomy with selective(level II, III, IV) and anterior compartment neck dissection. In operative findings, the right thyroid mass were connected to the retropharynx through the posterior portion of inferior constrictor muscle. Histopathologic findings revealed the papillary thyroid carcinoma extended to retropharynx. We report a unique case with a literature review.

• Journal of Chest Surgery
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• 제40권11호
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• pp.770-772
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• 2007

유두상 섬유 탄력종은 심장에 발생하는 양성 종양으로 그 빈도는 매우 드물다. 21세 남자 환자가 운동 시 발생하는 호흡 곤란을 주소로 내원하였고 심초음파상 전측유두근에 위치한 포도알 크기의 심장 종양이 진단되었다. 전신 색전증이 우려되어 응급수술을 통하여 전유두근 및 승모판막에 부착된 종양을 절제하였으며 기계판막으로 승모판치환술을 시행하였다. 환자는 수술 후 항응고제 치료를 받으면서 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제30권9호
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• pp.927-931
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• 1997

신생아에서 선천적 삼첨판 폐쇄부전은 자주 보고되지만 건삭파열에 의한 이차성 삼첨판 폐쇄부전은 아주 드물다. 환아는 생후 1일의 남아로 출생 직후부터 심한 호흡곤란, 청색증 및 산혈증이 관찰되었고, 무호흡과 함께 서맥이 빈번히 나타났다. 심초음파도 검사를 시행하여 폐동맥 판막을 통한 우심유출로 혈류가 관찰되지 않아서 폐동맥 폐쇄증으로 진단되었다. 수술 소견에서 폐동맥 및 폐동맥 판막의 기형은 전혀 없었고, 삼첨판의 전방 유두근 건삭파열이 새로이 확인되었다. 삼첨판 폐쇄부전은 건삭 형성술을 실시하여 성공적으로 교정하였으며, 술전 심초음파도에서 주폐 동맥에 폐혈류가 관찰되지 않았던 것은 심한 삼첨판 폐쇄부전 때문이었던 것으로 판단되었다.