• Journal of Chest Surgery
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• v.32 no.3
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• pp.303-306
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• 1999

This is a genuine case report of the Ross operation without the use of homografts or heterografts in reconstruction of the right ventricular outflow tract. A 8-year-old boy with congenital aortic stenosis underwent aortic valve replacement with a pulmonary autograft and right ventricular outflow tract reconstruction with a pericardial conduit bearing autologous aortic monocusp. The postoperative echocardiography and cardiac angiography revealed good ventricular function and competent neoaortic valve. He has been followed up for 19 months.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.399-402
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• 2018

A 61-year-old woman who presented with claudication and dyspnea on exertion was found to have severe calcified narrowing of the descending aorta and severe insufficiency of the aortic valve. These findings were compatible with Takayasu arteritis. To treat these hemodynamic abnormalities, extra-aortic bypass surgery combined with replacement of the aortic valve and ascending aorta-to-hemiarch replacement was performed through a separated upper hemi-sternotomy and limited median laparotomy. We present our successful surgical experience with this case.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.637-639
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• 2005

There are several methods of repairing in aortic periprosthetic leakage after aortic valve replacement. We present a case in with the aortic periprosthetic leakage with pseudoaneurysm was repaired with dacron patch.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.739-744
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• 1992

Discrete membranous subaortic stenosis[DMSS] is one of the subtype of congenital left ventricular outflow obstruction and can be associated with aortic regurgitation, infective endocarditis, ventricular obstruction. DMSS should be removed early, when diagnosed, and completely before secondary myocardial changes occur. Recently we experienced a case of DMSS with aortic regurgitation, and its left ventricular outflow tract obstruction[LVOTO] peak systolic gradient was 10lmmHg. Resection of membrane and aortic valve replacement is adequet for LVOTO and postoperative pressure gradient was 26mmHg. Postoperative echocardiogram shows no obstuctive membrane and well functioning aortic valve.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.355-360
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• 1979

Mitral and aortic valve replacement with tricuspid annuloplasty was undertaken in 5 patients out of 38 valvular surgery between the period from Jan. 1977 to May 1979 in the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital. All were male patients with age ranging from 18 to 42 years, and preoperative evaluation revealed one case in Class IV, and four cases in Class III according to the classification of NYHA. Preoperative diagnosis was confirmed by routine cardiac study including retrograde aorto- and left ventriculography, and there were two cases with MSi+ASi+Ti, two cases with MSi+Ai+Ti, and one case with Mi+Ai+Ti. Double valve replacement was performed under the hypothermic cardiopulmonary bypass with total pump time of 247 min. in average ranging from 206 min. to 268 min. During aortic valve replacement, left coronary perfusion was done in the first two cases, and cardiac arrest with cardioplegic solution proposed by Bretschneider was applied in the remained three cases. Starr-Edwards, Bjork-Shiley prosthetic valves and Carpentier-Edwards tissue valve were replaced in the aortic area, and Carpentier-Edwards and Angell-Shiley tissue valves were replaced in the mitral area with each individual combination [three prosthetic and two tissue valves in the aortic, and five tissue valves in the mitral area respectively]. Postoperative recovery was uneventful in all cases except one case with hemopericardium, which was managed with pericardiectomy on the postoperative 10th day in good result. Follow-up after double valve replacement of the all five cases for the period from 6 months to 33 months revealed satisfactory adaptation in social activity and occupation with cardiac function of Class I according to the classification of NYHA In all five cases.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.496-498
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• 2008

Cardiac papillary fibroelastomas are the second most common primary cardiac tumor. This tumor is usually benign and it involves the cardiac valve. However, most cardiac papillary fibroelastomas originate from a single site, and the incidence of cardiac papillary fibroelastomas originating from multiple sites is very rare (5%). A 55-year-old woman who presented with momentary dizziness and syncope was evaluated by performing echocardiography. Multiple tumors attached to the aortic valve were noted. The mass was removed freely without leaving any defect on the aortic valve leaflet. After the recovery period, the patient is currently being followed up at the outpatient department.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.445-447
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• 2007

Occlusion of a coronary artery ostium and especially occlusion of the right by an aortic cusp is a rare condition. We experienced an adult patient with occlusion of the right coronary ostium that was due to fusion of the right coronary cusp to the aortic wall along with underlying rheumatic aortic valve stenosis. During the operation, the adherent right coronary cusp was excised. After confirming that the right coronary ostium was patent, the other cusps were removed, and this followed by replacement of the aortic valve with a mechanical valve. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.458-469
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• 1983

Between October, 1978, and December, 1982, Glutaraldehyde-stablized pericardial xenografts [Ionescu-Shiley valve] were used for heart valve replacement in 409 patients.[251 mitral, 49 aortic, 11 tricuspid, and 98 multiple valve replacement]. There were 31 early deaths [7.6%], and 371 operative survival were observed for a total of 507.6 years over a period of 1 to 44 months. [mean 17 months]. Actuarial analysis of late results indicates an excepted survival rate at 4 years of 86.25.4% for patients with mitral, 79.37.1% for patients with aortic valve replacement. Actuarial survival rates for total patients at 4 years was 77.88.2%. The rate of systemic embolism has been 1.6% per patient-year for mitral and 1.8% per patient-year for aortic group in the presence of anticoagulation treatment. Among the 6 embolic episodes, 2 patients were died. The incidence of hemorrhagic complication was 1.3% per patient-year for anticoagulated patients. There were 6 confirmed valve failures, five in mitral and one in aortic position. Re-replacement of destructed valve was performed in one patient and others were treated medically. Among the 6 episodes, 3 occurred in children [Below 15 years], it account almost 9 times higher than adult. Our clinical data compare very favorable with those obtained with other available prostheses and tissue valves, but it should be considered to give short-term anticoagulation therapy to hemodynamically stable patients and aortic valve patients, and other prosthetic valve must be considered to use in children.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1117-1123
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• 1988

Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.