• 제목/요약/키워드: Atrial appendage

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둔상에 의한 외상성 좌심실 파열환자를 성공적으로 치료한 예 (Successful Treatment of Blunt Traumatic Rupture of the Left Atrial Appendage and Pericardium: A Case Report)

  • 경규혁;정성호;홍석경
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.168-170
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    • 2011
  • Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.

삼중방심 치험 1례 (Cor Triatriatum (A case report))

  • 인강진
    • Journal of Chest Surgery
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    • 제22권4호
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    • pp.667-671
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    • 1989
  • Cor triatriatum is a rare congenital malformation of the heart in which a diaphragm stretches in a transverse plane through the left pulmonary venous chamber, thus creates two subchambers. The proximal chamber connects with the pulmonary veins, and the distal one has left auricle and the mitral valve. A 3 year old boy who had Cor triatriatum underwent surgical excision of the abnormal diaphragm in March, 1989 in Chungnam University Hospital. An obliquely oriented fibromuscular diaphragm divided the left atrium into a proximal chamber which was connected to the pulmonary veins and a distal chamber which had the atrial appendage and the mitral valve. The opening in the diaphragm was 5 mm in diameter. There were no associated abnormalities. The abnormal diaphragm was completely excised. The postoperative result was excellent.

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우측 상대정맥의 좌심방으로 이상환류의 수술치험 (Surgical Correction of Anomalous Right Superior Vena Cava[RSVC] into the Left Artium as an Isolated Anomaly - Report of a case -)

  • 백희종
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1455-1460
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    • 1992
  • Anomalous drainage of the right superior vena cava into the left atrium is a very rare congenital cardiac anomaly. Recently a patient with this venous anomaly was surgically corrected and forms the basis of this report. Patient findings were as follows: The patient has no other symptom but cyanosis which prompted cardiac evaluation Chest PA and electrocariogram were usual. Cross-sectional echocardiogram showed normally connected heart without intracardiac defect, Inferior vena cava drained normally into right atrium and coronary sinus was not dilated. Contrast, given into the right atrium, appeared in the left atrium This rare venous anomaly was confirmed by surgery. Surgical correction consisted of division of superior vena cava above the junction of left atrium and reanastomosis into right atrial appendage. Postoperative digital subtracion angiography confirmed the successful repair. She has doing well for 6months since operation. Systemic venous anomalies without intracardiac defect are very rare. However this anomalies should be considered in the differential diagnosis of cyanosis. The successfully corrected case is reported and literature is reviewed.

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Surgical Resection of Cardiac Hemangiosarcoma Using Articulated Surgical Stapler in a Dog

  • Woo-Jin Kim;Kyung-Min Kim;Won-Jong Lee;Chang-Hwan Moon;Hae-Beom Lee;Seong-Mok Jeong;Dae-Hyun Kim
    • 한국임상수의학회지
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    • 제41권1호
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    • pp.37-42
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    • 2024
  • This case report discusses the successful surgical resection of cardiac hemangiosarcoma in a dog using an articulated surgical stapler. Cardiac tumors, particularly hemangiosarcomas, have a poor prognosis. Recommended treatment involves surgical removal of the primary tumor, along with chemotherapy. However, the use of staples for cardiac tumor resection has not yet been extensively documented in the veterinary literature. A 10-year-old dachshund with pericardial effusion underwent surgery to remove a right atrial mass. An articulated linear cutting stapler was used for tumor resection. The patient experienced chylothorax as a complication but recovered well. However, the patient later developed respiratory symptoms and died, most likely due to aspiration pneumonia. The surgical stapler provided stability, convenience, and a shorter surgical time during tumor resection. Surgical resection combined with chemotherapy improves the survival of dogs with cardiac hemangiosarcoma. The stability and adjustability of the stapling device make it advantageous for cardiac tumor resection. Although complications, such as chylothorax, can arise, appropriate management can lead to positive outcomes. This case report demonstrates the feasibility and safety of using an articulated surgical stapler for cardiac tumor resection in dogs. Insights from this case can guide future research and clinical practice.

Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports

  • Son, Shin-Ah;Cho, Joon Yong;Kim, Gun-Jik;Lee, Young Ok;Jung, Hanna;Oh, Tak-Hyuk
    • Journal of Yeungnam Medical Science
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    • 제38권4호
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    • pp.356-360
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    • 2021
  • Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

개심술 후 심폐소생술 실패환아에서의 체외막산소화 치험 1례 (Extracorporeal Membrane Oxygenation in the Patient with Cardiopulmonary Resuscitation Failure after Open Heart Surgery. - A case report -)

  • 전희재;성시찬;우종수;이혜경
    • Journal of Chest Surgery
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    • 제32권1호
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    • pp.53-57
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    • 1999
  • 저자들은 심장수술 후 발생한 심정지로 심폐소생술을 시행한 신생아에서 성공적인 체외막산소화 장치(ECMO)사용 1례를 경험하였다. 환자는 울혈성 심부전과 폐동맥 고혈압을 가졌던 4.4kg의 35일된 남아로 술중에 특별한 문제없이 심실중격결손증을 첨포봉합법으로 봉합하였다. 심장 중환자실에서의 술후 경과는 junctional ectopic tachycardia (JET)가 나타나기 전까지 약 5시간 동안은 특별한 문제가 없었다. junctional ectopic tachycardia (JET)가 나타난 후 50분경과한 뒤 갑작스러운 서맥이 나타나면서 수축기 혈압이 50mmHg로 하강하여 곧 흉골절개 봉합부(sternotomy incision)를 열고 심폐소생술을 바로 시행하였으며 심폐소생술을 시행한 지 4시간 후에 상행대동맥에 동맥관을 그리고 정맥관은 우심방이에 삽관하여 체외막산소화 장치를 시작하였다. 환자의 혈액동력학은 체외막산소화 동안 안정적이었으며, 시작 후 38.5시간 만에 중지하였다. 흉골지연봉합을 시도하였고, 환자는 수술 후 7일째 인공호흡기를 제거했으며, 신경학적 합병증없이 수술 후 21일째 퇴원하였다.

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가슴 통증을 동반한 선천성 부분 심낭 결손증 (Congenital Partial Pericardial Defect Presenting as Chest Pain)

  • 김용호;강민웅;임승평;이영;길홍량;유재현
    • Journal of Chest Surgery
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    • 제40권10호
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    • pp.719-721
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    • 2007
  • 심낭 결손증은 드문 선천성 기형으로 대부분의 경우 증상이 없이 우연히 발견되지만, 심장의 일부가 탈장되어 흉통 등의 증상을 나타내는 경우도 있다. 본 증례는 14세 여자 환자가 내원 3개월 전부터 발생한 운동 시 호흡곤란과 가슴 통증을 주소로 내원하여 부분 심낭 결손을 통한 좌심방 부속지의 탈장(herniation)이 진단되어 수술적 치료를 시행하여 보고하는 바이다.

좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 - (Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report -)

  • 강신광;박상순;나명훈;유재현;임승평;이영;성인환
    • Journal of Chest Surgery
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    • 제34권6호
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    • pp.490-493
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    • 2001
  • 17세 여자 고등학교 학생이 전흉부 동통을 주소로 입원하였다. 약물 치료와 대동맥내 풍선 펌프에도 불구하고 폐부종과 순환 허탈이 악화되었다. 급성 전격성 심근염 추정 진단 하에 좌심실 보조장치를 설치하였다. 유입구 도관은 유방하 좌전개흉술로 좌심이를 통하여 좌심방에 삽입하였고, 좌심이의 일부를 조직검사를 위해 떼어냈다. 유출구 도관은 좌측 대퇴 동맥에 PTFE도관을 간치시켜 삽입하였다. 체외순환 158시간 후 심초음파에서 좌심실의 운동성이 거의 정상으로 회복되었고, 좌심실 보조장치를 성공적으로 이탈할 수 있었다. 면역화학 검사와 중화 항체 검사에서 콕사키바이러스가 확인되었다. 환자는 입원 23일 째 아무런 심부전 증상없이 퇴원하였다.

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완전방실차단을 동반한 감염성 심내막염 환자에서 판막치환술 후 관정맥동을 통해 좌심실을 조율하는 심박조율기 시술 (Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block)

  • 조관훈;김인호;안서희;오용석
    • Journal of Yeungnam Medical Science
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    • 제31권2호
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    • pp.113-116
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    • 2014
  • A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • 이섭;김웅한;강형석;배지훈;전상훈;권오준;안욱수
    • Journal of Chest Surgery
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    • 제34권9호
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    • pp.672-679
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    • 2001
  • 배경: 폐정맥 및 상대정맥의 폐쇄와 동방결절의 기능장애 등은 상대정맥으로 환류되는 부분폐정맥 연결이상의 수술교정 이후 발생할 수 있는 합병증으로 술 후 정기성적을 결정하는 요인이 되어왔다. 저자들이 시행하고 있는 수술방법을 기술하고 조기결과를 분석하였다. 대상 및 방법: 1999년 4월부터 2000년 1월까지 세종병원과 대구가톨릭대학병원에서 5명의 환자가 상대정맥으로 환류되는 부분폐정맥 연결이상으로 교정수술을 받았다. 환자의 나이는 생후 2개월부터 66세까지였다. 수술방법은 우심방 피판(2례)이나 첨포(3례)를 사용하여 이상폐정맥을 심방간 통로를 통하여 좌심방으로 정상환류시키고, 상대정맥을 이상폐정맥의 상부에서 절단한 후 근위부를 폐쇄하고 상대정맥의 원위부를 우심방이에 단단문합함으로써 상대정맥과 우심방의 혈류를 재건하였다. 결과: 모든 환자가 합병증 없이 술 후 9일과 15일 사이에 퇴원하였다. 퇴원 후 본국으로 돌아간 러시아 환아를 제외한 4명의 환자는 평균 17.75$\pm$4.27 개월의 추적기간 동안 증상 없이 정상동율동을 보였다. 술후 12개월에서 24개월에 시행한 심장초음파검사상 폐정맥이나 상대정맥의 협착 및 잔류단락은 보이지 않았다. 결론: 저자들은 상대정맥으로 환류되는 부분폐정맥 연결이상 환자에서 기술한 수술방법으로 폐정맥 및 상대정맥 혈류의 협착 없이 좋은 결과를 얻을 수 있었다. 상대정맥과 우심방접합부위를 가로지르는 절개를 피함으로써 동방결절 및 그 동맥의 손상을 최소화 할 수 있을 것으로 생각된다.

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