• 제목/요약/키워드: Bleeding heart

검색결과 252건 처리시간 0.024초

월경통 환자의 월경주기에 따른 심박변이도(Heart Rate Variability) 차이에 대한 고찰 (Effects of Menstrual Cycle on Heart Rate Variability in Dysmenorrhea Patients)

  • 김은숙;문승준;조한백;임은미;고성규;조정훈
    • 대한한방부인과학회지
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    • 제23권2호
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    • pp.124-130
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    • 2010
  • Purpose: The aim of the study was to investigate menstrual cycle phase differences in Heart Rate Variability(HRV) in dysmenorrhea patients. Methods: 16 dysmenorrhea patients were enrolled. The severity of dysmenorrhea was measured by Visual Analog Scale(VAS). Recordings for HRV analysis were obtained during the two phases of the menstrual cycle (follicular phase 4~10 days and luteal phase 18~23 days from the start of bleeding). Results: No measure of HRV was significantly different between two menstrual cycle phases. Conclusion: We concluded that menstrual cycle was not significantly associated with changes in autonomic nervous system as measured by HRV in dysmenorrhea patients.

Percutaneous Extracorporeal Membrane Oxygenation for Graft Dysfunction after Heart Transplantation

  • Lim, Jae Hong;Hwang, Ho Young;Yeom, Sang Yoon;Cho, Hyun-Jai;Lee, Hae-Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • 제47권2호
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    • pp.100-105
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    • 2014
  • Background: We evaluated the safety and efficacy of percutaneous extracorporeal membrane oxygenation (ECMO) in patients with primary graft dysfunction after heart transplantation. Methods: Of 65 patients (44 males and 21 females) who underwent heart transplantation from January 2006 to December 2012, 13 patients (group I) needed peripheral ECMO support due to difficulty in weaning from cardiopulmonary bypass (CPB) and 52 patients (group II) were weaned from CPB without mechanical support. The mean age of the patients at the time of operation was $54.4{\pm}13.6$ years. There were no differences in the preoperative characteristics of the two groups. Multivariable analysis was performed to identify the risk factors for ECMO therapy. Results: All group I patients were successfully weaned from ECMO after $53{\pm}9$ hours of circulatory support. Early mortality occurred in four patients (1 [7.7%] in group I and 3 [5.8%] in group II, p>0.999). There were no differences in the postoperative complications between the two groups, with the exception of reoperation for bleeding. A greater number of group I patients underwent reoperation for bleeding (5 [38.5%] in group I vs. 6 [11.5%] in group II, p=0.035). In multivariable analysis, preoperative mechanical support (ECMO and intra-aortic balloon pump) and longer CPB time were the risk factors of ECMO therapy for graft dysfunction (odds ratio, 6.377; 95% confidence interval, 1.519 to 26.77; p=0.011 and odds ratio, 1.010; 95% confidence interval, 1.001 to 1.019; p=0.033). Conclusion: Percutaneous ECMO support could be a viable option for rescuing patients when graft dysfunction refractory to medical management develops after heart transplantation.

Delayed Sternal Closure Using a Vacuum-Assisted Closure System in Adult Cardiac Surgery

  • Hyun Ah Lim;Jinwon Shin;Min Seop Jo;Yong Jin Chang;Deog Gon Cho;Hyung Tae Sim
    • Journal of Chest Surgery
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    • 제56권3호
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    • pp.206-212
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    • 2023
  • Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

개방성 동맥관과 우폐동맥 이상기시를 동반한 대동맥 폐동맥 중격결손증 1례 보 (Aortopulmonary septal defect with anomalous origin of the RPA from aorta and PDA)

  • 남구현
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.398-401
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    • 1984
  • Aortopulmonary septal defect is rare congenital heart disease. An 8-year-old girl was diagnosed as a ventricular septal defect with patent ductus arteriosus at Department of Thoracic and Cardiovascular Surgery of Chungnam National University Hospital. On operation, the defect was confirmed as an aortopulmonary septal defect [Type I], anomalous origin of right pulmonary artery from aorta [Type Ill] and patent ductus arteriosus. The defect was repaired anatomically with cardiopulmonary bypass. But she was not survived because of uncontrollable bleeding from aorta.

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The Unusual Suspect: Anemia-induced Systolic Anterior Motion of the Mitral Valve and Intraventricular Dynamic Obstruction in a Hyperdynamic Heart as Unexpected Causes of Exertional Dyspnea after Cardiac Surgery

  • Mun, Jeong-Beom;Oh, Ah-Reum;Park, Hwa-Sun;Park, Chul-Hyun;Park, Kook-Yang;Moon, Jeonggeun
    • Journal of Chest Surgery
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    • 제46권6호
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    • pp.457-460
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    • 2013
  • Dynamic left ventricular (LV) outflow tract obstruction is a characteristic feature of hypertrophic cardiomyopathy; however, it can also occur in association with hyperdynamic LV contraction and/or changes in the cardiac loading condition, even in a structurally normal or near-normal heart. Here, we report a case of anemia-induced systolic anterior motion of the mitral valve and the resultant intraventricular obstruction in a patient who underwent coronary artery bypass grafting and suffered from anemia associated with recurrent gastrointestinal bleeding.

술후 심잡음이 들리는 심실중격결손증의 수술전후 혈역학적 비교 (Pre-and postoperative cardiac catheterization in 20 patients ungergoing closure of VSD whose murmur was sustained after open heart surgery)

  • 박병순
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.780-785
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    • 1984
  • We had studied 20 cases of VSD patients whose murmur was sustained after open heart surgery from 1977 to 1984. The postoperative cardiac catheterization was performed on post-op. 20th day. Their ages ranged from 5 to 25 years old. Among them, 4 patients had significant residual shunt which required reoperation. [1 patient; re-op, 3 patient; refused]. Sex ratio was 13:7 in male and female. Associated anomalies were PDA, ASD, Pulmonary stenosis, Mitral insufficiency. Except 1 case, all of them was Kirklin type II VSD. Postoperative complications were I RBBB, residual shunt, cardiac tamponade due to bleeding, wound infection. Preoperative pulmonary artery systolic pressure was highly related to residual shunt in our study. Postoperative LVEDV returned to normal range on the 3rd week.

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선천성 심기형에 동반된 누두흉에서 동시에 시행안 심기형 교정 및 Nuss 수술 -1예 보고- (Nuss Operation with Simultaneous Intracardiac Repair -A case report-)

  • 허재학;장지민;김욱성;장우익;정철현
    • Journal of Chest Surgery
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    • 제37권6호
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    • pp.536-538
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    • 2004
  • 선천성 심기형과 흉벽기형이 동반되어 있는 경우 이 두 질환을 동시에 수술하는 경우에 변형된 늑연골의 광범위한 절제에 따른 합병증이 단점으로 지적되고 있다. 본원 흉부외과에서는 부분 방실중격 결손증과 오목가슴이 동반된 8세 환아에서 개심술 시에 Nuss 술식을 이용하여 오목가슴을 교정함으로써 광범위한 늑골절제에 따른 수술시간의 지연이나 출혈, 흉벽의 불안정성 등의 단점없이 좋은 결과를 얻었기에 이를 보고하는 바이다.

양대동맥 우심실기시증의 전교정술 - 45예 보고 - (Total Correction of Double-Outlet Right Ventricle [DORV]: Report of 45 cases)

  • 서울의대
    • Journal of Chest Surgery
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    • 제23권6호
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    • pp.1174-1179
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    • 1990
  • Forty-five patients with double-outlet right ventricle[DORV] underwent complete intracardiac repair between July, 1983 and June, 1989. Patients with complete atrioventricular canal, atrioventricular discordance and uni-ventricular heart were excluded. The 32 male and 13 female patients ranged in age from 3 months to 15 years[mean 4 years]. Thirty-two patients had pulmonary stenosis. The early mortality was 11.ltd[5 /45] None of 27 died after a completely intraventricular repair. The mortality was 20%[1/5] for repair using transannular patch, 20% [1/5] for REV operation, 33.3%[1/3] for repair including extracardiac valved conduit, and 50% [1/2] for Jatene operation, respectively. Two modified Fontan procedures were performed without mortality. One died after Senning operation. Causes of early deaths included high residual right ventricular pressure[one patient] small left atrial and left ventricular volume[one patient], persisting severe pulmonary hypertension [one patient] and low cardiac output of unknown cause [two patients]. Complete heart block developed in one patient. Two late deaths occurred among the 40 operative survivors [5.0Po] from persisting severe pulmonary hypertension and bleeding at reoperation. Our results indicate that significant defects can be repaired with low mortality and morbidity.

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Segmental Artery Injury Following Percutaneous Vertebroplasty Using Extrapedicular Approach

  • Heo, Dong-Hwa;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • 제49권2호
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    • pp.131-133
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    • 2011
  • We performed a percutaneous vertebroplasty at the compressed L2 vertebral body of a 73-year-old female using a left-sided unilateral extrapedicular approach. She complained severe radiating pain and a tingling sensation in her left leg two hours after the vertebroplasty. Spinal computed tomographic scan showed a large retroperitoneal hematoma, and a subsequent spinal angiography revealed a left L2 segmental artery injury. Bleeding was successfully controlled by endovascular embolization. Recently, extrapedicular approaches have been attempted, allowing for the avoidance of facet and pedicle injury with only a unilateral approach. With this approach, however, the needle punctures the vertebral body directly. Therefore, this procedure carries the potential risk of a spinal segmental artery.