• Journal of Chest Surgery
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• v.3 no.1
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• pp.3-12
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• 1970

During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital. This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage. The results were obtained as follows. 1.Left pneumonectomy was done in sixty-six of 100 patients [66 %] and the right one was done in the rest thirty-four[34 %]. The ratio between left and right was nearly 2:1. 2.Of all oostoperative complications, the intrapleural infection was most common, and these were 53 % in empyema thoracis and 12.7 % in pulmonary tuberculosis respectively. 3.More postoperative complications could be seen after right pneumonectomy than the left one. 4.It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy,postoperatlve tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver. 5.The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window. 6.Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy. 7.The mortality rate was 10 % in our cases and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.606-609
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• 1995

We have experienced ten cases of emergent operation for the complications of cardiac catheterization during the period from 1985 to September 1994.Catheterization was done for the evaluation of the cardiac or vascular problem in 8 cases and 2 cases of neurosurgical problem. The extracardiac injection of contrast material have occurred in 3 cases[primum ASD,Trilogy,VSD . Six cases were unable to remove the catheter from femoral artery or vein. The catheters were knotted, coiled, impacted or broken. An embolectomy was done 40 years old man who suffered from chronic left subclavian artery obstruction a day after angiography. Open heart surgery was performed in 5 cases of cardiac perforation,impacted catheter in left inferior pulmonary vein and broken catheter of VSD. Arteriotomy was done in 4 cases to remove the knotted and coiled catheter. There was no complication or mortality for the emergent operation.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.165-173
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• 1985

A clinical analysis was performed n 706 uses of patent ductus arteriosus experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 27 years period from 1958 to 1984. Of the 706 patients of PDA, 244 patients were male and 462 patients were female and ages ranged from 2 months to 53 years old with the average age of 8.5 years. The chief complaints on admission were dyspnea on exertion and frequent URI in 58.9%, non specific symptoms such as palpitation and easy fatigability in 9.7%, symptoms of CHF in 2.0% and no subjective symptoms in 29.4%. On auscultation of heart, continuous machinery murmurs were heard in 82% and only systolic murmurs were heard in 18% of patients. On simple chest PA of patients, cardiomegalies were detected in 78% and there were increased pulmonary vascularities in 93% of patients. EKG findings were as followed; LVH 56.9%, BVH 12.6%, RVH 2.9% and WNL 27.6%. Cardiac Catheterizations were performed in 512 patients and mean Qp/Qs was 2.56 and mean systolic pulmonary artery pressure was 45mmHg. Operation methods were as followed; in patients in whom operations were performed on PDA only, ligation 94.3%, division 3.7% and ligation [0.5%] or trans-pulmonary artery suture closure [1.5%] under cardiopulmonary bypass 2.0% and in patients in whom operations were performed with associated anomalies, ligation 17.6%, division 2.4%, and ligation [44.7%] or trans-pulmonary artery suture closure [35.3%] under cardiopulmonary bypass 80%. 52 postoperative complications [8.4%] were developed in 42 patients [6.8%] and its were as followed; permanent or transient hoarseness 16 [2.6%], intraoperative rupture of PDA 8 [1.3%], recannalization 6 [1.[%], operative death 5 [0.8%], late death 4 [0.6%] and other miscellaneous complications 13 [2.1%]. 140 associated cardiac anomalies [19.8%] were found in 105 patients [14.9%] and its were as followed; VSD 68 [9.6%], COA 15 [2.1%], Subaortic discrete membrane 7 [0.9%], ASD 6 [0.8%], TOF 5 [0.7%] and other miscellaneous and

• Journal of Chest Surgery
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• v.14 no.1
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• pp.9-16
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• 1981

Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.320-326
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• 1985

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.143-147
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• 1988

Congenital coronary arteriovenous fistula is a communication of a coronary artery with one of the atria, ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. We had a successful surgical experience with 63 year-old-female patient who complained substernal chest pain on exertion for 8 years. On auscultation, a continuous murmur was heard at the left second to third intercostal space along the left sternal border. The right cardiac catheterization was revealed to 4% oxygen step up between right ventricle to main pulmonary artery, and Qp/Qs was 1.3:1. The selective coronary arteriography showed markedly tortuous dilated vessel which originated from left coronary artery draining into the main pulmonary artery. The operation performed to mid portion of tortuous and dilated fistula by multiple ligation with 3-0 Mersilene and suture ligation with pledgetted 3-0 Prolene on distal draining site, Postoperative course were uneventful without any symptoms and complications.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.124-128
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• 2009

Pulmonary arteriovenous malformations (PAVMs) are direct communications between pulmonary arteries and pulmonary veins, resulting in right-to-left shunts that may cause cyanosis, dyspnea, and digital clubbing. Neurological complications such as intracerebral hemorrhage or brain abscess may result from cerebral thrombosis or emboli. In most cases, they remain unrecognized until the late teenage years. Here, we report a case of a 6-year-old boy who presented with perioral cyanosis, digital clubbing, and dyspnea on exertion. A plain chest X-ray showed a focal nodular opacity in the right lower lobe (RLL), and a diagnosis of a large PAVM in the RLL was confirmed by chest computed tomography. A right lower lobectomy was successfully performed without any complications. Although their incidence in children is low, PAVMs should be suspected as a possible cause of cyanosis and dyspnea of non-cardiac origin, and should be treated promptly to prevent further neurological complications.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.644-656
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• 1984

In Tetralogy of Fallot, the most common congenital cyanotic heart disease, the mortality is decreasing continuously with adequate type and timing of operation. At S.N.U.H., 195 patients were operated from January 1982 to December 1983 and 176 patients among them were analysed in the view of pre-operative pulmonary arterial condition measured by cardiac cineangiogram. The most common associated anomaly was PFO and ASD and they did not affect the postoperative course and mortality. The overall mortality rate was 8.5% in 1982 and 6.8% in 1983 but under 2 years of age, the mortality rate was relatively high as 25% in 1982 and 16.7% in 1983, and when transannular patch widening of Right Ventricular Outflow Tract was used, the mortality rate was 12.5% in 1982 and 27.3% in 1983. Preoperative angiographic measurements of the pulmonary arterial status for prediction of the ratio between the Left Ventricular and Right Ventricular peak systolic pressure were calculated retrospectively according to the Blackstones formula, and the predicted value of PRV/LV greater than 0.6 carried apparently high complication and mortality rate as 16.6% M.R. in 1982 and 11.1 % in 1983. Among postoperative complications, c-RBBB occurred most frequently about 50% but did not influenced to mortality, Low Cardiac Output Syndrome was developed in about 40%. If we select the patient who should have the staged operation including shunt operation and choose the type of RVOT relief, we expect the improvement of postoperative clinical results.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.428-434
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• 2023

Pulmonary veins (PVs) and their myocardial sleeves play an important role in the development of atrial fibrillation. Hence, detailed knowledge of PV anatomy is required to improve the procedural success rate and prevent complications during cardiac procedures. The aim of this study was to evaluate the PV anatomy along with anatomical variations in the Indian population. Total 100 formalin fixed cadaveric hearts were examined. The number and pattern of the PVs were observed along with the measurement of their horizontal and vertical diameters. The ovality index for each PV was calculated. Classical PV pattern was observed in 62% cases. Variant pattern like additional right middle PV pattern and left common PV pattern were found in 20% and 10% cases respectively. A separate pattern with presence of both right middle PV and left common PV was observed in 6% cases. In the classical pattern right superior PV was the largest followed by right inferior, left superior and left inferior PV. The additional right middle PV had the smallest diameter whereas the left common PV had the largest diameter. Almost all the veins had greater vertical diameters in comparison to horizontal diameters. The variant PVs were oval and had greater ovality index compared to the normal PVs. In classical pattern 54.8% hearts whereas in variant pattern 79% hearts had one or more oval PV. The given data can help clinicians for planning and execution of various interventional and electrophysiological procedures involving PVs.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.934-940
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• 2023

Ventriculoperitoneal shunting is the most common neurosurgical procedure for treatment of hydrocephalus. Shunt-related complications are relatively common and associated with a high rate of shunt revision. However, migration of the distal ventriculoperitoneal shunt, especially into the cardiac and intravascular regions, has rarely been reported. Awareness of this rare but potentially hazardous complication is important owing to its significant morbidity, which can be prevented by prompt management. Here, we introduce a case of a 23-year-old male with migration of the distal shunt catheter through the left internal jugular vein into the cardiac chamber and both pulmonary arteries, which occurred 2 months after receiving ventriculoperitoneal shunting. Furthermore, we discuss the possible mechanisms and management of this condition.