• Journal of Chest Surgery
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• v.20 no.4
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• pp.765-772
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• 1987

Double-chambered right ventricle [DCRV] as a clinical and anatomic entity was separated from other forms of right ventricle obstruction, and frequently associated with VSD. We experienced surgical treatment of 6 cases of DCRV with VSD. Among them, PDA in a case, PFO in two cases and one case of mild infundibular PS were associated. Preoperative cardiac catheterizations and RV cineangiograms showed about 69 mmHg. of pressure gradient in average between RV inflow and outflow portion, and filling defect by anomalous muscle bundles in the sinus portion of RV. On operation, VSD and other associated anomaly were corrected after resection of anomalous muscle bundle for relief of the obstruction through the vertical RV-tomy site. Postoperative EKG showed complete RBBB, but hemodynamic problems were not developed. Postoperative cardiac catheterizations showed markedly decreased pressure gradient between two chambers, that was about 15 mmHg. in average. Postoperative course was smooth and discharged without any problems.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.786-792
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• 1987

Congenitally corrected transposition of the great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. This report describes a 17 year old male patient who had congenitally corrected transposition of the great arteries associated with ventricular septal defect and patent ductus arteriosus, underwent patch closure of the ventricular septal defect and suture closure of patent ductus arteriosus, and was discharged on 9th day after surgery with good condition.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.764-768
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• 1990

Congenitally corrected transposition of great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. A 8-year-old girl had congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary valvular stenosis. By transaortic approach, ventricular septal defect was closed and pulmonary valvotomy was performed by transpulmonary approach. No heart block or aortic insufficiency developed postoperatively.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.672-677
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• 1986

From April, 1984 to August, 1986, 214 cases of cardiovascular surgeries had been performed at Yeungnam University Hospital consisting 158 open heart surgeries and 56 non-open heart surgeries. The leading cardiac anomaly of open heart surgeries was ventricular septal defect which was 43% of congenital heart diseases, and most of remaining non-open heart surgeries were ligating patent ductus arteriosus. We had observed 33 postoperative complications such as wound problems, transient arrhythmia, postpericardiotomy syndrome, bleeding requiring reoperation and so on. 3 cases of surgical mortality were present [2 in congenital heart diseases and 1 in acquired heart disease], which resulting 1.9% of surgical mortality rate in the open heart surgeries.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1465-1470
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• 1992

We experienced one case of total anomalous pulmonary venous connection to coronary sinus with secondum type ASD. The case was 21 years old woman with mild dyspnea on exertion and ill looking appearance. The disease was confirmed by 2D echocardiogram and cardiac catheterization. Under the conventional cardiopulmonary bypass, we repaired the anomaly by use of Dacron patch. The postoperative course was uneventful and discharged with excellent general condition and has been good during follow-up.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.85-92
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• 1974

During the years 1959 to 1974, 99 patients with patent ductus arteriosus were admitted to National University Hospital. These includes 5 patients with additional cardiovascular and 5 patients with severe pulmonary hypertension. All were operated upon except three refused operation. In all instances, the diagnosis was made by history and physical, roentgenological and electrographic examinations. In addition, in 53 patients, special diagnostic procedures were carried out either for diagnosis or for evaluation of pulmonary hypertension and associated cardiovascular anomalies. Right cardiac catheterization was resorted to in 51 patients. In one of these patients catheterization was incorrectly interpreted [ventricular septal defect]. Retrograde aortogram was performed in two patients. In both cases the ductus itself was visualized on the x-ray film. An additional vascular anomaly, namely the persistent left superior vena cava, was confirmed by retrograde angiogram in one of them. In 5 cases the pulmonary arterial pressure was elevated well over 80 mmHg. In these instances,the operative mortality was 80% [4 out of 5 patients]. The management of patent ductus arteriosus when associated with severe pulmonary hypertension. and/or other cardiac anomalies is controversial. Opinions differ as to how to close the ductus and to repair the cardiac anomalies as well as to whether a one-staged or two-staged procedure should be resorted to. The author is of the that each case must be evaluated individually before any specific surgical treatment is ou.tlined. The literature on the subject is reviewed in this paper.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.430-437
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• 1990

We clinically evaluated 121 cases of ventricular septal defect which we operated from April, 1986 to December, 1989 at Inha General Hospital, Seong-Nam, Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University. These patients were occupied 54.8% of all congenital heart diseases operated on its same period. Of the 121 patients, 63 patients were male[52.1%] and 58 patients were female[47.9i]. The two most common symptoms were frequent upper respiratory infection and dyspnea on exertion. By Kirklin s anatomical classification, type I constituted 34.7%, type II 61.98%, type III 0.03% and type IV not occupied. Associated cardiac anomalies were found in 34 cases, and PDA was most common associated anomaly, occupied in 22 cases. On the cardiac catheterization data, there were statistically significant correlation between VSD size[cm2 /BSAm2] and systolic pulmonary arterial pressure[sPAP], pulmonary to systemic flow ratio[Qp/Qs] & pulmonary to systemic pressure ratio[Pp/Ps] respectively, Type II [r=0.53, p<0.01] was more correlated than type I [r=0.49, p<0.05] between VSD size and Qp /Qs. We could not found the correlationship between age and Qp/Qs [Type I; r=0.16, Type II; r=-0.15] All cases were operated under cardiopulmonary bypass and 58 cases[46.3%] were operated through the right atrial approach, and 34 cases[28.1%] through the pulmonary arterial approach. Operative mortality rate was 4.13%[5 cases].

• Journal of Chest Surgery
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• v.35 no.4
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• pp.303-306
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• 2002

Patients with severe Ebstein's anomaly showing in the neonatal period, represent progressive cardiac enlargement with pulmonary hypoplasia and functional pulmonary atresia with patent ductus alteriosus-dependent pulmonary circulation. Biventricular repair in these patients had been mostly unsuccessful except for Starnes' procedure that converts the anatomy to single ventricle physiology for Fontan procedure. A 4-days old male was admitted with the diagnosis of severe Ebstein's anomaly with anatomic pulmonary atresia and severe cardiac enlargement. He successfully underwent biventricular repair with vertical plication method of atrialized right ventricle, tricupid annuloplasty, transannular right ventricular outflow tract reconstrulltion, atrial septal defect patch closure with fenestration, and right atrial reduction angioplasty Postoperatively, cardiothoracic ratio was significantly reduced and mild tricuspid regurgitation was remnant in echocardiography. The patient is currently 10 months old and is fully active without restrictions.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.618-626
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• 1986

Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.554-560
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• 2003

Purpose : To investigate the teratogenic effect of gamma-ray on the heart of chick embryo. Methods : 50 rad, 100 rad, 150 rad, 200 rad, 250 rad, and 300 rad of gamma-ray were used to irradiate three days old chick embryos. The control group was not irradiated. After three weeks, the embryos were sacrificed and examined for cardiovascular malformation. Results : The survival rate of the gamma-ray irradiated group was significantly lower than that of the control group(33.3-63.3% vs 76.4%, P=0.001). The cardiac malformation rate of the experimental group was 11.0%. In the control group, no congenital cardiac malformations were observed. The experimental groups had a significantly higher malformation rate(P=0.001). The types of malformation were ventricular septal defect, tricuspid atresia, Ebstein anomaly and aortic arch anomaly. In the gamma-ray irradiated group, the cardiac malformations were : 14 small ventricular septal defects (VSDs), five large VSDs, two tricuspid atresias, and one Ebstein anomaly. The higher the dose of radiation applied, the higher the incidence of cardiac malformation was noted. Conclusion : Gamma-ray irradiation of 3 days old chick embryos increased the rate of death and the rate of cardiac malformation significantly.