• Journal of Chest Surgery
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• 제9권1호
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• pp.55-62
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• 1976

This is a report of 8 cases cardiac arrest developed in the operating room at Jeonbug university Hospital from January 1973 to October, 1975. Four patients of cardiac arrest developed during the elective operation, 3 during the emergency operation and the remaining one, bronchoscopy for foreign body removal under the general anesthesia. Immediate closed chest cardiac massage was performed in the 7 patients and the remaining one underwent open chest cardiac massage. Five of 7 patients with the closed chest cardiac massage regained consciousness and restored respiration, but 3 patients of these survived to be discharged. Two patients who underwent pneumonectomy for multiple lung abscess and open drainage for liver abscess, were resuscitated but did survived. The Latter died from bleeding due to rupture of the liver that developed during the closed chest cardiac massage. One patient who had open chest cardiac massage survived to be discharged without any sequele. Unsuccessful resuscitation was observed in two patients, one had a complication of malignant hyperthermia with muscle rigidity during gastrectomy for ulcer perforation and another had not firm support on the back during massage.

• Journal of Chest Surgery
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• 제47권4호
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• pp.394-397
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• 2014

Numerous technical modifications and various complications of the Senning procedure have been described in the literature. We describe the excellent clinical status and anatomic result of a 33-year-old patient who underwent a modified Senning operation using the left atrial appendage for reconstruction more than 30 years prior to presentation.

• Journal of Chest Surgery
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• 제24권8호
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• pp.741-750
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• 1991

Between April, 1986 and July, 1991, 477 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. There were 242 patients [50.7%] of acyanotic congenital anomalies, 34 patients [7.1%] of cyanotic congenital anomalies, and 187 patients [39.2%] of acquired heart diseases, 8 patients [1.7%] of coronary artery diseases, and 6 patients [1.3%] of mixed anomalies. Among the 276 congenital cardiac anomalies, 147 patients [53.3%] were male and 129 patients [46.7%] were female, ranged in age from 2 years to 58 years. Among the 187 acquired heart diseases, 72 patients [38.5%] were male and 115 patients [61.5%] were female, ranged in age from 10 years to 68 years. The common congenital defect were VSD and ASD in acyanotic cardiac patients, and TOF in cyanotic cardiac patients. Among the 187 acquired heart diseases, 180 patients underwent operation for cardiac valvular diseases, 4 patients were resected left atrial myxoma, and 3 patients underwent operation for aortic regurgitation with ascending aortic aneurysm. The operative mortality rate was 1.2% in acyanotic cardiac patients, 11.8% in cyanotic cardiac patients, and 6.9% in acquired cardiac patients, with overall mortality rate 4.2%.

• Journal of Chest Surgery
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• 제23권1호
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• pp.22-32
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• 1990

Postoperative cardiac performance of cyanotic congenital heart disease is somewhat different from that of other cardiac diseases. For the evaluation of postoperative cardiac performance in the cyanotic congenital heart disease we measured cardiac output by thermodilution technique at 1, 4, 8, 12, 16, 20, 24, 36, 48 postoperative hours in 14 patients operated from Feb. 1989 to Nov. 1989 in The Department of Thoracic and Cardiovascular Surgery, Seoul National University Children`s Hospital. At the same time, we checked left atrial pressure [LAP], central venous pressure [CUP], and mixed venous oxygen saturation [SvO2] to detect correlation between them. Immediate postoperative cardiac index was 3.585 $\pm$ 0.945 L/min/m2, and it decreased maximally to 3.322$\pm$1.007 L/min/m2 at postoperative 16 hours. After then it increased and stabilized from 36 hours after operation, and its value was 4.426$\pm$1.358 L/min/m2. There were no correlations between cardiac index and left atrial pressure or central venous pressure. Between mixed venous oxygen saturation and cardiac index, there was no correlation in the early postoperative period but after postoperative 16 hours, there was significant correlation between them and correlation coefficients were 0.573 [16hrs], 0.743 [20hrs], 0.436 [24hrs], 0.560 [36hrs], 0.636 [48hrs], respectively. From these results, we concluded that in the corrective surgery of cyanotic congenital heart disease, cardiac performance was depressed in the early postoperative period. It improved from postoperative 16 hours, and stabilized from 36 hours after operation. During early postoperative period, mixed venous oxygen saturation should not be used as a predictor of cardiac performance but it could be used as a predictor of cardiac performance from 16 hours after operation.

• Journal of Chest Surgery
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• 제17권4호
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• pp.715-722
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• 1984

From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.

• 대한수의학회지
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• 제35권2호
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• pp.399-404
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• 1995

In order to clarify the significance of serum CPK for the diagnosis of the cardiac disease in ruminant, the fluctuation of serum total CPK activities and CPK isoenzyme fractions was examined before and after operation in Korean native goats with artificially induced cardiac injury. In the change of serum total CPK activities, those of experimental group were changed with higher values than those of control group and significant increase was found on 2-week after operation(P<0.05). In the fluctuation of serum CPK isoenzyme fractions, significant increase of both CK1 and CK3 fractions was observed on 2-week after operation in experimental group(P<0.05), but significant difference was not found in CK2 fraction between experimental and control groups. From these findings, it is considered that taking note of increase of not only serum total CPK activities but also CK1 and CK3 fractions is important for the diagnosis of traumatic cardiac disease in ruminant.

• Journal of Chest Surgery
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• 제19권4호
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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.

• Journal of Chest Surgery
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• 제26권10호
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• pp.804-807
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• 1993

We experienced a case of cardiac rhabdomyoma,which is incidentally found at perinatally checked sonography.The cardiac rhabdomyoma is the most common cardiac tumor of infants & children, and second most common cardiac tumor of all age groups, which is usually multiple in the case of 90%, invariably involves the ventricles affecting the left & right side equally. In more than fifty percents, the size of cardiac rhabdomyoma is enough large to threatening the life of newborn within 24hrs of birth. Cardiac rabdomyoma is actually a myocardial harmatoma rather than a true neoplasm,because of the finding of complete lack of mitotic activities. Recently,more advanved instruments such as ultrasonography or echocardiography allows to us early detection & surgical intervention of this tumor. In our case, the tumor was found at both ventricles, which occupied nearly total chambers of both ventricles. The patient was operated on 3 day after birth. The operation was removal of the tumor through left ventriculotomy and right ventriculotomy respectively. He expired in the immediate postoperative period due to low cardiac output syndrome, despite of massive inotropic agents.

• Clinical and Experimental Pediatrics
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• 제45권2호
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• pp.208-213
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• 2002

목 적 : 수술 중, 후의 심근 손상은 선천성 심질환에 대한 개심술 후 심장 기능 부전의 주원인이다. 이 연구에서는 심근 세포에서만 발견되는 cardiac troponinI를 측정함으로서 수술 중, 후 심근 손상 정도와 회복 여부를 반영할 생화학적 표지자로서의 가치를 확인하고자 하였다. 방 법: 2001년 4월부터 7월까지 선천성 심질환으로 진단받고 개심술을 위해 본원에 입원한 환아 34명을 대상으로 하였다. Cardiac troponin I 치의 측정을 위해 술전 24시간 이내, 술후 1, 2, 3, 7일째에 각각 채혈을 시행했고, CPB 시간, ACC 시간, 기도 삽관시간, 수술 후 입원 기간을 측정하였다. 결 과 : Cardiac troponin I 치는 수술 후 1일째가 수술 전에 비해 유의한 증가가 있었고, 2, 3, 7일째에는 점차적으로 유의한 감소를 보였다. 심질환 별로는 수술 후 1일째 대혈관 전위에서 cardiac troponin I 치가 가장 높았고, 활로씨 4징, 방실중격결손, 심실중격결손, 심방중격결손 순으로 높은 치를 나타내었다. 심장폐 우회술 시간이 길수록, ACC 시간이 길수록 수술 후 1일째 cardiac troponin I 농도가 높았고, cardiac troponin I 농도가 높을수록 기도삽관 시간이 길었으나 입원 기간과는 상관관계가 없었다. 결 론: 개심술 후 시간에 따라, 개심술을 시행한 심질환에 따라 cardiac troponin I 농도의 의미 있는 증가와 점차적인 감소를 보임으로써 cardiac troponinI는 개심술 후 심근 손상의 정도 및 심근 손상에서의 회복 여부를 반영하는 생화학적 표지자로 가치가 있을 것으로 생각된다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1185-1191
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• 1992

Cell mediated immunity is depressed following surgical procedure and the degree of immunosuppression is directly related to the magintude of the procedure, blood transfusion, and length of operation. So we would expect cardiac operations to be highly immunosuppressive, although little is konwn about their immunosuppressive effect. The nearly complete consumption of complement factors and decreased levels of IgM and IgG resulting in an impaired opsonizing capacity. Additionally, peripheral blood mononuclear cell counts including T-and B-lymphocytes and T-cell subsets are reduced. Depression of cell-mediated immunity following open-heart surgery is potentially detrimental because it could increase the susceptability of patients to viral and bacterial infection. We reviewed 20 patients after cardiac operation to search for changes in peripheral blood lymphocyte subsets. Lymphocyte subsets were measured by flow cytometer and the preoperative values of lymphocyte subsets were compared with those from the first, fourth, and seventh days after operation. After cardiac operation, total mumbers of T lymphocyte was severely depressed on the first postoperative day and returned to the preoperative level by the seventh day after operation. CD3, CD4, and CD8 lymphocytes were decreased on the first postoperative day and returned to the preoperative level by the seventh day also. There was four cases of wound infection and these patients had increased CD4 lympocyte and more decreased CD19 lymphocyte compared with the non-infected group. It is concluded from these data that cell-mediated immunity is significantly depressed for at least one week following open-heart surgery and this result was closely related to the postoperative infection.