• Journal of Chest Surgery
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• 제19권1호
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• pp.122-133
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• 1986

Thirteen patients with cyanotic cardiac malformations having more complex intracardiac defects, hemodynamics and operative procedures than ones in Tetralogy of Fallot undertaken total surgical corrections from July 1981 to August 1985. The cases of corrective surgery for complex cardiac malformations were 3.9% of all congenital cardiac malformations and 12.6% of cyanotic cardiac malformations. Six patients died within 30 days after surgery. So operative mortality was 46%; Transposition of the great arteries, two of 4 patients, due to low cardiac output syndrome and tracheal bleeding ; Univentricular heart, one of 3 patients, due to bleeding; Corrected transposition of the great arteries, one of 2 patients, due to acute heart failure; Tricuspid atresia, one of 2 patients, due to low cardiac output syndrome; Double outlet right ventricle, one of single patient, due to respiratory failure. The cases of surgical correction for complex cardiac malformations are progressively increasing in numbers. The more accurate evaluation of anatomical condition and hemodynamics in preoperative diagnosis, studies on applicable surgical procedure and perioperative care of patients are necessary in the improvement of clinical and surgical results.

• Journal of Chest Surgery
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• 제5권1호
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• pp.29-34
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• 1972

Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

• Journal of Chest Surgery
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• 제19권3호
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• pp.429-432
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• 1986

Cardiac myxoma is most significant benign tumors constituting nearly 50% of all primary cardiac tumors. Its diagnosis is important because prognosis is excellent by surgical therapy and is usually fatal if unrecognized and untreated. Recently the development of diagnostic procedure and cardiac surgery increased the accuracy of diagnosis and the opportunity of successful treatment. Two cases of left atrial myxoma removed successfully were presented.

• 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 Yeungnam Medical Science
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• 제36권3호
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• pp.260-264
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• 2019

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

• 대한핵의학회지
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• 제33권3호
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• pp.273-281
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• 1999

목적: 우리는 비심장 수술 환자에서 수술전후의 심장사건의 위험도를 평가할 때 미국 순환기학회/미국 심장학회(이하ACC/AHA)에서 제시한 임상적 여러 지표에 더하여 심근관류 SPECT가 도움되는지 연구하였다. 대상 및 방법: 1997년에 비심장 수술을 시행한 118명(혈관수술 18, 비혈관수술 100)을 대상으로 수술 전에 휴식 T1-201/부하 Tc-99m MIBI 심근관류 SPECT를 시행하고 중한 심장사건과 경한 심장사건의 발생을 조사하였다. 임상적 지표, 운동능력, 수술 종류에 따라 분류한 것의 심장사건 예측률과 심근관류 SPECT 소견을 가역관류감소, 지속관류감소, 정상으로 나누었을 때 심장사건 예측률을 조사하였다. 임상적 지표들에 대해 심근관류 SPECT가 부가 효용이 있는지 다변량 로짓 회귀분석을 하였다. 결과: 심장사건은 전체 환자의 21%에서 발생하였으며 심근관류 SPECT에 가역적 심근관류 이상이 있는 경우에 심장사건의 발생빈도가 높았다. 임상적 분류와 수술 종류도 사건 발생을 예측할 수 있었으나 다변량 분석에 수술 종류(p=0.0018)와 심근관류 SPECT 소견(p=0.0001)이 유의한 예측지표이었다. 심근관류 SPECT 결과가 수술 종류에 따른 위험 예측을 더욱 계층화할 수 있었다. 결론: 비심장수술 환자에서 수술 종류에 더하여 심근관류 SPECT가 심장사건 발생을 예측하는 유용한 지표이었다.

• Journal of Chest Surgery
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• 제50권3호
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• pp.171-176
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• 2017

Background: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. Methods: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was $8{\pm}11$ (high risk). Results: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow‐up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium ($53.4{\pm}7.5cm$) and the 19 patients who did not have reduction plasty ($48.7{\pm}5.7cm$). Conclusion: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.

• Journal of Chest Surgery
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• 제48권2호
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• pp.99-104
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• 2015

Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were $194.8{\pm}48.6$ minutes and $126.1{\pm}22.6$ minutes in mitral valve repair operations and $132.0{\pm}32.0$ minutes and $76.1{\pm}23.1$ minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was $128.3{\pm}43.1$ minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

• Journal of Chest Surgery
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• 제56권3호
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• pp.186-193
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• 2023

Background: Complete surgical excision is the only curative treatment for primary cardiac tumors. For wide excision, interatrial septal reconstruction (ISR) is commonly performed. We hypothesized that ISR may increase the risk of postoperative atrial tachyarrhythmia (AT) after surgical resection of cardiac myxoma. Methods: After excluding patients with a history of cardiac surgery and concomitant procedures unrelated to tumor resection and those with AT or permanent pacemakers, we finally enrolled 272 adult patients who underwent benign cardiac tumor surgery from 1995 to 2021 at our institution. They were divided into the ISR (n=184) and non-ISR (n=88) groups. The primary outcome was postoperative new-onset AT. Results: The study cohort predominantly consisted of women (66.2%), with a mean age of 57.2±13.6 years. The incidence of postoperative new-onset AT was 15.4%. No 30-day mortality or recurrence was observed. The cardiopulmonary bypass time and aortic cross-clamping time were significantly longer in the ISR group than in the non-ISR group (p<0.001). The median duration of hospital stay of all patients was 6.0 days (interquartile range, 5.0-7.0 days), and no significant difference was observed between the 2 groups (p=0.329). ISR was not an independent predictor of new-onset AT (p=0.248). Male sex and hypertension were found to be independent predictors of new-onset AT. Conclusion: ISR was not a significant predictor of postoperative new-onset AT. ISR might be a feasible and safe procedure for surgical resection of cardiac myxoma and should be considered if needed.

• Journal of Chest Surgery
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• 제23권5호
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• pp.944-952
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• 1990

In 1989, We experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 27 years old male with mild dyspnea on exertion and easy fatigability. All clinical symptoms, physical examinations, laboratory findings, echocardiogram, cardiac catheterization and angiogram revealed supracardiac type T.A.P.V.D. drained through left innominate vein. Operation was done by manner of modified Schumacker procedure. The other case was 6 years old male with cardiac type drained to right atrium through coronary sinus. Two patients were well in postoperative 15 and 8 months.