• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.787-792
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• 1995

The obstruction of inferior vena cava(IVC) is uncommon condition. The classification is based on the obstructive sites of major anatomic segments of IVC. The main collateral pathways of interruption of IVC were central channels through ascending lumbar veins, intervertebral veins and azygos-hemiazygos complex. However, the complete obstruction of mid-portion of IVC, accompanying collateral cirulation with pericardiacophrenic vein was rarely reported. We had experienced a case of complete obstruction of mid-portion of IVC with lobulated left cardiac border, which was unforgettable characteristic finding on chest radiograph. It was confirmed by venographic examination that the lobulated left cardiac shadow was a collateral circulation of pericardiacophrenic vein.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.661-666
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• 1989

Congenital coronary arterial fistulae are the most prevalent hemodynamically significant congenital coronary artery malformations. Definition of congenital coronary arterial fistula is a direct communication between a coronary artery and the lumen of one of the four cardiac chambers or coronary sinus or SVC, pulmonary artery or pulmonary vein close to the heart. It is often associated with additional congenital or acquired heart disease. A 49 year old male patient was admitted with the chief complaints of anginal pain and exertional dyspnea for 9 months. He was diagnosed as the right coronary arterial fistula combined with right coronary arteriosclerotic stenosis and old inferior myocardial infarction by cardiac evaluation. The right coronary arterial fistula was communicated between the just distal portion of acute marginal branch and coronary sinus. The operative procedure was as followings; after suture ligation of fistula opening in the coronary sinus under beating heart, coronary arterial bypass grafting with saphenous vein was performed at the just proximal portion of the posterior descending branch under cardiopulmonary bypass. The postoperative course was uneventful and he was discharged without anginal pain at the 8th postoperative day.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.948-953
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• 1988

A technique applicated for physiologic correction of complex congenital cardiac disease suitable for Fontan procedure in which drainage of left superior vena cava and hepatocardiac vein to left atrium combined is described. We made one systemic venous baffle from left hepatocardiac vein to left superior vena cava and another systemic venous baffle from right inferior vena cava to the right superior vena cava with rigid prosthetic material[0.5mm thickness PTFE patch]. And then we anastomosed directly between the right sided atrial appendage and right pulmonary artery, and left-sided atrial wall beneath the appendage and left pulmonary artery. We believe that this procedure is superior to the method using intraatrial tube graft to divert the left hepatocardiac venous blood to right atrium, and applicable for physiologic correction of any complex congenital cardiac disease suitable for Fontan-type procedure in which anomalies of systemic venous drainage combined.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.403-407
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• 2020

To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1401-1404
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• 1996

Central venous line insertion is an essential procedure in a cardiac operation. For this, percuteneous Insertion is usually done in the internal jugular vein or the subclavian vein. However, this method can create such complications as pneumothorax and hemothorax, and repeated failure in inserting the cathet r, especially in infant and child patients, can waste excessive time. Consequently, in our hospital, catheterization of the innominate vein was done after the completion of sternotomy in the cardiac operation of infant and child patients weighing under 1 Okg. During operation, the catheter was placed in the left atrium through the foramen ovate or pulmonary artery to be used for pressure monitoring. When the patient's hemodynamic became stabilized, the catheter was withdrawn to either the right atrium or superior vena casa to be used as the channel for fluid replacement or drug administration. In our hospital, this procedure has been used in 96 cases since 1989. No complications such as pneumothorax and hemothorax occilrred, and neither bleeding after the removal of the catheter was seen.

• Clinical and Experimental Pediatrics
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• v.55 no.1
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• pp.24-28
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• 2012

Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

• Korean Circulation Journal
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• v.53 no.5
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• pp.273-293
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• 2023

Pulsed field ablation (PFA) was recently rediscovered as an emerging treatment modality for the ablation of cardiac arrhythmias. Ultra-short high voltage pulses are leading to irreversible electroporation of cardiac cells subsequently resulting in cell death. Current literature of PFA for pulmonary vein isolation (PVI) consistently reported excellent acute and long-term efficacy along with a very low adverse event rate. The undeniable benefit of the novel ablation technique is that cardiac cells are more susceptible to electrical fields whereas surrounding structures such as the pulmonary veins, the phrenic nerve or the esophagus are not, or if at all, minimally affected, which results in a favorable safety profile that is expected to be superior to the current standard of care without compromising efficacy. Nevertheless, the exact mechanisms of electroporation are not yet entirely understood on a cellular basis and pulsed electrical field protocols of different manufactures are not comparable among one another and require their own validation for each indication. Importantly, randomized controlled trials and comparative data to current standard of care modalities, such as radiofrequency- or cryoballoon ablation, are still missing. This review focuses on the "pearls" and "pitfalls" of PFA, a technology that has the potential to become the future leading energy source for PVI and beyond.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.207-211
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• 2000

Backgroud: Conventional cardiac transplantation with each atrial anastomosis designed by Shumway and associates has been used widely in cardiac transplantation because of its simplicity and efficiency. There have been many reports about the postoperative atrioventricular value regurgitation resulting from the alteration in atrial geometry after cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was introduced to overcome the those problems. We performed this study to test the feasibility of this new surgical technique prior to application to clinical practice. Material and Method: Conventional cardiac transplantation was performed on 12 mongrel dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data, and echocardiographic findings between two groups. Result : The cardiopulmonary bypass time and graft ischemic time were 119.0$\pm$4.4 minutes, 162.0$\pm$4.5 minutes respectively in group I, and 140.0$\pm$7.1 minutes, 180.5$\pm$5.4 minutes respectively in group II. The cardiopulmonary time and graft ischemic time in group II were longer than those of group I (p<0.05). There were 3 cases of failure to weaning from cardipulmonary bypass onein group I and two in group II, and this difference was not significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and 82%(group II), without statistical significant between 2 groups. Postoperative echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral regurgitation in group I, and no regurgitation of atrioventricular value in group II. Conclusion: Although these was no statistically significant difference between 2 groups, there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in group II. We suggested that the new surgical technique could be a useful strategy in heart transplantation, especially in the case of size mismatching between donor and recipient.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.528-533
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• 1986

Total anomalous pulmonary venous connection is relatively rare cyanotic congenital heart diaease, which represents 1-4% of all congenital cardiac defects. Generally in the majority cases, severe heart failure and cyanosis develops in the early infancy. Because of high mortality in the untreated infants and surgical risk, there are still many things to be improved. Two patients with total anomalous pulmonary venous connection are presented, which we recently experienced. The one was 10 year old female with supracardiac type drained through left innominate vein, and survived the operation and continuous to do well for 1 year. The other 5 year old female with mixed type (right pulmonary vein drained via coronary sinus and left pulmonary vein through left innominate vein) was operated successfully under hypothermia and extracorporeal circulation, and followed up for 6 months without problem. It was very rare case in the literature.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.356-360
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• 2021

Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.