• Journal of Chest Surgery
• /
• 제6권1호
• /
• pp.63-68
• /
• 1973

Two patients operated upon for tricuspid atresia by Glenn operation are presented. They were five years old and four years old females who were cyanotic shortly after birth, and remained cyanotic. On physical examination, cyanosis on digits and lips, clubbing of fingers, thrill and grade III systolic murmur on 4th I.C.S. along left sternal border were noted. In the first case, chest roentgenograms showed normal pulmonary markings, and the electrocardiogram was interpreted as showing left ventricular hypertrophy with left axis deviation and peaked P-wave in lead IL Right heart catheterization showed high pressure in right atrium and the catheter tip was easily inserted into the left atrium through septal defect. In the second case, chest roentgenograms showed cardiomegaly with sparse pulmonary vascular markings and narrowed vascular pedicle, and the electrocardiogram showed left ventricular hypertrophy with some element of right atrial hypertrophy. Angiocardiogram showed changes characteristic of tricuspid atresia, including "right ventricular window" The findings of right heart catheterization were similar to those of first case. On the basis of these observations, they were diagnosed as tricuspid atresia, and Glenn operation was performed. Normal position of great vessels combined with ventricular septal defect and pulmonary stenosis were noted on the first case, and on second case, transposition of great vessels was additional finding. Postoperative course was uneventful and favorable outcome was obtained.

• Clinical and Experimental Pediatrics
• /
• 제56권2호
• /
• pp.90-93
• /
• 2013

Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.

• 한국임상수의학회지
• /
• 제18권4호
• /
• pp.452-454
• /
• 2001

A two-month-old female Yorkshire terrier was referred to the Veterinary Teaching Hospital, College of Veterinary Medicine, Kyungpook national University. The patient was presented with a history of dyspnea, cough, exercise intolerance and abdominal distension, but she was appetence. In physical examination the puppy was coughed on slight tracheal compression. Rectal temperature, pulse and respiratory rate were normal, and grade 3/6 systolic murmur heard at the left heart base. The murmur was crescendo-decrescendo. Electrocardiography showed sinus arrhythmia, right-ventricular hypertrophy pattern, and right axis deviation. Thoracic radiography revealed cardiomegaly, bulging of the main pulmonary artery, and enlarged left side heart. Abdominal radiography revealed abdkominal distention. Echocardiography showed hypertrophy of right ventricle and turbulence in the pulmonary artery in parasternal oblique view. Subvalvular pulmonic stenosis was diagnosis based upon the clinical signs, physical examination, electrocardiography, radiography and echocardiography. We treated the patient with furosemide, enalapril and $\beta$-blocker. After the clinical signs of cough, abdominal distension and dyspnea were disappeared, she was on just $\beta$-blocker for prevention of occurrence of congestive heart failure. Now she was recovered her health, and she is not on any medication.

• Journal of Chest Surgery
• /
• 제22권2호
• /
• pp.234-245
• /
• 1989

Between January 1984 and December 1986, sixty nine patients, aged 16 months to 25 years [mean age 10.05*6.40 years], underwent total correction of tetralogy of Fallot in Kyungpook national university hospital. In 66 hospital survivors, 30 patients were followed up for 12 to 48 months [mean 30.10*10.26 months]. These 30 patients were classified in two groups, TAP [transannular patch] and Non-TAP group. There were 9 patients in TAP group, and 21 in Non-TAP group. There were no significant differences between two groups in terms of age at operation, follow up duration, ACC time, and bypass time. All patients were evaluated by two dimensional echocardiography, Doppler echocardiography, standard 12-lead electrocardiography, and plain chest X-ray. Right ventricular systolic pressure, pulmonary arterial systolic pressure, pressure gradient between the right ventricle and the pulmonary artery, presence or absence of pulmonary regurgitation and its grading, fractional shortening of the left ventricle, and Qp/Qs in case of remnant ventricular septal defect were obtained by echocardiographic examination. Cardiothoracic ratio was measured by plain chest film, and ventricular dysrrhythmia was detected by electrocardiogram. Comparing the data between two groups, there was significant difference in incidence of postoperative pulmonary regurgitation [p< 0.05], 100%[9/9] in TAP group and 47.6 %[10/21] in Non-TAP group, but all the regurgitations were not severe. There were no significant differences in other comparisons, despite of higher incidence of cardiomegaly in TAP group [CT ratio: 59.3*5.3% VS 54.7*6, 4 %].

• Journal of Chest Surgery
• /
• 제14권2호
• /
• pp.140-143
• /
• 1981

Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

• Journal of Chest Surgery
• /
• 제14권2호
• /
• pp.135-139
• /
• 1981

Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

• Journal of Chest Surgery
• /
• 제14권3호
• /
• pp.254-259
• /
• 1981

This is a case of successfully surgically treated RVOT obstruction caused by projection of the herniated aortic cusp through subpulmonic supracristal VSD at Department of Thoracic and Cardiovascular Sugery, Hanyang University Hospital. The patient was a 17 year old boy. Congenital heart anomaly was suspected at 2 years of his age. He had palpitation, dyspnea on exertion and epistaxis for 2 years prior to admission to our hospital. On examination, the blood pressure was 170/0mmHg. And the pulse rate was 100/rain. Widening of pulse pressure, water hammer pulse [bounding pulse]. To and fro murmur and head nodding were noted. Cardiomegaly was seen in chest x-ray. EKG, Echocardiography, Cardiac catheterization and angiocardiography were performed. On April 27, 81. Open heart surgery was performed under the impression of VSD combined with AI. On Rt. ventriculotomy, we noticed RVOT obstruction caused by prolapsed rt coronary cusp through a VSD. The subpulmonic supracristal VSD measuring 2.5 x 3 Cm in diameter was closed with Teflon patch graft and then the prolapsed aortic leaflet was plicated by placing three 8-figure suture between the free edge and the base of the leaflet through transverse aortotomy. After operation, excellent result was obtained: B.P, was 110/50mmHg and any sign of AI or residual shunt was not found at discharge.

• Journal of Chest Surgery
• /
• 제24권7호
• /
• pp.701-711
• /
• 1991

We experienced 6 cases of primary cardiac tumor, all received operation for removal of tumor. Mean age was 43.8 years-old ranging from 17 years-old to 66 years-old. Five cases were female, one case was male. Five cases were benign, myxoma, all located within left atrium. One case was malignant, angiosarcoma within right atrium. All patient showed cardiac manifestations. One case was in NYHA functional class II, two were in III, three were in IV. Four patients showed constitutional symptoms, but no one showed evidence of embolic phenomenon. All case of myxoma showed cardiomegaly except one malignancy. Only one case was regular sinus rhythm, three were sinus tachycardia 8z two were atrial fibrillation. The most common site of tumor origin was fossa ovalis limbus[four of all]. Two of five myxomas received emergency operation, one patient died postoperatively. Lived four patients showed no evidence of recurrence[mean follow-up, 3,5 years], but one patient has Grade II /IV mitral regurgitation & in OPD follow-up now, One malignant case, 17 years-old cerebral palsy female, was angiosarcoma occupied most of right atrial chamber originated from anterior wall of right atrium, received emergency operation which was removal of mass & reconstruction of right atrium with artificial pericardial patch. This patient died on postoperative 36th day due to persistent LCOS[low cardiac output syndrome] with combined sepsis.

• Journal of Chest Surgery
• /
• 제30권11호
• /
• pp.1125-1127
• /
• 1997

본 8kg, 18개월 환아는 다른 병원에서 심실 중격 결손증 수술을 받았으며 수술후 합병증으로 약물치료를 받아 왔으나 심실 비대와 심부전증이 악화되었으며 본원에서 시행한 심도자 결과 좌심실과 대동맥간 혈압 차이는 55mmHg를 보였다. 본원에서는 이와 같은 소아에서의 심실 중격 결손증 수술후 발생한 대동맥 판막하 협착증의 성공적 수술 증례를 보고하는 바이다.

• Clinical and Experimental Pediatrics
• /
• 제55권1호
• /
• pp.24-28
• /
• 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.