• Journal of Chest Surgery
• /
• v.17 no.2
• /
• pp.189-196
• /
• 1984

Although the conventional methods of cardiopulmonary bypass for open heart surgery have been employed, it has been usual method to repair of congenital heart disease in infancy using deep hypother-mia and circulatory arrest technique. In 1980, we reported total correction of congenital heart disease using surface induced hypothermia-total circulatory arrest and rewarming with limited cardiopulmonary bypass. in 1981, three patients below 10 kilogram, who had ASD and PDA, and two of VSD with pulmonary hypertension were operated on using simple deep hypothermia without cardiopulmonary bypass. During surface cooling, there were no ventricular fibrillation and arrhythmia. There were no difficulties to resuscitate the heart. Postoperative respiratory and neurologic complication were not occurred. Follow up examination for two to three years gave no evidence of cerebral damage due to circulatory arrest.

• Journal of Chest Surgery
• /
• v.25 no.5
• /
• pp.526-532
• /
• 1992

The effect of cardiopulmonary bypass on platelet count and function was studied in 20 patients who underwent cardiac operation from April 1991 to August 1991 at the Department of thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. Ten patients were perfused with a bubble oxygenator, 10 with a membrane oxygenator. During and after bypass, platelet counts decreased in both groups and significantly reduced in those perfused with a bubble oxygenator. All 20 patients studied for platelet functions had an abnormal postoperative aggregation response to collagen and epinephrine, but no significant difference in both groups. One hour after bypass, bleeding times increased in both groups but did not differ significantly between groups. Postoperative 24 hour blood losses were significantly higher in patients perfused with a membrane oxygenator. Platelet damage and postoperative blood loss are less severe after cardiopulmonary bypass performed with a membrane oxygenator than with a bubble oxygenator.

• Journal of Chest Surgery
• /
• v.24 no.3
• /
• pp.253-260
• /
• 1991

The adequacy of anticoagulation with heparin during cardiopulmonary bypass, and precise neutralization with protamine at the conclusion of cardiopulmonary bypass, were important. In sixty children undergoing cardiopulmonary bypass, ACT and heparin dose-response curve were studied. Total dose of heparin before bypass were 2.80$\pm$0.74 mg/kg and the amount of protamine administered after bypass were 3.0$\pm$1.23 mg/kg. So protamine: heparin ratio was 1.07: l.c After administration of protamine which dose is calculated with heparin dose-response curve, ACTs were returned to normal range[mean 114.8 $\pm$13 second]. The heparin sensitivity and its half-life do not have relationship with age, weight, height, surface area and urine amount during operation. And there are too much individual variations in heparin sensitivity and its half-life. So conventional heparin protocols can overestimate or underestimate the amount of heparin and protamine. Heparin dose-response curve makes it possible to maintain anticoagulation in a safe range during bypass with adequate amount of heparin individually. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine amount of protamine needed for neutralization of the heparin. But heparin dose-response curve to be used clinically, further studies will be needed about relationship between ACT and heparin level in the high range, influence of hemodilution and hypothermia to ACT and discrepancy between true adequate amount of protamine and calculated amount by heparin dose-response curve.

• Journal of Chest Surgery
• /
• v.29 no.11
• /
• pp.1267-1269
• /
• 1996

Coronary artery bypass grafting without cardiopulmonary bypass is now one of accepted technique of myocardial revascularization. This technique is an alternative method for patients with lesions in the left anterior descending coronary artery and right coronary artery. We report a case of coronary artery bypass grafting without cardiopulmonary bypass or cardiac arrest.

• Journal of Chest Surgery
• /
• v.28 no.1
• /
• pp.1-6
• /
• 1995

• Journal of Chest Surgery
• /
• v.46 no.5
• /
• pp.380-382
• /
• 2013

• Journal of Chest Surgery
• /
• v.23 no.6
• /
• pp.1152-1157
• /
• 1990

Colloid solution is commonly used to increase the oncotic pressures of priming solutions used in the cardiopulmonary bypass circuit. To study the effectiveness of this practice, we retrospectively evaluated 24 patients undergoing cardiac operations to receive isoelectric solution plus 50 gm of albumin[group A], isoelectric solution plus 25 gm of albumin[group B] and isoelectric solution without albumin[group C] as the prime solution for the bypass circuit. Various clinical parameters related to the perioperative fluid balance, cardiopulmonary function, and renal function were studied. There were no differences between the three groups with regard to postoperative clinical parameter of cardiopulmonary, liver function and renal function. But at the previous report by Cho et al. [38], there was a significant difference between groups with regard to hematologic property, especially in crenated red blood cells. These hematologic events did not affect the clinical outcome but thorough evaluations are needed in order to prove the clinical effect of crenated red blood cell. We conclude that there is no clinically detectable advantage for the routinely supplementing of albumin to the priming solution of bypass circuit in cardiac operations. Whether this practice can be of value in selected cases needs to be further studied.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.12
• /
• pp.1657-1663
• /
• 2000

The authors report a case of a 72-year-old woman who presented with intraventricular and subarachnoid hemorrhage of Hunt and Hess grade IV after the rupture of a giant aneurysm arising from the right internal carotid artery. The aneurysm was clipped successfully with the aid of cardiopulmonary bypass(closed chest method), deep hypothermic circulatory arrest, and cerebral protection with barbiturate resulting in moderate disability. We discuss the usefulness and problems related to technique of circulatory arrest and cardiopulmonary bypass using closed chest method, and suggest the possible benefits of open chest method in elderly people and the importance of preoperative plan to coordinate anesthesia and operation.

• Journal of Chest Surgery
• /
• v.39 no.1 s.258
• /
• pp.60-63
• /
• 2006

Vasodilatory shock has been implicated in life-threatening complications after cardiac surgery. This syndrome may result from the vasopressin deficiency following cardiopulmonary bypass (CPB), which do not respond to fluids or usual intravenous inotropes. We used arginine-vasopressin in adults with vasodilatory shock coming on cardiopulmonary bypass. Therefore, we report these cases with a review of articles.

• Journal of Chest Surgery
• /
• v.16 no.2
• /
• pp.175-183
• /
• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.