• Journal of Chest Surgery
• /
• v.33 no.8
• /
• pp.681-683
• /
• 2000

A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.

• Journal of Chest Surgery
• /
• v.46 no.5
• /
• pp.373-376
• /
• 2013

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.213-218
• /
• 1996

Total anomalous pulmonary venous return (TAPVR) is very rare congenital heart disease. 25-year old male was admitted our hospital with dyspnea, headache and syncope as chief complaint. He was confirmed as mixed type TAPVR by echocardiography and cardiac catheterization. In this case, mixed type TAPVR was consisted with supracardiac type connection of left pulmonary vein and cardiac type of right pulmonary vein. Supracardiac type of left pulmonary common channel was anastomosed to the left auricular appendage during total cardiopulmonary bypass with fibrillating heart. Cardiac type of right pulmonary vein was operated during moderate hypothermia and aortic cross clamping. Coronary sinus septum was incised into ASD and closed with Gore-Tex patch so that right pulmonary blood flow directed to the left atrium. The patient's post-operative course was uneventful.

• Journal of Chest Surgery
• /
• v.16 no.3
• /
• pp.316-321
• /
• 1983

Left ventricular-right atrial [LV-RA] shunt is a relatively uncommon defect but is being encountered with increasing frequency. The diagnosis is often not suspected on the basis of clinical findings and so the specific anatomic diagnosis depends upon the use of selective left ventriculography. Recently we experienced LV-RA shunt associated with PDA, which was underwent successful surgical correction under the cardiopulmonary bypass. On the preoperative diagnosis coexistence of PDA was overlooked and identified at the time of operation. The type of LV-RA shunt was supravalvular, which was closed by direct suture with pledget.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.711-717
• /
• 1985

Over a period from July 1984 to June 1985, 39 cases of open heart surgery were done under cardiopulmonary bypass. There were 23 male and 16 female patients, ranging in age from 18 months to 58 years. Thirty cases were valvular disease. The most common of congenital heart disease is VSD. Among the 9 cases of acquired valvular diseae,1 MAP, 5 MVR, 2 MVR+TAP, and 1 MVR+AVR were done. There were 1 operative death[11%] which was done MVR+TAP. Operative mortality in 30 congenital heart disease was 7%; 1 death [5%] in 22 acyanotic and 1[13%] in 8 cyanotic cases. Finally, overall mortality for 39 cases was 8%; 7% for congenital heart disease and 11% for acquired heart disease.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.716-720
• /
• 1988

Since Krause first described coronary arteriovenous fistula in 1865, there have been nearly 300 additional patients with this malformation reported in the literature. Increasing numbers of patients with this anomaly are being recognized each year resulting from the widespread use of cardiac catheterization and selective coronary arteriography in the evaluation of a variety of cardiac problems. A 9 month old male was admitted with the chief complaint of cardiac murmur and frequent URI and diagnosed as coronary A-V fistula at the distal portion of left anterior descending coronary artery to the apex of the right ventricle by cardiac catheterization and aortography. On the operative field, the left anterior descending coronary was markedly dilated about 1.5 cm in diameter from the aorta to the apex of the heart. The fistula opening was closed with 5-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia[28*C]. Postoperative course was uneventful and the patient was discharged without problem.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.721-726
• /
• 1988

Congenital supravalvar aortic stenosis is an obstruction caused by localized or diffuse narrowing of the aortic lumen commencing immediately above the aortic valve. We experienced a case of diffuse supravalvar aortic stenosis involving ascending aorta from just above the sinuses of Valsalva to the proximal l cm of the innominate artery. Supravalvar aortic stenosis in this patient, in contrast to the form seen in infants and children, was not associated with mental retardation, peculiar faces or the syndrome of hypercalcemia. Diagnosis was confirmed by retrograde left heart catheterization and left ventriculography. Surgical correction was performed by the replacement of oval shaped Woven Dacron patch over the narrow segment of aorta under the cardiopulmonary bypass. Blood pressure was controlled sufficiently with some adjunct of Inderal postoperatively. The patient was discharged with much improvement.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.613-618
• /
• 1988

The exposure of blood to foreign materials can cause the denaturation of plasma protein components such as immunoglobulins and complements. And those phenomena increase the morbidity and mortality after intracardiac operations through the cardiopulmonary bypass. From April, 1987 to September, 1987, we had observed the serial changes of plasma total protein IgG, IgA, IgM, complements[C3, C4] in bubble oxygenator group[n=5] and membrane oxygenator group[n=5]. Statistically significant difference between two groups were present in total protein and C3. We conclude that using membrane oxygenator in long extracorporeal circulation can reduce the activation of alternative pathway of complement system, and which can reduce post-perfusion complications of the lung though we can`t prove it in mass populations.

• Journal of Chest Surgery
• /
• v.32 no.12
• /
• pp.1111-1114
• /
• 1999

Cor triatriatum is a rare congenital heart disease that is often lethal in children if not correctly identified and properly managed, Characteristically an anomalous membrane divides the left atrium into two chambers one located posterosuperiorly which is connected to the common pulmonary venous trunk and the other anteroinferiorly which is connected to the left atrial appendage and the mitral valve. Eight patients with Cor triatriatum were been seen at our hospital from 1984 to 1999. The clinical presentation diagnostic evaluation and surgical results are outlined in this retrospective review. Resection of the obstructing anomalous atrial membrane was performed using a hypothermic cardiopulmonary bypass in all cases. Right atriotomy was performed in all patients and left atriotomy was performed in a patient who had poor preoperative general conditions and serious cardiac defects(TAPVR & hypoplastic left ventricle) died of low cardiac output during the immediate postoperative period. The postoperative course has been excellent in the remaining. Cor triatriatum is amenable to surgical repair with excellent results when diagnosed early and in those who are not complicated by other complex cardiac anomalies.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1398-1400
• /
• 1996

The cardiac anatomic position immediately beneath the sternum leaves it vulnerable to injury when this bone is fractured. Cardiac rupture, however, is uncommon but survival following this injury is rare. We report the case of one patient who survived right ventricle perforation resulting from sternal fracture. The patient developed signs of pericardial tamponade and was brought to the operating theatre immediately for surgery through the emergency anterolateral thoracotomy Perforation of th right ventricle was repaired by direct closure without cardiopulmonary bypass. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and surgery.