• Journal of Chest Surgery
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• v.24 no.7
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• pp.647-655
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• 1991

The efficacy of cold blood potassium cardioplegia during periods of ischemic arrest was assessed in 88 patients undergoing open heart surgical procedures at Chonnam National University Medical School from December, 1987 to January, 1989. The purpose of this study was to determine if the aortic cross clamping time[ACCT] over 120 minutes correlated with operative mortality, incidence of postoperative ventricular tachyarrhythmias, needs of postoperative inotropic support and serum enzyme levels. The patients were divided according to aortic cross clamping time[less than 120 minutes and 120 minutes or greater]. The results were as follows: 1. The operative mortality was 3.2% in ACCT<120min group and 7.7% in ACCT>120 min group. 2. The incidence of postoperative ventricular tachyarrhythmia was 1.6% in ACCT <120min group and 11.5% in ACCT>120min group[p<0.05]. 3. The incidence of postoperative inotropic support in congenital heart disease was 13.0Fo in ACCT<120min group and 45.0%o in ACCT>120min group[p<0.05]. The incidence in acquired heart disease was 26.0% in ACCT<120min group and 40.0% in ACCT> 120min group. 4. After cardiopulmonary bypass, serum GOT, LDH, CPK and CPK - MB were elevated prominently. Children showed higher value of the enzymes examined than adults did before and after cardiopulmonary bypass. In congenital heart diseases, postoperative serum GOT, LDH, CPK and CPK - MB levels of ACCT>120min group were significantly higher than those of ACCT<120min group. Postoperative serum GOT, LDH and CPK - MB levels of ACCT>=120min group were significantly higher than those of ACCT<120min group also in acquired heart diseases. The results suggest that the myocardial protective effect with cold blood potassium cardioplegic solutions was not sufficient when the aortic cross clamping time was over 120 minutes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.9
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• pp.4437-4446
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• 2013

The purpose of this study was to development and evaluate the effects of cardiocerebrovascular disease prevention program for taxi drivers on physiological variables(blood pressure, blood sugar, serum lipids) and physical variables(body fat, muscle endurance, cardiopulmonary endurance, balance). This study consisted of two phases: developing the program and evaluating its effectiveness. 1 phase, 321 taxi drivers investigated a health condition and a life habit and an educational need and developed a program with the ground which will reach. 2 phases, The effectiveness of the program was tested in October 2011, with 51 taxi driver. The experimental group was given 12 weeks period exercise 1 weeks 3 time, disease education 4 time, 2 nutrition consultations. Although there was no significant reduction in blood pressure, heart rate, blood sugar, serum lipids, there were statistically significant increases in muscle endurance (t=-7.62 p<.001), cardiopulmonary endurance (t=-3.39, p<.001), balance(t=-4.13, p<.001) and decreased body fat (t= -3.11, p<.015) in before compared to after. These findings suggest that an integrated cardiocerebro-vascular disease prevention program improves physical fitness.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.23-29
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• 1979

Hyuk An, M.D.Atrial myxoma constitutes the most significant of all cardiac neoplasm. About 75% occur in the left atrium and 25% in the right. They may cause severe and progressive disease mimicking valvular heart disease. But recently attention to differential point in the clinical features along with various diagnostic techniques have allowed pre-operative diagnosis in the most cases. From April, `77 to Aug., `78, three cases of left atrial myxoma and one case of right atrial myxoma were operated in Seoul National University Hospital. Pre-operative diagnosis was established with echocardiography and cardiac angiography. In all cases, tumors were resected with cardiopulmonary bypass successfully, and discharged with good results.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.158-161
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• 1990

A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.98-106
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• 1982

Cardiac Myxoma is a most frequent benign tumor in primary cardiac tumors. About 75% occur in the left atrium & 20% in the right atrium, ventricular Myxoma is a very rare one among the cardiac myxoma. They may cause severe and progressive disease resembling valvular heart disease. With the advent of various diagnostic modalities, especially real time bidimensional echocardiography enabled us more accurate diagnosis of cardiac myxoma noninvasively and preoperatively. From April 1977 to Sept. 1981, 16 cases of cardiac myxomas were operated in Seoul National University Hospital using cardiopulmonary bypass. There were 13 cases of left atrial myxomas and each of a case was right atrial and right ventricular and left ventricular one. In all cases tumors were resected successfully & were discharged in healthy state. Follow up results of each patient was excellent.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.548-551
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• 2014

Type II chronic dissecting thoracoabdominal aortic aneurysms are a surgically challenging disease. The conventional thoracoabdominal aortic aneurysm repair technique using cardiopulmonary bypass is a high-risk procedure. However, a recently developed endovascular technique may be an alternative treatment for the disease, but faces the obstacle of lesional restriction. This new technique uses a hybrid strategy to overcome the limits of endovascular thoracoabdominal aortic aneurysm repair. Herein, we report on a successful outcome after performing the hybrid visceral debranching procedure.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.58-64
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• 1978

Left atrial myxoma, an unusual clinical entity, may cause severe and progressive cardiac disease mimicking mitral valvular disease. In recent years, increased clinical awareness and improved diagnostic techniques has led to a higher incidence of correct preoperative diagnosis. Recently we experienced 2 cases of left atrial myxoma, which were removed successfully under the cardiopulmonary by pass. The first case was 45 years old woman and the second was 23 years old female. Preoperative definite diagnosis was entertained by angiocardiography and echocardiography in both cases. In the first case, tumor was removed with left atriotomy and atrial septectomy was done with additional right atriotomy. In the second case, tumor and atrial septum were removed en bloc through the right atrium. Both patients were discharged with good results 2 weeks postoperatively.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.418-425
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• 2009

Background: Cardiopulmonary bypass (CPB) involves use of an initial priming volume which can cause side effects such as hemodilution, transfusion, inflammatory reaction and edema. Hence, there have been efforts made tore-duce the initial priming volume. We compared this traditional method to a CPB method that uses a minimized priming volume (MPV). Material and Method: For 97 patients who underwent congenital cardiac surgery between July 2007 to June 2008, we discussed each case and decided which method to use. We reviewed the medical records and cardiopulmonary bypass sheets of the patients. Result: We used a MPV method for 46 patients, and a traditional method for the other 51. There were no significant differences in preoperative and intraoperative characteristics between the two groups, such as body weight, age, cardiopulmonary bypass time, lowest body temperature, etc. However, the priming volume was much smaller in the MPV group than the traditional group (p<0.001). The volume of initially mixed packed RBC was also much smaller in the MPV group (p<0.001). There were no significant differences in postoperative mortality and neurologic complications. Conclusion: We could significantly reduce the initial priming volume and initially mixed pRBC volume with the revised CPB method. We suggest that this method be used more widely for congenital cardiac surgery.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.9
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• pp.146-155
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• 2018

This study was conducted to evaluate the clinical outcomes of coronary artery bypass surgery for ischemic heart disease according to use of a cardiopulmonary bypass machine. The subjects were 10,981 patients who underwent coronary artery bypass grafting for ischemic heart disease from July 2008 to June 2012. Analysis data were retrospectively collected using health insurance claims data. The results of the study showed that mean time to surgery (280 min vs 357 min, p<0.0001) and intubation time (about 24 hours vs 40 hours, p<0.0001) were significantly shorter in the Off-Pump CABG (OPCAB) group than in the On-Pump CABG (ONCAB) group. The rate of reoperation because of postoperative bleeding and hematoma was lower in the OPCAB group (2.7% vs 8.3%, p<.0001). The odds ratio of risk adjusted 30 days mortality rate was 0.339 (0.266-0.434) and the postoperative length of stay was decreased in the OPCAB (p<0.0001). Overall, the 30 days mortality and reoperation rates were lower in the OPCAB, as was the resources use.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.4
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.