• Title/Summary/Keyword: Cardiovascular protection

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Use of Embolic Protection Devices during Hybrid Thoracic Endovascular Aortic Repair for a Shaggy Aorta: A Case Report

  • Kim, Eun Chae;Lee, Jae Hang;Chang, Hyoung Woo;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.513-516
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    • 2021
  • An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV6 Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

Surgical Treatment of an Innominate Artery Aneurysm Using Near-Infrared Spectroscopy for Cerebral Monitoring: A Case Report

  • Jeon, Byeng Hun;Lee, Chul Ho;Bae, Chi Hoon;Jang, Jae Seok;Cho, Jun Woo
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.517-520
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    • 2021
  • Innominate artery aneurysms are challenging for surgeons to treat because of the requirement for brain protection during surgery. In innominate artery aneurysms, the endovascular approach does not require cardiopulmonary bypass, but patients who can be treated using this approach are limited in number, and the long-term results of endovascular treatment are unclear. Here, we report our experience of successfully treating a patient with an innominate artery aneurysm using near-infrared spectroscopy without cardiopulmonary bypass support or hypothermic circulatory arrest.

Protective Effect on the Rat's Myocardium with Changes in Magnesium Concentrations (마그네슘 농도변화에 따른 흰쥐의 심근 보호효과)

  • Hong, Chi-Uk;Jo, Gyu-Seok;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.11-16
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    • 1997
  • The Increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter(group A, n: 10) or 15mMo1 per liter(group B, n: 10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas'Hospital solution) was infused for 2 minutes, and prepared within 4$^{\circ}C$ Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfuslon was reestablished after I hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, $\pm$ dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and flutamic oxaloacetic transaminase) were performed each other at whic rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, + dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P < 0.05). But, there were no signicant differences in the recovery rate of dp/dt max, and reperfunion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid (P > 0.05).

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Development of Soluble Epoxide Hydrolase Inhibitor Screening Methods for Discovery of Drug Candidate in Cardiovascular Diseases (심혈관계 질환 치료제 후보물질 발굴을 위한 Soluble Epoxide Hydrolase 억제평가 방법 개발)

  • Lee, Gwan-Ho;Kim, Bong-Hee;Kim, Sang-Kyum
    • YAKHAK HOEJI
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    • v.56 no.1
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    • pp.42-47
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    • 2012
  • Soluble epoxide hydrolase (sEH) is a metabolic regulator of epoxyeicosatrienoic acids (EETs). EETs have many beneficial effects, vasodilation, anti-diabetes, anti-inflammation, cardiovascular protection, renal protection. Therefore, selective sEH inhibitors have a potential for treating these diseases. In the present study, screening methods for sEH inhibitors using PHOME ((3-phenyl-oxiranyl)-acetic acid cyano-(6-methoxynaphthalen-2-yl)-methyl ester) and 14-15-EET as substrates were established. To determine selectivity, microsomal epoxide hydrolase (mEH) inhibition assay was also developed using styrene oxide as a substrate of microsomal epoxide hydrolase. Our results obtained from 12-[[(tricyclo[3.3.1.13,7]dec-1-ylamino)carbonyl]amino]-dodecanoic acid (AUDA) used as a positive sEH inhibitor and valpromide used as a positive mEH inhibitor showed that these methods are useful for discovery of drug candidates.

Changes of Myocardial Ultrastructure During Open Heart Surgery (개심수술중 심근 미세구조의 변화)

  • Hur, Jin;Kong, Joon-Hyuk;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.707-715
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    • 2000
  • Background: Cold blood cardioplegic solution has been used to protect myocardium during open heart surgery with the hypothesis stating that it provides more oxygen supply to myocardium compared to crystalloid caridoplegic solution. We repeatedly infused cold blood cardioplegic solution to achieve myocardial protection. We biopsied a small portion of papillary muscle of patients with mitral valve replacement or double valve replacement during aortic cross-clamp time and evaluated the method of myocardial protection through the observation of changes in ultrastructure. We then analysed the relationship between changes in ultrasructure and peak postoperative CK-MB value and SGOT value. Material and method: We report observation on changes of myocardial ultrastructure, postoperative CK-MB and SGOT, and electrocardiogram in 31 patients who underwent cardiac operation. There were 11 males and 20 females, and they ranging in age from 28 to 69 years(mean score was 2.08$\pm$0.560, it was 2.37$\pm$0.558 at 40 minutes, and it was 2.36$\pm$0.523 at 70minutes. Mitochondrial score increased significant at 40 minutes. Mean value of postoperative peak CK-MB and SGOT were 37.3$\pm$17.061IU, 144.5$\pm$125.5IU respectively. We were not able to find any new Q were in EKG after the operation. There was no significant relationship between myocardium mitochondrial score and mean value of postoperative peak CK-MB and SGOT. Conclusion: In conclusion, with this study the cold blood cardioplegic solution was incomplete in preserving ultrastructure of myocardium even with satisfactory results in serum enzyme and EKG evaluation.

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Surgical Treatment of Spontaneous Pneumothorax (자연기흉의 외과적 치료)

  • Hur, Yong;Kim, Kyung-Hoon;Kim, Chul-Whan;Park, Sung-Dong;Park, Jae-Hong;Moon, Joon-Ho;Kim, Byung-Yul;Lee, Jung-Ho
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.1002-1007
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    • 1994
  • The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.

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A Comparison of the Effects of Histidine-tryptophan-ketoglutarate Solution versus Cold Blood Cardioplegic Solution on Myocardial Protection in Mitral Valve Surgery (승모판막수술 시 히스티딘를 함유한 결정성 심정지액(Histidine-tryptophan-ketoglutarate Solution)과 저온 혈성 심정지액이 심근기능 보존에 미치는 영향 비교)

  • Choi, Yong-Seon;Bang, Sou-Ouk;Chang, Byung-Chul;Lee, Sak;Park, Chol-Hee;Kwak, Young-Lan
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.399-406
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    • 2007
  • Background: Ischemia-reperfusion injury related to unsuccessful myocardial protection affects postoperative ventricular function and mortality during open-heart surgery. We prospectively compared the effects of administration of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia (CBC) on myocardial protection and clinical outcome in patients undergoing mitral valve surgery. Material and Method: Seventy patients with mitral regurgitation (MR) undergoing mitral valve surgery were randomly divided into the HTK group (n=31) and the CBC group (n=31 ): eight patients were excluded. Perioperative hemodynamics, cardiac medications, pacing, postoperative outcomes and complications were recorded during the hospital stay. All patients received follow-up for at least 6 months postoperatively for morbidity and mortality. Resuか: There were no significant differences in the hemodynamics between the groups during the study period, except for the mean pulmonary artery pressure (MPAP), PCWP and CVP that were lower in the HTK group at 15 min after weaning of CBP. There were no differences for inotropic support and pacing during the 12 hrs postoperatively between the groups. CK-MB values on day 1 and day 2 were $77{\pm}54$ and $41{\pm}23$ for the HTK group and $70{\pm}69$ and $44{\pm}34$ for the CBC group, respectively (p=NS). Postoperative clinical outcomes were similar in both groups for at least 6 months during the follow-up period. Conclusion: These results suggest that the use of HTK solution is as safe as cold blood cardioplegia in terms of myocardial protection.

Repair of Postinfarction Ventricular Septal Defect on a Beating Heart -One case report (심근경색 후 심실중격렬손의 심박동 상태에서의 교정술 -1예 보고-)

  • Kim, Hyuck;Lee, Hyung-Chang;Kim, Young-Hak;Chung, Won-Sang;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.543-545
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    • 2004
  • Postinfarction ventricular septal defect often induces cardiogenic shock and requires operative treatment early after myocardial infarction. Although the operative mortality of this disease has decreased during the past 3 decades, it is still relatively high. In this case, to prevent global myocardial ischemia, we used the technique of repair of postinfarction ventricular septal defect on a beating heart. This approach does not requir aortic cross-clamping and provides superior myocardial protection.