• Journal of Chest Surgery
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• v.15 no.3
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• pp.267-273
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• 1982

We have observed 360 cases of spontaneous pneumothorax from Jan. 1971 to Dec. 1981 at the department of Thoracic and Card iovascular Surgery, Yonsei University College of Medicine. The patients age ranged from 2 days to 95 year-old. The associated pulmonary lesions were shown pulmonary tuberculosis in 158 cases[43.9%], bullae in 35, pulmonary emphysema In 32, pneumothorax in 10, paragonimiasis In 7 and unknown underlying pathology in 109 patients. 70 [51.1 %] out of 1 37 cases who received conservative medical treatment Including thoracentesis were cured completely, but the 67 cases [48.9 %] of remaining uncured patients were treated by surgical procedures. The 290 patients who received surgical management were recovered without recurrent pneumothorax. The surgical procedures were closed thoracotomy drainage or explothoracotomy. The choice of treatment should be based on the extent of pneumothorax or the presence of underlying pulmonary disease. Tube thoracotomywas the most effective procedure in achieving the expansion of collapsed lung. On the other hand, open thoracotomy could be a good approach to recurrent pneumothorax, persistent air leakage, incomplete expansion of the lung and bilateral pneumothorax. The minithoracotomy Is the best procedure to recurrent pneumothorax.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.274-279
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• 1995

To evaluate clinical pattern and operative outcome of atherosclerotic obstructive disease in the lower extremity, surgical experience in 25 patients between September 1987 and June 1994 was analyzed. There were 24 male patients and 1 female patient. The age of the patients ranged between 36 and 77 years[mean:60.9 years . Disabing intermittent claudication, rest pain, or ischemic gangrene[or ulceration was the operative indication. The patients were classified into three groups according to the level of obstruction: Aortoiliac level[11 cases/44% , femoropopliteal level[6 cases/24% , and whole level[8 cases/32% . Anatomic bypass with prosthetic graft was performed in all cases: aortobifemoral or aortofemoral bypass in 15 procedures, iliofemoral bypass in 5 procedures, femoropopliteal bypass in 13 procedures. The perioperative mortality rate was 12%. Two patients received postoperative major amputation. Twenty two patients were followed-up for 1 to 70 months[mean: 21 months . Late graft obstruction occurred in two patients. The cumulative patency rate at 3 years was 69.5%. The cumulative limb salvage rate at 3 years was 92.0%.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.99-104
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• 2015

Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were $194.8{\pm}48.6$ minutes and $126.1{\pm}22.6$ minutes in mitral valve repair operations and $132.0{\pm}32.0$ minutes and $76.1{\pm}23.1$ minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was $128.3{\pm}43.1$ minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1137-1144
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• 1988

Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60$^\circ{C}$ for 90 seconds. The accessory pathway was successfully ablated without specific problems.

• Journal of Chest Surgery
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• v.50 no.3
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• pp.220-223
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• 2017

A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. R adiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.356-360
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• 2021

Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.438-444
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• 1992

We analysed 7,180 annual cases of surgical treatment performed by Department of Thoracic and Cardiovascular Surgery of 6 major institutes in Seoul Korea, All cases were applied to 101 of 140 coded items applicable to the field of Thoracic and Cardiovascular Surgery, in the book of "Standard Price List for Medical Service" which was notified by the Ministry of Health and Social Affairs, and of them, applied field specific items were 70 of 93 applicables. The most frequently applied items were those associated to ECC[extracorporeal circulation] 1,510 cases, and then item of closed thoracostomy 751 cases was next. Except the items associated to ECC, the coded item of the highest "Total cost[fee x total applied numbers]" was mitral valve replacement 182,356,570 won[534,770 won x 341 cases]. 140 items were arranged in "Total cost" order, and then categorized into 5 groups. Medical insurance fees of each group were modified by different grades without changes in sum of total fees. Fees of Group 1, the highest group in "Total cost" were pulled up, on the other hand, Group 4, the lowest group, were pulled down, Group 5, composed of overlapping items with other fields, were not changed. The result of adjustment by grouping showed 21.2% increment effect[535,749,105 won] in real income. And we found that new coded items for modern high technological procedures should be added to "Standard Price List for Medical Service “Standard Price List for Medical Service".

• Journal of Chest Surgery
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• v.44 no.6
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• pp.452-454
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• 2011

The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.260-265
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• 2011

Tracheobronchial ruptures (TBR) rarely complicate surgical procedures under general anesthesia. Seemingly uneventful intubations can result in injury to the trachea, which often manifests as hemoptysis and subcutaneous emphysema. We present 2 patients with postintubation TBR who were treated surgically and discuss considerations in the management of this potentially lethal injury.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.492-496
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• 1985

Two cases of surgical correction of funnel chest using metal struts were presented. The main procedures of the method were transverse submammary incision, subperichondrial resection of the deformed costal cartilages, division of the xiphisternal joint, wedge osteotomy of the sternum, freeing of the posterior surface of the sternum and stabilization by means of 2 metal struts. The struts were removed postoperative 3 and 6 months by a small incision under the local anesthesia. The results in both patients were satisfactory. This method of correction is simple, easy to perform and free of any operative risks.