• Title/Summary/Keyword: Congenital Heart Defect

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Half-turned Truncal Switch Operation for Transposition of Great Arteries, Ventricular Septal Defect and Pulmonic Stenosis (폐동맥 협착과 심실 중격 결손을 동반한 대혈관 전위에서 시행한 반회전 동맥간 전환술)

  • Lim Hong Gook;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Kim Jun Seok;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.145-149
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    • 2006
  • The surgical management of patients with transposition of the great arteries, ventricular septal defect, and pulmonary stenosis remains a challenge. The Rastelli operation or Lecompte operation is the preferred surgical procedure, but its long-term results are not optimal because of a warped left ventricular outflow tract through a space-occupied intraventricular tunnel and a contrived right ventricular outflow tract. We performed a half-turned truncal switch operation as an alternative surgical procedure in a 3-year-old boy (weighing 9.6 kg) with this anomaly. Postoperative echocardiography showed laminar flow through straight and nonobstructive aortic and pulmonary ventricular outflow tracts.

Open Heart Surgery 110 Cases in One Year(1987) (연간 (1987년) 개심술 110례에 대한 검토)

  • 조광현
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.351-365
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    • 1988
  • During one year[1987], 110 cases of open heart surgeries were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje Medical College. And the results were summarized as follows. 1. Among the 110 cases, there were 77 cases of congenital heart diseases and 33 cases of acquired heart diseases. Age range of the congenital patients was 8 months to 30 years with the mean age of 8 years, and acquired patients was 16 to 56 years with the mean age was 32 years. 2. The heart lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 50 of membrane type and 60 of bubble type. For all cases GIK[glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 77 congenital anomalies, there were 67 cases of acyanotic patients[ASD: 12, VSD: 50, PS: 1, AP window: 1, Gerbode defect: 1, ECD: 2] and 10 cases of cyanotic patients[TOF: 10], and to all of which the appropriate radical operations were applied. 4. Among the 33 acquired diseases, there were one case of left atrial myxoma, one of annuloaortic ectasia, 20 of mitral valve diseases[MS: 2, MSr: 8, MR: 2, MRs: 8], 9 of double valve diseases[MRs+AR: 1, MRs+ARs: 2, MRs+TR: 1, MSr+TR: 3, MSr+ASr: 1, MSr+ARs: 1], 2 of triple valve diseases[MSr+AR+TR: 1, MSr+ASr+TR: 1]. The left atrial myxoma was removed well with right atriotomy and atrial septal approach. And to the annuloaortic ectasia, Bentall operation was applied with good result. Mitral valve replacement[MVR] was applied to 20 cases of mitral valve diseases, double valve replacement[MVR+AVR] was applied to 6 cases of double valve diseases, MVR & tricuspid annuloplasty[TVA] was applied to 3 cases of mitral 5. The number of replaced valve were 39 in 31 cases. In MVR, 5 of mechanical valves[St. Jude Medical Valve] and 26 of tissue valves[Carpentier-Edward valve] were used. In AVR, 3 of mechanical valves and 5 of tissue valves were used. 6. Postoperative complications were occurred in 23 cases, and among them 21 cases were recovered with intensive cares, but 2 cases were expired[mortality: 1.8%].

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Lung Biopsy in Congenital Heart Disease (선천성 심장 질환 환자의 폐 생검)

  • 김광호
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.9-16
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    • 1981
  • Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

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Totally Thoracoscopic Ablation for Treatment of Atrial Fibrillation after Atrial Septal Defect Device Closure

  • Kim, Young Su;Jeong, Dong Seop;Kang, I-Seok;On, Young Keun
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.280-282
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    • 2014
  • Atrial septal defect (ASD) is one of the most common congenital heart defects in adults. Surgical repair is the most common treatment approach, but device closure has recently become widely performed in accordance with the trend toward less invasive surgical approaches. Although surgery is recommended when ASD is accompanied by atrial fibrillation, this study reports a case in which a complete cure was achieved by closure of a device and totally thoracoscopic ablation.

The Effects of Right Anterolateral Thoracotomy in Cardiac Surgery (개심술시 우전측방흉부절개술의 효과)

  • Gwak, Mong-Ju;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.986-990
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    • 1997
  • Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect; 1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective me hod to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.

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Open Heart Surgery of Congenital Heart Diseases -Report of Four Cases- (선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) -)

  • Kim, Kun Ho;Park, Young Kwan;Jee, Heng Ok;Kim, Young Tae;Rhee, Chong Bae;Chung, Yun Chae;Oh, Chull Soo
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.1-9
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    • 1976
  • The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

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Tracheoplasty for Congenital Tracheal Stenosis-Two case reports- (선천성 기관 협착 환자의 기관성형술 2예)

  • Lim Hong Gook;Lee Chang-Ha;Hwang Seong Wook;Lee Cheul;Kim Jae Hyun;Seo Hong Joo;Jung Sung Chol
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.583-588
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    • 2005
  • Congenital tracheal stenosis can be a life-threatening disease, especially in cases involving the long-segment of the trachea. When patients are symptomatic immediately after birth or develop an accompanying complex cardiac anomaly, surgical repair can be a considerable challenge. We experienced a tracheoplasty in one early infant weighing 2.6 kg and one neonate who had ventilator dependency from long-segment congenital tracheal stenosis and congenital cardiac anomaly. One early infant, who had diffuse stenosis of distal trachea after ventricular septal defect closure, underwent resection and extended end to end anastomosis. One neonate who had diffuse stenosis of proximal trachea with tetralogy of Fallot (TOF), underwent slide tracheoplasty with total correction for TOF Postoperative chest computed tomography showed widely patent trachea. Both infants are now well without symptoms.

Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery (흉강경 수술로 확인한 우연히 발견된 기흉을 동반한 심막결손)

  • Hyunwoo Cho;Eun-Ju Kang;Moon Sung Kim;Sangseok Jeong;Ki-Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.749-755
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    • 2021
  • Congenital defects of the pericardium, which are generally asymptomatic, are rare disorders characterized by complete or partial absence of the pericardium. Here, we report a rare case of a 19-year-old male who was incidentally diagnosed with congenital absence of the left pericardium during examination for symptoms of pneumothorax. Chest radiography and CT revealed a collapsed left lung without any evidence of trauma, no unusual findings of free air spaces along the right side of the ascending aorta, heart shifted toward the left side of the thorax, and a shallow chest. Subsequent thoracoscopy confirmed the absence of the left pericardium and displacement of the heart toward the left thoracic cavity. We further discuss the correlation between radiologic images and surgical findings of a congenital pericardial defect associated with spontaneous pneumothorax.

Ventricular septal defect in an Abyssinian cat

  • Lee, Seung-Gon;Moon, Hyeong-Sun;Choi, Ran;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.99-103
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    • 2008
  • A 2-month-old female Abyssinian cat was presented with a severe ascites, cyanosis, and exercise intolerance. Diagnostic studies revealed V/VI holosystolic murmur, sinus tachycardia, generalized cardiomegaly with marked left atrial enlargement and shunt flow between left and right ventricles. Doppler study showed bi-directional shunts in rest and right-to-left shunt after exercise. Based on clinical signs and diagnostic findings, the cat was diagnosed as a reversed ventricular septal defect. The cat was treated with furosemide, nitroglycerine, dobutamine and oxygen supplement. Despite initial improvement of clinical signs after initiation of medical treatment, the cat died of sudden cardiac arrest. Necropsy revealed a perimembranous ventricular septal defect.

Atrial Septal Defect in Dogs (개에서 심방중격결손의 증례)

  • 정주현;엄기동;장광호;오태호;이영원;장동우;윤정희
    • Journal of Veterinary Clinics
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    • v.19 no.1
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    • pp.110-113
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    • 2002
  • An atrial septal defect (ASD) is a congenital hole in the atrial septum that allows flow between the two atria. Small ASDs are usually well-tolerated defects and do not result in significant clinical abnormalities. In large ASDs or in the presence of other cardiac defects, clinically significancy is increased. Atrial septal defects in 2 Dogs with cardiac and respiratory signs were diagnosed at seoul animal medical center. In ascultation, systolic murmur and the splitting of second heart sound were heard at pulmonary or tricuspid valve region. In radiograph, right-sided cardiomegaly, pulmonary artery dilation, increased pulmonary vasculature makings, and pleural effusion or pulmonary edema signs were observed. In echocardiography, the region, location and size of septal defect was identified. Also, the direction and degree of shunt was measured. These dogs were treated with medicine for cardiac failure. One dog is well-tolerated, the other dog died.