• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.5 no.1
• /
• pp.18-22
• /
• 2009

A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.

• Journal of Chest Surgery
• /
• v.12 no.3
• /
• pp.263-268
• /
• 1979

In the course of treating approximately 740 patients with open heart surgery, we experienced 38 patients who underwent open heart surgery as the second operation after initial operation on heart at Seoul National University Hospital. Twenty four cases of congenital 14 acquired heart disease were found. There was 14 operative death of 38 patients, resulting in overall mortality 36.8 %; 8 death [33.3 %] in congenital group, 6 [42.9 %] in acquired group. Principal causes of death were lower cardiac output syndrome and congestive heart failure. Compared with foreign report, as this data shows still high overall mortality, this review suggests that second open heart surgery can be performed safely with reasonable operative mortality and satisfactory prognostic outlook in the near future.

• Journal of Chest Surgery
• /
• v.16 no.1
• /
• pp.65-74
• /
• 1983

Fifty cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Busan National University Hospital during 16 months from July, 1981 to October, 1982. The clinical data were analyzed and summerized as follows. 1. There were 34 cases (68%) of congenital anomalies and 16 cases (32%) of acquired heart diseases. Among the congenital cases, 27 were acyanotic and 7 were cyanotic. All of the acquired heat diseases, 16 cases were valvular diseases and they had valvular replacement surgery. 2. The age distribution of the congenital anomalies ranged from 6 to 27 years with mean age of 14.2 years, and the acquired heart diseases from 18 to 44 years mean age of 27.5 years. The difference of sex distribution was no significance. 3. The clinical minifestations in acyanotic congenital anomalies were exertional dyspnea (81.5%), recurrent respiratory infection (55.6%) and palpitation (22.2%), and in cyanotic congenital anomalies were exertional dyspnea (100%), syncope(57.1%) and growth retardation(57.1%), and in acquired heart diseases were dyspnea(100%), edema (62.5%) and general weakness (62.5%) 4. During the cardiopulmonary bypass, mild to moderate core cooling was performed and added topical cooling for more accurate myocardial preservation. 5. Two kinds of cardioplegic solution used in our institute were Bretschneider solution for the first 7 cases and mixed Harmann's solution 1 L with glucose 5gm, potassium chloride 26 mEq and sodium bicarbonate 24 mEq, making 376 mosmol/L and pH 8.3 at $25^{\circ}C$, for the rest 43 cases. 6. Various kinds of postoperative complications occurred in 14 cases (28%) and showed overall mortality 12%. The mortality along with each disease was 7.4% in congenital acyanotic cases, 42.9% in congenital cyanotic cases and 6.3% in acquired valvular diseases. 7. Pre-and postoperative diagnostic incompatibility was seen in 6 cases (12%). 8. The artificial valves used in the replacement surgery were lonescu-Shiley bovine xenograft in 6 cases and Carpentier-Edwards porcine xenograft in 10 cases.

• Journal of Chest Surgery
• /
• v.46 no.1
• /
• pp.56-59
• /
• 2013

Cardiac surgery in neonates with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight neonates with congenital heart disease continue to challenge the intellectual and technical skills of healthcare professionals. We present a case of a low-birth-weight neonate with pulmonary atresia and a ventricular septal defect, in whom palliation was achieved with a right ventricular outflow tract stent using a hybrid procedure.

• Clinical and Experimental Pediatrics
• /
• v.60 no.11
• /
• pp.344-352
• /
• 2017

Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction abnormalities, and genetic arrhythmia such as congenital long-QT syndrome are classified as nonbenign arrhythmias. Although most neonatal arrhythmias are asymptomatic and rarely life-threatening, the prognosis depends on the early recognition and proper management of the condition in some serious cases. Precise diagnosis with risk stratification of patients with nonbenign neonatal arrhythmia is needed to reduce morbidity and mortality. In this article, I review the current understanding of the common clinical presentation, etiology, natural history, and management of neonatal arrhythmias in the absence of an underlying congenital heart disease.

• Journal of Chest Surgery
• /
• v.11 no.1
• /
• pp.46-57
• /
• 1978

Ventricular septal defect was the most common congenital Heart disease admitted to the Severance Hospital from December, 1963 to June 30. 1977. A total of 1,811 cardiac patients received cardiac catheterization in the CardiacCenter of Yonsei University Medical College. Out of the 1,811 cardiac patients, 791 cases had congenital heart disease and of these 172 cases had ventricular septal defect. This amounted to 21.7% of all those with congenital heart disease. Seventy cases of ventricular septal defect operated on in the chest surgery department are presented. Of these 70 cases of ventricular septal defect, 54 cases were male and 16 cases were female. Their ages ranged from 4/12 months to 32 years. The ratio of systolic pressure of the main pulmonary to systemic artery [Pp/Ps] for 29 of the 59 isolated ventricular septal defects was below 45 percent. Pp/Ps ratio for 19 of the 59 isolated ventricular septal defects was 75 percent. The patients were mostly below fifteen years of age. Out of 64 cases, there were 36 cases of type II defects, 20 cases of type I, 4 cases of type III , 2 cases of type IV, one case of both type II and one case of left ventricular right atrial communication. The anomalies associated with ventricular septal defect were 13 in all; 4 cases of aortic insufficiency, 3 cases of ruptured aneurysm of the sortie sinus of valsalva, 2 cases of ruptured aneurysm of the sortie sinus of valsalva with aortic insufficiency, 2 cases of patent ductus arteriosus, one case of ruptured aneurysm of the aortic sinus of valsalva with atrial septal defect [secundum type] and one case of atrial septal defect [secundum type]. Overall mortality was 8.6 percent. The mortality in pulmonary artery banding was 37.5 percent. The causes of mortality were in one case congestive heart failure, in one case asphyxia and in one case respiratory insufficiency. Tile mortality in ventricular septal defect associated with pulmonary hypertension was 7.1 percent. The cause of mortality was in one case low cardiac output syndrome. There was no mortality in the ventricular septal defects without pulmonary hypertension and mortality in the ventricular septal defect. In ventricular septal defect associated with combined anomalies, the causes mortality were in one case respiratory insufficiency and in one case congestive heart failure.

• Journal of Chest Surgery
• /
• v.27 no.8
• /
• pp.700-704
• /
• 1994

Congenital coronary arteriovenous fistula is relatively rare congenital heart disease which has formation of fistula between coronary artery and cardiac ventricle, atrium, or pulmonary artery, but that can be repaired with simple surgical procedure. We experienced three cases of congenital coronary arteriovenous fistula, which were repaired surgically under cardiopulmonary bypass, so we report these cases with review of the literatures.

• Clinical and Experimental Pediatrics
• /
• v.56 no.3
• /
• pp.125-129
• /
• 2013

Purpose: The use of implantable cardioverter defibrillators (ICDs) to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was $14.5{\pm}5.4$ years (range, 2 to 22 years). The follow-up duration was $28.9{\pm}20.4$ months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1), cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years). Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia. During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

• Journal of Korean Academy of Nursing
• /
• v.40 no.3
• /
• pp.411-422
• /
• 2010

Purpose: In the present study, an analysis of the life of adolescents with complex congenital heart disease (CHD) was done using grounded theory. Consideration was given to the socio-cultural context of Korea. Methods: After approval from the institutional review board of Y hospital, 12 patients ranging in age from 14 to 35 were recruited. Data were gathered using in-depth interviews. Theoretical sampling was performed until the concepts were saturated. Results: The results confirmed the life of adolescents with complex CHD as a 'journey to finding uniqueness of oneself as a person with CHD'. The life consisted of 3 stages. In the crisis stage, participants had a feeling of threat to self-existence, and made an effort to be the same as others. In the self-recognition stage, participants who had sufficient role-performance built self-esteem while those who did not fell into self-accusation. In the self-establishment stage, participants who reached sufficiency in independence and knowledge planned the future, whereas those who did not conformed to the realities of life. Conclusion: The results of present study provide help in understanding the experiences of adolescents with CHD and provide a basis for developing nursing intervention strategies for these patients.

• Child Health Nursing Research
• /
• v.26 no.1
• /
• pp.107-120
• /
• 2020

Purpose: This study was conducted to investigate the educational needs of parents of infants and toddlers with congenital heart disease (CHD) after hospital discharge. Methods: Qualitative content analysis was conducted of in-depth interviews of eight parents, and the results of an online survey of 171 parents were analyzed quantitatively. Results: Only 16.4% of parents reported that they had received education after hospital discharge on how to provide care for a child with CHD at home. The main reason why parents did not receive education on this topic was that they did not have sufficient opportunities or information (75.5%). In addition, 97.1% of parents stated that they needed educational programs that would be available at home after discharge. In terms of specific educational content, parents expressed the highest needs for education on the symptoms of CHD and ways to cope with them, the prognosis of CHD, and the growth and development of infants and toddlers with CHD. Conclusion: The study showed that parents' educational needs were high in many ways. However, the information and educational opportunities offered after discharge were insufficient compared to those needs. Further research is needed to develop post-hospital educational programs that meet their needs.