• Title/Summary/Keyword: Congenital Heart Disease

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Cytomegalovirus Myocarditis Required Extracorporeal Membrane Oxygenation Support Followed by Ganciclovir Treatment in Infant

  • Kim, Bong Jun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.199-202
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    • 2016
  • A 7-month-old girl with no medical history was treated with mechanical circulatory support due to myocarditis. Her cardiac contractility did not improve despite more than one week of extracorporeal membrane oxygenation treatment. Thus, we planned a heart transplant. However, a high level of cytomegalovirus was found in blood laboratory results by quantitative polymerase chain reaction. The patient's heart contractility recovered to normal range four days after ganciclovir treatment. She was discharged with slightly decreased cardiac contractility with a left ventricular ejection fraction of 45%.

Intracardiac Thrombosis Involving All Four Cardiac Chambers after Extracardiac Membranous Oxygenation Associated with MTHFR Mutations

  • Kim, Bong Jun;Song, Seung Hwan;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.207-209
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    • 2016
  • A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.

Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

  • Kim, Ha Eun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.203-206
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    • 2016
  • Patients with venoarterial extracorporeal membrane oxygenation (ECMO) frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA) decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

Clinical Evaluation of Open Heart Surgery - Review of 114 Cases - (개심술 114례의 임상적 고찰)

  • 장운하;이문금;김병린
    • Journal of Chest Surgery
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    • v.26 no.2
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    • pp.115-121
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    • 1993
  • Between March, 1988 and July, 1992, 114 patients underwent Open Heart Surgery under hypothermic cardiopulmonary bypass. There were 29 cases of congenital heart anomalies (25%), and 85 cases of acquired heart diseases (75%) consisting of 53 cases of valvular heart disease, 31 cases of ischemic heart disease, and a case of left atrial myxoma. The age distribution of 114 cases was 4 to 73 years, and mean age was 43 years old consisting of mean age of congenital heart disease 23, valvular heart disease 47, and ischemic heart disease 57 years old. Overall operative mortality was about 7.9%.

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Clinical experience of open heart surgery -100 cases- (개심술 100예에 대한 임상적 고찰)

  • 공국영
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.663-671
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    • 1986
  • 100 cases of open heart surgery were done in the Dept. of Thoracic and Cardiovascular Surgery, Won Kwang University Hospital from July, 1984 to October, 1986. l. Among the 100 cases, there were 51 cases [51%] of acyanotic congenital heart anomalies, 10 cases [10%] of cyanotic congenital heart anomalies and 39 cases [39%] of acquired heart disease. 2. The age distribution of 100 cases was 18 months to 56 years old and mean age was 10.8 years old in congenital heart anomalies and 34.7 years old of acquired heart disease. 3. The overall mortality was 8%. and the mortality in each entity is 5.9% in congenital acyanotic cases, 10% in congenital cyanotic cases and 10.3% in acquired valvular heart disease. 4. For myocardial protection, high concentration potassium of cold blood cardioplegic solution [30mEq/L] had been used, associated with topical cooling of ice-slush.

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Family Stress, Perceived Social Support, and Coping of Mothers Who have a Child Newly Diagnosed with Congenital Heart Disease (선천성 심장병환아 어머니가 인지하는 가족 스트레스, 사회적 지지, 대처)

  • Tak Young-Ran
    • Child Health Nursing Research
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    • v.7 no.4
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    • pp.451-460
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    • 2001
  • Congenital heart disease is now estimated to be the most prevalent chronic illness in children. The overall purpose of study is to enhance our understanding of mother's perception of family stress, perceived social support, and coping who has a child newly diagnosed with congenital heart disease. In this investigation, the relationship between family stress, perceived social support, and coping within the context of a acute, non life- threatening chronic illness in the situation of newly diagnosed as Rolland's typology of chronic illness. The study employed data from a subset of a large longitudinal study, children's chronic illness: parents and family adaptation conducted by M. McCubbin (5 R29 NR02563) which was funded by the NIH. The subject for this study were 92 mothers who have a child under age 12 who was newly diagnosed with congenital heart disease within the last 3-4 months. Results form correlational and regression analysis revealed that perceived social support operated as a resiliency factor between family stress and coping of mothers. Child and family characteristics appeared to be important predictors of perceived social support and mother's coping. Therefore, the findings provide an incremental contribution to the explanation of effects for perceived social support and may challenge resiliency model in previous literature. Further, these findings suggest that perceived social support and coping are both influencing in the resiliency of relatively high risk groups of families who has a child with congenital heart disease.

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Tricuspid Valve Re-Repair in Ebstein Anomaly Using the Cone Technique

  • Kim, Do Jung;Suh, Jee Won;Shin, Yu Rim;Shin, Hong Ju;Park, Han Ki
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.35-38
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    • 2016
  • The management of recurrent tricuspid regurgitation after tricuspid valve repair in patients with Ebstein anomaly is difficult, and tricuspid valve replacement is most commonly performed in such patients. We report two cases of recurrent tricuspid regurgitation in patients with Ebstein anomaly that were successfully re-repaired using the cone technique. The cone repair technique is a useful surgical method for reconstructing a competent tricuspid valve, and can be applied in patients who have undergone previous tricuspid valve repair.

MR Imaging of Congenital Heart Diseases in Adolescents and Adults

  • Yeon Hyeon Choe;I-Seok Kang;Seung Woo Park;Heung Jae Lee
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.121-131
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    • 2001
  • Echocardiography and catheterization angiography suffer certain limitations in the evaluation of congenital heart diseases in adults, though these are overcome by MRI, in which a wide field-of view, unlimited multiplanar imaging capability and three-dimensional contrast-enhanced MR angiography techniques are used. In adults, recently introduced fast imaging techniques provide cardiac MR images of sufficient quality and with less artifacts. Ventricular volume, ejection fraction, and vascular flow measurements, including pressure gradients and pulmonary-to-systemic flow ratio, can be calculated or obtained using fast cine MRI, phase-contrast MR flow-velocity mapping, and semiautomatic analysis software. MRI is superior to echocardiography in diagnosing partial anomalous pulmonary venous connection, unroofed coronary sinus, anomalies of the pulmonary arteries, aorta and systemic veins, complex heart diseases, and postsurgical sequelae. Biventricular function is reliably evaluated with cine MRI after repair of tetralogy of Fallot, and Senning's and Mustard's operations. MRI has an important and growing role in the morphologic and functional assessment of congenital heart diseases in adolescents and adults.

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The Clinical Experience of 610 Cases Open Heart Surgery (개심술 610례에 관한 임상적 고찰)

  • 정황규
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.36-47
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    • 1988
  • 610 cases of open heart surgery was performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July 1981 to September 1987. The clinical data was summarized as follows: 1. The age distribution of congenital heart surgery patients was 2 to 41 years old [mean; 13.2 years] and surgery for acquired heart disease was 10 to 57 years old [mean: 32.8 years]. 2. There were 389 cases [63.8%] of acyanotic congenital heart anomalies, 63 cases [10.3%] of cyanotic congenital anomalies and 158 cases [25.9%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and then since 1983, GIK solution has been used with repeated infusion method once for every 20 to 30 minutes of time interval after starting initial cardioplegia during operation with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, sodium bicarbonate, mannitol, potassium chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 96 cases [15.7%] of mild hypothermia, 333 cases [54.6%] of moderate hypothermia and 181 cases [29.7%] of intermediate hypothermia. 6. The mortality rate was 2.3% [9 out of 389 cases] in acyanotic congenital heart disease, 36.5% [23 out of 63 cases] in cyanotic congenital heart disease and 10.8% [17 out of 158 cases] in acquired heart disease, with overall mortality rate of 8.0% [49 out of 610 cases].

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Right-sided heart failure in congenital heart diseases (선천성 심질환에서 우심부전)

  • Jung, Jo Won
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1055-1060
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    • 2007
  • Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right-sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases.