• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.268-271
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• 2017

A 1.3 year-old Castrated male Bedlington terrier (10.0 kg of body weight) was presented with heart murmur and occasional coughing. Diagnostic imaging studies revealed supravalvular pulmonic stenosis (maximal velocity 2.91 m/s) from abnormal membranous structure (aperture) distal to the pulmonary valve in the main pulmonary artery. Further study also revealed pulmonic regurgitant (1.82 m/s of peak velocity, 13.2 mmHg of pressure gradient) jets started from the abnormal membranous structure. Since the dog had no obvious clinical signs related to heart failure, no interventional therapy including balloon dilation was considered in this case. Instead, medical treatment for preventing further deterioration of clinical signs related to PS was done with enalapril. This case report described a rare case of type III supravalvular PS in a dog, which has never been reported. Further deterioration of clinical signs has yet been recognized after medical treatment.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.654-658
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• 1990

Between January of 1980 and December of 1989, we are encountered 121 cases of Down syndrome here at Yonsei University Medical Center. of these being endocardial cushion defect, ventricular septal defect, tetralogy of Fallot, atrial septal defect, patent ductus arteriosus and complicated anomalies. The mean age was 1 month 2 years with the sexual division at 31 males and 29 females. Among these 60 patients, 10 of them were treated trough surgical management, 8 of them being open heart surgeries, the 8 open heart surgeries are broken down as follow: 4 total correction of ECD, 2 patch repair of VSD, 1 total correction of TOF, 1 patch repair of ASD secundum. Another 2 operative management are ligation of PDA and modified Blalock - Taussig shunt of TOF. Postoperatively all patients were weaned and extubated on an artificial ventilator without any respiratory complications, and were discharged without incident.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.209-216
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• 2016

Purpose: This study aimed to evaluate and compare the characteristics of infective endocarditis (IE) between children and adults with congenital heart disease (CHD) at a single tertiary care center. Methods: In this retrospective medical record review, we extracted the demographic characteristics, diagnostic variables, and outcomes of patients diagnosed with IE and CHD between 2000 and 2016. Results: We identified a total of 14 pediatric patients (nine male; median age at diagnosis, 3 years). Of the 14 patients, six had a history of previous open heart surgery, while four had undergone tetralogy of Fallot repair, with transannular patch or Rastelli procedure. Among the 10 children with positive blood cultures, the most common isolated organism was Staphylococcus spp. (8/10, 80%). Eleven adult patients had IE and CHD. Among the adult patients, only four were diagnosed with CHD before IE, and ventricular septal defect was the most common CHD. The most common isolated organism was Streptococcus spp. (6/11, 55%). Compared with adult patients, pediatric patients had a higher incidence of previously diagnosed CHD (P=0.001), with Staphylococcus spp. as the causative organism (P=0.027). The median duration between the onset of symptoms and diagnosis of IE was 9 days in children and 42 days in adults (P=0.012). Conclusions: Significant differences with regard to the diagnosis and progress of IE were observed between children and adults. Age-adjusted and systematic reassessment may be necessary for the diagnosis and management of IE.

• Journal of Veterinary Clinics
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• v.39 no.5
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• pp.240-245
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• 2022

A 15-year-old, neutered male, Shih-Tzu, was presented at the Chonnam National Veterinary Medical Teaching Hospital for evaluation of acute onset of persistent coughing, exercise intolerance, and abnormal heart sound. On thoracic auscultation, a split-second heart sound and a wheezing sound were detected on both sides of the chest walls. On physical examination, the dog's body condition score (BCS) was 7/9, and had stenotic nares. Thoracic radiographs revealed right-sided enlargement of the cardiac silhouette (vertebral heart score (VHS) 11.2; reference interval = 8.9-10.1), mild main pulmonary artery (MPA) bulging, mild interstitial infiltration, and hepatomegaly. The electrocardiogram showed right axis deviation, suggesting right ventricular hypertrophy. The echocardiographic study showed moderate pulmonary hypertension and moderate tricuspid regurgitation. There were no findings of a tracheobronchial disease, pulmonary thromboembolism, congenital shunt, left heart disease, or parasitic disease. Based on clinical signs and diagnostic findings, the dog was diagnosed with pulmonary hypertension secondary to brachycephalic syndrome. To rectify respiratory exacerbating factors, the dog was recommended weight control by restricting dietary intake and managing concurrent Cushing's syndrome. Treatments included sildenafil, pimobendan, furosemide, and ramipril. After five months of taking medications and weight control, the severity of pulmonary hypertension improved from moderate to mild. The clinical signs of the patient, including coughing and exercise intolerance, improved a lot. For 5 months of follow-up, the patient has not reported further recurrence of respiratory distress.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.251-256
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• 1996

Kartagener's syndrome, a congenital disease transmitted as an autosomal recessive illness with a prevalence of approximately 1:20,000 persons, is characterized by the triple association of situs inversus, bronchiectasis, and sinusitis. Affected persons have an incoordination of ciliary motility that leads to defective mucociliary transport, chronic bronchial infections. Kartagener's syndrome is a subset of the immotile cilia syndrome and therefore all patients with Kartagener's syndrome have immotile cilia with obvious ultrastructural defects in the ciliary axoneme. In the respiratory tract this inability presumably causes impaired clearance of mucus and inhaled particles and results in the chronic infections of the sinuses and bronchial trees that are characterized of the disease. The end-stage phenomenon in Kartagener's syndrome, respiratory or heart failure is a less common event and heart-lung transplantation is becoming an accepted therapy for patients with end-stage pulmonary disease in Kartagener's syndrome in many institutes. We report one case of Kartagener's syndrome in a 25-year-old young woman who was presented as respiratory and right heart failures, with review of literatures.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.854-863
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• 1990

Since the open heart surgery was performed, various kinds of problem concerning the extracorporeal circulation[EGG] have been known. The author investigated the changes of serum potassium ion before and after ECC among the 102 patients including 63 adults and 39 children who underwent open heart surgery from April 19S6 to February 1990 in Chung-Ang University Hospital. The mean values of potassium ion before and after ECC were analyzed according to the influencing factors such as priming solution, aortic cross clamping time, the underlying disease, the type of oxygenator and the amount of cardioplegic solution. The results were as follows: l. In the aspect of congenital and acquired heart disease groups, the mean values of serum potassium ion[Mean\ulcornerS.D.] before and after ECC revealed a significant change only in the acquired heart disease group[congenital; 3.87$\pm$0.48mEq /L vs. 4.05$\pm$0.73mEq /L, P>0.05, acquired: 4.40 $\pm$0.98mEq /L vs. 4.11$\pm$0.52mEq /L, P<0.05]. Between the two groups, the changes of the mean values of serum potassium ion before and after ECC were significant[P<0.05]. But all values were within normal limits. 2. In the aspect of the aortic cross clamping time[ACCT], in the groups of less or more than 120 minutes, the mean values of serum potassium ion before and after ECC revealed no significant change[less than 120 min; 3.97+-0.64mEq /L vs. 3.99+0.67mEq /L, P>0.05, more than 120 min; 4.34+0.82mEq /L vs. 4.27+0.62mEq /L, P>0.05], and The changes of mean values of serum potassium ion between the two groups were not significant[P>0.05]. 3. In both membrane and bubble oxygenator groups, the mean values of serum potassium ion before and after ECC did not reveal a significant difference respectively [membrane; 4.74 +1.40mEq /L vs. 4.28+0.3lmEq /L, P>0.05, bubble; 4.02 +0.60mEq /L vs. 4.05 L0.68mEq/L, P>0.05], and no differences between the membrane and bubble oxygenator groups[P >0.05]. 4. In the groups of membrane and bubble oxygenator in the cases of ACCT more than 120 minutes, the mean values of serum potassium ion before and after ECC did not reveal a significant difference respectively[membrane; 4.36$\pm$0.85mEq /L vs. 4.37$\pm$0.26mEq /L, P>0.05, bubble; 4.30 $\pm$0.80mEq/L vs. 4.23$\pm$0.67mEq/L, P>0.05], and no differences between the two groups[P>0.05]. 5. In spite of increased amount of cold potassium cardioplegic solution, the mean values of serum potassium ion before ECC were similar to those of serum potassium ion after ECC[less than 20ml /kg

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.523-528
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• 2006

Purpose : The purpose of this study was to investigate the relationship between depression and resilience in adolescents with congenital heart disease(CHD) and to identify the variables associated with depression. Methods : The Resilience Scale(cronbach's ${\alpha}=0.92$), Children's Depression Inventory(cronbach's ${\alpha}=0.72$) and Maternal Behavior Research Instrument(cronbach's ${\alpha}=0.88$) were applied and analyzed to assess depression and resilience among 231 adolescents after surgery for CHD from three major cardiac centers in Korea. This group consist of 114 males and 117 females. The mean age was 15.8 years(range : 13-18 years). The clinical severity of illness was rated by CHD functional index and NYHA functional class. Results : The mean score for depression and resilience was 16.74(range : 0-49) and 115.84(range : 70-132) respectively. Depression was significantly related to age(r=0.25, P<0.001) and NYHA functional class(r=0.35, P<0.001), as well as being negatively correlated with oxygen saturation(r=-0.39, P<0.001), academic achievement(r=-0.41, P<0.001), parental attitude(r=-0.49, P<0.001) and resilience (r=-0.59, P<0.001). The results of multiple regression analysis showed that parental attitude(${\beta}=-0.48$, P<0.01) and resilience(${\beta}=-0.62$, P<0.01) were related to depression. Conclusion : This study demonstrated that adolescents with CHD had a higher resilience and were less depressed with an affectionate parent. With respect to medical and nursing intervention programs, it is essential to identify strengths of adolescents with CHD in order to increase their resilience. Additionally, it is also important that parenting and counseling programs be implemented for the parents of adolescents with CHD.

• Journal of Chest Surgery
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• v.52 no.2
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• pp.100-104
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• 2019

Shone complex is a rare congenital disorder that involves 4 obstructive lesions of the left heart, as follows: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta. Incomplete forms with 2 or 3 of these lesions in adult patients have been rarely reported in the literature, meaning that insufficient general data exist concerning the surgical strategy and clinical follow-up. Herein, we report the case of a 31-year-old woman with a diagnosis of incomplete form of Shone complex with parachute mitral valve and coarctation of the aorta who underwent successful single-stage surgical repair.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1183-1194
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• 1998

Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

• Journal of Chest Surgery
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• v.13 no.3
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• pp.229-232
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• 1980

Approximately 5 percent of infective endocarditis are limited to the right side of the heart, the tricuspid valve being the usual site of involvement. Usually there is no underlying cardiac disease, and the vegetations occur on previously normal tricuspid leaflets. This paper reports a case of bacterial endocarditis involving the bio-tricuspid valve in a patient with tetralogy of Fallot, and who required prosthetic valve replacement in addition to surgical therapy for the congenital lesions.