• Journal of Chest Surgery
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• 제20권1호
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• pp.148-155
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• 1987

From May 1977 to June 1986, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. There were 278 male and 222 female patients ranging from 6 months to 69 years. 363 cases[73.6%] were congenital heart diseases, and 137 cases[27.4%] were acquired heart diseases, which were 33 valvular diseases, 3 myxomas and 1 IVC obstruction. There were 363 congenital heart anomaly with 35 operative deaths[9.6%], consisting of 279 acyanotic cases with 12 deaths [4.3%] and 85 cases of cyanotic cases with 23 deaths[28.4%]. In 133 patients of acquired valvular disease, 124 valves were implanted and operative death of valvular disease was 12%. Finally the operative mortality was 9.6% in congenital anomaly, and 12.4% in acquired heart disease, overall mortality rate was 10.4%.

• Journal of Chest Surgery
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• 제21권1호
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• pp.48-54
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• 1988

168 cases of open heart surgery had been performed in Korea Veterans Hospital from Aug. 1984 to Nov. 1987. There were 150 cases of congenital heart disease and 18 cases of acquired heart disease. In congenital heart cases, 123 cases [82%] were acyanotic and 27 cases [18%] were cyanotic. Common congenital defects were VSD, TOF, ASD, PS in order of frequency. There were 11 cases of operative mortality; 5 cases [4%] in acyanotic group, 6 cases [22\ulcorner6] in cyanotic group. There was no mortality in valvular heart disease group. Overall mortality rate was 6.5%.

• Journal of Chest Surgery
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• 제13권4호
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• pp.394-404
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• 1980

During the period of June 1976 October 1980 131 cases of Open heart Surgery was performed at the National Medical Center in Seoul under the extracorpocal circulation. 77 cases were congenital heart disease and 54 were acquired heart disease. The age of the patients ranged between 2$\frac{1}{2}$ and 51 years. For all patients partial hemodilution technique and moderte hypothermia was used during extracorporeal circulation and cardioplegia was done for myocardial protection since April 1978. 41 of congenital cases were non-cyanotic group and 1 case died. 36 of congenital cases were cyanotic group and revealed very high mortiality rate (16 death, 39%). 53 of acquired cases were cases of valvular heart disease, 34 mitral (3 death), 1 aortic, 4 mitral with aortic 12 mitral with tricuspid (3 death), 2 triple valves (2 death), and revealed mortality rate of 15.1% (8 death). 1 of acquired cases were left atrial myxoma. There were 25 cases of operative death and over all motality rate was 19.1%.

• Journal of Chest Surgery
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• 제17권4호
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• pp.804-810
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• 1984

Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.385-388
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• 2005

In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.

• Journal of Chest Surgery
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• 제20권2호
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• pp.270-280
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• 1987

One hundred thirteen cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery of Inha General Hospital from April 1986 to April 1987. There were 73 cases of congenital heart disease and 40 cases of acquired valvular heart disease, including one redo case respectively. The technique of deep hypothermia with circulatory arrest was used widespreadly for infants and small children, and early extubation was performed as possible in the great number of all cases. There were three operative deaths [2.7%], all in congenital cases, and three follow-up deaths, all in acquired cases.

• Journal of Chest Surgery
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• 제11권4호
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• pp.523-528
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• 1978

Recent advances in the surgical treatment of congenital disorders of the heart have necessitated an accurate preoperative diagnosis. Right heart catheterization has become widely accepted as a research tool and diagnostic test to detect the heart diseases, especially in the congenital heart anomalies. Right heart catheterizations were carried out in 50 cases of congenital heart diseases at Department of Thoracic and Cardiovascular Surgery, , Kyungpook National University Hospital, during the period of June, 1975 through September 1978. In age distribution, 27cases were below 10 years of age, 18 cases between 11 and 20, and 5 cases above 20 male to female ratio was 2.8:1. The distribution of congenital heart diseases was VSD [42%], TOF [36%], PDA [10%], ASD [8%], and PS[4%]. Of these, 44 cases [88%], were compatible with the clinical impressions that were made preliminarily before cardiac catheterization, and all the cases except 1 case of VSD was correlated well with the postoperative diagnosis. The right heart catheterization is considered to be reliable and accurate toll in the preoperative diagnosis of congenital heart diseases. These procedures caused complications such as left side hemiplegia [lcase], occlusion of the femoral artery [lcase], and transient ventricular tachycardia [1case], and so the complication rate of right heart catheterization was 6% [3 cases]. None of patients who have undergone right heart catheterization was died.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1025-1035
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• 1989

Since we first performed open heart surgery on December 30, 1986, 126 cases were operated on up to August 31, 1989. Among the 126 cases, 65 cases were congenital heart disease of which 63 were acyanotic disease, and 61 cases were acquired heart disease, most of which were valvular heart disease. The age distribution of congenital heart disease was from 1 years 2 months to 48 years, and males had a slightly higher incidence. The age of acquired heart disease was from a minimum of 15 years to a maximum of 68 years, and the male to female ratio was 1;1.5. Midsternotomy was performed in all cases, and the aortic cannula was inserted through ascending aorta and the venous cannula inserted into the SVC and IVC through the right atrium. Vent was inserted through the right superior pulmonary vein. Cardioplegia solution was used in all cases; it was composed of sodium bicarbonate 3.5 ampule, KCL 14 mEq, 2% lidocaine 2.5 ml, 20 % albumin 50 ml and heparin 1000 units mixed to 950 ml with Hartman solution, and was made to 4oC and infused 10 ml per Kg every 20 minutes. The congenital heart disease had a variety of VSD in 32 cases, ASD 23 cases, PS 6 cases, PDA 2 cases, and one case each of Ebsteins anomaly and tricuspid atresia. The operations performed for acquired heart disease were 4 cases of OMC, 33 cases of MVR, and 5 cases of AVR, and 1 case of AVR with CABG. DVR was perfomed in 13 cases, and triple valve replacement was done in 1 case. Other than these, excision of LA myxoma was 2 cases, and repair of traumatic VSD and removal of a pulmonary embolism were one case each. The surgical mortality was 5 cases[4%], all of which occurred in valve replacement cases. Follow-up study revealed 2 late deaths. One died after a traffic accident and one died due to sepsis after he had received a gastrectomy for ulcer bleeding. The remaining patients were in good condition.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1192-1202
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• 1992

Postoperative cardiac outputs and other hernoaynamic values were serially measured in fifteen patients of cyanotic congenital heart disease, after use of blood cardioplegic solution. Cardiac indices showed no change untill eight postoparative hours, then it began to decline to reach as low as 3.22$\pm$0.7L/min/m2 at 12 hours. After then gradual increse occ-ured to recover upto immediate postoperative value at 20 hours. Sharp decrese of heart rate and increse of systemic vascular resistance during 8~16 hours and steady increase of stroke indices during the whole study periods were observed. These observations suggested that the myocardium recovered gradually after open heart surgery, and that the decrease of cardiac indices during 8~16 hours could be a result of decrease of heart rates and increase of afterload. The changes of cardiac indices correlated with the changes of heart rate, postoperative time and mixed venous oxygen saturation [p<0.05]. No other hemodynamic values found to be in statistically significant correlation with the changes of cardiac indices. Left ventricular dysfunction seemed to occur more frequently during 8~12 hours, but it was not statistically significant. [p=0.73] In conclusion, great care must be taken during 2~3 days after the operation of cyanotic congenital heart disease, not to fall into a low cardiac output state, by maintaing adequate heart rates and reducing afterload especially when the systemic vascular resistance increases.

• Journal of Chest Surgery
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• 제23권1호
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• pp.49-60
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• 1990

Between Jan. 1962 and Dec. 1988 380 cases of palliative operations were done in 357 patients for congenital heart disease. These includes 55 cases of classic Blalock-Taussig shunt, 212 cases of modified Blalock-Taussig shunt, 17 cases of Glenn shunt, 26 cases of Waterston shunt, 3 cases of Brock procedure, 33 cases of pulmonary artery banding, 6 cases of transpulmonary valvotomy, 4 cases of unifocalization, and 10 cases of open atrial septectomy. We divided the operative procedures into the conventional and the unconventional. Under the unconventional procedures, the cases since April, 1986 were only included. The number of patients who died within the early 30 days after operation is the following: 40 in systemic-pulmonary shunts, 2 in Brock procedure, 12 in PAB, 15 in unconventional procedures. The age of the patients who need palliative operation is lowering more and more and their characteristics of the disease is being transferred to the more complexities. So the role of palliative surgery in the congenital heart disease is changing.