• Journal of Chest Surgery
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• 제28권5호
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• pp.453-463
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• 1995

During 42 month period 91 consecutive patient underwent coronary artery bypass surgery. The mean age of these patient was 57 years [range from 28 to 78 years . There were 57 men and 34 women. The preoperative risk factors that include beyond the 50 % of total patients were male sex, obesity, hypo-high-density lipoproteinemia, smoking, hypercholesterolemia, hyper-low-density lipoproteinemia, hypertriglyceridemia and hypertension. Preoperatively 27 patients had stable angina pectoris and 39 patients of unstable angina pectoris. Twenty five patients had previous myocardial infarction history. The patterns of disease were 8 patients of single vessel involvement, 18 patients of double vessel involvement, 54 patients of triple vessel involvement and 11 patients of left main coronary artery disease. Fifty five patients were in Canadian Cardiovascular Society functional class III. Myocardial revascularization was performed under emergency conditions in 5 patients. Nine percent of patients had previous PTCA history. We performed 16 cases of sequential anastomosis, internal mammary artery harvest in 86 percent of total patients and total 284 distal anastomoses[mean 3.1 anastomosis per patient . The mean ACC time was 60.5 minutes and ECC time was mean 110 minutes. The combined surgeries were 16 cases of endarterectomy, 2 cases of LV aneurysmectomy, 1 case of Bentall operation, 1 case of repair of sinus of Valsalva, 1 case of ligation of coronary AV fistula and 1 case of excision of breast mass. The most common complication was wound infection[12 cases, 13 % . There was one hospital death due to postoperative respiratory failure and low output syndrome in patient with postinfarction VSD, LV aneurysm. Postoperative 88 patients were in Functional class I or II. The 99mTc-MIBI myocardial perfusion scan that used as evaluation of postoperative state was well correlated with patient`s symptoms instead of some disadvantages.

• Journal of Chest Surgery
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• 제41권1호
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• pp.102-105
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• 2008

대혈관 사이로 주행하는 관상동맥의 이상 기시는 매우 드문 심기형으로 심근허혈이나 급사를 초래할 수 있다. 이런 기형을 교정하기 위해 몇몇 술식들이 소개되어 왔다. 우관상동맥의 이상기시 환자에서 우관상동맥의 또 다른 개구부를 만들어주는 Extended Unroofing 술식을 성공적으로 수행하였다. 술 후 3개월 째 심근허혈이나 대동맥판막역류증 없이 새로 만든 개구부는 넓게 잘 유지되었다.

• Journal of Chest Surgery
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• 제38권2호
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• pp.101-109
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• 2005

배경: 심정지와 같은 위급상황에서 관상동맥의 혈류를 유지하는 것은 심장근육의 보존과 회복 및 환자의 생명을 보존하는 데 중요하다. 최근 들어 Extra-Corporeal Life Support System (ECLS)의 기계식 순환장치의 사용으로 심정지 환자의 생명을 보존하고자 하는 노력이 시도되고 있다 본 연구는 체외순환 모델에서 박동성 혈류와 비박동성 혈류가 관상동맥의 혈류량 및 심근에 미치는 영향에 대해 알아보고자 하였다. 대상 및 방법: 실험은 $25\~35Kg$의 돼지 14마리를 각각 7마리씩 두 군으로 나누어 진행하였다. 제 1군은 비박동성 혈류 펌프인 원심펌프를 사용하였고 제2군은 이중 박동형 펌프를 사용하였다. 체외순환은 우심방에서 상행대동맥으로 심폐바이패스를 하고, 9V의 전기 충격으로 심실세동을 만들었다. 체외순환은 2시간 동안 유지하였으며, 펌프량은 두 군 모두 2 L/min로 유지하였다. 초음파를 이용한 관상동맥 혈류 측정장치를 이용하여 좌전하행지의 관상동맥 관류량을 펌프 시작 전(기초치)과 시작 후 20분마다 측정하였다. 또한 관상 정맥동의 혈액을 펌프 시작 전(기초치)과 시작 후 1시간, 2시간에 채취하여 두 군간의 심근효소의 차이와 대사물질의 차이를 비교하였다. 각 관찰지표의 군간 비교는 STATISTICA 통계프로그램(Version 6.0)의 Mann-Whitney U test를 이용하였고 통계적 유의수준은 p값이 0.05 이하인 경우로 하였다. 결과: 관상동맥의 저항지수는 제 2군에서 낮게 나타났으며, 펌프 구동 후 40분, 80분, 100분, 120분에서 통계적으로 의미 있게 나타났다 (p<0.05). 관상동맥의 평균 혈류 속도는 제 2군에서 펌프 구동 후 20분부터 의미 있게 높게 유지되었다(p<0.05). 관상동맥의 혈류량도 제2군에서 높게 유지되었으며, 펌프 구동 후 40분, 60분, 100분, 120분에서 통계적으로 의미 있는 차이를 보였다(p<0.05). 그러나, 관상정맥동의 혈액학적 검사에서는 두 군간에 차이가 없었다. 결론: 박동성 혈류는 비박동성 혈류보다 좌전하행지 관상동맥의 저항지수를 낮추고, 관상동맥의 관류속도를 빠르게 하여, 관상동맥으로의 혈류량을 높게 유지하였다.

• Journal of Chest Surgery
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• 제19권2호
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• pp.273-279
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• 1986

Total anomalous pulmonary venous return is a cardiac malformation in which there is no direct connection between any pulmonary vein and the left atrium but, rather all the pulmonary veins connect to the right atrium or one of its tributaries. TAPVC is a relatively uncommon anomaly, accounting for only about 1.5-3% of cases of congenital heart disease. Recently improvement in intraoperative techniques did eventually bring substantial improvements in the results in infants. 4 cases of TAPVC was successfully treated with one-stage operation, in the Dept. of Thoracic and Cardiovascular Surgery, National Medical Center in which 2 cases are supracardiac types and the other 2 cases are cardiac types. Sex ratio was 1:1, and the range of age was 2 years-18 years. The common pulmonary venous sinus was connected to the left vertical vein and innominate vein: in 2 supracardiac types and coronary sinus in 2 cardiac types. All cases are operated with standard cardiopulmonary bypass, and the hospital mortality was 0%.

• Journal of Chest Surgery
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• 제18권3호
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• pp.456-460
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• 1985

A case of Annuloaortic Ectasia associated with Marfan syndrome was treated by replacement of aorta and aortic valve with a valved conduit. A 26 years old man had suffered from palpitation and precordial pain. He had stigmata of Marfan`s syndrome. Aortogram and 2-D echocardiogram confirmed aneurysm of the ascending aorta with aortic insufficiency. Surgery was performed under the moderate hypothermia to 28oC. There was marked dilatation of the aortic annulus as well as sinus of Valsalva, with displacement of the coronary ostia. Aortic valve and aneurysm was replacement with 25mm, woven Dacron tubular graft, to which a 25mm, S.T. Jude Medical valve had been previously sutured. Right & left coronary ostia were anastomosed to the graft with the use of 3O Nylon pledget suture. The patient had a satisfactory post operation period with out specific complication.

• Journal of Chest Surgery
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• 제46권5호
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• pp.353-356
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• 2013

A 74-year-old man was diagnosed with aortic root aneurysm and two-vessel coronary disease. Echocardiographic assessment revealed an enlarged sinus of Valsalva 60 mm in diameter with mild aortic regurgitation. Florida sleeve repair was performed using a vascular graft combined with coronary artery bypass grafting. The postoperative course was uncomplicated and follow-up echocardiographic evaluations showed an aortic root diameter of 38 mm without aortic insufficiency up to 1 year after surgery.

• Journal of Chest Surgery
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• 제18권3호
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• pp.436-439
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• 1985

A patient of Ebstein`s anomaly underwent surgical repair on Oct. 24th, 1984. Tricuspid valve was replaced by 31mm St. Jude mechanical valve without plication of atrialized right ventricle. The annulus has been placed below the coronary sinus, with care not to damage the conduction system. But postoperatively complete heart block developed. Permanent pacemaker was implanted on his 12th POD. Now he has been followed up for 9 months. There was no hemodynamic problems yet.

• Journal of Chest Surgery
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• 제23권5호
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• pp.944-952
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• 1990

In 1989, We experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 27 years old male with mild dyspnea on exertion and easy fatigability. All clinical symptoms, physical examinations, laboratory findings, echocardiogram, cardiac catheterization and angiogram revealed supracardiac type T.A.P.V.D. drained through left innominate vein. Operation was done by manner of modified Schumacker procedure. The other case was 6 years old male with cardiac type drained to right atrium through coronary sinus. Two patients were well in postoperative 15 and 8 months.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1465-1470
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• 1992

We experienced one case of total anomalous pulmonary venous connection to coronary sinus with secondum type ASD. The case was 21 years old woman with mild dyspnea on exertion and ill looking appearance. The disease was confirmed by 2D echocardiogram and cardiac catheterization. Under the conventional cardiopulmonary bypass, we repaired the anomaly by use of Dacron patch. The postoperative course was uneventful and discharged with excellent general condition and has been good during follow-up.

• Journal of Chest Surgery
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• 제21권4호
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• pp.692-699
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• 1988

In 1987, we experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 28 years old male with supracardiac type drained through left innominate vein. He was oldest patient among T.A.P.V.D. which was reported in Korea. The other case was 14 years old male with cardiac type drained to right atrium directly without communication with coronary sinus. Two patients were well in postoperative 9 and 10 months and have NYHA functional class I.