• Journal of Chest Surgery
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• 제19권4호
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• pp.578-583
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• 1986

Tetralogy of Fallot is the most common cyanotic congenital anomaly, which needs some operation for the survival. Perioperative mortality of the Tetralogy of Fallot was lowered remarkably in recent years, but some discussions were presented for the criteria of the corrective surgery and the corrective method of the pulmonary stenosis. In the Department of Thoracic and Cardiovascular Surgery of the Chunbug National University Hospital, 17 cases of tetralogy of Fallot were corrected totally from July in 1983 to August in 1984. In correction of the pulmonary stenosis, transannular patch was applied in B patients, infundibulectomy in 5, RVOT patch without transannular patch in 3, and isolated patches on RVOT and pulmonary trunk. Preoperative and early postoperative hemodynamic study revealed increased RA pressure in transannular patch group, which was significant statistically. [p<0.01]. Clinically, perioperative death occurred only in transannular patch group, and right heart failure signs including hepatomegaly, ascites, pleural effusion and peripheral edema were high in frequency in transannular patch group.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1238-1241
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• 1991

Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

• Journal of Chest Surgery
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• 제16권4호
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• pp.452-457
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• 1983

Transposition of great arteries is relatively common cyanotic heart disease excluding TOF and is divided to two groups: complete TGA and congenitally corrected TGA. We experienced operations in 3 cases of TGA, the 1st case was 12 year-old male: TGA[SDD] + VSD+PS and treated with Rastelli`s operation, but expired due to low cardiac output syndrome postoperatively. The 2nd case,13 year-old male was also TGA[SDD]+VSD+PS and treated with Rastelli`s operation with good operative result. The 3rd case was 18-year old male: congenitally corrected TGA[SLL]+VSD+ PA+ASD and operation was done according to the met. hod reported by Danielson et al in 1980. Post-operative AV block led to implantation of permanent epicardial pacemaker with good result.

• Journal of Chest Surgery
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• 제16권2호
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• pp.147-156
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• 1983

Over a period from May, 1977 to SEptember, 1982, 101 cases ofopen heart surgerywere done under cardiopulmonary bypass. There were 50 male and 51 female patients, and the ages of the patients ranged from 19 months to 48 years. Sixty-nine cases were congenital heart disease and 32 cases were acquired heart disease, which consisted of 30 valvular disease, 1 IVC obstruction, and 1 myxoma. Among the 30 cases of valvular disease, 12 MVR, 4 MVR+TAP, 2 MVT+AVR, 1 MAP, and 11 OMC were done. There were 3 operative deaths (17.5%) in 16 MVR, 1 in 2 MVR+AVR, and 1 in 11 OMC. Operative mortality in 69 congenital heart disease was 13.0% ; 3 deaths (6.7%) in 45 acyanotic and 6(25.0%) in 24 cyanotic cases. The overall mortality for 101 cases was 14.8%; 13.0% for congenital and 18.8% for acquired heart disease.

• Journal of Chest Surgery
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• 제19권3호
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• pp.528-533
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• 1986

Total anomalous pulmonary venous connection is relatively rare cyanotic congenital heart diaease, which represents 1-4% of all congenital cardiac defects. Generally in the majority cases, severe heart failure and cyanosis develops in the early infancy. Because of high mortality in the untreated infants and surgical risk, there are still many things to be improved. Two patients with total anomalous pulmonary venous connection are presented, which we recently experienced. The one was 10 year old female with supracardiac type drained through left innominate vein, and survived the operation and continuous to do well for 1 year. The other 5 year old female with mixed type (right pulmonary vein drained via coronary sinus and left pulmonary vein through left innominate vein) was operated successfully under hypothermia and extracorporeal circulation, and followed up for 6 months without problem. It was very rare case in the literature.

• Journal of Chest Surgery
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• 제24권7호
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• pp.719-724
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• 1991

A case of pulmonary atresia with intact ventricular septum was presented in a 10-month-old cyanotic female patient, which was congenitally rare. Infant with pulmonary atresia and intact ventricular septum usually require urgent surgical intervention. Angiogram showed the pulmonary atresia at the level of the pulmonary valve, the hypoplasia of tricuspid valve and atrial septal defect without patent ductus arteriosus. We performed the pericardial patch graft on the right ventricular outflow tract and pulmonary artery after ventriculotomy using pacemaker wire as electrical saw and main pulmonary arteriotomy and then modified Waterston shunt from the ascending aorta to patch on the right ventricular outflow tract without extracorporeal circulation. Patient was postoperatively good condition.

• Advances in pediatric surgery
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• 제11권2호
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• pp.123-130
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• 2005

Gastric perforation of the newborn is a rare and life threatening problem. The pathogenesis of gastric perforation is not clear. Since ischemia is responsible for intestinal perforation, a similar mechanism may result in gastric perforation. Twelve patients with neonatal gastric perforation who were treated at the Department of Pediatric Surgery, Hanyang University Hospital from 1987 to 2002 were reviewed. Eight patients were male and four female. The age of perforation was 1 day to 8 days of life. Ten patients were operated upon and 2 patients were treated nonoperatively. The perforation site was located on the anterior wall along the greater curvature of the stomach in 8 patients and along the lessor curvature of the stomach in 2. The precipitating factors were prematurity, gastroschisis, mechanical ventilation, intestinal obstruction, cyanotic heart disease and indomethacine medication. In 5 cases the cause of perforation was not identified. The mortality rate was 25 % (3 of 12). Earlier recognition and treatment were thought to be crucial prognostic factors.

• Journal of Chest Surgery
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• 제16권3호
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• pp.310-315
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• 1983

The combined anomaly of pulmonary stenosis with atrial or ventricular septal defects is usually associated with decreased pulmonary blood flow and right to left shunt, and result in generalized cyanosis. Non-cyanotic pulmonary stenosis patients have generally been considered to have isolated pulmonary stenosis with intact septa. We are going to report a case of pulmonary stenosis with septal defects who have no frank cyanosis at rest because of the predominant intracardiac shunt from left to right. Recently, we managed surgically a case of pulmonary valvular stenosis combined with secundum type atrial septal defect, type II ventricular septal defect, and patent ductus arteriosus. The clinical manifestations of this patient were exertional dyspnea, frequent upper respiratory infection, chest discomfortness and lethargy since late childhood and these had been progressively aggravated. Pulmonary valvular stenosis, atrial septal defect and ventricular septal defect were closed through simply right atriotomy and patent ductus arteriosus through pulmonary arteriotomy. Immediate postoperative course was uneventful and one year follow up is excellent.

• Journal of Chest Surgery
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• 제18권4호
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• pp.643-648
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• 1985

Tricuspid atresia is the third most common cause of cyanotic heart disease, following T.O.F. and T.G.A. It is seen in about 30% of patients with congenital heart disease on postmortem examination. Recently, we experienced a case of tricuspid atresia, who had received Blalock-Taussig Shunt operation 10 years ago. The Patient was 15 year-old girl with the complaints of persistent cyanosis and exertional dyspnea. Cineangiography revealed Keith type lib tricuspid atresia, so, RA appendage was anastomosed to the right pulmonary artery and ASD was also closed using patch. Postoperative course was very difficult because of persistent right heart failure and weak respiratory power, but from postoperative 15th day, all cardiac and respiratory problems were resolved. We followed up this patient for about 1 year, and her condition is excellent up to now.

• Journal of Chest Surgery
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• 제18권4호
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• pp.711-717
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• 1985

Over a period from July 1984 to June 1985, 39 cases of open heart surgery were done under cardiopulmonary bypass. There were 23 male and 16 female patients, ranging in age from 18 months to 58 years. Thirty cases were valvular disease. The most common of congenital heart disease is VSD. Among the 9 cases of acquired valvular diseae,1 MAP, 5 MVR, 2 MVR+TAP, and 1 MVR+AVR were done. There were 1 operative death[11%] which was done MVR+TAP. Operative mortality in 30 congenital heart disease was 7%; 1 death [5%] in 22 acyanotic and 1[13%] in 8 cyanotic cases. Finally, overall mortality for 39 cases was 8%; 7% for congenital heart disease and 11% for acquired heart disease.