• Journal of Chest Surgery
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• v.47 no.1
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• pp.32-34
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• 2014

Anomalous aortic origin of the left subclavian artery (LSCA) from the left pulmonary artery (LPA) is a rare congenital cardiac malformation. We describe a case of LSCA from the LPA via ductus arteriosus in association with a double-outlet right ventricle, which never has been reported previously in Korea.

• The Korean Journal of Nuclear Medicine
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• v.7 no.2
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• pp.27-34
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• 1973

Pulmonary perfusion scan with radioactive $^{113m}In$-iron hydroxide particle was performed in the 25 cases of heart disease which had been diagnosed by cardiac catheterization prior to surgery from July, 1972 to July, 1973 at the Department of Radiology and Nuclear Medicine, Yonsei Medical College. It consists of 7 mitral stenosis, 2 mitral insufficiency, 1 aortic insufficiency, 3 atrial septal defect, 5 ventricular septal defect, 2 patent ductus arteriosus, 1 transposition of great vessel and 4 Tetralogy of Fallot. Findings of pulmonary perfusion scan in relation to hemodynamic data of cardiac catheterization were examined. 1) Out of 10 cases of acquired valvular heart disease, In 6 cases of mitral stenosis and 1 case of aortic insufficiency, radioactivity was increased at both upper lung. This finding is noted when pulmonary wedge or venous pressure was elevated above 22 mmHg and arterial systolic pressure above 33 mmHg. 2) Out of 15 cases of congenital heart disease. In almost all cases of atrial septal defect and ventricular septal defect except 2 cases, radioactivity was even at both entire lung. In 2 cases of patent ductus arteriosus, radioactivity was decreased especially at the left lung. It is observed that in acyanotic congenital heart disease, radioactivity of lung is not related with pulmonary arterial pressure. In 3 cases of Tetralogy of Fallot, radioactivity was even at both entire lung and in 2 of them, extrapulmonary radioactivity of liver or kidney which depends on size of defect and volume of right to left shunt reversible, was noted.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.418-421
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• 2003

Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.165-173
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• 1985

A clinical analysis was performed n 706 uses of patent ductus arteriosus experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 27 years period from 1958 to 1984. Of the 706 patients of PDA, 244 patients were male and 462 patients were female and ages ranged from 2 months to 53 years old with the average age of 8.5 years. The chief complaints on admission were dyspnea on exertion and frequent URI in 58.9%, non specific symptoms such as palpitation and easy fatigability in 9.7%, symptoms of CHF in 2.0% and no subjective symptoms in 29.4%. On auscultation of heart, continuous machinery murmurs were heard in 82% and only systolic murmurs were heard in 18% of patients. On simple chest PA of patients, cardiomegalies were detected in 78% and there were increased pulmonary vascularities in 93% of patients. EKG findings were as followed; LVH 56.9%, BVH 12.6%, RVH 2.9% and WNL 27.6%. Cardiac Catheterizations were performed in 512 patients and mean Qp/Qs was 2.56 and mean systolic pulmonary artery pressure was 45mmHg. Operation methods were as followed; in patients in whom operations were performed on PDA only, ligation 94.3%, division 3.7% and ligation [0.5%] or trans-pulmonary artery suture closure [1.5%] under cardiopulmonary bypass 2.0% and in patients in whom operations were performed with associated anomalies, ligation 17.6%, division 2.4%, and ligation [44.7%] or trans-pulmonary artery suture closure [35.3%] under cardiopulmonary bypass 80%. 52 postoperative complications [8.4%] were developed in 42 patients [6.8%] and its were as followed; permanent or transient hoarseness 16 [2.6%], intraoperative rupture of PDA 8 [1.3%], recannalization 6 [1.[%], operative death 5 [0.8%], late death 4 [0.6%] and other miscellaneous complications 13 [2.1%]. 140 associated cardiac anomalies [19.8%] were found in 105 patients [14.9%] and its were as followed; VSD 68 [9.6%], COA 15 [2.1%], Subaortic discrete membrane 7 [0.9%], ASD 6 [0.8%], TOF 5 [0.7%] and other miscellaneous and

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.287-292
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• 1986

A clinical analysis was performed on 61 cases of patent ductus arteriosus experienced at Yeungnam University Hospital during 3 years period from Aprial, 1984 to December, 1986. Of the 61 patient of PDA, 13 patient were male and 48 patient were female and age ranged 2 months to 26 years old with the average age of 9.4 years. The chief complaints on admission were frequent URI and dyspnea on exertion. Main diagnostic procedure were Doppler Echocardiogram(in 53 among 61). All of the operations were performed the method of ligation of PDA. Three posterative complication were developed, but there was no operative mortality.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.26-31
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• 2000

Background: This study was aimed at analyzing the preoperative conditions post-operative results indication and methods of surgical closure of patent ducturs arterio년 in prematures low birth weight infants and neonates. Patients and Methods: We retro-spectively studied two groups of patients (prematures group and neonates group) who underwent surgical closure of the patent ductus arteriosus between March 1995 and June 1998. Results: The premature group consisted of 9 patients(3 males and 6 females) Their mean gestational period was 30.7 weeks(ranging from 26 weeks to 33 weeks) mean age 27.8 days(11 days to 55 days) and mean body weight 1.56 kg. Prominent preoperative symptoms were dependency on mechanical ventilation generalized edema and hepatomegaly. We performed PDA ligation via thoracotomy in all premature patients. The neonate group consisted of 16 patients and their mean body weight was 3.75 kg. Major symptoms of this group was tachypnea and intercostal retraction resistant to medical treatment. We performed video-assisted PDA clipping to them all. There were no postoperative complications or operation-related mortality in both groups. Comparing the ratio of size of PDA(mm)/body weight(kg) the ratio of premature group (ligation through thoracotomy) was higher than that of neonate group ( video-assisted clipping) that is 3,89:1.21(p=0.03) Conclusion : We conclude that the surgical closure of PDA can be a safe method of treatment for prematures low birth weight infants and neonates with compromised general conditions. Choice of surgical technique depends on the surgeon's preference but there was a tend-ency to choose the ligation method through thoracotomy for patients with small body weight and large PDA.

• Journal of Chest Surgery
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• v.34 no.1
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• pp.35-40
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• 2001

배경: 혈역학적으로 문제가 되며 인도메타신 치료가 불가능한 미숙아 동맥관 개존증에서 동맥관 결찰술은 비교적 안전하고 효과적인 치료법으로 알려져 있다. 대상 및 방법: 1995년 1월부터 2000년 5월까지 동맥관 개존증을 가진 50명의 미숙아를 대상으로 인도메타신 치료와 동맥관 결찰술의 치료성적을 검토하였다. 결과: 50례의 미숙아 동맥관 개존증 중 28례에서 혈역학적으로 문제가 되어 치료가 요구되었고 그 중 5례에서는 인도메타신 치료를, 나머지 23례는 인도메타신 치료의 금기가 되어 동맥관 결찰술을 시행하였다. 제태기간과 출생시 체중은 치료를 시행하지 않았던 군(32.1$\pm$2.1주, 1731$\pm$450.9g)과 인도메타신 치료군(32.0$\pm$2.1주, 1830$\pm$165.5g)보다 동맥관 결찰술군(29.6$\pm$2.1주, 1435$\pm$431.0g)이 가장 짧았다(p<0.05). 치료를 시행한 28례에서 치료시 나이(8.6$\pm$5.5일, 7,3$\pm$4.4일)는 인도메타신 치료군과 동맥관 결찰술군 간에 차이가 없었으나, 체중(1670$\pm$43.6g, 1211$\pm$22.4g)은 동맥관 결찰술군에서 의의있게 적었다(p<0.05). 치료후 생존율은 100%와 73.9%로 인도메타신 치료군에서 높았고 술후 사망은 23.7$\pm$22.4일(6-68일)째 발생하였으며 사망원인은 패혈증 5례, 뇌실질내 출혈과 기관지폐이형성증이 각각 2례, 패혈증 쇼크와 기흉이 각각 1례로 수술과는 직접적인 관련이 없었다. 결론: 미숙아 동맥관 개존증에서 조기에 동맥관 결찰술을 시행하는 것은 비교적 안전하고 효과적이며, 특히 인도메타신 치료를 시행할 수 없는 경우와 초저체중의 미숙아에서도 안전하게 적용 될 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• v.34 no.4
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• pp.351-355
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• 2001

개흉술에 의한 수술적 폐쇄방법 및 경도관 동맥관 폐쇄술은 동맥관 개존중의 치료방법으로 발전되어 왔으나, 이러한 술식은 개흉술에 의한 합병증, 지속적인 단락 및 용혈의 가능성, 기구의 이동이나 색전증의 발생, 지속적인 단락시 세균성 심내막염 방지를 위한 지속적인 항생제 사용등의 단점이 있어 저자들은 흉강경을 이용한 수술을 시행하였다. 총 6례의 환자에서 흉강경을 이용한 동맥관 개존증 수술을 시행하였으며. 이중 대동맥 외막(adventitia) 박리중 지형이 잘 되지 않았던 1례에서는 소개흉술(minithoracotomy)로 전환하였다. 술 후 이시행한 이학적 검사상에서 모든 환아에 심잡음이 소실되었음을 확인할 수 있었으며, 흉부 방사선 검사상 점진적인 폐혈관음영의 감소를 관찰할 수 있었으며 수술중 동맥관 파열이나 불완전한 동맥관 폐쇄, 기흉, 애성(hoarseness) 등의 합병증은 발생되지 않았다. 환아들은 술후 평균 3.4일째 퇴원하였으며, 퇴원후 외래추적 관찰검사시 시행한 심초음파 검사상 동맥관의 재개통이나, 잔류단락은 관찰되지 않았다. 본원에서는 개흉술 및 경도관 동맥관 폐쇄술의 단점을 방지할수 있으며, 성공적인 동맥관 폐쇄, 작은 피부절개 반흔에 의한 미용적 효과, 짧은 재원기간등의 장점을 가진 흉강경을 이용항 동맥관 결찰술을 시해앟여 문헌 고찰과 함께 보고하는 바이다.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.507-510
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• 2014

An 8 month-old female Pomeranian dog was presented with major complaints of heart murmur and cardiomegaly. Diagnostic study found the left-to-right patent ductus arteriosus (PDA) with moderate heart failure (ISACHC II). The PDA occlusion was successfully accomplished using a $5mm{\times}3loops$ embolic coil through right femoral artery. Two months later, the dog came back to clinic with marked hypotension, severe diarrhea and pleural effusion. Diagnostic study found severe pulmonary hypertension and tricuspid regurgitation. The clinical condition was controlled by the administration of sildenafil (3 mg/kg, PO, TID). However, the dog was expired by dislodged embolic coil and inconsistent medication by the owner. Postmortem study found the pulmonary hypertension was occurred by the abnormally dislodged embolic coil. Although the embolic coil is widely used for PDA occlusion in toy dogs with PDA, the more careful evaluation for the size and shape of PDA is necessary to minimize the risk of dislodgement of pre-placed coil.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.228-238
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• 2023

Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.