• Journal of Chest Surgery
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• 제48권6호
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• pp.415-418
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• 2015

Right aortic arch with isolation of the left subclavian artery is a rare anomaly. The incidence of bilateral ductus arteriosus is sporadic, and a right aortic arch with isolation of the left subclavian artery in association with bilateral ductus arteriosus is therefore extremely rare. Since the symptoms and signs of isolation of the left subclavian artery can include the absence or underdevelopment of the left arm, subclavian steal syndrome, or pulmonary artery steal syndrome, the proper therapeutic approach is controversial. We report a case in which surgical reconstruction was used to treat isolation of the left subclavian artery with right aortic arch in association with bilateral ductus arteriosus and a ventricular septal defect.

• 한국임상수의학회지
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• 제34권2호
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• pp.90-93
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• 2017

A nine-month-old intact female Maltese dog (body weight: 1.5 kg) presented with frequent syncopal episodes (1-2/day), exercise intolerance, and dyspnea. Cardiomegaly with marked dilation of right and left atria along with ascites was indicated on radiography. Tricuspid regurgitant jets (4.36 m/s), pulmonary regurgitant jets (3.4 m/s), left-to-right shunting flow at the ductus arteriosus, and an atrial septal defect were observed on echocardiography. A bubble study with agitated saline found right-to-left shunting at the interatrial septum. Based on diagnostic studies, the dog was diagnosed with right-to-left atrial septum defect (ASD) compounded with patent ductus arteriosus (PDA). The treatment was directed to reduce the pulmonary hypertension, improve cardiac performance, and lower fluid retention. Despite medical treatment for 2 months, the dog died of sudden cardiac arrest. Herein, we describe a very rare case of right-to-left ASD compounded with PDA.

• Neonatal Medicine
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• 제18권2호
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• pp.365-369
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• 2011

폐동맥폐쇄가 동반된 팔로네증은 팔로네증 중에 가장 심한 형태이다. 이런 종류의 선천성 심질환에서 폐혈액 순환을 지속하기 위하여 동맥관 개존을 유지하는 것은 생명을 구하는 매우 중요한 치료이다. Milrinone은 선택적 인산이에스테르효소 3 억제제이며 강력한 혈관 확장제로 알려져 있다. 저자들은 폐동맥 폐쇄가 동반된 팔로네증 신생아에서 폐순환을 지속시키기 위하여 동맥관 개방을 유지하는 치료로 milrinone을 성공적으로 사용한 증례를 보고한다. Milrinone은 동맥관 개방효과뿐 아니라, 심근수축 촉진, 이완 촉진, 폐혈관 확장 효과가 있으며 부작용은 심하지 않아 더 이로운 치료방법이 될 가능성이 있다. Milrinone의 치료효과를 밝히기 위하여 더 많은 치료증례 조사와 타 약제와의 비교 연구 등이 필요하다.

• 농업과학연구
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• 제14권1호
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• pp.191-195
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• 1987

충남대학교 부속가축병원에 내원(來院)한 shepherd 견(犬)을 대상으로 임상진단(臨床診斷), 심전도(心電圖) 및 X-ray 검사(檢査)를 실시하여 개방성(開放性) 동맥관(動脈管)으로 진단된 예(例)에 있어서 이를 확인하고 또 치료할 목적(目的)으로 진단적(診斷的) 개흉술(開胸術)을 시도하였다. Pentobarbital sodium을 사용한 마취로 좌측 제(第)4늑간(肋間)에서 개흉(開胸)하여 동맥관(動脈管) 이중결찰법(二重結紮法)으로 시술(施術)하였다. 시술결과(施術結果)는 개방성(開放性) 동맥관(動脈管)의 결찰 3 분준(分俊)에 심실세동(心室細動)이 발생하였기에 defibrillator 로 제세동(除細動)을 실시하였으나 효과(效果)없이 회복하지 못하였다. 합병증이나 cyanosis가 있을 경우에는 수술적합성 여부를 신중히 고려하여야 될 것으로 생각된다. 조직학적(組織學的) 소견(所見)으로는 간(肝)의 만성(慢性) 수동성(受動性) 충혈소견(充血所見)이 인정(認定)되었다.

• Journal of Chest Surgery
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• 제18권4호
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• pp.537-541
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• 1985

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

• Journal of Chest Surgery
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• 제7권1호
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• pp.85-92
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• 1974

During the years 1959 to 1974, 99 patients with patent ductus arteriosus were admitted to National University Hospital. These includes 5 patients with additional cardiovascular and 5 patients with severe pulmonary hypertension. All were operated upon except three refused operation. In all instances, the diagnosis was made by history and physical, roentgenological and electrographic examinations. In addition, in 53 patients, special diagnostic procedures were carried out either for diagnosis or for evaluation of pulmonary hypertension and associated cardiovascular anomalies. Right cardiac catheterization was resorted to in 51 patients. In one of these patients catheterization was incorrectly interpreted [ventricular septal defect]. Retrograde aortogram was performed in two patients. In both cases the ductus itself was visualized on the x-ray film. An additional vascular anomaly, namely the persistent left superior vena cava, was confirmed by retrograde angiogram in one of them. In 5 cases the pulmonary arterial pressure was elevated well over 80 mmHg. In these instances,the operative mortality was 80% [4 out of 5 patients]. The management of patent ductus arteriosus when associated with severe pulmonary hypertension. and/or other cardiac anomalies is controversial. Opinions differ as to how to close the ductus and to repair the cardiac anomalies as well as to whether a one-staged or two-staged procedure should be resorted to. The author is of the that each case must be evaluated individually before any specific surgical treatment is ou.tlined. The literature on the subject is reviewed in this paper.

• Journal of Chest Surgery
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• 제17권2호
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• pp.250-256
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• 1984

Eisenmenger syndrome is a condition which systemic arterial blood oxygen unsaturation occurs if obstruction in the pulmonary capillaries raises the pulmonary vascular resistance and pulmonary arterial pressure to or beyond systemic levels and then a significant right to left shunt develops across a preexisting cardiac septal defect or an aortopulmonary communication-We have experienced 3 cases of similar condition. Case I is 24 year old man who has had cyanosis and dyspnea on exertion since childhood. His pulmonary arterial pressure was 110/80mmHg. He was operated under diagnosis of the mitral stenosis and tetralogy of Fallot, but it was finally discovered that he had patent ductus arteriosus and ventricular defect was closed with perforated prosthetic patch, but the patient expired due to right heart failure low cardiac output. Case II was 16 year old female who had pulmonary hypertension of 110/85mmHg. She was diagnosed as Eisenmenger syndrome combining with atrial septal defect and patent ductus arteriosus. Case III was 20 year old male. His pulmonary arterial pressure was 110/70mmHg and the underlying defect was patent ductus arteriosus.

• Journal of Chest Surgery
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• 제43권1호
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• pp.89-91
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• 2010

동맥관개존증을 가진 어른 환자에서 대동맥판막과 폐동맥판막의 심내막염이 발생한 경우는 드물게 보고되고 있다. 60세 여자 환자에서 두 개의 판막에 심내막염과 동맥관개존증이 동반되었음을 진단하였고 수술적인 치료를 하였기에 보고 하고자 한다.

• Journal of Chest Surgery
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• 제15권4호
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• pp.381-386
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• 1982

Pulmonary artery aneurysm usually carries an ominous prognosis due to the associated pulmonary hypertension. In July 1981, a patient with a huge aneurysm of main pulmonary artery secondary to pulmonary hypertension and bacterial endocarditis due to a patent ductus arteriosus was treated by resection of the aneurysm and Dacron patch graft replacement and closure of the patent ductus arteriosus. The immediate postoperative result was excellent. We now report the surgical treatment, clinical course, and one and half years follow up of the patient.

• Journal of Chest Surgery
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• 제16권4호
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• pp.492-497
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• 1983

24 cases of patent ductus arteriosus were experienced from Aug. 1977 to October 1983, at the department of thoracic surgery. Chungnam National University Hospital. Patent ductus arteriosus is one of the common congenital heart disease and the diagnosis can be made easily and simply. Interruption is done by thoracic surgeons and it is considered on of the simple separation. 1. Age ranged from 10 month old to 19 year old. 2. Sex ratio [male to female] was 1:2. 3. Diagnosis was made by the finding of the physical examination, chest X-ray, E.K.G., and Cardiac catheterization. 4. Operation was performed with double ligation and transfixion suture ligation at 23 cases, division was one case. 5. Postoperative recanalization was occurred in one patient, who had subacute bacterial endocarditis.