• Journal of Chest Surgery
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• v.25 no.11
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• pp.1337-1345
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• 1992

One hundred and fourty-one Bjork-Shiley Monostrut valves were implanted in 105 consecutive patients from November 1983 to February 1990. There were 61 male and 44 female patients with a mean age of 33.6 years at the surgery. The cummurative follow-up was 370.3 patient-years with a mean of 44.0 months per patient. The operative mortality rate was 3.8%, and the linealized late mortality was 1.18%/patient-year. The incidence of major complications were 4.59%/patient-year, and the actuarial rate of freedom from valve-related morbidity was 80.2$\pm$4.4% at 7 years. The 7-year survival rate was 90.5$\pm$4.1%, and the actuarial rate of freedom from thromboembolism at 7 years was 93.3$\pm$2.3%. The linealized annual rates of complication were ; structural valve failure 0.27% /patient-year, non-structural valve failure 0.54% /patient-year, thromboembolism 1.62% /patient-year; bleeding 1.62% /patient-year; endocarditis 0.54% /patient-year. On the basis of our experience, we judged the Bjork-Shiley Monostrut valve reliable, with similar incidence of valve-related morbidity of other mechanical prosthetic valves.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.373-377
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• 1978

Aneurysmal rupture of sinus Valsalva is known as one of rare cardiac disease and not controlled with medical treatment. We experienced 9 cases which were composed with 7 case of male and 2 cases of female during last 15 years. 7 cases were ruptured into right ventricle from right. coronary sinus and 2 cases were ruptured into right atrium from non-coronary sinus. The diagnosis was made with cardiac catheteriza1icn and cineangiccardicgram but 2 cases were misdiagnosed with only cardiac catheterization. All cases were corrected under cardiopulmonary bypass with means of direct suture with tdlon pledget by transatrial or transventricular approach. All were not confirmed in it's origin because of no history, no evidences of syphilis, TB, or bacterial endocarditis and only fibrosis in pathologic report. In postoperative course, 1 case had postoperative bleeding and 1 case was sufferd from left hemiplegia due to may be air embolism. Follow up study revealed all patient go on their usual life well with good improvement at this present time.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.276-282
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• 1988

Surgery is now the usual mode of therapy in patients with severe valvular heart disease. Until recently, clinicians and pathologists attributed nearly all acquired valvular heart diseases to a rheumatic origin, except some obviously resulting from acute infection and syphilis. Although many clinicians and pathologists describe that the origin of aortic valvular disease is a nonrheumatic origin, we recognize the major origin of aortic valvular disease in Korea as a rheumatic origin. We excised 47 cardiac valves from valvular heart diseased patients and performed anatomical and pathological analysis for its origin and underlying pathology. The purpose of this article is to provide an update for the clinicians of evolving issues related to the pathology of valvular heart disease. But myxomatous origin and infective endocarditis valvulitis will not be covered in detail.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.995-1001
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• 1994

The CarboMedics valve prosthesis is a relatively new. low profile bileaflet prosthesis. During a 6 year period from Aug. 1988 to July 1994. 158 patients had CarboMedics prostheses implanted in the mitral [n=94], aortic [n=25], or aortic and mitral [n=39] in National Medical Center. Hospital mortality was 9.4% and the main cause of death was low output syndrome. Follow up was 96% complete, with 365.4 patient-years and a mean follow up of 30 months [ range 1 to 72 months ] . The overall actuarial 6 year survival rate was 91.61 3.47% and actuarial 6year freedom from all valve related complications was 73.9 7.67%. The linearized incidence of vavle related complications was as follows: thromboembolism 1.37%/patient-year ; valve thrombosis 0.82%/ patient-year ; anticoagulant related hemorrhage 0.85%/patient-year ; perivalvular leakage 0.55%/paitent-year: prosthetic valve endocarditis 0.82%/patient-year ; reoperation 1.37%/patient-year. There were no instances of structural failure. We conclude that the Carbomedics valve has a low rate of complications that further improves the quality of life in patients with heart valve prostheses.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.428-431
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• 1997

We experienced a casts of prosthetic mitral paravalvular leak after redo DVR. As far as nonstructural dysfunction is concerned, the prosthetic paravalvular leak is not the result of prosthetic valve endocarditis, but is due to technical difficulties at the time of operation, either residual calcification or poor native tissue. Occasionally paravalvular leaks, particulary around mitral prostheses, may be silent. Paravalvular leaks are usually repaired when there is significant anemia or hemodynamic compromise. At reoperation, some of theses leaks can be repaired simply by patch losure around the paravalvular leak without placing additional suture or explanting the valve.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.247-249
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• 2011

We report a case of pseudo-pseudoaneurysm, which is a very rare complication of myocardial infarction. A 69-year-old man was admitted to our clinic with chest tightness and dyspnea. He had undergone aortic valve replacement with a pericardial bioprosthetic valve, ring mitral annuloplasty, and reconstruction of an aortic annular defect due to infective endocarditis with bovine pericardium 4 years prior. Echocardiography and computed tomography showed pericardial effusion and a 16-mm cavity at the anterolateral wall of the left ventricle. Magnetic resonance imaging suggested either pseudo-pseudoaneurysm or myocardial abscess. We successfully repaired the myocardial defect using a patch made from a vascular graft with pledgeted horizontal mattress sutures under cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.25 no.2
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• pp.158-166
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• 1992

From 1985 to 1990, a total of 160 new valves were implanted for 125 adult patients to whom prosthetic valve replacement had been performed [One patient had consecutive 2 reoperations]. Following data are the results from the follow-up study from January 1985 to February 1991. Mean age of the patients was 37.9$\pm$12.1 years. Mean follow-up period was 25.8$\pm$18.8 months. In bioprosthesis, mean interval between the previous operation and reoperation was 85.6$\pm$36.4 months in aortic valve, and 87.3$\pm$30.0 months in mitral valve. The causes of reoperation were prosthetic valve failure[103 patients, 81.7%], prosthetic valve endocarditis[17 patients, 13.5%], periprosthetic leakage[5 patients, 4.0%], and aneurysm of ascending aorta[1 patient, 0.8%]. Fourteen patients[11.1%] died in hospital; 5 in 22 replacement of aortic valve[22.7%], 6 in 73 rereplacement of mitral valve[8.2%], and 3 in 31 replacement of multiple valves [9.7%] Except for 3 intraoperative deaths, postoperative, major and minor complications occurred in 39 patients[31.0%]. And the actuarial 5-year survival rate of operative survivors was 95.5$\pm$8.6%.

• Journal of Chest Surgery
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• v.15 no.4
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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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• v.16 no.4
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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.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.656-662
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• 1991

endocarditis, 1.475% /pt-yr, overall valve failure, 3.319% /pt-yr; and primary tissue failure, 1.475% /pt-yr. The actuarial probability of survival was 94.3$\pm$3.6% and the probability of freedom from thromboembolism 90.6$\pm$4.6% at 11 years after surgery respectively. And, the probability of freedom from primary tissue failure was 60.4$\pm$16.9% also at 11 years The evidence of possible premature and accelerated failure of the pericardial valve in the aortic position among the young population was not clear on the age-related analysis of the structural failure, and no suggestion could be made to indicate age limit when the use of the pericardial valve would better be avoided.