• Journal of Chest Surgery
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• v.37 no.7
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• pp.613-616
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• 2004

Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.223-230
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• 1984

Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.75-78
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• 1985

From April, 1984 to January, 1985, 57 cases of cardiovascular surgeries were performed at Yeung Nam University Hospital consisting 31 cases of open heart surgery and 26 cases of ligating patent ductus arteriosus. Among 31 cases of open heart surgery, all cases are congenital acyanotic heart disease except a case of rheumatic aortic valvular heart diseases taken aortic valve replacement with Bjrk-Shiley 25mm. Only 2 cases of transient hemoglobinuria were complicated. A case of surgical mortality was present died of acute respiratory failure and intractable arrhythmia, which resulting 3.2% of mortality rate.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.146-151
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• 1997

Between December 1993 and March 1996, 75 patients had undergone ubannular procedures in mitral valve reconstruction. Their mean age was 45 years and they consisted of 28 males and 47 females. The cause of mitral disease in 75 patients were classified as follow : 29 cases were degenerative, 40 cases were rheumatic, 3 cases were congenital, 2 cases were infectious and 1 case was ischemic. Average number of mitral anatomical lesion per patient was 3.1 and we used average 1.5 procedures on subannular structure in mitral valve per patient. Subannular procedures were chordae shortening 21, chordae transfer 22, new chordae formation 20, papillary muscle splitting 33, shortening of papillary muscle 2. Intraoperative transesophageal echocardiography was carried out for providing an immediate and accurate assessment of the adequacy of the reconstruction. There was no operative death. Patients have been followed up from 2 to 29months, mean 12.5. There were two failures that necessitated reoperation. The mean functional class (NYHA) was 3.19 preoperative and improved to 1.12 postoperatively. After mitral valve repair, the patients were improved hemodynamic, echocardiographic data. In conclusion, subannular procedure in mitral valve repair when feasible is stable and safe with a low prevalence of reoperation.

• Korean Journal of Veterinary Service
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• v.47 no.1
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• pp.1-7
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• 2024

Radiographic left atrial dimension (RLAD) is a valuable metric for assessing left atrial enlargement in dogs. While there have been studies on the use of RLAD and the increase in C-reactive protein (CRP) levels based on heart disease stages, there has been no prior research on the correlation between RLAD and CRP. In this study, the objective was to investigate the relationship between the rise in RLAD as myxomatous mitral valve disease (MMVD) stages advance and the increase in CRP levels with MMVD stage progression. In this study, a total of 30 small-breed dogs were included as subjects. These dogs were diagnosed with MMVD at the American College of Veterinary Internal Medicine (ACVIM) stage B1 or B2, or stage C, based on a comprehensive assessment including physical examination, thoracic radiography, and echocardiography. Measurements of VHS and RLAD were compared to assess any significant differences. There were significant differences in RLAD between dogs with MMVD ACVIM stage B1 and those with stage C. The monocytes and CRP levels showed significant differences between ACVIM stage B1, B2 and ACVIM C. Additionally, a significant correlation was observed between the RLAD and VHS measurements. This underscores the notable association between MMVD stage advancement and elevated monocyte and CRP levels. The RLAD scores exhibited a significant difference among dogs with ACVIM stages B1, B2, and C, and significant variations were also observed in monocyte and CRP levels. These results suggest that monocyte and CRP levels may be a valuable diagnostic indicator for heart disease in dogs during the diagnostic evaluation.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.626-629
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• 2001

Congenital polyvalvular disease is a connective tissue disorder affecting more than one heart valve with variable involvement of the entire valvular and subvalvular apparatus. It is frequently associated with the Trisomy 18 and trisomy 13-15 or ventricular septal defect and patent ductus arteriosus. We present an isolated case of congenital polyvalvular disease in a new born baby with a review of the pertinent literatures, which has not been described in Korea. The mass was discovered as a right atrial mass in the prenatal ultrasonography and it was thought to be either a hematoma or a myxoma in the preoperative echocardiography. Microscopic examination of the surgically resected mass showed irregular thickening, nodulation, and additional features of calcification and ossification in the valvular connective tissue on the body of anterior and septal leaflet of tricuspid valve. Congenital polyvalvular disease should be included in the differential diagnosis in cases showing valvular calcification or ossification in the fetal echocardiography.

• Journal of Veterinary Science
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• v.22 no.5
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• pp.60.1-60.9
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• 2021

Background: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. Objectives: To establish the normal echocardiographic parameters for Maltese dogs. Methods: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. Results: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. Conclusion: This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.305-312
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• 2008

Background: Anatomic and functional abnormalities of the systemic atrioventricular (AV) valve are common in single ventricle. pathologies and continue to be associated with poor early and late outcomes in surgically palliated single. ventricle patients. We aggressively performed valvuloplasty for atrioventricular valve regurgitation (AVVR) during the course toward a Fontan operation. Material and Method: Between January 1995 and December 2004, 209 patients underwent a Fontan operation in our institution. We retrospectively evaluated the prevalence of AVVR and the influence of AV valve repair on outcome, and we analyzed the progression of AVVR after the Fontan operation for 168 patients where echocardiographic follow up results for more than 6 months after the Fontan operation were available. During the course toward a Fontan operation, 25 patients underwent 30 procedures for AVVR. These procedures. were. carried out during placement of a bidirectional cavopulmonary shunt (BCPS) for nine patients, between the time of placement of a BCPS and the Fontan operation for four patients, and during the Fontan operation for 17 patients. Five patients underwent procedures for AVVR twice. Result: The late mortality rate after the Fontan operation was 4.2% (n=7), with a median follow-up duration of 52 months (range, $6{\sim}123$ months). Seven patients (4%) had unfavorable outcomes such as significant (moderate or severe) AVVR in six patients, and significant AV valve stenosis in one patient was determined at the last follow up after the Fontan operation. Among the seven patients, four patients underwent AV valve repair after the Fontan operation, and one patient underwent subsequent AV valve replacement. Progression to AVVR of equal to or greater than grade 2 was noted in 30 patients (18%) at the last follow up after the Fontan operation, including 12 patients that underwent previous AV valve procedures. Initial grading of AVVR, a previous AV valve operation, and specific AV valve morphology such as a common AV valve or mitral atresia were significant risk factors for the progression of AVVR after the Fontan operation. Conclusion: In our surgical series, a small percentage of patients showed unfavorable outcomes. related to AVVR during the course toward a Fontan operation. However, a closer follow-up is required to evaluate the progression of the AVVR after a Fontan operation, especially for patients showing poor AV valve function at the first presentation and specific AV valve morphology.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.976-981
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• 1992

The results of the clinical observations on the 158 cases of the mitral valvular heart disease treated at the Department of Thoracic and Cardiovascular Surgery, Masan Koryo General Hospital from June, 1986 to December, 1991 were as follows; 1. There were 50 men and 108 women with sex ratio 1: 2.2. 2. The age of patient varied widely from 13 years to 65years. 3. The preoperative functional level accoridng to the NYHA classification were class II, III, IV in 18%, 67%, 15%. 4. All 158 patients were operated on under direct vision using extracorporeal circulation, mitral valve replacement in 118 cases, mitral and aortic valve replacement 40 cases. 5. The follow up period was between 2 months and 65 months postoperatively. [mean 30.1 months] 6. The early operative motality was 5.7%[9 cases], late motality was 4%[6 cases]. 7. The cardiothoracic ratio in the chest X-ray decreased at the 6th month postoperation. [pre-op: 0.60$\pm$0.07, post-op: 0.56$\pm$0.06 p<0.01]

• Journal of Chest Surgery
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• v.18 no.3
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• pp.446-455
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• 1985

A total and consecutive 156 patients have undergone cardiac valve surgery including 13 closed mitral commissurotomy, 13 open mitral commissurotomy, one mitral annuloplasty, 75 mitral valve replacement, one aortic annuloplasty, 24 aortic valve replacement, 3 tricuspid valve replacement, 25 double valve replacement and one triple valve replacement. 155 prosthetic valves were replaced in a period between September 1976 and August 1985. There were 68 males and 88 females with age range from 8 to 69 yrs [mean 36.5 yr]. Out of replaced valves, 61 was tissue valve including 54 Carpentier-Edwards, and 4 was mechanical valves including 74 St. Jude Medical, and the position replaced was 101 valves for mitral, 46 for aortic and 8 for tricuspid. Single valve replacement in 102 cases, double valve replacement in 25 cases [17 for AVR+MVR, and 8 for MVR+TVR], and only one case was noted in the triple valve replacement. Early mortality within 30 days after operation was noted in 11 cases [7%]; 7 after MVR, 2 after DVR, and each one after open mitral commissurotomy and mitral annuloplasty. Cause of death was valve thrombus, cerebral air embolism, low output syndrome, uncontrollable arrhythmia, parapneumonic sepsis, acute cardiac tamponade and left atrial rupture. 7 late deaths were noted during the follow-up period from 1 to 104 months [average 48 month]; three due to valve and left atrial thrombus formation, two due to CVA from overdose of warfarin, and each one due to congestive heart failure and chronic constrictive pericarditis, Anticoagulants after prosthetic valve replacement were maintained with warfarin, dipyridamole and aspirin to the level of around 50% of normal prothrombin time in 79 cases, and Ticlopidine with aspirin in 47 cases to compare the result of each group. There were 11 major thromboembolic episodes including 3 deaths in the warfarin group. Two cases of CVA due to overdose of warfarin was noted in the warfarin group. In the ticlopidine group, there was only one left atrial thrombus confirmed at the time of autopsy. Among the survived 138 cases, nearly all cases[136 cases] were included in NYHA functional class I and II during the follow-up period. In conclusion, surgical treatment of the cardiac valve disease in 156 clinical cases revealed excellent result with acceptable operative risk and late mortality. Prevention of thrombus formation with anti-platelet aggregator Ticlopidine has better result than warfarin group presently with no specific side effect such as bleeding or gastrointestinal trouble.