• 제목/요약/키워드: Heart Valve Diseases

검색결과 93건 처리시간 0.025초

심장다판치환술의 임상적 고찰 (Clinical Evaluation of Multiple Valve Replacement)

  • 오상기
    • Journal of Chest Surgery
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    • 제33권2호
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    • pp.160-166
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    • 2000
  • Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

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심장수술 1,000례의 임상적 고찰 (Clinical Experience of Open Heart Surgery; 1000 Cases)

  • 조광현
    • Journal of Chest Surgery
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    • 제26권4호
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    • pp.282-293
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    • 1993
  • From Sep. 1985 to Dec. 1992, total 1000 cases of open heart surgery [OHS] were performed in the department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College Of Medicine, Inje University.Among the total 1,000 cases of OHS, there were 823 cases with congenital heart diseases [CHD] and 177 cases with acquired heart diseases [AHD]. The age distribution was 9 days [4.0 kg] to 49 years in CHD and 11 to 64 years in AHD, In the 823 cases of CHD, there were 763 acyanotic cases and 60 cyanotic cases. The CHD cases consisted of 520 VSD [63.2 %], 177 ASD [21.5 %], 60 TOF[7.3 %], 27 PS [3.3 %], 17 ECD [2.1%], 7 Valsalva sinus rupture [0.9 %], 4 TGA [0.5 %], 3 Ebstein`s anomaly [0.4%], 3 DORV[0.4%], and others. The corrective operations were applied for congenital heart disease with the result of 2. 8 % hospital mortality. In the 177 AHD, 168 cases were valvular heart diseases, 7 cases were cardiac tumors and one LA thrombus and one annuloaortic ectasia. In the 168 valvular heart diseases, there were 115 single valve replacement cases [16 AVR, 99 MVR], 20 cases of double valve replacement[AVR & MVR], 15 cases of MVR with TVA, and 10 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 199`. In MVR, 66 of St. Jude Medical valves, 78 ofCarpentier-Edward valves, and 5 of Ionescu-Shiley valves were used. In AVR, 38 of St. Jude Medical valves and 12 of Carpentier-Edward valves were used.The hospital operation mortality rate of congenital acyanotic, cyanotic, and acquired heart diseases were 1.6%, 18.3 % and 3.4% respectively. The overall mortality rate was 2.9 % [29/1000].

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심장혈관질환의 수술치험 (clinical experience of cardiovascular surgery -An Analysis of 116 cases-)

  • 안병해;김성환;염욱
    • Journal of Chest Surgery
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    • 제19권2호
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    • pp.250-258
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    • 1986
  • From Aug. 1984 to May 1986, 116 cases of cardiovascular surgery including 85 cases of open heart surgery were performed at Korea Veterans Hospital. There were 108 congenital anomalies and 8 acquired valvular heart diseases. Among 108 congenital malformations 92 operations were done for acyanotic group, and 16 operations for cyanotic group. Thirteen cases of open heart surgery for infants or small children under 10kg of body weight were performed, which occupied 15.3 percent of total open heart surgery done in the same period. Common congenital cardiovascular anomalies were ventricular septal defect [40.7%], patent ductus arteriosus [29.6%], tetralogy of Fallot [12.[%], atrial septal defect [11.1%], and pulmonary stenosis [1.9%] in order of frequency. Valve replacement using lonescu-Shiley or Carpentier-Edwards valve was performed for 8 cases of acquired mitral valve disease, and valve replacement using St. Jude valve was done for a case of patent ductus arteriosus with severe mitral insufficiency. There was no mortality in acyanotic congenital malformations and acquired valve lesions, and 5 cases of mortality in cyanotic congenital malformations. Overall mortality was 4.3 percent for total cases and 5.9 percent for 85 cases of open heart surgery.

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개심술 치험 35예 (Clinical Experience Of Open Heart Surgery: 35 Cases)

  • 유영선
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.403-407
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    • 1981
  • Thirty-five cases of heart disease were operated on with cardiopulmonary bypass between November, 1980 and September, 1981. 1. There were 8 cases of congenital anomaly and 17 cases of acquired heart diseases. 2. There were 7 male and ] 8 female patients, with a mean age of 21 .9 years [range 7 to 42 years]. 3. There were 2 cases of valve replacement cases with operative mortality of 8.3%. 4. Operative mortality for congenital anomaly was ~ 6.7% and 5.9% for acquired heart diseases. 5. Over all operative mortality was 11.4%.

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원판형 심장판 주위의 혈액 흐름에 대한 수직 해석 (A Numerical Study on the Blood Flow through a Disc Type Heart Valve)

  • 박영필;이신재
    • 대한의용생체공학회:의공학회지
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    • 제2권2호
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    • pp.89-102
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    • 1981
  • The recirculating flows which occur in the prosthetic heart valve have been known to cause several diseases in the human body. And the recent studies show that the shear stress at the wall of the artery is also very important factor in the formation of thrombus. And many studies knave been devoted in obtaining more information about the blood flow through the prosthetic heart valve. In this Paper, the steady axisymmetric flow through the Disc-Type Heart Valve is studied by using the numerical method. The geometry of the Disc-Type Heart Valve is simplified, and the flow is assumed to be steady axisymmetric flow. The vorticity transport equation derived from the Wavier-Stoke's equation is used as the governing equation, and the explicit finite difference method is used to obtain the steady state solution. The results for several Reynolds numbers show that the recirculating flow becomes large as the Remolds number increases. Furthermore, it can be shown that the magnitudes of the vorticity and the stresses are also increased with the Reynolds number, but there is only a little change in their configurations of distribution and in their positions of maximum values.

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승모판막질환을 합병한 심방중격결손증의 수술요법6례 보고 (Coexistent Atrial Septal Defect with Mitral Valve Disease: a report of 6 cases)

  • 조성래;채헌;노준량
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.339-345
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    • 1979
  • Mitral valve disease is the most common disease of the acquired heart diseases, and atrial septal defect is also one of common congenital heart diseases. Coexistence of these two lesions is rare, but of great hemodynamic interest. Among 443 cases with mitral valve disease and 90 cases with atrial septal defect experienced in the Department of Thoracic Surgery, Seoul National University Hospital, there were 6 cases with atrial septal defect complicated by mitral valve disease. 1. Of the 6 patients, four were female and two were male. The age was ranged from 18 to 46. 2. Atrial septal defect was ostium secundum type in all cases, and the mitral valvular lesions were regurgitation in four and stenosis in two. Type II ventricular septal defect was also combined in one of the cases. 3. The atrial septal defect was corrected by, primary closure and the mitral valve was replaced with the prosthetic or bioprosthetic valve in all cases. The combined ventricular septal defect was closed using Teflon felt patch. 4. The operative result was good except in one who was expired of bacterial endocarditis 4 months after hospital discharge.

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심장질환의 외과적 치료 -1640 수술예 보고- (Cardiac Surgery : A report of 1640 cases)

  • 이영균
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.92-99
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    • 1980
  • From 1958 up to the end of April 1980, during the period of 12 years 1640 cardiac surgery cases including 1069 open heart surgery and 304 valve replacement cases, were operated in this Department. There were 1070 congenital anomaly and 570 acquired disease cases. In 1070 congenital anomaly cases 673 acyanotic and 397 cyanotic anomaly patients were noted. In acquired diseases 94 pericardial and 456 valvular cases were found. Among 456 valve cases 189 mitral stenosis, 133 mitral insufficiency, 30 aortic valve lesion, 97 double valve, and 7 triple valve lesion patients were noted. Among 304 valve replacement cases 209 mitral, 34 aortic, 5 tricuspid, 34 aortic with mitral, 20 mitral with tricuspid, and 2 triple valves were replaced. Annual increase `of open heart surgery cases and decrease of operative deaths were remarkable in recent years. In recent years Shiley** oxygenator in pump-oxygenator set up and Ionescu** bovine pericardial xenograft bioprosthesis were used for valve replacement mainly.

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개심술 치험 보고: 12예 (Clinical experience of open heart surgery: 12 cases)

  • 최영호
    • Journal of Chest Surgery
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    • 제16권3호
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    • pp.289-294
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    • 1983
  • The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

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뉴럴네트워크를 이용한 심음의 정상 비정상 분류 (Classificatin of Normal and Abnormal Heart Sounds Using Neural Network)

  • 윤희진
    • 융합정보논문지
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    • 제8권5호
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    • pp.131-135
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    • 2018
  • 현대인의 사망원인 2위를 차지하고 있는 심장병은 자각 증세 없이 갑자기 돌연사를 당할 수 있는 무서운 질병으로 예방이 중요하다. 심장병 중 대동맥판막 협착증을 판단하기 위해서 physioNet에서 제공하는 심음 데이터 중 S1과 S2 사이의 수축 심음 데이터를 이용하여 병명을 진단하였다. 대동맥 판막은 좌심실에서 대동맥으로 피가 유출되는 부위의 판막이다. 심장병 중 대동맥판막 협착증은 대동맥판막이 좁아져 좌심실의 수축 시 판막이 열리지 않는 질환이다. 위 논문에서는 정상인과 대동맥판막 협착증 환자를 합쳐 특징이 180개로 이루어진 3126개의 샘플 심음 데이터를 실험데이터로 사용하였다. 정상과 대동맥판막 협착증 환자를 구분하기 위해 가중퍼지신경망(NEWFM, Neural Network with Weighted Fuzzy Membership Function)이용하였다. 가중퍼지신경망의 특징선택 방법으로 가중치의 평균 방법을 이용하였으며, 분류 결과는 91.0871%의 정확도를 나타내었다.

개심술 치험 50례 (Clinical Experiences of Open Heart Surgery [50 Cases])

  • 임진수
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.692-699
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    • 1985
  • Fifty cases of Open Heart Surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 1985. 1. The age of the congenital heart disease was from 7 to 29 years, the mean age was 14.5 years. In the acquired heart disease, the age was from 14 to 48 years, and the mean age was 22.3 years. The ratio of male to female was about 1.8:1. 2. The number of congenital cyanotic heart disease were 7 patients, congenital acyanotic heart disease were 17 patients and acquired valvular heart disease were 26 patients. All of the acquired heart disease was one or more valve disease. 3. Preoperative symptoms of the congenital heart disease were exertional dyspnea [cyanotic 100%, acyanotic 70.6%] and palpitation [cyanotic 28.6%, acyanotic 76.1%], and the acquired heart diseases were exertional dyspnea [92.3%], palpitation [34.1 %], and chest discomfort [30.8%]. 4. The method of the myocardial protection during the cardiopulmonary bypass were mild or moderate hypothermia, intermittent coronary perfusion of the cardioplegic solution, topical myocardial hypothermia with 4oC Hartmann`s solution. 5. In the cases of the valve replacement, postoperative oral anticoagulant therapy was started at oral intake of food using the warfarin and persantin, and the prothrombin time was maintained 30-50% of control value during 3-6 months for tissue valve replacement and permanently for metal valve replacement. 6. The postoperative complications were appeared in 24 cases and the complications were wound infection, occipital alopecia, hemorrhage etc. 7. The mortality after open heart surgery was 8 percents and the cause of death was low cardiac output syndrome, right heart failure, DIC, and Left ventricle rupture.

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