• 제목/요약/키워드: Heart block

검색결과 204건 처리시간 0.02초

Fallot 사징증의 완전교정에 대한 임상 경험: 100례 보고 (Total Correction of Tetralogy of Fallot Review of 100 consecutive patients)

  • 박국양
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.598-604
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    • 1985
  • One hundred consecutive patients with the Tetralogy of Fallot underwent total correction at National Medical Center during the period 1977 to 1984, Oct. During this study period, we adopted more active policy towards reconstruction of right ventricular outflow tract across pulmonary valve. The mortality was 48% for patients less than 15 kg and 19% in patients above 15kg. Initially Bretschneider`s solution was used as cardioplegia, which was replaced by St. Thomas` solution since 1983, Jan. After then overall mortality dropped to 9% compared to 45% of initial learning period. Heart block occurred In 11 patients, 10 of whom died of combined low cardiac output syndrome. Pure low cardiac output syndrome was noted in 18 patients, most of whom responded to medical measures well except 4 patients. Recently sepsis of Serratia marcescence, which occurred explosively during several months to open heart surgery patients, attacked 3 tetralogy patients resulting in 2 hospital deaths. Our experience has shown that body weight, choice of cardioplegia and accumulation of experience as well as advance of operative and postoperative techniques are still important factors affecting survival rate at initial learning period.

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태음인(太陰人)의 천식(喘息)을 마황정천탕(麻黃定喘湯)을 사용하여 치료한 치험 1례 (A Clinic Study of the Treatment for Asthma in Taeumin with RBBB(Right Bundle Branch Block))

  • 김달래;서영광;김선형
    • 사상체질의학회지
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    • 제19권3호
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    • pp.293-299
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    • 2007
  • 1. Objectives The main ingredient of ephedra is ephedrine which affects on autonomic nervous system induce some adverse effects just like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, and etc. and heart disease. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only may minimize the anxiety but maximize the potential curative value in Asthma Treatment. 2. Methods On a day three times in Mahangjungchentang taken patients who with Ventricular septal defect in the aftermath of the RBBB. We are observed that the main symptoms of change, vital sign, sleep, stool, urine, heart disease. 3. Results Teaumin with asthma, the effect of Mahuang, and the side effects are fewer. The individual effects of herbs are important. but Sasang constitutional effects are important too. 4 Conclusions Mahuang can increase heart disease. But there was a difference among Sasang constitution classification. This has no side effects from Teaumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic. We have an excellent effect on the treatment of asthma.

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심장-폐이식 1례보고 (The First Successful Heart-Lung Transplantation in Korea)

  • 박국양;김주이;박철현;김상익;김정철;현성열;심현자;정미진;권진형
    • Journal of Chest Surgery
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    • 제31권6호
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    • pp.610-614
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    • 1998
  • 12세된 여자 환자에서 한국에서는 처음으로 심장-폐 동시이식이 성공적으로 이루어 졌다. 환아는 심실 중격결손증이 없는 폐동맥 폐쇄증으로 좌폐부전과 함께 우심실의존성 관상동맥혈류를 가지고 있었으며 개심술에 의한 일반적인 심장 수술은 불가능하였다. 장기 제공자는 9세된 남아로 교통사고에 의한 뇌출혈이 사망의 원인이었다. 심장폐이식은 1997년 4월 20일 이루어 졌다. 이식시 수술 방법은 소위 아리조나 방법으로 양측 폐문부를 환아의 횡격막 신경위로 놓는 방법을 사용하였는데 수술시 지혈에 큰도움이 되었다. 수술후 환자는 두가지 큰 합병증이 발생하였는데 하나는 발열이고 둘째는 기관 문합부위 협착을 들수가 있다. 수술후에 계속되었던 발열은 결핵약 투여후 극적으로 소실되었으며 기관 협착에 의한 호흡 곤란은 수술후 제 71일째 실시한 금속성 그물망에 의한 확장으로 치유 되었다. 환자는 수술후 7개월째 호흡 곤란은 보이지 않고 있으며 운동 및 일상 생활에 지장이 없이 양호한 상태로 지내고 있다.

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단일심실증의 수술요법 (Surgical management ofuniventricular heart)

  • 노준량;김응중
    • Journal of Chest Surgery
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    • 제19권4호
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    • pp.618-626
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    • 1986
  • Univentricular heart is a rare congenital cardiac anomaly in which the atrial chambers are connected to only one ventricular chamber and it consists of a diverse group of cardiac malformation characterized by both AV valves or a common AV valve opening into the same ventricle, or the presence of only a solitary AV valve. In spite of recent development in cardiac surgery, corrective operations for univentricular heart still have high mortality and complication rate. Twenty eight patients underwent corrective operation for univentricular heart at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital from February 1979 to July 1986. Of the 28 patients, 7 patients were operated on by ventricular septation and 21 patients by modified Fontan operation. Of the 28 patients, 19 patients were male and 9 patients female and ages ranged from 5 months to 18 years old with the average age of 7.3 years. There were 2 mortalities in 7 patients operated on by septation with the mortality rate of 28.6% and 5 complications, 3 complete AV block, 1 low cardiac output and 1 arrhythmia. All survived patients are being followed up without specific problem till now. There were 10 mortalities in 21 patients operated on by modified Fontan operation with the mortality rate of 47.6% and 10 complications, 2 low cardiac output, 2 respiratory failure necessitating tracheostomy, 2 persistent cyanosis, 2 arrhythmia, 1 missing of left AV valve in situs inversus patient due to misdiagnosis and one rupture of closed right AV valve. Incremental risk factors for operative mortality are young age less than 5 years old, anomalous pulmonary and systemic venous drainage and atrial septation procedure. In 11 survived patients, 9 patients show good follow-up results but one patient complains of persistent cyanosis and another one patient is suffered from CHF. In our series, results of corrective operation for univentricular heart shows continuing improvement but still high mortality and complication rate. So there must be continuing improvement in surgical result by selection of patient, by adequate decision making for timing and method of operation and by improving operative methods.

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Pace-maker 사용 4예 경험 (Clinical Use of the Pace-maker in four cases)

  • 이성구
    • Journal of Chest Surgery
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    • 제13권3호
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    • pp.219-228
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    • 1980
  • The heart block and bradyarrhythmia with or without Stokes-Adams attacks are serious, usually terminal events and the immediate mortality is very high. Stimulation with an artificial pacemaker is now an accepted form of treatment in cases of Stokes-Adams syndrome in which medication in unable to produce any lasting improvement. Permanent pacemaker therapy is indicated in these circumstances. The purpose of this report is to describe the successful use of pacemaker in 3 cases of Stokes-Adams syndromes and a case of sinoatrial block with bradyarrhythmia at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine. Electrode catheter was passed through the right external jugular vein and attached to the endocardial surface of the right ventricle. In case 1, fixed type generator was used at first and for the case 2, 3, 4, and case 1 at second, demand type generators were used. The bipolar electrode catheters were used for the three cases and unipolar electrode catheter for case 4. The results of immediate and late period were satisfactory.

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심전도 신호를 이용한 심장 질환 진단에 관한 연구 (A Study of ECG Based Cardiac Diseases Diagnoses)

  • 김현동;윤재복;김현동;김태선
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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    • pp.328-330
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    • 2004
  • In this paper, ECG based cardiac disease diagnosis models are developed. Conventionally, ECG monitoring equipments can only measure and store ECG signals and they always require medical doctor's diagnosis actions which are not desirable for continuous ambulatory monitoring and diagnosis healthcare systems. In this paper, two kinds of neural based self cardiac disease diagnosis engines are developed and tested for four kinds of diseases, sinus bradycardia, sinus tachycardia, left bundle branch block and right bundle branch block. For diagnosis engines, error backpropagation neural network (BP) and probabilistic neural network (PNN) were applied. Five signal features including heart rate, QRS interval, PR interval, QT interval, and T wave types were selected for diagnosis characteristics. To show the validity of proposed diagnosis engine, MIT-BIH database were used to test. Test results showed that BP based diagnosis engine has 71% of diagnosis accuracy which is superior to accuracy of PNN based diagnosis engine. However, PNN based diagnosis engine showed superior diagnosis accuracy for complex-disease diagnoses than BP based diagnosis engine.

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Partial Atrioventricular Canal Defect in a Maltese Dog

  • Lee, Seung-Gon;Nam, So-Jeong;Moon, Hyeong-Sun;Hyun, Chang-Baig
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.195-199
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    • 2008
  • A 2-year-old female Maltese dog was referred with primary complaints of exercise intolerance and abnormal heart sound. Clinical and diagnostic investigation revealed split S2 and S4 gallop in the cardiac auscultation, tall P wave and left anterior fascicular block in the electrocardiogram, left atrial enlargement on the thoracic radiography, ostium primum atrial septal defect and cleft of the anterior leaflet of the mitral valve on the echocardiography. Based on those findings, the dog was diagnosed as the partial atrioventricular canal defect. Since the dog showed mild exercise intolerance, enalapril and furosemide were prescribed.

방실중격 결손증의 외과적 치료 (Surgical Treatment of Atrioventricular Septal Defect)

  • 오태윤
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.41-48
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    • 1990
  • Thirteen patients underwent repair of atrioventricular septal defect [AVSD] from January 1980 to July 1989 at Kyungpook National University Hospital. Two patients had complete AVSD [Rastelli type A] and eleven patients had partial AVSD [ostium primum atrial septal defect and cleft of anterior mitral leaflet]. In all the patients of partial AVSD, atrial septal defect was closed with Dacron patch and the mitral cleft was approximated with interrupted simple sutures. In one patient of complete AVSD, one patch technique was used to close the atrial and ventricular septal defect, and in the other patient of complete AVSD, two patch technique was used. In six patients, there were associated anomalies; four had isolated ostium secundum ASD, two had patent foramen ovale. Postoperative complete A-V block was noted in a patient of partial AVSD, but it was returned to 1st degree A-V block 30 months later and in another case of partial AVSD, severe congestive heart failure [NYHA functional class IV] due to residual mitral insufficiency was developed postoperatively, but this patient was recovered to the state of functional class I after receiving mitral valve replacement. There was one hospital death [8 %] resulting from low cardiac output.

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Residual Multi-dilated convolution U-Net을 이용한 다중 심장 영역 분할 알고리즘 연구 (Multi-Class Whole Heart Segmentation using Residual Multi-dilated convolution U-Net)

  • 임상헌;최한승;배희진;정서경;정진교;이명숙
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2019년도 춘계학술발표대회
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    • pp.508-510
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    • 2019
  • 본 연구에서는 딥 러닝을 이용하여 완전 자동화된 다중 클래스 전체 심장 분할 알고리즘을 제안하였다. 제안된 방법은 recurrent convolutional block과 residual multi-dilated block을 삽입하여 기존 U-Net을 개선한 인공신경망 모델을 사용하였다. 평가는 자동화 분석 결과와 수동 평가를 비교하였다. 그 결과 96.88%의 평균 DSC, 95.60%의 정확도, 97.00%의 recall을 얻었다. 이 실험 결과는 제안된 방법이 다양한 심장 구조에서 효과적으로 구분되어 수행되었음을 알 수 있다. 본 연구에서 제안된 알고리즘이 의사와 방사선 의사가 영상을 판독하거나 임상 결정을 내리는데 보조적 역할을 할 것을 기대한다.

Ebstein 심기형의 개심술 1례 (Surgical Treatment of Ebstein`s Anomaly Report of a case)

  • 박국양;이정호;유회성
    • Journal of Chest Surgery
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    • 제18권3호
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    • pp.436-439
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    • 1985
  • A patient of Ebstein`s anomaly underwent surgical repair on Oct. 24th, 1984. Tricuspid valve was replaced by 31mm St. Jude mechanical valve without plication of atrialized right ventricle. The annulus has been placed below the coronary sinus, with care not to damage the conduction system. But postoperatively complete heart block developed. Permanent pacemaker was implanted on his 12th POD. Now he has been followed up for 9 months. There was no hemodynamic problems yet.

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