• Journal of Chest Surgery
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• v.28 no.8
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• pp.747-753
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• 1995

Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.414-417
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• 1980

During the period from 1958 to July 31, 1980, there were 1764 Cardiovascular Surgical cases consisting of 1166 congenital and 598 acquired lesions in the Department of Cardiothoracic Surgery, Seoul National University Hospital. For 1764 cases 1162 open heart surgery and 602 conventional operations were performed. Among 1166, congenital lesions 266 adult cases were found. Adult cases occupy 15.1% of the total cases consisting of 24.5% of acyanotic and 19.9% of cyanotic group. Over all operative mortality of adult cases was 6.8% compared with 12.4% of total cases. Left over congenital cardiovascular anomalies in Korea can be safely operated at the present time. The oldest operated patient among adult congenital cardiovascular anomalies was 57 years old female atrial septal defect case. For 1162 cases open heart surgery bubble oxygenators were utilized except 2 membrane oxygenators. Various kinds of bubble oxygenators have been used but recently Shiley**** oxygenators are being used exclusively with satisfactory results.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.95-105
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• 1989

The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.769-776
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• 1992

Total 632 cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery, Pusan Paik Hospital, Inje University from october 1985 to december 1990. Among them, there were 503 cases of congenital heart disease and 129 cases of acquired heart disease. In the cases of 503 congenital heart disease surgically corrected, 122 cases over 15 years of age were reviewed and its results were summarized as follows ; l. In total 122 cases 65 were male and 52 female. 2. There were 54 patients under 20 years of age, 31 between 20 & 24 years, 20 between 25 & 29 and 17 over 30 years of age. The eldest was a 46-year-old female of atrial septal defect group. 3. There were 63 cases of VSD[51.7%], 38 of ASD[31.2%], 11 cases of TOF[9%] and so on. 4. In recovery cases, main post-operative complications were as follows; cardiac tamponade, arrhythmia, low cardiac output syndrome, pulmonary, edema pericarditis, mediastinitis, sepsis and DIC. 5. There were 3 cases of post-operative death in this series, so operative mortality rate was 2.5% compairing with 1.8% of pediatric cases below 15 years of age. 6. This reviewed series reveal that aggressive surgical approach in adult congenital heart disease can be justified with low operative mortality like as pediatric age group.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.371-382
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• 1985

Over the past 4 decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of congenital and acquired cardiovascular diseases in Korea. Clinical data on cardiovascular surgical cases performed in all 22 hospitals for open heart surgery in Korea was collected from it`s starting up to December 1984. The first recorded open heart surgery for a young adult atrial septal defect was performed by Young Kyoon Lee, M.D. on August 7, 1959, Seoul National University Hospital, Korea. And, some scattered reports on cardiovascular surgical cases in it`s early period have changed recently the number of hospitals for open heart surgery and clinical cases enormously in total amount of 13, 100 cardiovascular operations performed on 12, 990 cases up to December 1984. Of the total 13, 100 cardiovascular operations, congenital cardiovascular anomaly occupied 70%. Of the congenital cases, 6, 580 operations for acyanotic group [operative mortality 4.5%], and 2, 489 operations for cyanotic group [operative mortality 20%]. The incidence of congenital cardiovascular anomaly in order of frequency was ventricular septal defect [29%], patent ductus arteriosus [26%], Tetralogy of Fallot [22%], atrial septal defect [8, 6%], pulmonary valve stenosis [3.0%], and endocardial cushion defect [1.1%]. Of the 3, 412 valvular heart disease cases, which occupied 85% of total 4, 031 acquired cardiovascular disease, individual incidence was in mitral 2, 565 [63.5%], double valve 451 [11.1%], and simple aortic valve 351 [8.7%]. Total number of valve replaced, mechanical and tissue, was 2, 795, and 1, 884 for mitral, 808 for aortic, and 103 for tricuspid in position. Operative mortality for prosthetic valve replacement in total was 9.8%. Remained acquired cardiovascular cases chronic constrictive pericarditis [7.9%], cardiac tumor [1.9%], coronary artery bypass [1.8%], cardiac trauma [1.2%] and less than 1% of thoracic aortic aneurysm. Overall operative mortality for open and non-open cardiovascular surgical operation was 7.7% [congenital acyanotic group 3.2%, congenital cyanotic group 19.4%, and acquired group 7.8%]. In conclusion, present status of cardiovascular surgery in Korea is stabilized with accumulation of clinical cases and experiences, and the future in the field of cardiovascular surgery is promising, especially in the infant cardiac surgery and aortocoronary bypass surgery, with abrupt increase of specialized cardiac centers, trained specialists, and expanding social health insurance.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.187-192
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• 2023

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.116-121
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• 1986

Patients over 15 years of age who have undergone a surgical correction of a congenital cardiac malformation during period of January 1958 through January 1986 have been reviewed. During this period there were 3957 congenital cardiac lesions consisting of 2712 acyanotic and 1245 cyanotic cases. Among them, a total of 725 adults [18.3%] with a variety of congenital heart lesions, 548 acyanotic group and 177 cyanotic group were operated on. 372 patients were male and 252 patients were female. There were 280 patients under 20 years of age, 206 between 20-24 years, 102 between 25-29 years, 48 between 30-34 and 89 over 35 years. The most common defects were atrial septal defect which accounted for 207 cases [28.6%] and other common anomalies were VSD [140 cases, 19.3%], TOF [136 cases, 18.6%], PDA [120 cases, 16.6%] and PS [33 cases, 4.6%] in order of incidence. Overall operative mortality for this series was 3.6% [1.8% of a cyanotic group and 9.0% of cyanotic group] compared with 2.8% of total cases of congenital heart disease [acyanotic group 1.1% and cyanotic group 6.5%]. This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

• Journal of Chest Surgery
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• v.13 no.1
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• pp.34-40
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• 1980

Total 193 patients over 16 years of age who have underwent a surgical correction of congenital heart diseases during the period 1964 to September of 1979 were reviewed. 106 patients were male and 87 patients were female. 85 patients were in the ages of 16 years through 20 years. The oldest patient was 54 years old male who had atrial septal defect. The commonest defects were atrial septal defect that accounted for 66 cases [34.2%]. Ventricular septal defect was next one that accounted for 66 cases [34.2%]. Patients with tetralogy of Fallot defects were 34 cases [17.6%]. 25 cases had patent ductus arteriosus [13.0%]. Patients with pulmonary stenosis were 17 cases [8.8%] and transposition of the great arteries cases were 2 cases [1%]. There were 14 cases of operative death in this series. So operative mortality rate was 7.3%. The commonest cause of death was low output syndrome and next was renal failure. This reviewed series reveals the incidence of operable congenital heart defects appearing in adult cardiac surgical patients and an aggressive surgical approach can be justified with low operative mortality like as pediatric age group.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.811-816
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• 1995

Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.931-933
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• 2006

Robotic assisted surgery in adult patient with congenital ventricular septal defect Since December in 2005, we have done minimally invasive surgeries in selected cases of mitral valve diseases, tricuspid valve diseases, atrial septal defects and atrial fibrillations with the $AESOP^{TM}$ robotic arm. We have had a better surgical view and skill, according to accumulation of the experience of this procedure. Recently, we performed robotic assisted surgery in a 47-year-old female with congenital perimembranous ventricular septal defect.