• International Journal of Vascular Biomedical Engineering
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• v.1 no.2
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• pp.36-41
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• 2003

Both flow visualizations and computational fluid dynamics were performed to determine hemodynamics in a total cavopulmonary connection (TCPC) model for surgically correcting congenital heart defects. From magnetic resonance images, an anatomically correct glass model was fabricated to visualize steady flow. The total flow rates were 4, 6 and 8L/min and flow rates from SVC and IVC were 40:60. The flow split ratio between LPA and RPA was varied by 70:30, 60:40 and 50:50. A pressure-based finite-volume software was used to solve steady flow dynamics in TCPC models. Results showed that superior vena cava(SVC) and inferior vena cava(IVC) flow merged directly to the intra-atrial conduit, creating two large vortices. Significant swirl motions were observed in the intra-atrial conduit and pulmonary arteries. Flow collision or swirling flow resulted in energy loss in TCPC models. In addition, a large intra-atrial channel or a sharp bend in TCPC geometries could influence on energy losses. Energy conservation was efficient when flow rates in pulmonary branches were balanced. In order to increase energy efficiency in Fontan operations, it is necessary to remove a flow collision in the intra-atrial channel and a sharp bend in the pulmonary bifurcation.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.383-390
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• 1992

From Oct. 1983 to Dec. 1991, 135 cases of atrial septal defect which were operated at the department of Thoracic and Cardiovascualr Surgery, Chonnam National University Hospital, were analysed retrospectively. They were 23.7% of all congenital heart diseases operated in the same period. Among the 135 cases, 62 cases were male and 73 cases were female. Their ages were ranged from 2 to 54 years and the mean was 18 years old. Main symptoms at admission were exertional dyspnea[70.37%], frequent URI[49.12%] and palpitation[32.59%], but 12 cases[8.88%] were asymptomatic. Electrocardiographic findings wer regular sinus rhythm in 96.99%, RVH in 64.66%, incomplete RBBB in 27.06%, complete RBBB in 42.10%, and first degree AV block in 9.02% All 135 cases were operated under the direct vision with cardiopulmonary bypass. Anatomically, most frequent type was fossa ovalis defect with complete septal rim[78.52%]. 117 of 135 ASD patients were repaired with pathch closure[86.66%] and 14 patients were repaired with direct closure[10.37%] and 4 patients in mutiple ASD were repaired with patch and direct closure[2.96%]. Postoperative complications were occured in 21 cases[15.56%], and they were wound infection, pleural effusion, postoperative bleeding, urinary tract infection, and heart failure mainly. One case died due to epidural hematoma and operative mortality was 0.74%.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.174-181
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• 1985

From Jun. 1980 to Mar. 1984, 33 cases of atrial septal defect, secundum type, operated at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University, were analyzed retrospectively. They were 24.3% of all congenital heart diseases operated in the same period. Among the 33 cases, 17 cases were males and 16 cases were females. Their ages were ranged from 4 to 42 years and cases of over 15 years of age were 60.6%. Main symptoms at admission were exertional dyspnea [69.7%], palpitation [63.6%] and frequent upper respiratory infections [51.5%], but 2 cases [6.1%] were asymptomatic. All 33 cases were operated under the direct vision with cardiopulmonary bypass. All cases were secundum type defect of atrial septal defect and single defect were in 29 cases [90.6%], and oval type defect were in 31 cases [96.9%]. In 7 cases [21.9%], other lesions of cardiovascular system were associated, and the most common lesion was pulmonic valvular stenosis [4 cases; 12.5%]. The defects were closed directly in 27 cases and in 6 cases with Dacron patch. Postoperative complications were occurred in 8 cases [24.2%], and they were pleural effusion, congestive heart failure, and alopecia mainly. One case died due to air embolism postoperatively and operative mortality was 3.1%.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.986-990
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• 1997

Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect; 1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective me hod to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.112-114
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• 2016

The half-turned truncal switch (HTTS) operation has been reported as an alternative to the Rastelli or $r{\acute{e}}paration$ $\grave{a}$ $l^{\prime}{\acute{e}}tage$ ventriculaire procedures. HTTS prevents left ventricular outflow tract (LVOT) obstruction in patients with complete transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS), or in those with a Taussig-Bing anomaly with PS. The advantages of the HTTS procedure are avoidance of late LVOT or right ventricular outflow tract (RVOT) obstruction, and of overstretching of the pulmonary artery. We report the case of a patient who underwent HTTS for TGA with VSD and PS, in whom there was no LVOT obstruction and only mild aortic regurgitation and mild RVOT obstruction, including observations at 12-year follow-up. Our experience with long-term follow-up of HTTS supports a solution for late complications after the Rastelli procedure.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.448-451
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• 2004

Report of right atrial thrombus complicating pulmonary embolism after cardiac surgery is rare. A 54-year-old woman operated on the atrial septal defect 10 months ago was admitted for left pleuritic pain and dyspnea. Multiple segmental perfusion defects were detected in lung perfusion scan. Transesophageal echocardiography showed a large mobile right atrial mass attached to the free wall of the right atrium with a stalk. Despite the intravenous heparinization for 13 days, follow-up echocardiography revealed the right atrial mass had not diminished in size. The mass which was confirmed as an organizing thrombus was excised under cardiopulmonary bypass. The patient recovered uneventfully and was discharged on warfarin therapy.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.122-126
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• 2014

Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intraaortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.124-128
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• 2018

Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical repair or percutaneous device closure. Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by transesophageal echocardiography revealed a mobile mass at the patch repair site in the left atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation. Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to consider cardioembolic source as being part of the etiology of stroke recurrence, even if the event occurs many years after intracardiac shunt closures.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.220-238
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• 1976

Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976. Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic stenosis with patent ductus arteriosus were operated. Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer's lactate solution, 5% dextrose in water, mannitol, and ACD blood. Flow rate ranged from 2.0 to $2.4L/M^2/min$. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into superior and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia ($30^{\circ}C$) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal efects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by d:rect closure with Dacron patch reinforcement. Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma. Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of $O_2$, electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.198-203
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• 2007

Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.