• 제목/요약/키워드: Heart defects

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성인 선천성 심장기형의 개심수술 (Open Heart Surgery for Congenital Heart Disease in Adult)

  • 구본원;허동명
    • Journal of Chest Surgery
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    • 제29권9호
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    • pp.940-944
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    • 1996
  • 경북대학교 병원에서는 1990년 1월부터 1994년 10월까지 그 연령이 15세 이상인 선천성 심장병 환자 를 수술적 치료로 교정하였다 이 기간동안 총 628례의 선천성 심장병 환자중 22.4%인 143명이 성인 환자였다. 그중 10대가 23례, 20대가 58례, 30대가 34례, 40대가 18례, 50대가 10례였다. 가장 많은 질환은 전체의 51.1 % (73례)를 차지한 심방중격결손이었고, 39.9 % (57례)의 심실중격결손, 2.8 % (4례)의 활로씨 4징후순이었다. 술후 합병증은 10례 (6.9 %)에서 있었고 수술 사망은 없었다 이상의 결과로 성인에 있어서 수술이 가능한 예의 빈도를 알수 있었으며,이러한 경우에는적은수술 사망과 술후 합병증으로 수술이 가능하였다.

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개와 사람의 선천성 심장 전도장애에 대한 분자 유전학적 이해 (Molecular Genetics of Inherited Cardiac Conduction Defects in Humans and Dogs)

  • Hyun, Changbaig
    • 한국임상수의학회지
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    • 제21권2호
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    • pp.219-228
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    • 2004
  • 심장 전도계에 관련된 심장 질환은 심장 전도계의 원발성 결함이나 형태학적 심장 질환 및 약물 중독 같은 속발성 원인에 의해 발생한다. 특히 선천성 심장 전도 장애의 경우, 이온 채널, 이온 채널에 관련한 세포질성 단백질, gap-junction 단백질, transcription factors (심장 발생에 관련된 유전자들) 및 kinase subunit을 전사하는 유전자의 돌연변이가 원발성 선천성 심장 전도장애의 원인으로 밝혀지고 있다. 사람의 부정맥 발생에 관련된 발병기전에 커다란 진보가 이루어지고 있음에도 불구하고, 개의 경우, 저먼 세퍼드의 급사 증후군 (sudden death syndrome)을 제외한 다른 전도 장애에 대한 연구는 극히 미비한 상태이다. 본 종설에서는 지금까지 밝혀진 심장 부정맥 발생의 분자 유전학적 고찰과 이와 관련된 사람의 유전학적 질환들과 이와 유사한 개의 선천성 심장 전도 장애에 대해 연구 고찰하였다.

심근병에서 $^{123}I-MIBG$ 영상을 이용한 교감신경기능의 평가 (Evaluation of Sympathetic Innervation in Cardiomyopathy with $^{123}I-MIBG$)

  • 김선정;이종두;이도연;박창윤;함진경;정남식;조승연;이성숙;김용수
    • 대한핵의학회지
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    • 제27권2호
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    • pp.195-202
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    • 1993
  • $^{123}Iodine$-metaiodobenzylguanidine (MIBG) which is a norepinephrine analogue, can be used to evaluate the sympathetic innervation of the heart. In this study, cardiac imaging with $^{123}I-MIBG$ was performed in patients with 9 dilated cardiomyopathy, 2 ischemic cardiomyopathy and 1 acute myocardial infarction to evaluate the sympathetic nervous function. $^{123}I-MIBG$ imaging showed multifocal defects (8), diffuse defect (2), near non-visualization (2). The defects of MIBG scans were found to be larger and more severe on 4 hours image than 30 minutes. Heart to lung, heart to mediastinum ratios were decreased at 4 hours than those at 30 minutes. Measured LVEF values were not correlated with the severity of MIBG uptake. $^{99m}Tc-MIBI$ imaging was also performed in all patients to find the relationship with $^{123}I-MIBG$ scan. $^{99m}Tc-MIBI$ scan showed multifocal defects in 9 patients, diffuse defects in 1 patient and no defect in 2 patients. The defects are similar in size, severity and extent, but more larger and severe on $^{123}I-MIBG$ imaging. Therefore, cardiac $^{123}I-MIBG$ imaging is a useful method to evaluate the sympathetic nervous function in cardiomyopathy.

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1세이하 영아에서의 개심술 (Open Heart Surgery in Infancy)

  • 권영무
    • Journal of Chest Surgery
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    • 제24권10호
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    • pp.960-966
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    • 1991
  • From February 1984 through July 1991, 104 infants less than 1 year of age with congenital heart defects underwent open heart repair with conventional cardiopulmonary bypass which occupied 10.7% of all patients with congenital heart defects operated on during same period. There were 66 boys and 38 girls 7 days to 12 months [mean age, 8.2 months]. Four patients were neonates, 8 were 1 to 3 months, 23 were 4 to 6 months, and 69 were 7 to 12 months of age. Mean body weight at repair was 6.9kg and mean BSA, 0.36m2 Indications for operation were intractable congestive heart failure and severe pulmonary hypertension in patients with VSD and severe cyanosis and anoxic spells in patients with TOF. Conditions corrected were VSD[79], TOF[8], AVSD[4], PS[2], PA+IVS[2], TAPVC [2], MR[2], DOLV[l], Truncus arteriosus[1], D-TGA[1], and PA-VSD[1]. Twenty-three of 79 patients with VSD had associated cardiovascular anomalies which included PDA in 16 patients, PS in 9 patients, ASD in 5 patients, LSVC in 2 patients, MR in 1 patient, dextrocardia in 1 patient, and single coronary artery in 1 patient. The hospital mortality rate was 24.0% which was much higher than that of 6% in patients over 1 year of age. The greatest mortality occurred in babies of low weight under 6 months of age, There was no late death. Surviving infants showed marked symptomatic improvement and change in growth patterns. These surgical results were to be overcome with proper pre- and post-operative management and improvement of surgical technique

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Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제53권6호
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

성인의 선천성 심장질환의 외과적 교정

  • 김광호
    • Journal of Chest Surgery
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    • 제13권1호
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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.

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형제에서 발생한 선천성 심장질환 (Congenital Heart Disease in Siblings)

  • 박표원;홍장수;서경필
    • Journal of Chest Surgery
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    • 제14권1호
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    • pp.87-90
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    • 1981
  • Genetic and environmental factors are the two areas which have received attention in the etiology of congenital cardiac malformation. Genetic factor in many types of congenital heart disease have not been clearly delineated. Congenital heart diseases are a heterogenous category of developmental anomalies, representing in most cases the multifactorial inheritance of threshold characters, the expression of which is the product of a genetic - environmental interaction. Recently we experienced three pairs of congenital heart disease in siblings including ventricular septal defects in twin.

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직접봉합으로 치료한 단독 이차공 심방중격결손증 156례 보고 (Clinical Study of 156 Cases of Secundum Atrial Septal Defect closed by Direct Suture)

  • 송정근
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.335-339
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    • 1995
  • Secundum atrial septal defect occupies about 10 to 15% of congenital heart diseases, and the surgical accomplishment is outstanding, so that the operative mortality is getting near to zero percent. But, the methods of correction, direct closure versus patch closure are still controversial and there is no absolute method about it. Some surgeons prefer direct closure technique for its simplicity and lesser thrombogenicity but others, afraid of arrhythmia and suture detachment after closure of large defect, prefer patch closure. Usually most surgeons use direct suture technique in small and moderate sized defects and patch closure in large defects. In our hospital, 156 cases of isolated secundum atrial septal defect were closed directly by double continuous over and over suture using 5-0 polypropylene[prolene , regardless their sizes and the amounts of shunt flow. There were no operative mortality and no serious complications such as heart block, suture detachment and embolism.

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Double Outlet Right Ventricle: In-Depth Anatomic Review Using Three-Dimensional Cardiac CT Data

  • Hyun Woo Goo
    • Korean Journal of Radiology
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    • 제22권11호
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    • pp.1894-1908
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    • 2021
  • Double outlet right ventricle (DORV) is a relatively common congenital heart disease in which both great arteries are connected completely or predominantly to the morphologic RV. Unlike other congenital heart diseases, DORV demonstrates various anatomic and hemodynamic subtypes, mimicking ventricular septal defect, tetralogy of Fallot, transposition of the great arteries, and functional single ventricle. Because different surgical strategies are applied to different subtypes of DORV with ventricular septal defects, a detailed assessment of intracardiac anatomy should be performed preoperatively. Due to high spatial and contrast resolutions, cardiac CT can provide an accurate characterization of various intracardiac morphologic features of DORV. In this pictorial essay, major anatomic factors affecting surgical decision-making in DORV with ventricular septal defects were comprehensively reviewed using three-dimensional cardiac CT data. In addition, the surgical procedures available for these patients and major postoperative complications are described.

Cardiac biomarkers for early detection of heart diseases in small animals

  • Hyun, Chang-Baig
    • 한국임상수의학회:학술대회논문집
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    • 한국임상수의학회 2009년도 춘계학술대회
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    • pp.137-150
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    • 2009
  • Background: Heart failure can develop secondary to various heart diseases (e.g. mitral valvular insufficiency, congenital heart defects, heart worm infection). The clinical signs of heart failure can be confused with those of other conditions, such as respiratory disease. Therefore, specific, sensitive, rapid and inexpensive blood tests for heart failure are desirable. Cardiac troponins, natriuretic peptides and cytokines have been more recently used as indicators of heart disease in humans and animals. These peptides are sensitive to changes in vasoconstriction and dilation within the heart and are used for the diagnosis and prognosis of heart failure. Methods: Previously developed and newly developed cardiac biomarkers will be discussed for understating clinical implications and diagnostic values in heart diseases in small animals

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