• Journal of Chest Surgery
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• v.32 no.1
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• pp.58-61
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• 1999

Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.243-249
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• 1986

Thirty-two cases of tetralogy of Fallot corrected totally using extracorporeal circulation in this department are presented during the period from April 1983 to Feb. 1986. Types of right ventricular outflow tract obstruction were a case of pulmonic valvular stenosis, 3 cases of infundibular stenosis, and 28 cases of combined type. There were associated anomaly such as 3 cases of pulmonary arterial hypoplasia, 7 cases of atrial septal defect, a case of left superior vena cava, and 2 cases of right side aortic arch. Transannular patch for right ventricular outflow tract reconstruction was necessary in 12 cases. Operative death was 6 cases and late death was a case, but other remaining cases followed up over 2 months carried out normal life.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.162-168
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• 1990

Unroofed coronary sinus syndrome is an uncommon anomaly which is caused by incomplete formation of the left atriovenous fold and it is usually associated with persistent left superior vena cava. It may be diagnosed by cardiac catheterization and cineangiography but, if it is not diagnosed, it can bring out significant complications due to right to left shunt, such as brain abscess, cerebral embolism, transient ischemic attack, arterial desaturation and there will reduced patient`s life expectancy. Therefore corrective operation was needed. A case of unroofed coronary sinus syndrome which combines with valvular heart disease was experienced at the department of thoracic & cardiovascular surgery of Kosin medical college. The patient was 49 years old female and she complained dyspnea on exertion for 2 yrs. Cardiac catheterization with cineangiography and both superior venacavogram were performed for diagnosis and she was diagnosed as unroofed coronary sinus syndrome combined with mitral and tricuspid regurgitation. Surgical correction was accomplished by reroofing of coronary sinus with pericardial patch, closure of atrial septal defect and annuloplasty of both atrioventricular valves. Postoperative results were satisfactory and course of recovery was uneventful. We report a case of unroofed coronary sinus syndrome with review.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.110-117
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• 1980

This is a case report of total anomalous pulmonary venous drainage with Atrial septal defect, which was corrected surgically by intracardiac procedure under total cardiopulmonary bypass. This 9 years old girl, she complained mild cyanosis, exertional dyspnea, and frequent upper respiratory infection from 3 months age. The chest X-ray showed cardiomegaly and a "snow man appearance", she has systolic murmur with splitting of S2. The diagnosis was confirmed with right heart catheterization, the catheter was reached to right pulmonic vein passed through right atrium, right superior vena cava, innominate vein, left superior vena cava, and common venous trunk. On 28th, Dec. 1979, an anastomosis between common pulmonary venous trunk and left atrium, Pericardial patch closure of ASD, and ligation of left superior vena cava were performed with Extra-corporeal circulation. The postoperative course was uneventful and discharged with excellent general condition.Total Anomalous Pulmonary Venous Drainage with A.S.D. with A.S.D.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.16-23
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• 2016

Purpose: The 1p36 deletion syndrome is a microdeletion syndrome characterized by developmental delays/intellectual disability, craniofacial dysmorphism, and other congenital anomalies. To date, many cases of this syndrome have been reported worldwide. However, cases with this syndrome have not been reported in Korean populations anywhere. This study was performed to report the clinical and molecular characteristics of five Korean patients with the 1p36 deletion syndrome. Methods: The clinical characteristics of the 5 patients were reviewed. Karyotyping and multiplex ligation-dependent probe amplification (MLPA) analyses were performed for genetic diagnoses. Results: All 5 patients had typical dysmorphic features including frontal bossing, flat right parietal bone, low-set ears, straight eyebrows, down-slanting palpebral fissure, hypotelorism, flat nasal roots, midface hypoplasia, pointed chins, small lips, and variable degrees of developmental delay. Each patient had multiple and variable anomalies such as a congenital heart defect including ventricular septal defect, atrial septal defect, and patent duct arteriosus, ventriculomegaly, cryptorchism, or hearing loss. Karyotyping revealed the 1p36 deletion in only 1 patient, although it was confirmed in all 5 patients by MLPA analyses. Conclusion: All the patients had the typical features of 1p36 deletion. These hallmarks can be used to identify other patients with this condition in their early years in order to provide more appropriate care.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.78-85
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• 2017

Background: Closure of a secundum atrial septal defect (ASD) is possible through surgical intervention or device placement. During surgical intervention, concomitant pathologies are corrected. The present study was conducted to investigate the outcomes of surgical ASD closure, to determine the risk factors of mortality, and establish the effects of concomitant disease correction. Methods: Between October 1989 and October 2009, 693 adults underwent surgery for secundum ASD. Their mean age was $40.9{\pm}13.1years$, and 199 (28.7%) were male. Preoperatively, atrial fibrillation was noted in 39 patients (5.6%) and significant tricuspid regurgitation (TR) in 137 patients (19.8%). The mean follow-up duration was $12.4{\pm}4.7years$. Results: There was no 30-day mortality. The 1-, 5-, 10-, and 20-year survival rates were 99.4%, 96.8%, 94.5%, and 81.6%, respectively. In multivariate analysis, significant preoperative TR (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.09 to 3.16; p=0.023) and preoperative age (HR, 1.04; 95% CI, 1.01 to 1.06; p=0.001) were independent risk factors for late mortality. The TR grade significantly decreased after ASD closure with tricuspid repair. However, in patients with more than mild TR, repair was not associated with improved long-term survival (p=0.518). Conclusion: Surgical ASD closure is safe. Significant preoperative TR and age showed a strong negative correlation with survival. Our data showed that tricuspid valve repair improved the TR grade effectively. However, no effect on long-term survival was found. Therefore, early surgery before the development of significant TR mat be beneficial for improving postoperative survival.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.507-509
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• 2005

Open heart surgery via right thoracotomy can be accomplished in atrial septal defects, and mitral valve diseases. Recently, thoracoscopic atrial septal defect closure, mitral valve repair, Maze operation, and minimal invasive direct coronary artery bypass (MIDCAB) are accomplished with AESOP 3000. However, there is no report of thoracoscopic aortic valve replacement in Korea. We report a successful thoracospic aortic valve replacement assisted with AESOP 3000 in a 31-year-old female patient.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.94-99
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• 2014

Background: Surgical repair of a partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) may be complicated by sinus node dysfunction or SVC obstruction. We modified the Warden procedure by using a right atrial auricular flap to decrease the occurrence of these complications. Methods: Between February 2005 and July 2012, 10 consecutive patients underwent a modified Warden procedure to correct PAPVC. The median patient age was 5.7 years. Eight patients (80%) had an atrial septal defect. To surgically correct the PAPVC, we made a U-shaped incision on the right atrial appendage and sutured the flap to the posterior wall of the SVC. The anterior wall was reconstructed with various patch materials. Results: No early or late deaths occurred, nor did any patient require early or late reoperation for SVC or pulmonary venous obstruction. No new arrhythmias appeared during follow-up, which was complete in all patients (mean, 29.5 months). Conclusion: Our modification of the Warden procedure seems to be effective and safe. This technique may lower the risk of SVC obstruction, pulmonary venous obstruction, and sinus dysfunction.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.136-141
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• 2003

We assessed the intermediate-term result of tricuspid annuloplasty (TAP) for tricuspid valve regurgitation (TR) associated with congenital heart disease in adults. Risk factors for residual TR were also analysed. Material and Method: From August 1989 to June 2001, seventy three adult patients, 51 females and 22 males, underwent TAP for TR associated with various congenital heart disease. Their age ranged from 46 years to 73 years (mean:43). Associated heart anomalies were atrial septal defect (55), ventricular septal defect (6), partial anomalous pulmonary venous return (4) and others (8). Preoperative and post-operative TR velocities were 3.25 m/sec and 2.56 m/sec respectively, and the types of TAP were De Vega in 43, Kay in 18 and Ring annuloplasty in 12. Postoperative follow-up duration was 2,347 patient-month (mean: 32.6 months), and 134 two-dimensional echocardiographic examinations were done during this period. Residual TR greater than III/IV was considered as TAP failure. Result: TAP failure was observed in 7 patients (9.6%), and one patient among them underwent tricuspid valve replacement. Risk factors for TAP failure were diagnosis other than atrial septal defect (p=0.001), preoperative (p=0.038) and postoperative (p=0.028) high TR velocity. There was no statistical significance in terms of TAP methods. Conclusion: Careful evaluation of valve morphology and aggressive surgical intervention are mandatory for the repair of TR with preoperative or residual RV pressure overload.

• Journal of Chest Surgery
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• v.53 no.5
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• pp.306-309
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• 2020

A 59-year-old man presented for possible durable ventricular assist device (VAD) implantation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardiac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic regurgitation, we performed VAD implantation and aortic valve closure via a dual left thoracotomy and partial sternotomy.