• Journal of Chest Surgery
• /
• 제16권3호
• /
• pp.289-294
• /
• 1983

The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

• Journal of Chest Surgery
• /
• 제18권2호
• /
• pp.293-298
• /
• 1985

Cor triatriatum is a rare congenital malformation of the heart in which a septum stretches in a transverse plane through the left atrium, thus creates two left atrial subchambers. The upper one connects with the pulmonary veins, and the lower connects with the left ventricles. Due to the rarity of, and difficulty in diagnosing car triatriatum, data on the surgery of the disease are of necessity and very limited. A case of cor triatriatum combined with atrial septal defect and persistent left superior vena cava was experienced in November, 1984 in Chonnam University Medical School. There was a transverse septum in the left atrium below atrial septal defect, all pulmonary veins were drained into the upper chamber of the left atrium which connected with the right atrium via atrial septal defect and the lower chamber via an oval opening[8mm] in the abnormal septum and the lower chamber was connected with the left atrial appendage, and the left ventricle via mitral valve. There was persistent left superior vena cava drained to left atrium and coronary sinus. The abnormal transverse septum within the left atrium was completely excised and the atrial septal defect was repaired with Woven Dacron patch. The post-operative course was not eventful and the patient was discharged to home with good result on the 15th postoperative day, and has been in good condition upto now.

• Journal of Chest Surgery
• /
• 제24권12호
• /
• pp.1161-1167
• /
• 1991

The study consisted of all patients undergoing surgical repair of isolated secundum type atrial septal defect in patients ages 35 years or older for the period from October 1986 to October 1991. ASD was closed with direct suture in all patients. Response to surgery was excellent. Two patients who had atrial fibrillation was taken low-dose warfarin therapy to prevent stroke. All patients survived operation, and improved by at least one New York Heart Association functional classification. An old age was not a contraindication to surgery.

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.953-961
• /
• 1990

Congenitally corrected transposition of the great arteries is a rare congenital heart anomaly, in isolation, has no hemodynamic consequences. It is usually associated with one or more of a variety of intracardiac lesions, ventricular septal defect, valvular or subvalvular pulmonary stenosis, and deformity of the systemic atrioventricular valve with insufficiency. This report describes a successful two stage operation for congenitally corrected transposition, [SLL] type, with ventricular septal defect, pulmonary atresia, persistent ductus arteriosus, and atrial septal defect. A 9 years old patient underwent modified Blalock-Taussig operation because of severe pulmonary hypoplasia. 2 years later a corrective operation, direct closure of ASD and PDA, VSD closure with Dacron patch, Enlargement of left pulmonary artery with pericardial patch and Relief of ROTO with Rastelli procedure could be successfully performed without complication.

• Journal of Chest Surgery
• /
• 제17권4호
• /
• pp.607-613
• /
• 1984

Thirty seven patients with ostium secundum atrial septal defect, operated from January, 1976 to September, 1984 at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, were given clinical assessment. The following results were obtained. 1.Ostium secundum atrial septal defect was comprised of 18% of congenital heart disease. Their mean age was 15.7\ulcorner.42. Sex ratio [male:female] was 1:1.1. 2.Most frequent clinical symptom was dyspnea on exertion occurred in 26 patients [76.5%]. Only one patient had no symptom [2.9%]. 3.Pre-operative EKG findings revealed RVH in 61.8%, ICRBBB in 29.4%, and RAD in 41.2%. 4.Mean value of systolic pulmonary arterial pressure in patients over 20 years old was 37.8\ulcorner4.4mmHg and it was 28.1\ulcorner10.2mmHg in patients under 20 years old, but the difference between two groups was not statistically significant. 5. In large defect group [>3cm in diameter], Qp/Qs was significantly increased than small defect group [<3cm in diameter], but systolic pulmonary arterial pressure and Rp/Rs were not different between two groups. 6. Overall operative mortality was 5.4%.

• Journal of Chest Surgery
• /
• 제18권2호
• /
• pp.174-181
• /
• 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
• /
• 제22권6호
• /
• pp.990-995
• /
• 1989

Since 1984, 24 patients underwent repair of atrioventricular septal defect. Nineteen had a partial defect and 5 had a complete atrioventricular septal defect. There were 9 men and 15 women, ranging in age from 1 to 50 years [mean age, 13.3 years]. Four patients had a Downs syndrome. Additional congenital heart defects were present in 11 patients. One patient had palliative operation prior to total correction. In partial defects, the primum atrial septal defect was closed with Xenomedica patch and the mitral valve was repaired with simple closure of the septal commissure. Central incompetence from annular dilatation was repaired by a local annuloplasty. In complete defect, the septal defects were closed with two patches except one. Operative mortality was 5% in partial defects and 60% in complete defects and low cardiac output was the commonest etiology. In a mean follow-up period of 27.9 months [range, 4 to 63 months] there were no late death and no instances of late-onset complete heart block. One patient required reoperation [MVR] for residual mitral regurgitation. The majority of patients were asymptomatic and mean postop. NYHA functional class was 1.2.

• Journal of Chest Surgery
• /
• 제26권7호
• /
• pp.543-547
• /
• 1993

Cor triatriatum is a rare entity of congenital heart disease characterized by the presence of a fibrousmuscular diaphragm that subdivides the left atrium into a proximal or "accessory" chamber and a distal or "true" left atrial chamber. In the other hand, cor triatriatum is a variant of abnormal connection between the pulmonary vein and true left atrium which is separated from accessory left atrium receiving pulmonary venous blood flow by fibromuscular diaphragm. We experienced two cases of cor triatriatum. One of them was classical, and the other case was combined with atrial septal defect and all pulmonary veins were drained into the " common pulmonary venous chamber " which connected with right atrium and there was no direct communication between the accessory chamber and true left atrium. The abnormal diaphragms were excised and the atrial septal defect was repaired with pericardial patch in case II. The postoperative courses were not eventful and the patients were discharged with good result, and have been in good condition upto now.n good condition upto now.

• Journal of Chest Surgery
• /
• 제32권10호
• /
• pp.939-942
• /
• 1999

Partial anomalous pulmonary venous connection is frequently found in any ASD(atrial septal defect) patients. These patients are usually symptomatic, therefore, easily diagnosed as just simple ASD. We experienced a case of a 37-year-old female patient with ASD in which the left upper pulmonary vein was connected to SVC by the left inominate vein. The patient was diagnosed as simple ASD previously. During cardiac catheterization, we found a meaningful oxygen saturation step up between the SVC and its upper portion. Angiogram confirmed PAPVC. The surgical correction of anastomosis of PAPVC with left atrial appendage and direct closure of ASD were done. The patient was discharged 15 days later.

• Journal of Chest Surgery
• /
• 제13권1호
• /
• pp.1-12
• /
• 1980

In 1979 during the period of about 10 months 320 cases of open heart surgery were done in Seoul National University Hospital. There were 220 Congenital anomaly cases consisting of 113 acyanotic and 107 cyanotic varieties, and 1 O0 acquired cardiac lesions. Out of 100 acquired lesions 96 were valvular cues. Among 97 valve replacement cases 3 were Ebstein anomaly treated with plication and tricuspid valve replacement. Operative mortality rate for congenital anomaly was 10.6%, with 2.7% for acyanotic and 22.4% for cyanotic group. For acquired lesions over all operative mortality was 7%. Tetralogy of Fallot, ventricular septal defect, and atrial septal defect were the 3 main congenital anomalies, with 88 cues, 69 cases, and 27 cues respectively. In 61 simple ventricular septal defect without other anomalies operative mortality rate was 1.6%, in 27 atrial septal defect no death and, in tetralogy of Fallot 12.2%. Among 69 ventricular septal defect cases 19[27.5%] type I VSDs, after Kirklin-Becu classification, were found, rather high relative incidence of type I compared with Caucasian patients. Among 97 valve replacement cases 20 double valves were replaced-11 mitral with aortic and 9 mitral with tricuspid valves. Over all operative mortality rate for valve replacement was 8.2% with 3.3% in 61 mitral valve replace-merit. The over all operative mortality rate for 320 open heart surgery cases was 10.6%. Bubble type oxygenator and xenograft bioprosthetic valves were utilized In almost all cases.