• 제목/요약/키워드: Heart septal defect

검색결과 392건 처리시간 0.026초

태음인(太陰人)의 천식(喘息)을 마황정천탕(麻黃定喘湯)을 사용하여 치료한 치험 1례 (A Clinic Study of the Treatment for Asthma in Taeumin with RBBB(Right Bundle Branch Block))

  • 김달래;서영광;김선형
    • 사상체질의학회지
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    • 제19권3호
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    • pp.293-299
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    • 2007
  • 1. Objectives The main ingredient of ephedra is ephedrine which affects on autonomic nervous system induce some adverse effects just like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, and etc. and heart disease. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only may minimize the anxiety but maximize the potential curative value in Asthma Treatment. 2. Methods On a day three times in Mahangjungchentang taken patients who with Ventricular septal defect in the aftermath of the RBBB. We are observed that the main symptoms of change, vital sign, sleep, stool, urine, heart disease. 3. Results Teaumin with asthma, the effect of Mahuang, and the side effects are fewer. The individual effects of herbs are important. but Sasang constitutional effects are important too. 4 Conclusions Mahuang can increase heart disease. But there was a difference among Sasang constitution classification. This has no side effects from Teaumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic. We have an excellent effect on the treatment of asthma.

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선천성 심장질환을 가진 영아에서 발견된 폐 격리증을 동반하지 않은 폐의 이상 체 동맥 기시 1례 (Anomalous systemic arterial supply to lung without sequestration in an infant who has congenital heart disease : a case report)

  • 장연우;최덕영
    • Clinical and Experimental Pediatrics
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    • 제49권8호
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    • pp.895-897
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    • 2006
  • 폐 격리증이 없는 정상적인 폐에 체 혈관이 이상 기시하는 것은 매우 드문 질환이다. 저자들은 반복적인 하기도 감염을 보이는 영아에서 선천성 심장질환의 상태가 본 하기도 감염을 나타낼 정도로 심하지 않음을 이상히 여겨 컴퓨터 단층 촬영을 시행하였다. 그 결과 폐 격리증이 없는 폐의 이상 체 동맥 기시가 우측 폐하 엽에 존재함과 동시에 우측 하엽 폐동맥이 없는 사실을 확인하게 되었다. 어린 나이에 이 같은 선천성 질환의 조합은 이전에 보고 된 바가 없는 매우 드문 질환으로 생각된다.

성인에서 선천성 심장기형의 수술성적 -725 치험례 보고- (Operative result congenital cardiac disease in adult - A reort of 725 surgical cases-)

  • 이정렬;서경필
    • Journal of Chest Surgery
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    • 제19권1호
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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.

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Resolution of Protein-Losing Enteropathy after Congenital Heart Disease Repair by Selective Lymphatic Embolization

  • Kylat, Ranjit I;Witte, Marlys H;Barber, Brent J;Dori, Yoav;Ghishan, Fayez K
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.594-600
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    • 2019
  • With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

성인 선천성 심기형에 동반된 삼첨판막 폐쇄부전의 판막륜 성형술 후 중기성적 (Intermediate-term Result of Tricuspid Annuloplasty for Tricuspid Regurgitation Associated with Congenital Heart Disease in Adult)

  • 윤태진;김상화;이준완;박정준;송현;이재원;서동만;송명근;송종민;강덕현;송재관;장완숙;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • 제36권3호
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    • pp.136-141
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    • 2003
  • 성인 선천성 심기형에 동반된 삼첨판막 폐쇄부전에 대한 판막륜 성형술의 중기 성적 및 잔존폐쇄부전의 위험인자를 분석하였다. 대상 및 방법: 1989년 8월부터 2001년 6월까지 총 73명의 성인환자가 선천성 심기형에 동반된 삼첨판막 폐쇄부전으로 판막륜 성형술을 받았다. 환자의 성비는 51:22로 여자가 많았고 연령은 16∼73세(평균 43세)였다. 진단은 심방중격결손(55), 심실중격결손(6), 부분 폐정맥 환류이상(4), 기타(8)의 순 이였다. 수술 전, 후 판막 폐쇄부전의 평균 혈류 속도는 각각 3.25 m/sec, 2.56 m/sec이었고, 판막 성형술의 방법은 De Vega 형(43), Kay 형(18), Ring Annuloplasty 형(12)의 순 이었다. 외래 추적기간은 2,347 patient-month (평균: 32.6개월)이었고, 이 기간 중 총 134예의 심초음파가 시행되었다. 초음파상 III/IV 이상의 잔존 판막 폐쇄 부전이 있는 경우 판막 성명술 실패로 간주하였다. 결과: 7명의 환자(9.6%)에서 판막 성명술 실패의 소견을 보였고, 이중 1명에서 삼천판막 치환술이 시행되었다. 잔존 폐쇄부전의 위험인자로는 심방 중격 결손 이외의 진단, 폐쇄부전이 우심실 압력 과부하에 의한 경우, 수술 후 높은 판막 폐쇄부전 혈류 속도 등으로 해석되었고. 판막 성형술의 방법은 잔존 폐쇄부전과 무관하였다. 결론: 선천성 심기형에 동반된 삼첨판막의 폐쇄부전이 우심실 압력 과부하에 의한 경우 판막 성형술 시 주의를 요하며, 수술 후 우심실 압부하가 소실되지 않는 경우 잔존 폐쇄부전의 위험이 높다.

개심술후 폐기능 -수술직후 및 장기간의 추이에 대하여- (Pulmonary Function Following Open Heart Surgery -early and late postoperative changes-)

  • 이성행
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.364-374
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    • 1980
  • Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

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Left Ventricular Assist Device Implantation via Dual Left Thoracotomy in an Adult Patient with Congenitally Corrected Transposition of the Great Arteries

  • Kim, Shin;Cho, Yang-Hyun;Park, Pyo Won;Lee, Young Tak;Jun, Tae-Gook;Kim, Wook Sung;Sung, Kiick;Yang, Ji-Hyuk;Chung, Suryeun
    • Journal of Chest Surgery
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    • 제53권5호
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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.

모야모야 환자에게서의 인공심폐기를 이용한 개심술 -1예 보고- (Cardiac Surgery Using CPB in Moyamoya Disease - A Case Report-)

  • 이기복;김응중;신윤철;박종운;이원진;박진흥;손정환;지현근
    • Journal of Chest Surgery
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    • 제36권10호
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    • pp.772-775
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    • 2003
  • 모야모야 질환은 원위부 내경 동맥과 근위부 뇌동맥들의 폐쇄성 내피 이형증으로 특징지워는 뇌혈관 질환으로, 아직까지 정확한 병인이 밝혀지지 않은 질환이다. 상기 질환은 양측 내경 동맥의 원위부에 부분적인 협착이나 폐쇄를 야기하게 되고, 이러한 뇌혈관의 해부학적인 변이는 뇌의 기저부에 매우 미세한 혈관들의 문합을 형성하게 하는데, 이러한 신생 혈관들이 뇌혈관 조영검사상 구름처럼 보인다 하여 ‘Moyamoya’라 불리운다. 모야모야 환자군들에게서 관상 동맥 질환 등으로 인한 개심술의 시행은 매우 드물다고 알려져 있으며, 이러한 환자군들에서의 인공심폐기를 이용한 개심술은 수술 중, 그리고 수술 후 허혈성 뇌질환 등의 위험성이 매우 높다고 보고되고 있다. 본 교실은 모야모야 환자에서 심방중격결손 폐쇄와 관상동맥우회술을 인공심폐기를 이용한 개심술을 시행하여 성공적으로 치료하였기에 간략한 문헌 고찰과 함께 보고하는 바이다.

VSD 를 합병한 DCRV 의 외과적 수술에 대한 임상적 고찰 (A Clinical Study on the Surgical Treatment of Double Chambered Right Ventricle Associated with Ventricular Septal Defect)

  • 손동섭;김근호
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.241-249
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    • 1985
  • Twenty-one patients with Double Chambered Right Ventricle [DCRV] associated with Ventricular Septal Defect [VSD] were treated by open heart surgery under cardiopulmonary bypass with moderate hypothermia in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital between June 1982 and October 1984. The following results were obtained 1. The symptoms and physical signs, specific for DCRV, could not be identified. 2. The radiologic findings on simple chest X-ray, specific for DCRV, could not be identified. 3. Electrocardiographic findings, specific for DCRV, could not be identified. 4. Cardiac catheterization was found to be the most important diagnostic method, revealing pressure gradient between proximal chamber and distal chamber in the right ventricle. The average pressure gradient between two chambers showed 48.1523.29 mmHg[varying from 15mmHg to 94mmHg]. 5. Cardiac angiography was found to visualize the anomalous muscle bundles in right ventricle [in 17 cases, 81%] but the evidence of pressure gradient between two chambers within right ventricle is considered necessary for the diagnosis of DCRV. 6. Via surgical observation, anatomical and pathologic findings of the anomalous muscle bundles, associated DCRV were identified. 7. As the direct pressure was measured on the operating table before and after surgery, the average pressure gradient across the muscle bundles showed 40.5219.75mmHg [varying from 16 to 89mmHg] preoperatively and 8.909.72mmHg [varying from 0 to 32mmHg] postoperatively, indicating significant surgical correction of the obstruction present. 8. The presence of anomalous muscle bundles, dividing the right ventricle into two separated chambers, and the presence of the pressure gradient over 15mmHg are considered necessary for the diagnosis of DCRV.

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아버지로부터 유래된 9번 염색체 장완의 부분 세염색체 1례 (Case of Partial Trisomy 9q Derived from Paternal Chromosome)

  • 정지은;송은정;박혜진;이계향;이경훈;최은진;김진경;정혜리;서억수;김우택
    • Neonatal Medicine
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    • 제16권1호
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    • pp.71-75
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    • 2009
  • 9번 염색체 장완의 중복은 거의 드문 형태의 염색체 이상이며, 특징적인 얼굴형태와 손가락 형태, 정신지체 등이 나타나는 것으로 알려져 있다. 얼굴 형태는 정상이었으나 선천성 심장기형과 수신증, 음낭 탈장이 동반된 미숙아에게서 46,X,Y,dup(9)(q21.2q22.1)를 확인하였고, 표현형이 정상인 환아의 아버지에게서 유래된 것으로 생각되어진 예를 경험하였기에 보고하는 바이다.