• Journal of Chest Surgery
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• 제35권8호
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• pp.580-583
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• 2002

배경: 선천성 심장병 환자들의 교정 수술 후 정확한 형태학적 혹은 혈역학적변화를 아는 것이 술 후 추가적으로 내과적 혹은 외과적인 치료가 필요로 하는가를 결성하는데 매우 중요하다. 심실중격결손 봉합술 후 잔류단락의 발생 빈도와 소량의 포편 주위 단락의 변화를 조사하였다. 대상 및 방법: 1995년 3월부터 1999년 12월까지 영남대학교의료원 흉부외과에서 영아기에 단순 심실중격결손으로 포편봉합술을 시행한 43명의 환자들을 대상으로 수술 후 심초음파를 시행하여 잔류단락 유무를 조사하였다. 결과: 전체 43례의 환자 중 수술 직후 잔류단락이 관찰된 환자는 11례로 26%에서 잔류단락이 발견되었으나 혈역학적으로 유의한 단락으로 재수술을 시행한 경우는 없었다. 단락의 발생빈도는 심실중격결손의 형태와 봉합을 위해 사용한 포편의 종류와는 무관하였다. 잔류단락이 발견된 환자 중 9명에서 단락의 소실을 확인할 수 있었으며 2례는 추적관찰에서 탈락하였다. 단락이 소실된 9명의 환자들의 단락이 마지막 확인된 기간은 평균 $4.2{\pm}3.6$개월 이었다. 결론: 수술 직후 포편 주위의 잔류단락은 종종 발견될 수 있으며 혈역학적으로 유의하지 않은 잔류단락은 대부분 6개월 이내에 자연 소실되었다.

• Journal of Chest Surgery
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• 제18권2호
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• pp.299-304
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• 1985

The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

• Journal of Chest Surgery
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• 제28권6호
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• pp.623-629
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• 1995

Rupture of ventricular septum following myocardial infaction is one of the serious complication of coronary artery disease. The characteristic manifestations are sudden appearance of a harsh systolic murmur, precordial pain, cardiovascular collapse and permit early diagnosis. We report two cases of successful repair of postinfaction ventricular septal defect. The infarcted area was anterior wall of ventricle and VSD was placed near apex of heart in two cases all. VSD was closed with pledgetted Dacron patch and incised wall was sutured with Teflon felt and concomitant coronary artery bypass graft was done respectively .Postoperative courses were uneventful.

• Journal of Chest Surgery
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• 제33권1호
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• pp.96-98
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• 2000

A cosmetic incision for minimal invasive cardiac surgery is described. Through a small submammary skin incision combined with partial low sternotomy some kinds of cardiac operations are possible without extra-difficulty but with excellent cosmetic effect, No special instruments nor techniques are required. By this method routine cannulations for cardiopulmonary bypass as well as aortic cross clamping bicaval snaring and venting of cardiac chambers are possible, We performed 5 cases of open heart surgeries using this approach which includes two cases of atrial septal defect closure one case of ventricular septal defect closure one case of pulmonic valvotomy and one case of mitral valve replacement.

• Journal of Chest Surgery
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• 제12권3호
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• pp.247-258
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• 1979

Two hundred and six cases of open heart surgery were done with over all mortality of 8.3% during 1978 in this Department. There were 130 congenital and 76 acquired cases. In congenital anomaly 58 cases were acyanotic and 72 cyanotic, which showed 3.4% and 12.5% of operative mortality respectively. Thirty-six cases of ventricular septal defect and 10 atrial septal defect were repaired without mortality but in 60 cases of tetralogy of Fallot it was 10%. In 76 cases of acquired lesions 74 were valvular cases. There were 75 cases of valve replacement with over all operative mortality of 8%. In 75-valve replacement one case of Ebstein anomaly was found. There were 62 cases of single valve and 13 double valve replacement. In every case tissue valve was utilized and coumadin and Persantin 75 were administered as anticoagulant treatment for one year.

• Journal of Chest Surgery
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• 제17권2호
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• pp.250-256
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• 1984

Eisenmenger syndrome is a condition which systemic arterial blood oxygen unsaturation occurs if obstruction in the pulmonary capillaries raises the pulmonary vascular resistance and pulmonary arterial pressure to or beyond systemic levels and then a significant right to left shunt develops across a preexisting cardiac septal defect or an aortopulmonary communication-We have experienced 3 cases of similar condition. Case I is 24 year old man who has had cyanosis and dyspnea on exertion since childhood. His pulmonary arterial pressure was 110/80mmHg. He was operated under diagnosis of the mitral stenosis and tetralogy of Fallot, but it was finally discovered that he had patent ductus arteriosus and ventricular defect was closed with perforated prosthetic patch, but the patient expired due to right heart failure low cardiac output. Case II was 16 year old female who had pulmonary hypertension of 110/85mmHg. She was diagnosed as Eisenmenger syndrome combining with atrial septal defect and patent ductus arteriosus. Case III was 20 year old male. His pulmonary arterial pressure was 110/70mmHg and the underlying defect was patent ductus arteriosus.

• Journal of Chest Surgery
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• 제46권2호
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• pp.93-97
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• 2013

Background: Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. Materials and Methods: This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was $16.9{\pm}10.4$ months. Results: No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were $74.1{\pm}32.2$ and $157.6{\pm}49.7$ minutes, respectively. The postoperative hospital stay was $5.5{\pm}3.3$ days. Conclusion: The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.

• Journal of Chest Surgery
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• 제25권4호
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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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• 제49권2호
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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 Yeungnam Medical Science
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• 제31권2호
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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.