• Journal of Chest Surgery
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• v.23 no.6
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• pp.1158-1167
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• 1990

Since November 1979, 20 patients have undergone excision of an intracardiac myxoma, which was located in the left atrium in 18[90%], in the right atrium in 1[5%], and in the right ventricle in 1[5%], There were 17 female and 3 male patients with a mean age of 43.5 years [range 23 to 68 years]. Only one patient was asymptomatic, the others were seen mostly exertional dyspnea, palpitation, sings of systemic illness. Diagnosis was confirmed by echocardiography in all cases and angiography in two cases, preoperatively, The myxomas were successfully removed in all patients, either by shaving them from the atrial septum or by excising a portion of normal atrial septum with tumor. All heart chambers were carefully explored for presence of multi-centric myxoma or tumor debris. We conclude that excision of intracardiac myxoma is curative and long term survival is excellent and long term clinical and echocardiographic follow-up are recommended since late recurrence, although rare, has been reported.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.766-774
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• 1989

Four neonates with critical pulmonary outflow obstruction underwent emergency palliative operation between February 1988 and May 1989 at the department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. There were three boys and one girl, the mean age was 12.25 days [ranging from 3 days to 26 days], and the mean body weight was 3,625 gm [ranging from 3,450 gm to 4,200 gm]. Two patients had severe pulmonic valvular stenosis with intact ventricular septum, a third had pulmonary atresia with intact ventricular septum, and another had pulmonary atresia with ventricular septal defect. All were cyanotic, showed arterial desaturation with metabolic acidosis, and had congestive heart failure. To relieve the pulmonary outflow tract obstruction, we performed transventricular pulmonary valvulotomy [Brock operation] with a mosquito clamp in all cases without extracorporeal circulation. Three patients survived the operation and showed satisfactory postoperative results. The patient who had pulmonary atresia with ventricular septal defect expired 5 days after surgery. We consider transventricular pulmonary valvulotomy [Brock operation] with a mosquito clamp as one of the preferable procedures for critical pulmonary outflow obstruction in the neonatal period.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.95-97
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• 2015

We report the case of a 69-year-old woman who was diagnosed with intracardiac schwannoma without symptoms. Preoperative echocardiography and cardiac magnetic resonance imaging showed a mass attached to the interatrial septum. The initial diagnosis was a myxoma or a bronchogenic cyst. The tumor was successfully excised under cardiopulmonary bypass. However, the pathology of the excised tumor was consistent with schwannoma. We suggest that cardiovascular surgeons consider schwannoma to be a possible differential diagnosis for a mass close to the interatrial septum.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.49-59
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• 1981

This is one case report of surgically treated partial atrioventricular canal. The 22 year-old male patient had no definitive history of frequent respiratory infection and cyanosis in his early childhood. Since his age of 7 years, dyspnea was manifested on exertion. First appearance of congestive heart failure was at his age of 16 years old. The physical examination revealed that the neck veins were distended and heaving of precordium. A thrill was palpable on the left 3rd-4th intercostal space extending from the sternal border toward the apex and Grade IV/VI systolic ejection murmur was audible on it. Neither cyanosis nor clubbing was noted. Liver was palpable about 5 finger breadths. Chest X-ray revealed increased pulmonary vascularity and severe cardiomegaly (C-T ratio = 74%). EKG revealed LAD, clockwise rotation, LVH and trifascicular block. Echocardiogram showed paradoxical ventricular septal movement, narrowed left ventricular outflow tract and abnormal diastolic movement of the anterior leaflet of mitral valve. Right heart catheterization resulted in large left to right shunt (Qp : Qs = 5.7: 1), ASD and moderate pulfllonary hypertension. Finally, left ventriculogram revealed typical goose neck appearance of left ventrlcalar outflow tract. On Oct. 10, 1980, open heart surgery was performed. Operative findings were: 1. Large primum defect ($6{\times}5$ Cm in diameter) 2. Cleft on the anterior leaflet of mitral valve. 3. The upper portion of ventricular septum was descent but no interventricular communication. 4. Downward attachment of the atrioventricular valves on the ventricular muscular septum. 5. Medium sized secumdum defect ($2{\times}1$ Cm in diameter). The cleft was repaired with 4 interrupted sutures. The primum defect was closed with Teflon patch and the secundum defect was closed with direct suture closure. Postoperatively atrial flutter-fibrillation in EKG and Grade U/VI apical systolic murmur were found. The postoperative course was uneventful and discharged on 29th postoperative day in good general conditions.

• Journal of Veterinary Clinics
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• v.15 no.1
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• pp.14-21
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• 1998

Ultrasonogram for kidney, spleens liver, intestine and heart was evaluated 11 Chriu horses and 14 Thoroughbred horse. The kidney was determined at both flan and both 17th intercostal spaces. The spleen was determined at the left 13-17 intercom spacer and the liver was determined at the right 7-13 intercostal space. The heart was determined at the right 4-6 intercostal space and left 3-6 intercostal space. The length, of rig kidney at the Thoroughbred horse, Thoroughbred foul, Cheju horse and Cheju foul were 16.2, 12.6, 13.1 and 11.2 mm, respectively. The width of right kidney at the Thoroughbed horse, Thorughbred foul, Cheju horse and Cheju foul were 5.4, 4.3, 4.6 and 4.2 mm, respectively. The depth of right kidney at the Thoroughbred horsed Thoroughbred foul, Cheju horse and Chrju foul were 5.2, 4.4, 4.5 and 4.3 mm, respectively. Similar ultrasonographic measurements were obtained for the left kidney, The left ventricular end-diastolic diameter at the Thoroughbred horse, Thoroughbred fouls Cheju horst and Cheju foul were 107, 83, 85 and 73 mm, respectively. The left ventricular end-systolic diameter were at the Thoroughbred horse, Thoroughbred foul, Cheiu horse and Cheiu foul were 63, 52, 53 and 45 mm, respectively. Also, the interventricular septum in end-diastole, interventricular septum in end-systoles left ventricular wall end-diastoles left ventricular wall end-systoles right ventricular end-diastole diameter, aorta and left atrium at t Thoroughbred horse, Thoroughbred foul, Chriu horse and Chriu foul were measured. Experimental renal stone and enterolith of colon were observed by ultrasonography.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.297-304
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• 1989

A 45-year old woman with congestive heart failure due to left atrial tumor was operated on. Three tumor masses arising from posterior wall, atrial septum, anterior portion of mitral valve were resected. Pathological diagnosis was malignant fibrous histiocytoma [MFH]. Above one case and sixteen previous reports are reviewed. Eleven cases out of 17 were females. The tumors all originated primarily in the left atrium and 8 had distant metastases. The metastatic sites are lung [4 cases], brain [2 cases], liver, jejunum, cervix and pleura etc. Careful pathologic study is necessary to differentiate the uniformly fatal MFH of the heart from the more common benign atrial myxoma. The treatment modalities are surgical resection, chemotherapy, and radiation therapy & the prognosis of intracardiac MFH is poor. We underwent partial resection of left atrial MFH and obtained symptom relief and patient still alive 7 months post-operatively in state of NYHA class II.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.368-371
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• 2019

A unicuspid aortic valve is a rare congenital malformation that frequently presents with valvular dysfunction and dilatation or aortic aneurysm, requiring combined aortic valve surgery and aortic repair. Some patients show severe valve calcification extending into the interventricular septum, possibly resulting in damage to the conduction system during debridement for valve replacement. We present a rare case of severe aortic stenosis with a unicommissural unicuspid aortic valve diagnosed by preoperative transesophageal echocardiography in a 36-year-old man. After composite graft replacement of the aortic valve, aortic root, and ascending aorta, a permanent pacemaker was placed because of postoperative complete heart block.

• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1256-1256
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• 2005

Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.403-409
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• 2005

Pulmonary atresia with intact ventricular septum is morphologically heterogeneous, and the surgical outcome remains suboptimal compared to other complex congenital heart defects. We evaluated the long-term results for repair of pulmonary atresia with intact ventricular septum, Material and Method: Between January 1992 and June 2004, 38 patients underwent repair of pulmonary atresia with intact ventricular septum. The average age was 18 days $(2\~382\;days)$. The average Z-value of the tricuspid annulus diameter was -3.1$(-5.6\~0.8)$. Thirteen $(36\%)$ patients had right ventricle-to-coronary artery fistulas, and $4(11\%)$ patients had right ventricle-dependent coronary circulation. Average follow-up was 55 months $(3\;months\~2.2\;years)$, Result: Twenty-four patients under-went initial right ventricle (RV) decompression and 14 patients underwent systemic-to-pulmonary arterial shunt only. The average size of the tricuspid annulus of the patients who underwent RV decompression was significantly larger than that of the patients who underwent systemic-to-pulmonary arierial shunt only (Z-value -2.2 vs. -4.8, p=0.000). There were $5(13\%)$ early and 1 late deaths. Early deaths occurred in 3 patients who had undergone RV decompression, and in 2 patients who had undergone systemic-to-pulmonary arterial shunt only (p=1.0). Biventricular repair was achieved in $12(32\%)$ patients, single ventricular repair in $8(21\%)$, and one and a half ventricular repair in $4(l1\%)$ patients. Nine $(24\%)$ patients are waiting for the definitive repair. Kaplan-Meier survival at 5 and 8 years was $83.2\%$, respectively. Conclusion: Most of the deaths occurred after the initial palliation. Overall long-term survival was satisfactory. Early mortality should be reduced with careful preoperative evaluation and proper surgical strategy.

• Journal of Chest Surgery
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• v.25 no.9
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• pp.930-935
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• 1992

Cardiac myxoma is the most common benign tumor of the heart, accounting for about half of primary cardiac tumors. It has clinical importance because the excision of the intracardiac myxoma is curative and long term survival is excellant, Their average size is about 5~6cm in diameter in most reported cases. We have experienced a giant atrial myxoma, arised from the interatrial septum of the left atrial side, and resected under the cardiopulmonary bypass.