• Title/Summary/Keyword: Heart surgery

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Delayed Repair of Ventricular Septal Rupture Following Preoperative Awake Extracorporeal Membrane Oxygenation Support

  • Park, Bong Suk;Lee, Weon Yong;Lim, Jung Hyeon;Ra, Yong Joon;Kim, Yong Han;Kim, Hyoung Soo
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.211-214
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    • 2017
  • Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

Surgical Outcomes for Native Valve Endocarditis

  • Park, Bong Suk;Lee, Won Yong;Ra, Yong Joon;Lee, Hong Kyu;Gu, Byung Mo;Yang, Jun Tae
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.1-7
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    • 2020
  • Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients' characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1-107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346-0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459-394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353-505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

Left Atrial Myxoma Associated with Mitral Regurgitation and Coronary Artery Disease (승모판막폐쇄부전 및 관상동맥질환과 동반된 좌심방 점액종)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Park, Yoon-Ock;Moon, Hyun-Soo;Paik, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.862-865
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    • 2003
  • Obstructive intracardiac lesions, like mitral stenosis or insufficiency (MR), by myxomas of the left atrium have been commonly reported, but the attenuation of MR by myxoma combined with coronary artery disease is very rare. We report a 70-year-old female patient whose left atrial myxoma had attenuated moderate MR to mild MR and required mitral valve surgery after removal of the myxoma. She also had coronary artery disease, severe pulmonary hypertension and moderate tricuspid regurgitation due to the mitral valve lesions obstructed by myxoma. The patient underwent removal of myxoma, mitral and tricuspid valve reconstructions, and coronary artery bypass grafting. She was discharged at the postoperative 14 day without any problems.

Preoperative Extracorporeal Membrane Oxygenation for Severe Ischemic Mitral Regurgitation - 2 case reports -

  • Kim, Tae-Sik;Na, Chan-Young;Baek, Jong-Hyun;Kim, Jae-Hyun;Oh, Sam-Sae
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.236-239
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    • 2011
  • Indication for extracorporeal membrane oxygenation (ECMO) has been extended as the experience of ECMO in various clinical settings accumulates and the outcome after ECMO installation improves. We report two cases of successful mitral valve surgery for severe ischemic mitral regurgitation in patients on ECMO support for cardiogenic shock which developed upon coronary angiography.

Limited Posterior Approach for the Surgical Treatment of Intraarticular Fracture of Calcaneus (제한적 후방 도달법을 이용한 관절내 종골 골절의 치료)

  • Hyun, Yun-Seok;Song, Kyung-Won;Shin, Sung-Il;Lee, Jin-Young;Lee, Seung-Young;Kim, Gab-Lae;Shin, Kun-Ho;Seo, Eun-Ho;Ban, Tae-Seo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.79-85
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    • 2007
  • Purpose: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared $B{\ddot{o}}hler$ angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. $B{\ddot{o}}hler$ angle and Gissane angle were $7.6^{\circ}$, $102.4^{\circ}$, and it increased to $23.5^{\circ}$, $128.6^{\circ}$ after postoperative 1 year. Conclusion: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.

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A study on the change of limb muscle atrophy by the period of limited activities following the heart surgery in congenital heart disease children (선천성 심장질환아의 수술후 활동제한 기간에 따른 사지근 위축 변화에 관한 연구)

  • Choe Myoung Ae
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.17-30
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    • 1998
  • In order to investigate the effects of a decreased activity on skinfold thickness, circumference and muscle strength of the extremities during the recovery period following heart surgery, skinfold thickness, circumference and muscle strength of the extremities were measured on days 0, 3, 6, and 9 following the surgery, and compared with those on the arrival day of intensive care unit. Skinfold thickness was measured using a skinfold caliper(Saehan Cor., Korea), circumference of the limbs were measured with a tape measure, upper extremity strength was determined using the Takei grip dynamometer and lower extremity strength was measured by pressing the flatfoot on an electronic digital health meter while tying on a bed. Results from this study were thus : 1. Skinfold thickness of triceps, quadriceps and gastrocnemius muscle on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. 2. Circumference of midupperarm and midthigh on days 3, 6, 9 following the heart surgery was not significantly different from that of on the day of operation. Circumference of midcalf on days 3, 6 following the heart surgery was not significantly different from that of on the day of operation, while that of midcalf on day 9 following the surgery decreased significantly compared with that of on the day of operation. 3. Muscle strength of the upper extremity was not significantly different from that of on the day of operation, while that of the lower extremity on day 9 following the surgery decreased significantly compared with that of on the day of operation. From these results, it may be concluded that circumference and muscle strength of lower extremity can be decreased due to the postoperative inactivity following heart surgery in congenital heart disease children.

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Botryoid Odontogenic Cyst on Mandibular Anterior and Both Body Area: a Case Report (하악 정중부와 양측 체부에 걸친 botryoid odontogenic cyst: 증례보고 및 문헌고찰)

  • Nam, Jeong-Hun;Kim, Da-Young;Park, Young-Ju;Ahn, Jang-Hoon;Gang, Tae-In;Park, Mi-Hee;Yu, Woo-Geun;Kim, Bo-Gyun;Lee, Jung-Won;Kim, Jung-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.368-372
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    • 2010
  • Botryoid odontogenic cyst (BOC) is considered a rare multilocular variant of the lateral periodontal cyst. In this report, a 67-year-old male visited with chief complaint of severe mobility on mandibular incisors. Multilocular radiolucent lesion was seen from the right premolar to the left premolar area, involving almost the whole mandible. Histologically, the botryoid odontogenic cyst showed focal nodular thickening of the lining epithelium. These thickening often showed swirling appearance of the cells. Cyst enucleation and bone graft on mandible anterior and both body area were performed under general anesthesia, and postoperative healing was favorable without recurrence.

Pacemaker Lead Endocarditis Combined with Rupture of Sinus Valsalva after Redo Aortic Valve Replacement (대동맥판막재치환술 후 발생한 발살바동 파열을 동반한 심박조율도관 심내막염)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.780-783
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    • 2003
  • Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.

Clinical Report of 103 Cases of Open Heart Surgery in 1984 (1984 년도 년간 개심술 103례 보고)

  • 김규태
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.398-406
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    • 1985
  • 103 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1984. There were 90 congenital cardiac anomaly and 13 acquired heart diseases. Out of 90 congenital cardiac anomaly, 63 cases of acyanotic group and 27 cases of cyanotic group were noted. In 63 cases of acyanotic group, 11 ASD, 45 VSD and 7 other acyanotic anomaly were included. In 27 cases of cyanotic group, 4 Trilogy of Fallot, 15 TOF, 3 Pentalogy of Gasul and 5 other cyanotic anomaly were found. Among 13 cases of acquired heart diseases, 12 valvular lesions and 1 atrial myxoma were noted. Two open mitral commissurotomy and ten valve replacements were performed for 12 valve lesions. The frequent complications were acute respiratory insufficiency and low cardiac output syndrome occurred in 5 cases. The perioperative mortality was 4.8% in acyanotic congenital cardiac anomaly, 7.4% in cyanotic congenital cardiac anomaly, and 0% in acquired heart diseases. Overall mortality for 103 cases of open heart surgery was 4.9%.

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Clinical Experience of Open Heart Surgery - 168 cases - (개심술 168례에 관한 임상적 고찰)

  • Youm, Wook;Sung, Sang-Hyun
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.48-54
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    • 1988
  • 168 cases of open heart surgery had been performed in Korea Veterans Hospital from Aug. 1984 to Nov. 1987. There were 150 cases of congenital heart disease and 18 cases of acquired heart disease. In congenital heart cases, 123 cases [82%] were acyanotic and 27 cases [18%] were cyanotic. Common congenital defects were VSD, TOF, ASD, PS in order of frequency. There were 11 cases of operative mortality; 5 cases [4%] in acyanotic group, 6 cases [22\ulcorner6] in cyanotic group. There was no mortality in valvular heart disease group. Overall mortality rate was 6.5%.

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