• Journal of Chest Surgery
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• v.42 no.3
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• pp.361-363
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• 2009

A 17-year-old male patient was referred with symptoms of dyspnea. Multi-detector computerized tomography (MDCT) and echocardiography evaluation revealed quadricuspid aortic and pulmonary valves, an atrial septal defect (ASD), and pulmonary stenosis. We closed the ASD using a bovine patch and performed a commissurotomy of the pulmonary valve. Quadricuspid semilunar valves are very rare congenital abnormalities that are reported to occur nine times more frequently in the pulmonic valve than in the aortic valve. According to the Hurwitz Roberts classification, the aortic valve was type A, and the pulmonic valve was type B. The aortic valve normal function, but the pulmonic valve was stenotic and had abnormal function.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.163-169
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• 2014

Glucose metabolism abnormalities secondary to heart failure, including insulin resistance (IR) and impaired fasting glucose, have been gradually recognized as important prognostic factors in disease progression. However, to date, no study has investigated glucose abnormalities in dogs with chronic mitral valve insufficiency (CMVD). Thus, we hypothesized that glucose metabolism abnormalities due to heart failure may develop in dogs with CMVD. A prospective study was performed on 113 client-owned dogs with variable CMVD severities. Serum insulin, glucagon, fructosamine, and glucose concentrations were measured, and insulin resistance was determined using the homeostatic model assessment (HOMA) score. The serum insulin concentration had a significant inverse association with the heart failure severity. However, there was no significant association between the heart failure severity and fructosamine, HOMA score, and fasting blood glucose. Insulin, fructosamine, and HOMA had a significant positive association with body condition scores (BCS), whereas glucose had no association. This study found that insulin secretion in dogs with naturally occurring heart failure due to CMVD might be compromised as the disease worsens.

• Korean Journal of Radiology
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• v.24 no.10
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• pp.960-973
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• 2023

The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. The morphology of the BAV varies with the presence and position of the raphe and is associated with the type of valvular dysfunction and aortopathy. Therefore, accurate diagnosis and effective treatment at an early stage are essential to prevent complications in patients with BAV. This pictorial essay highlights the characteristics of BAV and its related congenital cardiovascular malformations, valvular dysfunction, aortopathy, and other rare cardiac complications using multimodal imaging.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.506-511
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• 1987

Increased clinical interest, stimulated by newer diagnostic techniques, has made it apparent that Ebstein`s anomaly represents a spectrum of right heart abnormalities. In the usual case, the septal and posterior leaflets of the tricuspid valve are not attached to the true annulus, but are displaced distally into the ventricle. Also the degree of malattachment and the structural deformities of the cusps may vary greatly. Recently we experienced 6 cases of Ebstein`s anomaly who underwent corrective operation in our hospital. Five patients were operated by plication and annuloplasty techniques based on the construction of a monocusp valve by the use of the anterior leaflet. Remained one was operated on by tricuspid valve replacement using No 31 mm C-E tissue valve. There was no operative mortality and the postoperative courses were relatively good with marked symptom improvement.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1055-1060
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• 1992

Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.859-862
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• 2007

A hemangioma at a cardiac valve leaflet is a rare finding. There are only five reported cases in the medical literature and no prior case reported in Korea. A previously healthy 45-year-old woman presented with an acute episode of numbness in the left side of the face and hand. Although no definite abnormalities were found on the neurological examination and testing the echocardiography revealed an echogenic mass in the anterior mitral valve leaflet. The tumor was excised en bloc from the leaflet and the defect was repaired with an autologous pericardial patch. Pathology examination confirmed the mass to be a hemangioma of the valve leaflet. Here we report this case and review the medical literature.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.667-671
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• 1989

Cor triatriatum is a rare congenital malformation of the heart in which a diaphragm stretches in a transverse plane through the left pulmonary venous chamber, thus creates two subchambers. The proximal chamber connects with the pulmonary veins, and the distal one has left auricle and the mitral valve. A 3 year old boy who had Cor triatriatum underwent surgical excision of the abnormal diaphragm in March, 1989 in Chungnam University Hospital. An obliquely oriented fibromuscular diaphragm divided the left atrium into a proximal chamber which was connected to the pulmonary veins and a distal chamber which had the atrial appendage and the mitral valve. The opening in the diaphragm was 5 mm in diameter. There were no associated abnormalities. The abnormal diaphragm was completely excised. The postoperative result was excellent.

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.226-229
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• 1999

A 5-month-old, 5kg, intact male mixed dog was admitted to the Veterinary Medical Teaching Hospital of the College of Veterinary Medicine Cornell University because of severe systolic murmur. On physical examination, the dog appeared to be thin and slightly small for his age. Radiographic studies with barium sulfate clearly showed the presence of loops of intestines in the pericardium. Based on these findings peritoneopericardial diaphragmatic hernia was diagnosed. Many abnormalities were found in dog's heart : ventricular septal defect, pulmonic stenosis with moderate pulmonic valve insufficiency, and mild mitral and tricuspid valve insufficiency. Puppy's longterm prognosis was fair. His intestines were removed from his pericardium and the defect in his diaphragm was closed. The surgery went smoothly and puppy recovered very nicely from anesthesia.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.305-312
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• 2008

Background: Anatomic and functional abnormalities of the systemic atrioventricular (AV) valve are common in single ventricle. pathologies and continue to be associated with poor early and late outcomes in surgically palliated single. ventricle patients. We aggressively performed valvuloplasty for atrioventricular valve regurgitation (AVVR) during the course toward a Fontan operation. Material and Method: Between January 1995 and December 2004, 209 patients underwent a Fontan operation in our institution. We retrospectively evaluated the prevalence of AVVR and the influence of AV valve repair on outcome, and we analyzed the progression of AVVR after the Fontan operation for 168 patients where echocardiographic follow up results for more than 6 months after the Fontan operation were available. During the course toward a Fontan operation, 25 patients underwent 30 procedures for AVVR. These procedures. were. carried out during placement of a bidirectional cavopulmonary shunt (BCPS) for nine patients, between the time of placement of a BCPS and the Fontan operation for four patients, and during the Fontan operation for 17 patients. Five patients underwent procedures for AVVR twice. Result: The late mortality rate after the Fontan operation was 4.2% (n=7), with a median follow-up duration of 52 months (range, $6{\sim}123$ months). Seven patients (4%) had unfavorable outcomes such as significant (moderate or severe) AVVR in six patients, and significant AV valve stenosis in one patient was determined at the last follow up after the Fontan operation. Among the seven patients, four patients underwent AV valve repair after the Fontan operation, and one patient underwent subsequent AV valve replacement. Progression to AVVR of equal to or greater than grade 2 was noted in 30 patients (18%) at the last follow up after the Fontan operation, including 12 patients that underwent previous AV valve procedures. Initial grading of AVVR, a previous AV valve operation, and specific AV valve morphology such as a common AV valve or mitral atresia were significant risk factors for the progression of AVVR after the Fontan operation. Conclusion: In our surgical series, a small percentage of patients showed unfavorable outcomes. related to AVVR during the course toward a Fontan operation. However, a closer follow-up is required to evaluate the progression of the AVVR after a Fontan operation, especially for patients showing poor AV valve function at the first presentation and specific AV valve morphology.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.362-370
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• 1984

The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.