• Journal of Chest Surgery
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• 제17권3호
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• pp.389-397
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• 1984

Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

• 한국산학기술학회논문지
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• 제12권9호
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• pp.3975-3983
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• 2011

본 연구는 심장판막수술환자에서의 자가간호역량과 삶의 질 정도와 자가간호역량이 삶의 질에 미치는 요인을 규명할 목적으로 실시하였다. 연구대상은 D시 2개 대학병원에서 외래방문 치료하는 환자 110명을 대상으로 구조화된 설문지를 이용하여 설문조사를 실시하였다. 연구 결과, 심장판막수술환자의 자가간호역량과 삶의 질 정도는 총 4.0점 중 각각 평균 2.71점과 2.96점으로 그다지 높지 않은 것으로 나타났다. 또한 심장판막수술환자의 자가간호역량이 삶의 질에 미치는 영향은 신체적 기술 (${\beta}$=.625, p<.001)로 심장판막수술환자들은 자가간호역량의 신체적 기술이 높을수록 삶의 질이 높음을 알 수 있다. 결론은 자가간호역량은 심장판막 수술환자의 삶의 질에 영향을 미치는 요인으로 확인되었으며, 심장판막 수술환자는 자가간호역량이 높을수록 삶의 질이 높은 것으로 나타났다. 따라서 심장판막 수술환자의 자가간호역량을 높이기 위해 심장판막 수술환자의 신체적, 심리적, 정신적 영역에 대한 간호사정과 그에 따른 적절한 간호중재를 개발할 필요가 있다.

• Journal of Chest Surgery
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• 제36권9호
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• pp.687-690
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• 2003

비상관성 심실중격결손을 동반한 양대혈관 우심실기시증의 수술적 교정방법은 형태학적 특징에 따라 다양하지만 삼첨판 건삭이 원추부 중격에서 기시를 하는 경우와 삼첨판막에서 폐동맥판막까지의 거리가 좁아서 그 사이로 첨포가 지나가기 힘든 경우는 특히 양심실성 교정이 매우 어렵다. 본원에서는 원추부 중격에서 기시하는 삼천판 건삭이 존재하고 삼첨판막과 폐동맥판막사이의 거리가 좁은 비상관성 심실중격결손을 동반한 양대혈관 우심실기시증 환자에서 심실중격결손부에서 폐동맥으로 첨포를 연결하고 동맥전환술을 함으로써 양심실성 교정을 성공적으로 시행하였기에 증례 보고하는 바이다.

• Journal of Chest Surgery
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• 제17권3호
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• pp.346-355
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• 1984

77 cases of Aortic Valve Replacement, which were composed of 64 rheumatic valvular heart disease and 13 combined congenital heart disease, were operated at Seoul National University Hospital for Aortic valvular disease during the period from June 1968 to December 1983. Among these 64 rheumatic aortic valvular heart disease cases, 8 patients were expired during and immediate after operation and overall mortality rate was 12.5%. For more precise remarks, these patients were divided into two periodic groups, 1st period [from 1968 to 1976] and 2nd [from 1977 to 1983] when annual open heart surgery were over 100 cases, and in 1st period three of four patients were died and in 2nd period five of sixty patients were died and its mortality rate was 8.3%. There were 12 cases of postoperative complication, which were 3 cases of remaining other valvular heart disease required MVR, 2 paravalvular leaks [one of them got Redo AVR], 4 thromboembolism or problem of anticoagulant therapy, 2 late death due to SBE with replaced valve failure and one functional AS with small sized valve. Operative death was affected by pump-time and aortic cross-clamping time, heart size, Ejection Fraction, LVEDP and symptom duration, and other many factors may influence the survival rate. Improved operative technique and myocardial protection and meticulous evaluation of the preoperative patient status will make the AVR safer.

• Journal of Chest Surgery
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• 제27권10호
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• pp.858-861
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• 1994

Prosthetic valve thrombosis is rare but it is one of fatal complication after heart valve surgery. Improvements of the valve design and the material have decreased the frequency of thrombosis but have not eliminated completely. And some cases of prosthetic valve thrombosis during pregnancy were reported inspite of adequate anticoagulation therapy.Urgent surgical intervention is indicated for prosthetic valve thrombosis but it is associated with high operative risk, therefore medical thrombolytic therapy such as urokinase or streptokinase therapy is regarded as an alternative therapy. This is a case report of the successful thrombolytic therapy for valve thrombosis in a pregnant patient after mechanical mitral valve replacement.

• Journal of Chest Surgery
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• 제36권11호
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• pp.862-865
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• 2003

좌심방 점액종에 의한 승모판막 협착이나 폐쇄부전은 흔히 보고되지만 관상동맥질환을 동반하면서 승모판막폐쇄부전을 약화시킨 좌심방 점액종은 매우 드물다. 저자들은 좌심방 점액종에 의해 승모판막폐쇄부전이 경도로 약화되어 있었지만 종양 제거 후 중등도 이상으로 평가되어 승모판막성형술이 필요하였던 70세 여자 환자를 보고한다. 환자는 관상동맥 협착 및 승모판막의 우섬유각 및 후교련 부위의 심방중격에서 기시한 점액종에 의해 승모판막 개폐구의 폐쇄로 심한 폐고혈압과 중등도의 삼첨판막폐쇄부전이 동반되어 있었다. 좌심방 점액종 제거, 승모판막성형술, 관상동맥우회술 및 삼첨판륜성형술을 받은 후 14일째 환자는 특별한 합병증없이 퇴원하였다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.167-173
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• 1980

From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

• Journal of Chest Surgery
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• 제36권5호
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• pp.316-320
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• 2003

배경: 경두개 초음파 검사에 의한 미세색전의 진단은 향후 뇌색전증의 위험이 높은 환자의 선별에 큰 도움이 되리라 기대된다. 우리는 전향적으로 심장 판막 수술 전과 후의 미세색전의 양성률과 빈도를 검사하였다. 대상 및 방법: 심장 판막 질환이 있는 50명의 환자를 대상으로 본 연구는 진행되었다. 뇌경색의 병력이 있거나, 과거에 인공 기계 심장 판막 수술을 받은 환자는 본 연구에서 제외하였다. 경두개 초음파 검사는 중대뇌동맥에서 1시간 동안 미세색전을 감시하였고, 수술 전과 수술 후 2차례 검사하였다. 결과: 기계 심장 판막 수술은 28명, 조직 판막 수술은 10명, 승모판막 성형술은 12명에서 시행되었다. 미세색전의 양성률은 수술 전(8%)에 비하여 수술 후(50%)에 의미 있게 증가하였으며 (p=0.00), 미세색전은 항응고제 강도, 심장 부정맥, 환자의 연령, 고혈압의 병력과 관련성이 없었다. 기계 심장 판막 이식수술 후 미세색전의 양성률(71.4%)은 조직 판막 이식수술(10%)이나 승모판막 성형술(33.3%)에 비하여 의미 있게 높았다(p=0.002). 결론: 미세색전은 심장 판막 수술 후 의미 있게 증가하며 이러한 변화는 인공 기계 심장 판막 수술 후 색전증의 위험과 관련되어 있다고 추정된다.

• Journal of Chest Surgery
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• 제13권4호
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• pp.375-384
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• 1980

Since 1958 up to the end of October 31, 1980, 2032 cases of cardiovascular lesions were operated, including 1225 open heart surgery and 354 valve replacement patients. There were 1271 Congenital anomaly cases and 761 acquired lesions including 149 vascular lesions. Among 1~271 congenital malformations 819 cases belong to acyanotic and 452 to cyanotic group. Over all mortality was 11.1 %, consisting of 12.4% for congenital and 8.9% for acquired lesions. Mortality for 1225 open heart surgery cases was 15% and 13.8% for various 354 valve replacement cases. In most of the open heart surgery cases Shiley oxygenator was utilized and Ionescu-Shiley bovine pericardial xenograft bioprosthesis**** valves were used mainly for valve replacement.

• Journal of Chest Surgery
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• 제33권2호
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• pp.160-166
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• 2000

Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.