• Journal of Chest Surgery
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• v.30 no.12
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• pp.1242-1246
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• 1997

Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

• International journal of advanced smart convergence
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• v.7 no.2
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• pp.1-6
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• 2018

In this paper, we propose an automatic left ventricle segmentation method in computed tomography angiography (CTA) using separating energy function. First, we smooth the images by applying anisotropic diffusion filter to remove noise. Secondly, the volume of interest (VOI) is detected by using k-means clustering. Thirdly, we divide the left and right heart with split energy function. Finally, we extract only left ventricle from left and right heart with optimizing cost function including orientation term.

• Korean Journal of Ichthyology
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• v.27 no.3
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• pp.228-232
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• 2015

The structure of the ventricle in the heart of Hypomesus nipponensis was investigated by light and scanning electron microscope. The heart consisted of four consecutive chambers, the sinus venosus, atrium, ventricle and bulbus arteriosus. The wall of the ventricle was divided into endocardium, myocardium, subepicardium and epicardium. The valves were observed in the artrioventricular and bulboventricular junctions. The ventricular myocardium was an entirely spongy without coronary vessels. The trabecular network was formed with lumina included a central lumen and the trabecula was cylindrical shape. Collagen distribution was apparent in the subepicardium, artrioventricular valve and bulboventricular valve. But in the trabeculae, collagen distribution was observed partly in the base of the ventricle. Especially, the endocardial bridges were observed between trabeculae. These results might be considered that the structure of the ventricle in the heart of pond smelt is adapted to sedentary habit associated with its habitat and lifestyle.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.289-296
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.167-171
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• 2018

Background: Heart transplantation (HTx) can be a life-saving procedure for patients in whom single ventricle palliation or one-and-a-half ($1\text\tiny{1/2}$) ventricle repair has failed. However, the presence of a previous bidirectional cavopulmonary shunt (BCS) necessitates extensive pulmonary artery angioplasty, which may lead to worse outcomes. We sought to assess the post-HTx outcomes in patients with a previous BCS, and to assess the technical feasibility of leaving the BCS in place during HTx. Methods: From 1992 to 2017, 11 HTx were performed in patients failing from Fontan (n=7), BCS (n=3), or $1\text\tiny{1/2}$ ventricle (n=1) physiology at Asan Medical Center. The median age at HTx was 12.0 years (range, 3-24 years). Three patients (27.3%) underwent HTx without taking down the previous BCS. Results: No early mortality was observed. One patient died of acute rejection 3.5 years after HTx. The overall survival rate was 91% at 2 years. In the 3 patients without BCS take-down, the median anastomosis time was 65 minutes (range, 54-68 minutes), which was shorter than in the patients with BCS take-down (93 minutes; range, 62-128 minutes), while the postoperative central venous pressure (CVP) was comparable to the preoperative CVP. Conclusion: Transplantation can be successfully performed in patients with end-stage congenital heart disease after single ventricle palliation or $1\text\tiny{1/2}$ ventricle repair. Leaving the BCS in place during HTx may simplify the operative procedure without causing significant adverse outcomes.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.136-146
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• 1996

Studies on normal human embryos and on malformed human hearts have been two main sources of the information on the developmental cardiology, Recent advances in the biological technology has opened a new era and descriptive embryology is being shifted into dynamic developmental biology. In this review, we discuss the current understanding on the cardiac embryology relevant to clinical practices of pediatric cardiology. Classical cardiac embryology starts with understanding on five segments of a straight heart tube : the sinus venosus, the primitive atria, the embryonic left ventricle, the embryonic right ventricle and the truncus arteriosus. Key steps in the normal morphogenetic process are the complex spiral septation of ventriculoarterial junction and two jumping connections : between the embryonic right atrium and embryonic right ventricle, and between the embryonic left ventricle and the aorta. Only after these two steps are successfully completed, the third fetal stage tak s place, when myocardial growth and remodeling take place There are two outstanding progresses on the cardiac embryology during recent five-year period. One is immunohistochemical mapping of the conduction system in the developing heart and the other is the understanding on the neural crest cell migration followed by molecular detection of the microdeletion of chromosome 22. A balanced progress of classical morphological studies, modern biological technics and advanced clinical medicine is an urgent task for doctors and scientists dealing with children with sick hearts.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.345-351
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• 1991

The myocardial temperature was monitored in 19 patients of open heart surgery using the Shiley myocardial temperature probe in Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. The myocardial temperature were measured time-wise: initial and 15 minutes following the infusion of the cardioplegic solution into the aortic root and upon reinfusion, which is 30 minutes apart from the initial. The measurements were made in the anterior wall of the right ventricle, the posterior wall of the left ventricle and the interventricular septum. Immediately after initial infusion, the temperature of the right ventricle[10.7 $\pm$4.3oC] was the lowest and that of the left ventricle[12.9$\pm$3.9 oC] the highest in the mean values among all 19 patients. However, no significant differences were noted among the different regions. At 15 minutes after infusion, the lowest temperature was in the right ventricle[17.5$\pm$5.1 oC], followed by interventricular septum[17.9$\pm$2.9 oC], and left ventricle[21.4$\pm$2.5 oC]. At 30 minutes after infusion, the lowest temperature was measured in the interventricular septum[13.6$\pm$2.7 oC ], followed by right ventricle[13.8$\pm$4.0 oC] and left ventricle[14.5$\pm$4.5 oC ]. Evaluating changes of myocardial temperature according to postinfusion time, the temperature at 15 minutes after infusion showed significant increase as compared with that immediately after the infusion in all three regions[p<0.05] and the temperature at 30 minutes after infusion showed significant decrease as compared with that at 15 minutes after the infusion in the left ventricle and the interventricular septum[p<0.05]. The left ventricle was rewarmed most rapidly and its temperature the highest in the mean values, Accordingly, the maintenance of optimal hypothermia of the left ventricle indicated a very careful factor in myocardial protection.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.3 s.168
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• pp.154-161
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• 2005

In this study, the leaflet motion of a mechanical heart valve and the characteristics of two-dimensional transient blood flow in an elastic blood vessel have been numerically investigated by using fluid-structure interaction method. Here, blood has been assumed as a Newtonian, incompressible fluid. Pressure profiles have been used as boundary conditions at the ventricle and the aorta. As a result, closing motion of the leaflet is faster than opening one. While opening angles of leaflet grow up, vortex is detected at the sinus and backward of the leaflets. When the leaflet is fully closed, vortex is detected at the ventricle and at that moment maximum displacement of the elastic blood vessel is observed in the vicinity of the sinus region. Maximum displacement is caused in association with the blood flow that is oriented toward the elastic blood vessel.

• Korean Journal of Artificial Intelligence
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• v.6 no.2
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• pp.17-22
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• 2018

According to the World Health Organization, the top 10 causes of death worldwide include heart disease. Heart diseases include coronary disease, which induces acute myocardial infarction. Ticagrelor drugs are being used to treat acute alliances, but it has become difficult to breathe due to the drugs. In a related study, Tobias predicted that uric acid causes acute respiratory distress independently of other factors, including BNP. And in the Ahmad study, serum uric acid numbers were related to the left ventricle depending on the level of uric acid. Experimental data are data used after 155 patients who received coronary intervention took ticagrelor. The research methods were leveraged by gradient decent algorithm and linear regression. In order to avoid overfitting in the experiment, training data and test data were separated into 70 and 30 percent respectively. The experimental results lacked the predictability of other attributes except DT in the correlation coefficient and crystal coefficient. However, all attributes related to dyspnea other than DT are determined to be related to causing relaxation of the heart in the left ventricle. Therefore, the attribute causing dyspnea is determined to be an attribute causing relaxation of the heart of the DT and left ventricle.