• Journal of Chest Surgery
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• 제38권1호
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• pp.63-66
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• 2005

전벽의 급성심근경색에 의한 좌심실류가 있는 경우 수술적 전측심실내복원술(SAVER)은 좌심실의 무운동과 이상운동 구획을 분리하여 정상적인 좌심실 원형구조와 심근벽의 긴장도를 정상적인 수준으로 감소시켜 줌으로써 혈역학적 향상을 기할 수 있는 술식이다 저자들은 급성심근경색에 의한 좌심실류로 좌심실류절제술을 시행 받은 과거력이 있는 40세 남환에서 12년간에 걸친 remodelling의 결과로 진행된 말기심부전의 치료방법으로써 다시 수술적 전측심실내복원술을 시행한 후 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제32권5호
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• pp.428-432
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• 1999

배경: 전기적인 자극에 의하여 골격근의 피로현상이 극복됨으로써 골격근을 심장보조장치에 이용할 수 있게 되었다. 인공심장이나 심실보조기구는 에너지원의 전원장치가 크고 거추장스러운 단점이 있어 아직 해결해야될 문제이다. 반면 골격근을 이용한 심실보조장치는 에너지원으로 환자 자신의 골격근 수축력을 이용할 수 있는 장점이 있어 이의 임상응용 가능성을 제시하고자 한다. 대상 및 방법: 8예의 광배근을 이용하여 골격근 심실의 모형을 만들었다. 물이 담긴 라텍스 주머니를 골격근이 한바퀴 반 감싸도록 고안하였고 골격근의 수축압력은 연결된 관을 통하여 변환기에 기록되도록 하였다. 전극은 흉배신경 주위에 설치한 후 Itrel 7420 박동기에 연결하였다. 프로그래머로 박동기를 조절하였으며 3.0Volt, cyclic burst, 0.31초 on time, 6.0초 off time의 자극을 주었다. 라텍스 주머니 내에 액체의 양을 25cc 씩 증가시키면서 전부하의 변화에 따른 골격근 심실의 박출량과 압력 및 수축력을 측정하였다. 결과: 골격근 심실의 전부하가 0인 경우 일회박출량은 76.3ml 이고, 전부하가 점차 증가함에 따라 일회박출량이 감소하는 경향을 보였다. 전부하가 75cc 이상이 되면 일회박출량은 70ml 이하로 감소하는 양상을 볼 수 있었다. 압력을 측정한 결과도 전부하가 75cc 이하인 경우 정상의 혈압과 비슷한 107mmHg 이상의 혈압을 보이고 있으나 전부하가 100cc 이상 증가하는 경우 혈압이 100mmHg 이하로 감소하는 것을 볼 수 있었다. 또한 최대의 골격근 수축력은 50cc의 전부하에서 16.6 W/kg의 힘을 분출하였다. 결론: 골격근 심실은 전부하의 변화에 따라 정상 심장보다도 강한 박출량과 압력의 변화를 관찰할 수 있었으며 임상 응용의 가능성을 볼 수 있었다.

• Journal of Chest Surgery
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• 제24권5호
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• pp.491-497
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• 1991

Coronary arteriovenous fistula is a relatively rare congenital heart disease and it drains into right atrium, right ventricle, pulmonary artery, coronary sinus or superior vena cava. We experienced one case of fistulous communication between right coronary artery and right ventricle which was most common condition. The patient was a 12 year old female and the only sign was continuous cardiac murmur. The cardiac catheterization and coronary angiography showed the fistulous communication between right coronary artery and right ventricle and aneurysmal dilatation of right coronary artery. Under the cardiopulmonary bypass with the hypothermic cardioplegia, fistula opening[7mm] which was located at right ventricle below the tricuspid valve annulus between septal and posterior leaflet was closed with 4 - 0 prolene continuous suture through right ventriculotomy. Her postoperative course was uneventful.

• Journal of Chest Surgery
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• 제26권9호
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• pp.710-713
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• 1993

Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.

• Journal of Chest Surgery
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• 제20권4호
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• pp.798-802
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• 1987

Origin of both great vessels from morphological left ventricle [DOLV] is a rare cardiac anomaly which embryologic possibility has been explained by differential conal development concept and differential canal absorption concept. Recently we had surgical experience of DOLV in 4 month-age infant weighing 5.7Kg. The chief complaints on admission were cyanosis and anoxic spell during severe crying, and right heart catheterization and right ventriculogram were performed but incorrect diagnosis was made. The operative procedures were ligation of patent ductus arteriosus, patch closure of subaortic VSD aligning aorta and pulmonary artery with left ventricle, suture closure of proximal pulmonary artery and valve and the use of extracardiac valved conduit [Carpentier-Edward l4mm] from right ventricle to distal pulmonary artery. Postoperative course was uneventful and discharged in the good condition.

• Journal of Chest Surgery
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• 제21권1호
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• pp.17-25
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• 1988

This study was undertaken to evaluate the efficacies for myocardial protective effect of retrograde right atrial perfusion [RRAP] of cardioplegia compared with antegrade aortic root perfusion [AARP]. Myocardial distribution of perfusate [using methylene blue] with RRAP was less poor to AARP. Myocardial protective effect was estimated with myocardial temperature and electron microscopy. Cooling protection of right ventricle with RRAP was similar to AARP. On the other hand, cooling protection of left ventricle with RRAP was slight poor to AARP. The electron microscopic ischemic change of right and left ventricle with RRAP was similar to AARP. RRAP was thought to be a good alternative method to perfuse cardioplegia and protect both ventricle.

• Journal of Chest Surgery
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• 제27권5호
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• pp.353-363
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• 1994

From January 1978 to December 1992, 59 patients of double chambered right ventricle were repaired. Surgical correction consisted of closure of the ventricular septal defect and resection of anomalous muscle bundles through right ventriculotomy [Group I ; 34 patients] or right atriotomy [Group II ; 25 patients]. Between these two groups, there was no difference in the operation time and the postoperative results. All patients survived. In group I, hemodynamically significant residual ventricular septal defect was found in three and reoperations were necessary. In one patient, subacute bacterial endocarditis developed postoperatively. In group II, complete atrioventricular block developed in one and mediastinitis in two. Follow-up period was from 2 to 75 months [mean 17.1 months]. There was no late death. All patients have remained in sinus rhythm except one patient. Careful evaluation of echocardiographic and catheterization data preoperatively and careful examination of the anatomy intraoperatively are necessary so that double chambered right ventricle should not be overlooked, because most ventricular septal defects are now closed through the right atrium. Repair of double chambered right ventricle is also easily performed through the atrial approach. Transatrial repair should be considered as an alternative to the transventricular approach in patients with this congenital heart defect. Successful surgical correction of double chambered right ventricle is expected with excellent long term results.

• Clinical and Experimental Pediatrics
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• 제56권3호
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• pp.101-106
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• 2013

Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

• 대한방사선기술학회지:방사선기술과학
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• 제47권2호
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• pp.125-135
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• 2024

This study analysed the factors that predict and influence heart disease through key indicators related to changes in left atrial and left ventricular size. Measurements recommended by the American Society of Echocardiography were used, and the influence of variables was assessed using multiple regression analysis. The results showed that left atrial volume index(LAVI) was significantly different by age, obesity, diabetes, hypertension, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Left ventricular mass index(LVMI) was significantly different according to age, body mass index, hypertension, diabetes, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Increases in LVMI and relative ventricular wall thickness(RWT) were associated with changes in LAVI(p<0.05). Age, systolic blood pressure, increased LAVI, and RWT influenced changes in LVMI, and left ventricular dysfunction was analysed as an influencing factor for both changes in LAVI and LVMI. Therefore, changes in left atrial and left ventricular size are indicators for early diagnosis and prevention of heart disease, and it is necessary to carefully observe structural changes in the heart and actively manage risk factors for the prevention and management of heart disease.

• Journal of Chest Surgery
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• 제49권3호
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• pp.190-194
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• 2016

Double outlet right ventricle (DORV) and transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS) are complex heart diseases, the treatment of which remains a surgical challenge. The Rastelli procedure is still the most commonly performed treatment. Aortic root translocation including an arterial switch operation is advantageous anatomically since it has a lower possibility of conduit blockage and the left ventricle outflow tract remains straight. This study reports successful aortic root transpositions in two patients, one with DORV with VSD and PS and one with TGA with VSD and PS. Both patients were discharged without postoperative complications.