• Title/Summary/Keyword: Improvement strategy

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Customer Value Factors Influencing the Continuous Use Intention of Department Store Mobile Apps : Focusing on the Customer of Sinsegae Department Store (백화점 모바일 앱 지속 이용 의도에 영향을 미치는 고객 가치 요인 : 신세계 백화점 이용 고객을 중심으로 )

  • Kim, So-hyun;Choi, Chang-bum
    • Journal of Venture Innovation
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    • v.6 no.4
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    • pp.23-40
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    • 2023
  • This study examines the customer value factors affecting the intention to continue using the mobile app of department stores, which are traditional offline retailers, in the retail industry that is rapidly digitalizing and becoming mobile. This study clarifies multidimensional customer value in three dimensions; functional, convenience, and social. Functional value refers to the integrated channel, and consistent customer experience provided between channels in the omnichannel retail environment, while convenience value is the convenience of saving time and effort save while customers use a mobile app. Social value refers to the improvement of social approval or social self-concept occurring due to the use of products or services related to green marketing within the mobile app of the department store. The influence of each on the dependent variable, the mobile app's continuous use intention, was analyzed by using the three dimensions of customer value as independent variables. Data was collected from customers who have a history of using the mobile app of Shinsegae Department Store in Korea, and a confirmatory analysis was conducted using Smart PLS 4.0. The analysis results showed that all three dimensions of customer value; functional value, convenience value, and social value, had a positive (+) influence on customers' intention to continue using the mobile app, and the influence of functional value had the greatest impact. As functional value appears to be the most important influencing factor due to the omnichannel retail trend by advancement of technology, it suggests that it is important for department stores, and offline retailers, to provide integrated channels. This provides insights into the direction of customer-centered strategy formulation for activating department store mobile apps and suggests basic analytical data for customized services and marketing activities that department stores can effectively meet the changing expectations and demands of customers through new mobile channels rather than existing offline channels.

A Study on the Social Venture Startup Phenomenon Using the Grounded Theory Approach (근거이론 접근법을 이용한 소셜벤처 창업 현상에 관한 고찰)

  • Seol, Byung Moon;Kim, Young Lag
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.1
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    • pp.67-83
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    • 2023
  • The social venture start-up phenomenon is found from the perspectives of social enterprise and for-profit enterprise. This study aims to fundamentally explore the start-up phenomenon of social ventures from these two perspectives. Considering the lack of prior research that researched both social and commercial perspectives at the same time, this paper analyzed using grounded theory approach of Strauss & Corbin(1998), an inductive research method that analyzes based on prior research and interview data. In order to collect data for this study, eight corporate representatives currently operating social ventures were interviewed and data and phenomena were analyzed. This progressed to a theoretical saturation where no additional information was derived. The analysis results of this study using the grounded theory approach are as follows. As a result of open coding and axial coding, 147 concepts and 70 subcategories were derived, and 18 categories were derived through the final abstraction process. In the selective coding, 'expansion of social venture entry in the social domain' and 'expansion of social function of for-profit companies' were selected as key categories, and a story line was formed around this. In this study, we saw that it is necessary to conduct academic research and analysis on the competitive factors required for companies that pursue the values of two conflicting relationships, such as social ventures, to survive with competitiveness. In practice, concepts such as collaboration with for-profit companies, value combination, entrepreneurship competency and performance improvement, social value execution competency reinforcement, communication strategy, for-profit enterprise value investment, and entrepreneur management competency were derived. This study explains the social venture phenomenon for social enterprises, commercial enterprises, and entrepreneurs who want to enter the social venture field. It is expected to provide the implications necessary for successful social venture startups.

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A Method of Utilizing ESG Evaluation by Small and Medium Enterprises: Focusing on the relationship between ESG Performance measure and Corporate Value (중소기업의 ESG 평가지표 활용 방안: ESG 평가지표와 기업가치의 관계를 중심으로)

  • Park Jae Hyun;Han Hyang Won
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.6
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    • pp.87-104
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    • 2023
  • Recently, concerns are growing over small and medium-sized companies holding out on debt as domestic loan interest rates have risen sharply due to the prolonged impact of COVID-19 and soaring raw material prices. In addition, loans from small and medium-sized enterprises, which are difficult in the business environment, are increasingly being rejected due to high loan interest rates and excessive submission documents and financial statements-oriented screening of loans by the financial sector. Therefore, since it is necessary to discuss ways to promote financing and investment by SMEs, this study intends to suggest ways to promote investment through the use of SMEs' ESG systems. The purpose of this study is to suggest that the use of ESG evaluation indicators used as non-financial indicators helps predict the corporate value of SMEs and the importance of SMEs actively participating in ESG information disclosure. This study suggests the necessity of introducing and practicing ESG by SMEs where financing is important, and aims to analyze as an empirical result that the use of non-financial indicators helps predict corporate value. As a result of the study, the ESG performance and corporate value of SMEs showed a positive (+) relationship. It can be seen that both the grades and corporate value of SMEs by ESG sector have a positive (+) influence relationship. The total ESG rating was confirmed to have a positive effect on corporate value, and it was confirmed that SMEs with higher ESG environment, social, and governance ratings were evaluated higher. According to the research results, it is suggested that SMEs also need to use ESG evaluation indicators, and in order to promote the growth of SMEs, it is suggested that research on ways to re-examine the corporate value of SMEs is necessary. Therefore, this study suggests that the use of ESG should be actively recommended and implemented as a way to establish a management strategy for SMEs, and that efforts to disclose ESG information can soon help SMEs solve information asymmetry. In addition, SMEs want to understand the investment mechanism that the introduction and practice of ESG can lead to the improvement of the value of SMEs and suggest the necessity of SME-type ESG policies in the future.

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Economic Feasibility Analysis Study to Build a Plant-based Alternative Meat Industrialization Center (식물성 기반 대체육 산업화센터 구축을 위한 경제적 타당성 분석)

  • Yong Kwang Shin;So Young Lee;Jae Chang Joo
    • Journal of Practical Agriculture & Fisheries Research
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    • v.25 no.4
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    • pp.118-126
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    • 2024
  • Recently, the alternative meat (food) market is growing rapidly due to the increase in meat consumption due to global population growth and income improvement, as well as issues such as equal welfare, carbon neutrality, and sustainability. The government is also developing a green bio convergence new industry development plan to foster alternative foods, but there are difficulties in commercialization due to the lack of technology and insufficient production facilities among domestic small and medium-sized enterprises, so it is necessary to build joint utilization facilities and equipment to resolve the difficulties faced by companies. am. In addition, small and medium-sized enterprises are having difficulty developing and commercializing plant-based meat substitutes due to a lack of technical skills, and related equipment is expensive, making it difficult to build equipment on their own. Accordingly, Jeollabuk-do is pursuing a strategy to secure the source technology for development, processing, and industrialization of plant-based substitute meat at the level of developed countries by establishing a plant-based alternative meat industrialization center. In this study, an economic feasibility analysis study was conducted when a plant-based alternative meat industrialization center is built in Jeollabuk-do. As a result of the analysis, B/C=1.32, NPV=374 million won, and IRR=4.8%, showing that there is economic feasibility in establishing an alternative meat industrialization center. In addition, as a result of analyzing the regional economic ripple effect resulting from the establishment of an industrialization center, if 38 billion won is invested in Jeollabuk-do, the nationwide production inducement effect is 74 billion won, the added value inducement effect is 29.8 billion won, and the employment inducement effect is 672 people

Aspects of Design and Construction in Entrance Space of the World Heritage Royal Tombs of the Joseon Dynasty (세계유산 조선왕릉 입구공간의 조성 양상)

  • So, Hyun-Su;Park, Hyun-Sook
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.3
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    • pp.47-58
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    • 2023
  • This study was conducted through reviewing Aspects of Design and Construction in Entrance Space of the World Heritage Royal Tombs of the Joseon Dynasty, which is equipped with parking lots, ticket offices, toilets, exhibition halls, information boards, and rest facilities for the convenience of visitors and the purpose of this study was to propose a direction for improvement. The results of the study are as follows: First, the reduced area of Royal Tombs of the Joseon Dynasty was unable to fully accommodate the ritual movement line, and as a result, the location of the entrance space in the current royal tomb was decided to accommodate minimal convenience functions. In the meantime, the entrance space of the royal tombs has been relocated or renovated in order to achieve its integrity as a World Heritage Site, rational arrangement of movement lines and spatial utility. Second, the size of the entrance space ranges from 1,000 square meters in Jeongneung in Seoul to 16,000 square meters in Hongyuneung in Namyangju, and the number of annual users varies greatly from 12,000 in Onneung in Yangju to 410,000 in Seonjeongneung in Seoul. Considering the conditions of the 16 royal tombs, the entrance space should be provided at an appropriate scale, reflecting the surrounding land use and accessibility that affect the influx of users, the size of the site, and the king's awareness and preferences. Third, the location of the parking lot, the presence or absence of an outer courtyard and an internal courtyard bordering the ticket and check offices, and the location of the Historical and Cultural Museum made it possible to know the aspects of entrance space of the Joseon Royal Tombs, where the spatial configuration is determined Fourth, according to the royal tombs, it was found that the entrance space should have essential parking, access control, information, and convenience functions, and that support, exhibition, passage, and recess functions should be optional. At this time, the management office and the Historical and Cultural Center are in charge of support and exhibition functions. The function of passage can be a strategy that provides a sense of entry and the function of recess which has been introduced in only four royal tombs requires an appropriate location and landscape access.

A Study on the Critical Success Factors of Social Commerce through the Analysis of the Perception Gap between the Service Providers and the Users: Focused on Ticket Monster in Korea (서비스제공자와 사용자의 인식차이 분석을 통한 소셜커머스 핵심성공요인에 대한 연구: 한국의 티켓몬스터 중심으로)

  • Kim, Il Jung;Lee, Dae Chul;Lim, Gyoo Gun
    • Asia pacific journal of information systems
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    • v.24 no.2
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    • pp.211-232
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    • 2014
  • Recently, there is a growing interest toward social commerce using SNS(Social Networking Service), and the size of its market is also expanding due to popularization of smart phones, tablet PCs and other smart devices. Accordingly, various studies have been attempted but it is shown that most of the previous studies have been conducted from perspectives of the users. The purpose of this study is to derive user-centered CSF(Critical Success Factor) of social commerce from the previous studies and analyze the CSF perception gap between social commerce service providers and users. The CSF perception gap between two groups shows that there is a difference between ideal images the service providers hope for and the actual image the service users have on social commerce companies. This study provides effective improvement directions for social commerce companies by presenting current business problems and its solution plans. For this, This study selected Korea's representative social commerce business Ticket Monster, which is dominant in sales and staff size together with its excellent funding power through M&A by stock exchange with the US social commerce business Living Social with Amazon.com as a shareholder in August, 2011, as a target group of social commerce service provider. we have gathered questionnaires from both service providers and the users from October 22, 2012 until October 31, 2012 to conduct an empirical analysis. We surveyed 160 service providers of Ticket Monster We also surveyed 160 social commerce users who have experienced in using Ticket Monster service. Out of 320 surveys, 20 questionaries which were unfit or undependable were discarded. Consequently the remaining 300(service provider 150, user 150)were used for this empirical study. The statistics were analyzed using SPSS 12.0. Implications of the empirical analysis result of this study are as follows: First of all, There are order differences in the importance of social commerce CSF between two groups. While service providers regard Price Economic as the most important CSF influencing purchasing intention, the users regard 'Trust' as the most important CSF influencing purchasing intention. This means that the service providers have to utilize the unique strong point of social commerce which make the customers be trusted rathe than just focusing on selling product at a discounted price. It means that service Providers need to enhance effective communication skills by using SNS and play a vital role as a trusted adviser who provides curation services and explains the value of products through information filtering. Also, they need to pay attention to preventing consumer damages from deceptive and false advertising. service providers have to create the detailed reward system in case of a consumer damages caused by above problems. It can make strong ties with customers. Second, both service providers and users tend to consider that social commerce CSF influencing purchasing intention are Price Economic, Utility, Trust, and Word of Mouth Effect. Accordingly, it can be learned that users are expecting the benefit from the aspect of prices and economy when using social commerce, and service providers should be able to suggest the individualized discount benefit through diverse methods using social network service. Looking into it from the aspect of usefulness, service providers are required to get users to be cognizant of time-saving, efficiency, and convenience when they are using social commerce. Therefore, it is necessary to increase the usefulness of social commerce through the introduction of a new management strategy, such as intensification of search engine of the Website, facilitation in payment through shopping basket, and package distribution. Trust, as mentioned before, is the most important variable in consumers' mind, so it should definitely be managed for sustainable management. If the trust in social commerce should fall due to consumers' damage case due to false and puffery advertising forgeries, it could have a negative influence on the image of the social commerce industry in general. Instead of advertising with famous celebrities and using a bombastic amount of money on marketing expenses, the social commerce industry should be able to use the word of mouth effect between users by making use of the social network service, the major marketing method of initial social commerce. The word of mouth effect occurring from consumers' spontaneous self-marketer's duty performance can bring not only reduction effect in advertising cost to a service provider but it can also prepare the basis of discounted price suggestion to consumers; in this context, the word of mouth effect should be managed as the CSF of social commerce. Third, Trade safety was not derived as one of the CSF. Recently, with e-commerce like social commerce and Internet shopping increasing in a variety of methods, the importance of trade safety on the Internet also increases, but in this study result, trade safety wasn't evaluated as CSF of social commerce by both groups. This study judges that it's because both service provider groups and user group are perceiving that there is a reliable PG(Payment Gateway) which acts for e-payment of Internet transaction. Accordingly, it is understood that both two groups feel that social commerce can have a corporate identity by website and differentiation in products and services in sales, but don't feel a big difference by business in case of e-payment system. In other words, trade safety should be perceived as natural, basic universal service. Fourth, it's necessary that service providers should intensify the communication with users by making use of social network service which is the major marketing method of social commerce and should be able to use the word of mouth effect between users. The word of mouth effect occurring from consumers' spontaneous self- marketer's duty performance can bring not only reduction effect in advertising cost to a service provider but it can also prepare the basis of discounted price suggestion to consumers. in this context, it is judged that the word of mouth effect should be managed as CSF of social commerce. In this paper, the characteristics of social commerce are limited as five independent variables, however, if an additional study is proceeded with more various independent variables, more in-depth study results will be derived. In addition, this research targets social commerce service providers and the users, however, in the consideration of the fact that social commerce is a two-sided market, drawing CSF through an analysis of perception gap between social commerce service providers and its advertisement clients would be worth to be dealt with in a follow-up study.

Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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A Basic Study on the Establishment of Preservation and Management for Natural Monument(No.374) Pyeongdae-ri Torreya nucifera forest of Jeju (천연기념물 제374호 제주 평대리 비자나무 숲의 보존·관리방향 설정을 위한 기초연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Oh, Hae-Sung;Choi, Byung-Ki;Lee, Jong-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.1
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    • pp.93-106
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    • 2014
  • In this study, Analyze environment of location, investigation into vegetation resources, survey management status and establish to classify the management area for Natural monument No.374 Pyengdae-ri Torreya nucifera forest. The results were as follows: First, Torreya nucifera forest is concerned about influence of development caused by utilization of land changes to agricultural region. Thus, establish to preservation management plan for preservation of prototypical and should be excluded development activity to cause the change of terrain that Gotjawal in the Torreya nucifera forest is factor of base for generating species diversity. Secondly, Torreya nucifera forest summarized as 402 taxa composed 91 familly 263 genus, 353 species, 41 varieties and 8 forms. The distribution of plants for the first grade & second grade appear of endangered plant to Ministry of Environment specify. But, critically endangered in forest by changes in habitat, diseases and illegal overcatching. Therefore, when establishing forest management plan should be considered for put priority on protection. Thirdly, Torreya nucifera representing the upper layer of the vegetation structure. But, old tree oriented management and conservation strategy result in poor age structure. Furthermore, desiccation of forest on artificial management and decline in Torreya nucifera habitat on ecological succession can indicate a problem in forest. Therefore, establish plan such as regulation of population density and sapling tree proliferation for sustainable characteristics of the Torreya nucifera forest. Fourth, Appear to damaged of trails caused by use. Especially, Scoria way occurs a lot of damaged and higher than the share ratio of each section. Therefore, share ratio reduction Plan should be considered through the additional development of tourism routes rather than the replacement of Scoria. Fifth, Representing high preference of the Torreya nucifera forest tourist factor confirmed the plant elements. It is sensitive to usage pressure. And requires continuous monitoring by characteristic of Non-permanent. In addition, need an additional plan such as additional development of tourism elements and active utilizing an element of high preference. Sixth, Strength of protected should be differently accordance with importance. First grade area have to maintenance of plant population and natural habitats. Set the direction of the management. Second grade areas focus on annual regeneration of the forest. Third grade area should be utilized demonstration forest or set to the area for proliferate sapling. Fourth grade areas require the introduced of partial rest system that disturbance are often found in proper vegetation. Fifth grade area appropriate to the service area for promoting tourism by utilizing natural resources in Torreya nucifera forest. Furthermore, installation of a buffer zone in relatively low ratings area and periodic monitoring to the improvement of edge effect that adjacent areas of different class.

A Study on Health Awareness of Middle and High School Students in Yong Nam Area (영남지역(嶺南地域) 중고등학교학생(中高等學校學生)들의 보건의식행태조사(保健意識行態調査) 연구(硏究))

  • Kim, Hyung Nam;Nam, Chul Hyun
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.119-135
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    • 1991
  • The study was designed to gain necessary basic data order to grasp health knowledge, attitude, practice level of middle and high school students and to analyse th problem and to point out the method of improvement in the field of school health education. The survery was carried out through this reporter's interview for 2,400 students who attend to ten schools in Young Nam area during the period of a month from 25 the June to 25th July 1989. The result of this study can be summaried as follows. 1. The total number of answers on the question was 2,346. As for general characteristics the percent of female middle school students was 60.6% and the percent of male students was 77.7%, 45.9% of high school students was evening school students. 52.9% of middle school students and 42.3% of high school students were borne in rural area. 2. The percentage of unknown and misunderstanding for Epidemic Hepatitis infection was 46.3% of middle school students and 29.6% of high school students. 3. The percentage of unknown and misunderstanding for Epidemic Hemorrhage fever infection was 85.6% of middle school students and 66.9% of high school students. 4. The percentage of right knowledge for AIDS infection was 66.0% of middle school students and 90.4% of high school students. 5. The percentage of right knowledge for Typhoid infection was 47.8% of middle school students and 69.4% of high school students. 6. The percentage of unknown and misunderstanding for Tuberculosis infection was 71.6% of middle school students and 62.2% of high school students. 7. As for personal hygiene, the percentage of toothbrushing after every meal was high level : 44.2% of middle school students and 42.0% of high school students. 8. 60.9% of middle school students take a bath twice a week, 49.2% oh high school students take a bath a week. Times of bath of middle school students was higher than that of high school students. 9.The percentage of washing hand after using toilet was 42.1% of middle school students and 35.1% of high school students. 49.0% of middle school students and 55.1% of high school students wash hand sometimes after using toilet. 10. The percentage of change of underwear twice a week was 57.6% of middle school students and 49.8% of high school students. 11. The percentage of habit of unbalanced diet was 30.% of middle school students and 27.6% of high school students. 50.8% of middle school students and 51.7% of high school students have balanced diet. 12. Index of health practice of personal hygiene can be summarized as follows. A. A case of middle school students. 1) The percentage of health practice index in male and female was 49.6% and 48.1% respectively. Index of female students was higher than that of male students. 2) As for parent's occupation, public servants and company emplyee was upper level. Farming was low level. 3) As for income level, middle, level with 56.5% was highest in high income level and low level with 27.4% was highest in low income level. B. A case of high school students. 1) Middle level of health practice index was 46.0% of male students, upper and low level was 32.4% and 28.0% of female students respectively. 2) Middle level of health practice index was high in farming and company employee and upper level was high in commerce and service, low level with 60.0% was high in unemployed. 3) Upper practice index 35.7% appears in the rich and low practice index 38.3% appears in the poor. 13. Average points of Health practice about personal hygiene were as follows. (Full marks at 4). A. A case of middle school. Female (1.87 point) was higher than male (1.26 point). Night time (2.03 point) was higher than day time (1.66 point) and middle or small cities (2.17 point) are high than any other places. As for parent's occupation, students whose parents are company clerk get high marks (2.32) and ten students whose parent's job are service get next high marks (2.20). B. A case of high school. Female (1.53 point) was higher than male (1.22 point), as parents educational level were higher the point were higher, and as income level was higher, the points of health practice (1.78) were higher, and as for parents occupation, service get highest point (1.93) and commerce get next high point (1.86) public servant get low point (1.66). 14. The percentage of experience in smoking was 11.9% of middle school students and 60.9% of high school students. 15. The percentage of experience in inhalation of bond and administrating LSD was 4.3% of male middle school students, 8.4% of female middle school students, 6.9% of male high school students and 4.2% of female high school students. The knowledge level of communicable disease infection are very low in middle and high school students and practice level of personal hygiene are also very low. As a whole we can evaluate that middle and high school students are low level of health knowledge and practice. In conclusion, we must consider preparation for school health education program through establishing of health subjects in the carriculum, and securing of health education teachers and using materials and media program of health education. It is very important to establish macroscopic policy and strategy for public health education and to get people have right knowledge and practice for health.

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Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.