• Journal of Chest Surgery
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• 제10권1호
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• pp.164-172
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• 1977

This is a report of a case in which a left atrial myxoma was successfully removed by total cardiopulmonary bypass with total hemodilution and moderate hypothermia. The patient was a 17 old girl with mitral valvular symptoms that occured suddenly three months prior to operation. After the onset of symptoms. it was progressively aggravated to serious general condition. The preoperative diagnosis of left atrial tumor was made from echocardiography. and the tumor was confirmed as myxoma by the histopathological examination of the tumor tissue removed during operation. The myxoma was unusually originated from posterior wall of the left atrium. which was located between drainage orifices of right and left pulmonary veins, The tumor developed in the left atrial cavity and one of the polypoid processes of the myxoma was prolapsed into the the left ventricle through the mitral orifice. Following operation. there was no evidence for peripheral vascular embolism, and all valvular symptoms disappeared. The postoperative course was uneventful.

• 대한두경부종양학회지
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• 제23권1호
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• pp.67-70
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• 2007

Myxoma is an uncertain mesenchymal cell origin, characterized by irregular round, stellate or spindle cells surrounded by the matrix containing abundant mucoid material and scant vascularity. Their occurrence in descending order of frequency is in the heart, subcutaneous tissue, bone and genitourinary tract. In the head and neck region, the most predilection sites are mandible and maxilla(more than 80%). Laryngeal myxoma is extremely rare：only 5 cases have been reported in the English literature. We report a rare case of laryngeal myxoma. A 60-year-old man with hoarseness visited the out-patient department. The mass was located between the vocal fold and the vocal ligament, filling with the left laryngeal ventricle. We planned the laryngo-microsurgery and successfully excised using $CO_2$ laser. The histopathologic finding revealed the myxoma. After 18 months of surgery, there is no evidence of recurrence and mucosal scarring in the vocal fold. This report is the first case of laryngeal myxoma involving the laryngeal ventricle and the true vocal cord together.

• Journal of Chest Surgery
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• 제28권5호
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• pp.491-494
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• 1995

A fibroma arising in the right ventricle outflow tract of a 14 month-old infant was successfully removed. The patient was first seen because of shortness of breath and tachycardia. Pertinent clinical and laboratory findings included a grade II/VI systolic murmur, blood pressure of 120/60 mmHg, slight cardiomegaly on chest X-ray, a mass obstructing the outflow tract of the right ventricle on echocardiography and magnetic resonance imaging. On october 30,1992, under cardiopulmonary bypass, a 4cm x 3cm x 3cm tumor was resected from the right ventricular outflow tract, together with a portion of the ventricular wall. Histologically, it was diagnosis as a fibroma. The patient was sent home on the 6th postoperative day following an uneventful recovery form the operation. Although cardiac fibroma is the second most common cardiac tumor in infancy and childhood, it is usually found in the left ventricle and one arising in the right ventricle is considered rare. Although it is a benign tumor, it could produce a severe cardiac dysfunction and even sudden death, depending on its size and location. With the advance in diagnostic techniques and operative management, there is a renewed interest in the early detection and operative removal of these tumors. The case herein presented is the first such case successfully managed and reported in the Korean literature.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.928-933
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• 2001

Intraventricular arachnoid cyst has been rarely reported. Here we present two cases of symptomatic intraventricular arachnoid cysts in the fourth ventricle and right lateral ventricle. The first patient was a 38-year-old female who complained of headache and left facial hypesthesia. Computed tomography and MR scan revealed large cystic lesion in the fourth ventricle. After cyst wall removal, facial hypesthesia disappeared immediately and headache improved slowly. The second patient was a 9-year-old girl who complained of headache, vomiting and paresthesia in her right low extremity. Cystic lesion in the right lateral ventricle was detected in the CT and MR scan. The symptoms improved after cyst wall removal. Surgical findings of these two cases showed that the cyst walls were attached firmly to the choroid plexus. Symptomatic intraventricular arachnoid cyst must be treated appropriately and we recommend complete cyst wall removal.

• Journal of Chest Surgery
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• 제21권5호
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• pp.905-910
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• 1988

Anomalous origin of the coronary artery from the pulmonary artery is a rare congenital coronary artery disease and the origin of the left coronary artery from the pulmonary artery represents the commonest form of these unusual lesions. Because of differences in symptomatology, clinical course and prognosis, this malformation has been divided into infant type[Bl-and-White-Garland syndrome] and adult type on the basis of the absence or presence of collateral circulation between the right and left coronary artery. The latter type has been reported relatively few cases. A 21-year-old male was admitted to the Yeungnam University Hospital, due to study of incidentally noticed heart murmur. At that time he was asymptomatic and past medical history was noncontributory. Chest roentgenogram was within normal limit and electrocardiogram was consistent with hypertrophy of left ventricle. Echocardiogram and aortogram demonstrated markedly dilated and tortuous right coronary artery and anomalous origin of the left coronary artery from the pulmonary artery. To prevent arteriosclerosis, progressive myocardial infarction, infection and aneurysmal rupture, Takeuchi operation which establish a two coronary system by transpulmonary arterial reconnection of the anomalous left coronary artery was done. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제33권3호
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• pp.252-256
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• 2000

There have been few reports documenting the outcome of arterial swich operations(ASO) in selected patients with transposition of great arteries(TGA) and with left ventricular outflow tract obstruction(LVOTO). In the case of TGA with LVOTO, if the atrial septal defect(ASD) is large and the ventricular septal defect(VSD) is restricive, this deprives the left ventricle(LV) of approporiate preload and could lead to underdevelopment of the ventircular mass and lead poor LV performance after the arterial switch operation, dspite a high pressure in the LV preoperatively. Because an increase in the systolic ventricular pressure is not necessarily paralleled by an increase in ventricular mass, which is also essential for optimal ventricular performance after the operation. We report here a case of rapid LV training after ASO in TGA with unprepared LV (because of large ASD and restrictive VSD) despite a high pressure in the LV(due to LVOTO) preoperatively.

• Journal of Chest Surgery
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• 제21권4호
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• pp.727-733
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• 1988

Two cases of the discrete membranous subaortic stenosis were experienced at the Department of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. Case I was 31 years old male with a history of aortic valve replacement[Ionescu-Shiley, 19mm] at the other hospital in 1980. Heart failure was noticed 6 years later. On cardiac catheterization, pressure gradient between left ventricle 4 aorta was 104 mmHg, but subvalvular aortic stenosis was not detected by preoperative 2-D echo <% left ventriculogram. Above case revealed stenoinsufficiency of the prosthetic valve. Under the diagnosis of the prosthetic valve failure, re-do aortic valve replacement[Bjork-Shiley, 23 mm] was done. During operation, the discrete membranous subaortic stenosis was incidentally found, and it was completely resected. So we thought that above discrete membranous subaortic stenosis was not detected at first operation, and it was progressed during 6 years, and accelerated the degeneration of the prosthetic valve. Case II was 20 years old female. Her complaints were exertional dyspnea, angina, syncope, which were aggravated since 5 years ago. 2-D echo <% left ventriculogram revealed the discrete membranous subaortic stenosis. Pressure gradient was 20 mmHg, but her symptoms were serious. Associated cardiac anomaly was the persistent left superior vena cava without connection with right superior vena cava. Complete excision of the membranous tissue was done. Post-operative pressure gradient between left ventricle & aorta was absent, and her complaints were nearly subsided. Both cases were type I according to the Newfeld classification of the discrete subvalvular aortic stenosis, and complete excision of the membranous tissue was done without myotomy or mymectomy. And short-term follow-up results[Case I:2 years, Case II: 1 ~ years] were good except soft systolic murmur[grade II/VI] at the aortic area in both cases.

• 한국임상수의학회지
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• 제27권6호
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• pp.735-739
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• 2010

8개월령 말티스가 호흡곤란, 운동불내성의 증상으로 내원하였다. 흉부방사선상 환자는 심한심종대와 주폐동맥의 확장 소견을 보였고, 심초음파상 대동맥근이 우심실을 향하고 좌-우 단락을 가지고 있는 대동맥하 심실중격결손증이 확인되었다. 또한 중격결손에 의한 좌-우 단락성 혈류에 의해 폐혈관계에 과순환 소견과 폐성 고혈압에 의한 심한 폐동맥 역류가 (최고속도 4.7 m/s, 압력구배 ~88 mmHg) 확인되었다. 상기의 소견을 토대로 환자는 양대혈관 우심실기시로 진단되었다. 환자는 우심실의 혈량과부하를 줄이기 위한 이뇨제 처치(furosemide 1 mg/kg), 심장재구성을 늦추어주기 위해 spironolatcone (1 mg/kg) 및 enalapril (0.5 mg/kg) 처치와 폐의 과순환과 폐성 고혈압을 완화시켜주기 위해 sildenafil (1 mg/kg)를 처방하였다. 일주일뒤 재검에서 환자의 임상 증상은 크게 개선되었다. 현재 환자는 생존해 있고 정기적으로 모니터하고 있다.

• Journal of Chest Surgery
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• 제15권3호
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• pp.325-330
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• 1982

A case of a 7 year old girl with rare congenital anomalies is reported. The anomalies as called Cantrell`s pentalogy is consisted of defect in supraumbilical abdominal wall, ventral diaphragm, adjacent pericardium, and lower sternum associated with cardiac malformation. Her cardiac lesion was muscular diverticulum of left ventricle. The diverticulum was resected and the other defects were repaired successfully.

• Journal of Chest Surgery
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• 제13권2호
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• pp.125-129
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• 1980

A patient with anomalous coronary artery crossing right ventricular outflow tract in association with Tetralogy of Fallot underwent total correction. The left anterior descending coronary artery was originated from right coronary artery anterior to the pulmonary valve ring. The incision from outflow tract to pulmonary artery tunneled underneath the aberrant artery and patch graft across the pulmonary valve ring to enlarge outflow of right ventricle and stenotic pulmonary valve ring.