• Title/Summary/Keyword: Left ventricular

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Surgical Removal of a Pedunculated Left Ventricular Thrombus (좌심실 혈전의 수술적 제거 -1예 치험)

  • 고광표
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.190-192
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    • 2000
  • A 53-year-old male patient who had suffered from acute myocardial infarction before a week was admitted due to postinfarction angina A mobile pedunculated left ventricular thrombus of 2.0-cm diameter which was overlooked in cardiac catheterization and ventriculographic study was diagnosed with transthoracic two-dimensional echocardiography. There was no exact clinical finding of left ventricular aneurysm and the thrombus was placed in the akinetic and hypokinetic apical portion. For preventing systemic embolism that was removed through a left ventriculotomy just prior to coronary artery bypass grafting.

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Hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction in a Maltese dog

  • Yoon, Won-Kyoung;Suh, Sang-Il;Oh, Yeon-Su;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.55 no.3
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    • pp.209-211
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    • 2015
  • An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.

Anatomical Repair of Double-Outlet Left Ventricle with Ventricular Septal Defect and Pulmonary Stenosis by Reight Ventricular Outflow Patch Reconstruction (폐동맥 협착증을 동반한 양대혈관 좌심실 기시증에서, 우심실 유출로 첩포 재건술을 이용한 해부학적 완전 교정술)

  • 한재진;장지원;원태희;김혜순;손세정
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.316-319
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    • 2000
  • Double-outlet left ventricle with ventricular septal defect and pulmonary stenosis was conventionally repaired with extracardiac conduit or pulmonary artery translocation. Here, we report an anatomically repaired double-outlet left ventricle without extracardiac conduit or pulmonary artery translocation in an 11 month old patient who had undergone palliative systemic-pulmonary shunt at a nonatal period. The location of ventricular septal defect, both great arteries and coronary arteries made it possible to reconstruct the right ventricular outflow tract using on-lay patch after incision and undercutting the tissue between the ventriculotomy and the pulmonary arteriotomy.

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The Characteristics of Electrocardiography Findings in Left Ventricular Remodeling Patterns of Hypertensive Patients

  • Choi, Sun Young
    • Biomedical Science Letters
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    • v.21 no.4
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    • pp.208-217
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    • 2015
  • The exact diagnosis of left ventricular hypertrophy (LVH) is very important in the treatment of hypertension. The purpose of our study is to determine the relationship between left ventricular remodeling patterns and electrocardiography (ECG) findings in hypertensive patients. We divided 137 patients into four groups according to left ventricular mass index (LVMI) and the relative wall thickness: normal, concentric remodeling, concentric hypertrophy, eccentric hypertrophy. LVH on the ECG was defined by three ECG criteria: Sokolow-Lyon voltage criteria, Cornell voltage criteria and Romhilt-Estes point score. LVH on the echocardiography was defined by LVMI. The prevalence of ECG LVH was increased in concentric hypertrophy and eccentric hypertrophy group. The QRS voltages by Sokolow-Lyon voltage criteria (r = 0.494, P = 0.002) and Cornell voltage criteria (r = 0.628, P < 0.001), and Romhilt-Estes point score (r = 0.689, P < 0.001) were positively correlated with LVMI. Also, the QRS voltages and point scores were significantly increased in the concentric hypertrophy and eccentric hypertrophy group with increased LVMI. The QRS voltage and Romhilt-Estes point scores were positively correlated with LVMI. The QRS voltages and Romhilt-Estes point scores were also increased in the left ventricular remodeling groups with increased LVMI.

Double-outlet Right Ventricle with Pulmonary Stenosis [DORV: S.D.D.,subaortic VSD with ps]: One Operative case Report (양대혈관 우심실 기시증: 폐동맥협착 동반례의 수술 치험)

  • Kim, Hyeong-Muk;Lee, Nam-Su;Song, Yo-Jun
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.148-155
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    • 1977
  • The clinical findings with cardioangiography and successful surgical treatment of a 10 year old girl with double-outlet right ventricle is reported at The Dept. of Thoracic and Cardiovascular Surgery, Korea University Hospital, College of Medicine. The patient has been suffered from intermittent cyanosis, palpitation, and exertional dyspnea since 1 year after NFSD, and a holosystolic ejection murmur of grade 4 at the left 3rd intercostal space with mild cyanosis of the lips was the only physical findings at the time of this admission. Cardiac catheterization revealed ventricular septal defect with left to right shunt of 43% and right to left shunt of 10.2%. On cardioangiography from the left ventricle revealed all of the left ventricular outflow shunted into the right ventricle through the large ventricular septal defect, and the aorta originated from the infundibular chamber of the right ventricle with left, anterior sided pulmonary artery. The atria, viscera, and ventricles were normally located, and right ventricular out-flow was narrowed with infundibular hypertrophy and pulmonary valvular stenosis. Surgical correction was accomplished by closure of the ventricular septal defect in such a way that left ventricular outflow was routed via a Teflon felt prosthetic tunnel to the aorta, and pulmonary valvulotomy with infundibulectomy Was done to pass Hegar`s dilator No. 15 for reconstruction of the right ventricular outflow tract. The patient tolerated complete repair and has continued to improve over a period of three months after operation with normal school life. Details of the disease and method of repair are presented with related references.

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Evaluation of Left Ventricular Volume in Tetralogy of Fallot by Biplane Cinecardioangiography (활로씨 4 증후군에서의 좌심실 용적에 관한 연구)

  • Lee, Cheol-Ju;Sim, Bong-Seop
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.19-23
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    • 1985
  • There are several factors influencing post-operative mortality in Tetralogy of Fallot, such as degree of RV outflow tract obstruction, combined anomaly, and age of the patient. Another factor is preoperative left ventricular volume reported by Kirklin and Graham in 1978. From March to September, 1984, 10 patient with Tetralogy of Fallot have been taken biplane cinecardioangiography [LAO and RAO projection] for measuring left ventricular volume by area-length method. The mean age of the patients was 84.9 [S.D.] and 3 males and 7 females were there. Mean value of left ventricle was 62.9ml/m2, which was no statistically difference from normal value. [p value=0.08]. In conclusion, though this study suggests that there is some decrease of left ventricular end-diastolic volume in Tetralogy of Fallot preoperatively as compared with normal individuals, further evaluation is needed to make it confirmatory with more number of patients and lesser range of age of the patients submitted to the study.

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Traumatic ventricular septal defect - One case report - (외상성 심실중격결손증 1례 보)

  • 성후식
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.411-415
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    • 1987
  • We have experienced a rare case of traumatic ventricular septal defect caused by fall down injury. The patient suffered from congestive heart failure after trauma and represented new developing typical murmur. Cardiac catheterization revealed a large left-to-right shunt at the ventricular level and a 4.4:1 ratio of pulmonary to systemic flow. Left ventricular angiogram also showed ventricular septal defect low in the muscular septum. At operation, the right ventricle and pulmonary artery were found to be moderately dilated. A marked systolic thrill was palpable over the right ventricle near the apex. Through a small left ventriculotomy an oval defect, 2x.3 cm with a firm scarred margin, was found in the lower muscular ventricular septum. This defect was repaired using Dacron patch and ventriculotomy was closed with long strip of Teflon felt. Postoperative course was uneventful and discharged in good condition.

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Postinfarction Left Ventricular Free Wall Rupture (급성 심근경색후 좌심실벽 파열 -2례보고-)

  • 김도균
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.834-838
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    • 2000
  • Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.

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Left ventricular aneurysm (Two cases report) (좌심실에 발생한 진성심실류 (2례 보고))

  • 이철세
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.175-183
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    • 1983
  • Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

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Left Ventricular Remodeling in Patients with Primary Aldosteronism: A Prospective Cardiac Magnetic Resonance Imaging Study

  • Tao Wu;Yan Ren;Wei Wang;Wei Cheng;Fangli Zhou;Shuai He;Xiumin Liu;Lei Li;Lu Tang;Qiao Deng;Xiaoyue Zhou;Yucheng Chen;Jiayu Sun
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1619-1627
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    • 2021
  • Objective: This study used cardiac magnetic resonance imaging (MRI) to compare the characteristics of left ventricular remodeling in patients with primary aldosteronism (PA) with those of patients with essential hypertension (EH) and healthy controls (HCs). Materials and Methods: This prospective study enrolled 35 patients with PA, in addition to 35 age- and sex-matched patients with EH, and 35 age- and sex-matched HCs, all of whom underwent comprehensive clinical and cardiac MRI examinations. The analysis of variance was used to detect the differences in the characteristics of left ventricular remodeling among the three groups. Univariable and multivariable linear regression analyses were used to determine the relationships between left ventricular remodeling and the physiological variables. Results: The left ventricular end-diastolic volume index (EDVi) (mean ± standard deviation [SD]: 85.1 ± 13.0 mL/m2 for PA, 75.9 ± 14.3 mL/m2 for EH, and 77.3 ± 12.8 mL/m2 for HC; p = 0.010), left ventricular end-systolic volume index (ESVi) (mean ± SD: 35.2 ± 9.8 mL/m2 for PA, 30.7 ± 8.1 mL/m2 for EH, and 29.5 ± 7.0 mL/m2 for HC; p = 0.013), left ventricular mass index (mean ± SD: 65.8 ± 16.5 g/m2 for PA, 56.9 ± 12.1 g/m2 for EH, and 44.1 ± 8.9 g/m2 for HC; p < 0.001), and native T1 (mean ± SD: 1224 ± 39 ms for PA, 1201 ± 47 ms for EH, and 1200 ± 44 ms for HC; p = 0.041) values were higher in the PA group compared to the EH and HC groups. Multivariable linear regression demonstrated that log (plasma aldosterone-to-renin ratio) was independently correlated with EDVi and ESVi. Plasma aldosterone was independently correlated with native T1. Conclusion: Patients with PA showed a greater degree of ventricular hypertrophy and enlargement, as well as myocardial fibrosis, compared to those with EH. Cardiac MRI T1 mapping can detect left ventricular myocardial fibrosis in patients with PA.