• Journal of Chest Surgery
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• 제10권1호
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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.

• Advances in pediatric surgery
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• 제13권2호
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• pp.212-216
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• 2007

Migration of a peritoneal catheter of a ventriculoperitoneal shunt into the scrotum is a rare complication. We treated a case of catheter migration in the scrotum. A 12-year old boy, who had had a ventriculoperitoneal shunt at the age of 4 months due to neonatal hydrocephalus, visited the outpatient clinic because of a right inguinal hernia. On physical examination, a firm mass was found in the left scrotum. Pelvic X-ray demonstrated a coiled catheter in the left scrotum. The catheter was successfully removed by exploring the left patent processus vaginalis after high ligation of the hernia sac. This case suggests a suction action of the patent processus vaginalis and the possibility of catheter migration long after shunt catheter insertion.

• 대한핵의학회지
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• 제20권2호
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• pp.47-52
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• 1986

A noninvasive procedure for diagnosis and quantitation of right-to-left intracardiac shunts will enhance the management of patients with cyanotic congenital heart disease. This study describes an application of radionuclide (RN) angiocardiography for quantitation of right-to-left shunt amount. Gamma variate model was fitted to radionuclide data recorded over the carotid artery. Data analysis was performed retrospectively in 35 patients who underwent cardiac catheterization within a week from the day of RN angiocardiography. Thirty one of the patient had right-to-left shunts and 4 of them had left-to-right shunts. Both the radionuclide and Fick measurements correlated well (r=0.93, 0.93, 0.89, p<0.01 in each measurements). Therefore, RN angiocardiography data may be used for accurate calculation of right-to-left shunts in cyanotic congenital heart disease patients.

• 대한수의학회지
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• 제50권1호
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• pp.49-53
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• 2010

A 5-year-old female Cocker spaniel dog (body weight 7.0 kg) was presented with primary complaints of exercise intolerance and loud precordial thrill which was noticed since she was a puppy. Physical examination revealed a grade V/VI continuous murmur over the maximal point of the left basal area, bounding femoral pulse, but no differential cyanosis. Tall R waves were detected in electrocardiogram, suggesting left ventricular enlargement. Diagnostic imaging studies showed enlarged left ventricle, bulged descending aorta (dAo), markedly dilated right pulmonary artery, and continuous shunt flow between the dAo and main pulmonary artery. Based on these findings, the dog was diagnosed as left to right shunted patent ductus arteriosus (PDA). The patent ductus arteriosus was treated by lodging a PDA duct occluder via the transvenous approach. Clinical signs were markedly improved after the ductal occlusion, the shunt flow was mildly persistent. The case presented is the first case of PDA occluded by the PDA duct occluder via the transvenous approach in a small breed of dog. Although the residual shunt flow was mildly persisted, the dog was clinically normal without detectable murmurs.

• 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.

• 한국임상수의학회지
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• 제34권2호
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• pp.90-93
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• 2017

A nine-month-old intact female Maltese dog (body weight: 1.5 kg) presented with frequent syncopal episodes (1-2/day), exercise intolerance, and dyspnea. Cardiomegaly with marked dilation of right and left atria along with ascites was indicated on radiography. Tricuspid regurgitant jets (4.36 m/s), pulmonary regurgitant jets (3.4 m/s), left-to-right shunting flow at the ductus arteriosus, and an atrial septal defect were observed on echocardiography. A bubble study with agitated saline found right-to-left shunting at the interatrial septum. Based on diagnostic studies, the dog was diagnosed with right-to-left atrial septum defect (ASD) compounded with patent ductus arteriosus (PDA). The treatment was directed to reduce the pulmonary hypertension, improve cardiac performance, and lower fluid retention. Despite medical treatment for 2 months, the dog died of sudden cardiac arrest. Herein, we describe a very rare case of right-to-left ASD compounded with PDA.

• 대한수의학회지
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• 제48권1호
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• pp.99-103
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• 2008

A 2-month-old female Abyssinian cat was presented with a severe ascites, cyanosis, and exercise intolerance. Diagnostic studies revealed V/VI holosystolic murmur, sinus tachycardia, generalized cardiomegaly with marked left atrial enlargement and shunt flow between left and right ventricles. Doppler study showed bi-directional shunts in rest and right-to-left shunt after exercise. Based on clinical signs and diagnostic findings, the cat was diagnosed as a reversed ventricular septal defect. The cat was treated with furosemide, nitroglycerine, dobutamine and oxygen supplement. Despite initial improvement of clinical signs after initiation of medical treatment, the cat died of sudden cardiac arrest. Necropsy revealed a perimembranous ventricular septal defect.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1135-1139
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• 1999

Multistage unifocalization and complete repair have been performed for pulmonary atresia ventricular septal defect and major aortopulmonary collateral arteries. We reported a case that divided major aortopulmonary collateral artery was changed into an aneurysm that compressed the left main bronchus. A 1-year-8-month old boy was operated. The Rastelli operation with left pulmonary artery reconstructuion ligation of patent ductus arteriosus and take-down of right Blalock-Taussing shunt was performed on the patient who had pulmonary atreisia ventricular septal defect patent ductus arteriosus and MAPCA at 1 year and 8 months of his age. He previously underwent the unifocalization and right B-T shunt at 9 months of age,. He repeatedly had difficulty in weaning from the mechanical ventilator, After removing the aneurysm from the divided MAPCA that compressed the left main bronchus externally it was possible to wean him from the mechanical ventilator.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1280-1287
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• 1990

A seven month old female infant with isolated ventricular inversion and anatomically corrected malposition of the great arteries in situs solitus, associated with ventricular septal defect, patent ductus arteriosus, right-sided juxtaposition of left atrial appendage, is reported. The patient showed usual atrial arrangement with somewhat superoinferior relation, a discordant atrioventricular connection, and a concordant ventriculoarterial connection with aorta in the right-sided position. A normal sized left atrium was connected to the left superiorly positioned morphologic right ventricle through a tricuspid valve, which crossed the left ventricular outflow tract anteriorly. Well developed bilateral[subaortic and sub-pulmonary]conus was documented at operative field. successful surgical repair was done by performing the Senning procedure and by closing the ventricular sepal defect with a patch through the right ventriculotomy. The infant’s postoperative course was uneventful with normal sinus rhythm. Postoperative cardiac catheterization revealed no hemodynamic obstruction or residual shunt.

• 대한핵의학회지
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• 제21권2호
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• pp.155-165
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• 1987

The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis-of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intra cardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs, intracardiac shunt could be differenciated from extracardiac shunts.