• 한국임상수의학회지
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• 제34권1호
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• pp.54-57
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• 2017

A 1-year-old castrated male Schnauzer dog was presented with heart murmur. Auscultation revealed systolic murmur located at the left heart base (grade 5/6). There were no remarkable findings on thoracic radiographs. Two-dimensional echocardiography revealed subaortic tunnel-like obstruction at the entrance to the left ventricular outflow tract. Anterior mitral valve leaflet appeared to be tethered to septum with minimal motion. Chordae tendineae was abnormally thickened. Color Doppler analysis revealed turbulent flow starting below the aortic valve. Mitral regurgitation was presented during systole. Spectral Doppler recordings revealed high velocity flow through the aorta and mitral regurgitation. Based on echocardiographic examination, the dog was diagnosed with subaortic stenosis concurrent with mitral dysplasia. The patient was medicated with ${\beta}-blocker$ and diuretics. It has been doing well without apparent clinical signs at 2 year after the diagnosis.

• Journal of Chest Surgery
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• 제21권5호
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• pp.850-855
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• 1988

From July 1983 to June 1988, twenty six patients underwent mitral valve repair for pure mitral stenosis[21 patient] or for mitral stenosis with a mild degree of regurgitation[5 patient] at Chonbuk National University Hospital. All patients underwent open mitral commissurotomy and 17 patients required to additional procedures for relief of obstructive subvalvular lesion. There was no operative death. The patients were followed from one to sixty months[mean 24. 1Mo.] One late death occurred due to cardiac and renal failure 10 month postoperatively. Of the 25 surviving patients at the time of follow-up, 17 patients[68%] were in NYHA functional class I and 8 patients[32%] were in class II.

• Journal of Chest Surgery
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• 제40권11호
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• pp.727-732
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• 2007

서론: 대동맥 판막 치환술 또는 벤탈수술 대상이 되는 환자들에서 다양한 정도의 승모판막 폐쇄부전이 동반될 수 있다. 대동맥 판막질환과 동반된 승모판막 폐쇄부전의 교정여부를 결정하기 위해서는 폐쇄부전의 원인과 정도, 추가 수술의 위험성을 고려해야 한다. 최근에는 수술시간과 심장 절개를 최소화하는 대동맥 근부를 통한 다양한 승모판막 수술이 시도되고 있다. 본원에서는 대동맥 판막 치환술 또는 벤탈 수술과 함께 기질적 변화가 심하지 않은 승모판막 폐쇄부전증에 대해 효과적인 대동맥 근부를 통한 승모판막 교련 성형술을 시행하였기에 보고한다. 대상 및 방법: 2002년 6월부터 2005년 6월까지 20명의 환자에서 대동맥 판막 치환술(14명), 벤탈(Bentall) 수술(6명)과 함께 대동맥을 통한 승모판막 교련 성형술을 시행하였다. 모든 환자에서 승모판막은 기질적 변화가 심하지 않은 중등도(grade 2) 이하의 부전증을 보였다. 술 전 승모판막 폐쇄부전의 진단은 경흉부 심초음파와 수술 중 경 식도 심초음파로 확진하였으며 수술 후 경흉부 심초음파로 추적 관찰하였다. 모든 환자에서 대동맥판막엽을 제거한 후 대동맥 근부를 통해 한 번의 매트리스 봉합으로 승모판막 교련 성형술을 시행하였다. 결과: 환자들의 평균 나이는 56.2세였고 65% (13명)가 남자였다. 수술 전 승모판막 폐쇄부전 정도는 경도(mild, 1)가 9 (45%)명, 경도와 중등도 사이(mild to moderate)가 8 (40%)명, 그리고 중등 도(moderate, grade 2)가 3 (9%)명이었다. 수술 사망은 없었고 평균 추적기간은 28개월이었다. 경흉부 심초음파로 추적한 승모판막 폐쇄부전은 모든 예에서 호전되었으며(p=0.002) 심실 구출률은 75%에서 호전을 보였다(p=0.005). 평균 대동맥 차단시간은 대동맥 판막 치환술을 받은 환자들에서는 $62.1{\pm}13.9분$, 벤탈 수술을 받은 환자에서는 $137.5{\pm}7.2$분이었다. 결론: 중등도 이하의 승모판막 폐쇄부전을 갖는 선택적인 환자에서 대동맥 판막 치환술 또는 벤탈 수술 시에 대동맥을 통한 승모판막 교련 성형술은 대동맥 차단시간의 증가나 추가의 절개 없이 시행될 수 있는 비교적 간단하고 효과적인 방법이라고 생각한다.

• Journal of Chest Surgery
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• 제18권2호
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• pp.299-304
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• 1985

The partial A-V canal defect consist of ostium primum type atrial septal defect with a cleft mitral anterior leaflet. The clinical findings depend upon the site and size of the left-to-right shunt, the degree of A-V valvular regurgitation, and the degree of resultant pulmonary artery hypertension. We experienced 3 cases of similar condition. The data were as follow: 1. Chest P-A showed increased pulmonary vascularity and moderate cardiomegaly with left atrial enlargement. 2. E.K.G. showed left axis deviation, left atrial enlargement, and left ventricular hypertrophy. 3. Right heart catheterization showed significant 02 step up of SVC-RA and left-to-right shunt. 4. Left ventriculogram showed mitral regurgitation and filling of both atrium. Operative findings were as follow: 1. Primum type atrial septal defect [2x2 cm]. 2. Cleft in the anterior leaflet of the mitral vave. 3. No evidence of ventricular septal defect and tricuspid anomaly. Through a right atriotomy with moderate hypothermia, the mitral cleft was approximated with interrupted sutures. The interatrial communication was closed by a patch of Dacron/pericardium. The patch was attached to junction of the mitral and tricuspid valves along the crest of the ventricular septum using interrupted sutures and the other site using continuous sutures. Postoperative course was uneventful and discharged in good general condition except postoperative bleeding in case 3.

• Journal of Chest Surgery
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• 제54권1호
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• pp.72-74
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• 2021

Congenital atresia of the left main coronary artery (LMCA) is an extremely rare coronary anomaly that necessitates surgical correction. Patients with LMCA atresia may have various clinical symptoms, which are determined by the degree of collateral vessel development from the right coronary system, the metabolic demands of the heart, and concomitant mitral insufficiency caused by myocardial ischemia. Unlike in adults, there are limited surgical options for coronary artery disease in children. Herein, we report a case of LMCA atresia with mitral regurgitation in a 19-month-old child that was successfully corrected by coronary artery bypass grafting and mitral valve repair.

• Journal of Veterinary Science
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• 제23권1호
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• pp.11.1-11.10
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• 2022

Mitral regurgitation (MR) is the most common heart disease in small-breed dogs. Mitral repair, which comprise artificial chorda tendineae implantation and mitral annuloplasty, has become the mainstay of treatment in the veterinary field. We report on two small dogs who underwent mitral repair surgery for MR. A Hegar dilator was used during mitral annuloplasty for accurate and reproducible surgery. In both cases, mitral regurgitant flow almost disappeared after surgery, and clinical signs improved. The treatment regimen was terminated 3 months after the surgery. We concluded that using a Hegar dilator may facilitate mitral valve repair surgery.

• Journal of Chest Surgery
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• 제20권3호
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• pp.610-618
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• 1987

A 23-y-o male patient was suffered from intermittent fainting and dyspnea on exertion [NYHA Class IIIIV]. 2-D - Echocardiogram and cardiac catheterization with cineangiogram showed typical IHSS findings those were asymmetrical septal hypertrophy [ASH], systolic anterior motion of anterior mitral leaflet [SAM] which induced mild mitral regurgitation [Seller Grade I/IV] and pressure gradient about 60 mmHg between left ventricle and the aorta. Medical treatment with 8-adrenergic blockade [propranolol] and Ca" channel antagonist [Verapamil] had no response. So, we performed trans-aortic ventricular septal myotomy and mymectomy. Resected rectangular muscle bar was 1 Cm x 1 Cm x 4.5 Cm. Post-operative pressure gradient between the left ventricle and the aorta was less than 10 mmHg and SAM. was disappeared with decreased mitral regurgitation grade. Post-operative course was smooth and his symptoms and signs were free without any medication during 12 months follow-up.w-up.

• Journal of Chest Surgery
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• 제24권3호
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• pp.296-302
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• 1991

Coronary artery involvement and myocardial ischemic symptom in Takayasu`s arteritis is uncommon Its presentation as coronary artery narrowing is a potentially lethal but correctable problem. In this case report, a 17-year-old woman of Takayasu`s arteritis with unstable anginal and moderate heart failure is presented. Her coronary angiogram showed that the main trunk of the left coronary artery was moderately narrowed and the proximal portion of the circumflex branch was severely obstructed and the right coronary artery was also narrowed diffusely. Simultaneously the patient had the moderate degree of mitral regurgitation. In order to save her life, the coronary bypass surgery using the saphenous veins and the modified Wooler`s mitral annuloplasty were done urgently, Immediate recovery was uneventful and the postoperative exercise capacity was markedly improved. But the long-term prognosis seems to be uncertain because of 3 reasons: 1] natural progress and complication of Takayasu`s arthritis; 2] fate of the saphenous vein grafts in a relatively young patient with aortitis; 3] residual mitral regurgitation. So long-term follow-up should be needed.

• Journal of Chest Surgery
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• 제22권1호
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• pp.116-122
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• 1989

During 22-year period ending in June 1988, operation was performed on 22 patients with primary heart tumor at Yonsei University College of Medicine. Mean age was 38.8*3.03[mean \ulcornerEM] ranging from 14 to 63 years old. Twenty cases were myxomas. Others were fibromyxoma and rhabdomyosarcoma. All patients complained of dyspnea on exertion. Nine cases had palpitation. Other constitutional symptoms were weight loss [7 cases], headache [4 cases], generalized edema [3 cases] and cough [3 cases]. Five cases had neurological symptoms and signs preoperatively. Preoperative NYHA Class was poor [Class II; 8 cases, III; 9 cases and IV; 5 cases]. The most common site of tumor origin was fossa ovalis limbus [16 cases; 72.8%]. Because of severe mitral regurgitation and of recurrent myxoma, 2 cases were reoperated for mitral valve replacement. Postoperative complications were postoperative mitral regurgitation [5 cases; 22.8%] and arrhythmia [4 cases; 18.2%], one of which was supra-His bundle block. All patient survived operation. Follow-up of 15 patients [mean 28.95*8.3 months] was good as functional class 1[8 cases] or II [7 cases]. More effective adjuvant therapy will be necessary to improve long-term prognosis for malignant primary heart tumor.

• 한국임상수의학회지
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• 제29권5호
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• pp.416-421
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• 2012

10살령의 4 kg 암컷 치와와가 심한 울혈성심부전의 수술적 치료를 위해서 내원하였다. 여러 가지 진단을 통해 이 환자는 심한 이첨판 폐쇄부전과 중등도의 삼천판 폐쇄부전이 확인되었다. 약물에 대한 치료적인 반응이 여의치 않아, 수술적으로 이첨판을 교정하는 치료방법으로 지시되었다. 체외순환을 이용한 심폐순환기하에서 이첨판교정술이 실시되었다. 하지만 이 환자는 교정 후에 마취에서 회복되지 못하고 사망하였다. 심장수술에 있어 실패를 유발하는 여러 가지 원인들에는 심폐순환기 운용, 저체온증, 장기부전, 출혈, 저혈압, 전해질과 산-염기 불균형, 그리고 감염 등이 있다. 비록 이 환자는 사망하였지만, 그 원인을 밝혀 내는 일은 수의학 분야에서 중요한 일이다. 이 증례의 사망원인을 고찰해 본 결과, 심한 저체온증에 의한 가스환기와 산소공급의 이상 그리고 심장수술과 관련한 저심박출량 증후군으로 인한 낮은 심박동수를 동반한 저혈압으로 사망한 것으로 생각되었다. 이 증례의 원인 규명을 위한 고찰은 이첨판성형술의 성공을 위해서는 좀더 세심한 주의가 요구됨을 알 수 있게 해주었고, 나아가 앞으로의 수술에서 성공률을 높일 수 있는 중요한 계기가 될 것이다.