• Journal of Chest Surgery
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• 제18권3호
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• pp.398-406
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• 1985

103 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1984. There were 90 congenital cardiac anomaly and 13 acquired heart diseases. Out of 90 congenital cardiac anomaly, 63 cases of acyanotic group and 27 cases of cyanotic group were noted. In 63 cases of acyanotic group, 11 ASD, 45 VSD and 7 other acyanotic anomaly were included. In 27 cases of cyanotic group, 4 Trilogy of Fallot, 15 TOF, 3 Pentalogy of Gasul and 5 other cyanotic anomaly were found. Among 13 cases of acquired heart diseases, 12 valvular lesions and 1 atrial myxoma were noted. Two open mitral commissurotomy and ten valve replacements were performed for 12 valve lesions. The frequent complications were acute respiratory insufficiency and low cardiac output syndrome occurred in 5 cases. The perioperative mortality was 4.8% in acyanotic congenital cardiac anomaly, 7.4% in cyanotic congenital cardiac anomaly, and 0% in acquired heart diseases. Overall mortality for 103 cases of open heart surgery was 4.9%.

• Journal of Chest Surgery
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• 제17권4호
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• pp.614-619
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• 1984

Atrioventricular canal is divided into incomplete, intermediate and complete types. In ostium primum ASD [incomplete type] mitral valve cleft is almost always present, but ostium primum ASD with tricuspid valve cleft is a rare congenital anomaly. The patient was a 7 year old female whose complains were palpitation, exertional dyspnea and growth retardation. The chest films showed moderate cardiomegaly [C-T ratio, 61%]. EKG, Echocardiography, cardiac catheterization and left ventriculography were performed. Open heart surgery was done under the impression of incomplete atrioventricular canal. At the time of operation, ostium primum ASD [2x2.5 cm in diameter], secundum type ASD [lxl.5 cm in diameter] and cleft in the septal leaflet of the tricuspid valve were noted. But mitral valve was normal without cleft and VSD was not noted. Each anomalous portion was repaired. The patient made an uneventful recovery and we report this case, review and discuss the literatures.

• Journal of Chest Surgery
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• 제18권3호
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• pp.383-390
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• 1985

108 cases of open heart surgery were done at our department in 1984. There were 58 male and 50 female patients ranging in age from 20 months to 52 years. 75 cases were congenital heart disease, and 33 cases were acquired heart disease. There were 75 congenital heart anomalies with 5 operative deaths [6.7%], consisting of 62 acyanotic cases with 2 deaths [3.2%] and 13 cases of cyanotic cases with 3 deaths [23.1]. In 33 patients of acquired valvular disease, 29 valves were implanted; 20 mitral valve replacement with 2 death [10%], 2 aortic valve replacement with 1 death [50%], 2 double valve replacement [MVR+AVR] and 2 open mitral commissurotomy plus aortic valve replacement with no death. Postoperative, Warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 9.2% in congenital anomaly, and 9.1% in acquired heart disease, overall mortality rate was 9.3%.

• Journal of Chest Surgery
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• 제35권12호
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• pp.890-893
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• 2002

Ebstein기형은 드문 선천성 심기형 중 하나초 삼첨판엽중 중격엽과 후엽이 판막균으로부터 하향 전위되어 신방화 심실을 형성하는 질환이다. 대부분 환자에서 나이가 들어가면서 삼첨판 폐쇄부전, 청색증, 우심실 기능저하 등의 증상이 생긴다 또한 드물게 심실중격결손, 승보판의 이상, 대혈관 전위등을 동반한다. 본원에서는 Ebstein기형, 실실중격결손, 이 중 승모판이 동반된 8개월된 남아에 대해 심방화된 심실의 주름성형술과 이차건삭 제거 및 유두근 절개, 하향 전위된 판막엽을 판막륜쪽으로 재부착, 자가 심낭 펠트를 이용한 판막윤 성형술을 이용하여 성공적으포 수술하였다. 수술 후 환아는 심장크기가 줄어들었고 심초음파상 삼첨판 폐쇄부전은 거의 없었다 현재 환아는 별다른 투약없이 건강하게 자라고 있다.

• 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 Chest Surgery
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• 제18권2호
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• pp.273-278
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• 1985

The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

• Journal of Chest Surgery
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• 제20권2호
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• pp.404-410
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• 1987

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

• Journal of Chest Surgery
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• 제18권3호
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• pp.371-382
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• 1985

Over the past 4 decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of congenital and acquired cardiovascular diseases in Korea. Clinical data on cardiovascular surgical cases performed in all 22 hospitals for open heart surgery in Korea was collected from it`s starting up to December 1984. The first recorded open heart surgery for a young adult atrial septal defect was performed by Young Kyoon Lee, M.D. on August 7, 1959, Seoul National University Hospital, Korea. And, some scattered reports on cardiovascular surgical cases in it`s early period have changed recently the number of hospitals for open heart surgery and clinical cases enormously in total amount of 13, 100 cardiovascular operations performed on 12, 990 cases up to December 1984. Of the total 13, 100 cardiovascular operations, congenital cardiovascular anomaly occupied 70%. Of the congenital cases, 6, 580 operations for acyanotic group [operative mortality 4.5%], and 2, 489 operations for cyanotic group [operative mortality 20%]. The incidence of congenital cardiovascular anomaly in order of frequency was ventricular septal defect [29%], patent ductus arteriosus [26%], Tetralogy of Fallot [22%], atrial septal defect [8, 6%], pulmonary valve stenosis [3.0%], and endocardial cushion defect [1.1%]. Of the 3, 412 valvular heart disease cases, which occupied 85% of total 4, 031 acquired cardiovascular disease, individual incidence was in mitral 2, 565 [63.5%], double valve 451 [11.1%], and simple aortic valve 351 [8.7%]. Total number of valve replaced, mechanical and tissue, was 2, 795, and 1, 884 for mitral, 808 for aortic, and 103 for tricuspid in position. Operative mortality for prosthetic valve replacement in total was 9.8%. Remained acquired cardiovascular cases chronic constrictive pericarditis [7.9%], cardiac tumor [1.9%], coronary artery bypass [1.8%], cardiac trauma [1.2%] and less than 1% of thoracic aortic aneurysm. Overall operative mortality for open and non-open cardiovascular surgical operation was 7.7% [congenital acyanotic group 3.2%, congenital cyanotic group 19.4%, and acquired group 7.8%]. In conclusion, present status of cardiovascular surgery in Korea is stabilized with accumulation of clinical cases and experiences, and the future in the field of cardiovascular surgery is promising, especially in the infant cardiac surgery and aortocoronary bypass surgery, with abrupt increase of specialized cardiac centers, trained specialists, and expanding social health insurance.

• Journal of Chest Surgery
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• 제16권3호
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• pp.289-294
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• 1983

The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

• Journal of Chest Surgery
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• 제17권2호
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• pp.305-314
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• 1984

From May 1977 to April 1984, 204 cases of open heart surgery were performed under cardiopulmonary bypass. There were 99 male and 105 female patients ranging in age from 19 months to 58 years. 136 cases [66.7%] were congenital heart disease, and 68 cases [33.3%] were acquired heart disease, which were 66 valvular disease [97.1%], 1 IVC obstruction, and 1 myxoma. There were 136 congenital heart anomaly with 16 operative deaths [11.8%], consisting of 94 acyanotic cases with 7 death [7.4%] and 42 cases of cyanotic cases with 9 deaths [21.4%]. In 66 patients of acquired valvular disease, 52 valves were implanted; 47 mitral valve replacement with 4 death [8.5%] and 5 double valve replacement [MVR+AVR] with 1 death [20%]. Postoperative, warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 11.8% in congenital anomaly, and 11.8% in acquired heart disease, overall mortality rate was 8.5%.