• Journal of Chest Surgery
• /
• v.11 no.4
• /
• pp.535-540
• /
• 1978

Between January 1974 and November 1978, 23 cases of double valve replacement were done in the Department of Thoracic Surgery, Seoul National university Hospital. All had symptoms of rheumatic valvular heart disease and belonged to functional class III or IV according to NYHA classification. Among 23 cases, mitral and aortic valves were replaced in 14, and mitral and tricuspid valves in 9 cases. Six operative deaths [26%] and 4 late deaths [23%] were found. In the former group 5 and in latter one operative death were noted. Main cause of operative death was low cardiac output syndrome due to myocardial failure. Among 4 late deaths, 2 were caused by thromboembolism, one by bacterial endocarditis, and one by arrhythmia.

• Journal of Chest Surgery
• /
• v.24 no.4
• /
• pp.361-365
• /
• 1991

We experienced one case of the coronary artery aneurysm. The patient was 67 years old female, who complained of dyspnea on exercise[NYHA functional class III] for two years. Coronary angiogram demonstrated a localized saccular aneurysm on left main coronary artery, just above bifurcation of left anterior descending coronary artery and circumflex artery. On the operative field, the aneurysm was 2cmx2cmx 1.5cm in size with 0.5cm in neck. Resection and aneurysmorrhaphy was done. The patient was recovered and discharged uneventfully. During 8 months follow-up period, she lives in good physical activity and absence of chest pain.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.692-699
• /
• 1988

In 1987, we experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 28 years old male with supracardiac type drained through left innominate vein. He was oldest patient among T.A.P.V.D. which was reported in Korea. The other case was 14 years old male with cardiac type drained to right atrium directly without communication with coronary sinus. Two patients were well in postoperative 9 and 10 months and have NYHA functional class I.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.15 no.4
• /
• pp.485-494
• /
• 2008

Purpose: In this study, relationships between symptom experience and quality of life in a cross-sectional sample of patients with Atrial Fibrillation (AF) were investigated. Methods: This descriptive study involved a convenience sample of AF patients from S university hospital, C city. One hundred and two AF patients completed psychometric validated measures of AF related symptoms and quality of life. Descriptive statistics and Pearson correlation coefficients with SPSS WIN 14.0 were used for data analysis. Results: Of 16 atrial arrhythmia-related symptoms, the patients reported 'tiredness' as the most frequent and 'shortness of breath' as the most severe. The level of overall quality of life for patients with AF was 53.92. There were significant differences in symptom frequency according to religion, New York Heart Association (NYHA) classification and left ventricular ejection fraction ; symptom severity according to monthly income and stroke ; quality of life according to age, job, alcohol intake, NYHA class and stroke. Quality of life for these patients was positively correlated with symptom frequency and symptom severity. Conclusions: This study demonstrated that patients with more frequent and severe symptoms perceive poorer quality of life than patients with less frequent and less severe symptoms. Symptom experience should be assessed early to improve quality of life for patients.

• Journal of Chest Surgery
• /
• v.24 no.4
• /
• pp.421-427
• /
• 1991

Atrial fibrillation[Af] is closely related to thrombus in left atrium, systemic embolism, and loss of the contribution of atrial contraction to cardiac output. Therefore maintenance of sinus rhythm[SR] is undoubtedly hemodynamically superior to Af in the clinical course of mitral valvular disease especially in the unstable period immediately after surgery. In this article, the conversion rate and the factors influencing the conversion of Af to SR after surgery were studied. Ninety-three patients with mitral valvular replacement at Chungnam National University Hospital were analysed with electrocardiography before and after surgery during the period from June 1985 to June 1990. Eighty patients presented Af before surgery. Twenty-four[30Yo] of the patients were converted to SR[A group] and fifty six presented continuous Af after surgery[B group]. The duration of preoperative Af, preoperative left atrial dimension[LAD], preoperative functional status[NYHA classification] and cardiothoracic[CT] ratio were factors influencing the conversion of Af to SR after surgery. The mean preoperative duration of Af was 3.5$\pm$2.6yr in group A and 7.6$\pm$4.9yr in group B. The mean preoperative LAD was 53. 7$\pm$9.4mm in group A and 62.5$\pm$11.2mm in group B. Before surgery, eleven patients[46%] were belong to NYHA class I, II in group A and eight[14%] in group B. The preoperative CT ratio was 62$\pm$6% in group A and 69$\pm$8% in group B.

• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.606-613
• /
• 1996

Cardiac transplantation has been the treatment of patients with end-stage heart disease since it was first performed in 1967. In Korea the first case was performed in 1992 and 42 patients underwent heart trans- plantation so far. The purpose of this article is to report short-term result of cardiac transplantation at our center. Between April 1994 and September 1995, 14 patients had undergone orthotopic heart transplantations. There was 12 male and 2 female patients. Mea recipient age was 34 years(range 11 to 54 years) and mean donor age was 28.4 years(16 to 50 years). Mean graft ischemic time was 120.7minutes(80 to 280 minutes). The follow-up period after transplantation was 11 months(3 to 17 months). Recipient diagnosis included dilated cardiomyopathy in 10, ischemic cardiomyopathy in 2, valvular cardiomyopathy in 1, congenital complex heart disease in 1 patient. The preoperative status of the recipients were state I (50%) and ll (50%) by UNOS classification and class 111 (5 patients) and class IV (9) by NYHA functional class. All patients were treated with triple-drug immunosuppression (cyclosporine, azathioprine, steroid) and induction with RATG. The rejection episodes were 5 times in 3 patients during the follow-up. Causes of infection were aspergillosis (2), and hepes zoster (1), CMV pneumonitis (1). Permanent pace- maker was inserted in 1 patient. Currently 9 patients are alive with seven patients in WYHA functional class I and two in class l . The ejection fraction increased from preoperative value of 19.9 $\pm$ 3.4% to postoperative value of 69.0 $\pm$ 5.6%. The causes of death were cellular rejection (1),chronic graft failure due to size-mismatching (1),respirat- oxy insufficiency due to asthma attack (1), subarachnoid hemorrhage (1), and RIO humoral rejection (1).

• Journal of Chest Surgery
• /
• v.32 no.11
• /
• pp.1017-1022
• /
• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• Journal of Chest Surgery
• /
• v.46 no.1
• /
• pp.41-48
• /
• 2013

Background: We present our 12-year experience of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Materials and Methods: Between January 1999 and March 2011, 16 patients underwent pulmonary thromboendarterectomy. Eleven patients (69%) were classified as functional class III or IV based on the New York Heart Association (NYHA) classification. Seven patients had a history of inferior vena cava filter insertion, and 5 patients showed coagulation disorders. Pulmonary thromboendarterectomy was performed during total circulatory arrest with deep hypothermia in 14 patients. Results: In-hospital mortality and late death occurred in 2 patients (12.5%) and 1 patient (6.3%), respectively. Extracorporeal membrane oxygenation support was required in 4 patients who developed severe hypoxemia after surgery. Thirteen of the 14 survivors have been followed up for 54 months (range, 2 to 141 months). The pulmonary arterial systolic pressure and cardiothoracic ratio on chest radiography was significantly decreased after surgery ($76{\pm}26$ mmHg vs. $41{\pm}17$ mmHg, p=0.001; $55%{\pm}8%$ vs. $48%{\pm}3%$, p=0.003). Tricuspid regurgitation was reduced from $2.1{\pm}1.1$ to $0.7{\pm}0.6$ (p=0.007), and the NYHA functional class was also improved to I or II in 13 patients (81%). These symptomatic and hemodynamic improvements maintained during the late follow-up period. Conclusion: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension shows good clinical outcomes with acceptable early and long term mortality.

• Journal of Korean Biological Nursing Science
• /
• v.21 no.1
• /
• pp.22-36
• /
• 2019

Purpose: Even though advanced heart failure (HF) severely affects the patient's health-related quality of life (HRQoL), there is little information regarding this issue. This review is aimed to describe the relevant clinical characteristics of patient with advanced HF and identify factors influencing HRQoL in these patients. Methods: Empirical articles were searched from electronic databases issued from January 2000 to June 2018 with using the key terms 'heart failure' and 'quality of life'. There were a total of 22 articles that met the inclusion criteria and were analyzed for this study. Results: First, nine studies among 22 studies clearly stated that their participants were samples of patients with advanced HF. Most reviewed studies showed the New York Heart Association (NYHA) class as the criteria for identifying advanced HF. Second, the level of HRQoL varied depending on the measurement tools utilized by the researchers. Third, the NYHA class, gender, and symptoms were mainly associated with HRQoL in patients with advanced HF. Also, nurse- or physician-led intervention, exercise, spiritual-focused intervention, and palliative care improved the HRQoL of the patients with advanced HF. Conclusion: This study found that the clear application of criteria for advanced HF and the development of advanced HF-specific HRQoL measurement was needed. Prospective studies should be considered for identifying differences in the levels and factors influencing HRQoL in patients with early stage or advanced HF to design patient-centered care.

• Journal of Chest Surgery
• /
• v.28 no.9
• /
• pp.811-816
• /
• 1995

Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.