• Journal of Chest Surgery
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• 제15권1호
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• pp.46-52
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• 1982

Activities of serum glutamic pyruvic transaminase [SGPT], serum glutamic oxaloacetic transaminase [SGOT] and serum lactic dehydrogenase [LDH] were determined during and after surgery In a total of 18 patients with heart diseases Including 8 cases of congenital heart anomaly and 10 cases of acquired valvular diseases who undergone open heart surgery under cardiopulmonary bypass. The results obtained are as follows: 1]The average value of the activity of SGPT before the surgery was $27.94{\pm}12.24$ units. The value was increased following the operation and reached to the maximum value of $43.83{\pm}37.02$ units 2 days after the operation, which was slightly deviated from the normal range. The enzyme activity returned to the normal range of $32.82{\pm}23.61$ units 4 days after the operation. 2]The average value of the activity of SGOT before the surgery was observed to be $30.5{\pm}11.29$ units. The value increased during the operation and reached to the maximum value of $95.56{\pm}43.38$ units. 2 days after the operation, the enzyme activity was gradually decreased thereafter and returned to the normal range 6 days after the operation. 3]The average value of the activity of serum LDH before the surgery was found to be $258.0{\pm}88.96$ units. The value was increased during the operation and reached to the maximum value of $930.55{\pm} 258.23$ units 2 days after the operation. The enzyme activity was gradually decreased thereafter and returned to normal range 7 days after the operation. 4]It was observed that the longer the time required for the extracorporeal circulation in the open heart surgery became, the greater the changed in activity of SGOT, SGPT and serum LDH were found.

• 한국보건간호학회지
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• 제4권1호
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• pp.25-35
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• 1990

This study examined the evaluation of the information effects of the teaching on knowledge and daily activities of open heart surgery patients between 2 and 6 weeks after discharge. The subject was 29 patients being taught with teaching materials at discharge as experimental group, 20 patients who received no education as control group among the patients who had undergone open heart surgery in S.N.U.H. And research method was non-equivalent control group non-synchronized quasi-experimental design. As the tool of this study, 30 items of knowledge measurement scale which was extracted among the content of teaching materials to evaluate the effect of education and 28 items of which were designed to measure the daily activities of patients with myocardial infarction for the estimation of the degree of observance in daily activities were used. For data analysis, frequency, t-test, Pearson's correlation coefficient and Cronbach's $\alpha$ were used. The result were as follows; 1. Informations given through teaching materials were effective for increasing the knowledge of the patient with open heart surgery. The knowledge of patients increased to the top level (p<0.05) in 2 weeks after discharge. In control group, the knowledge level of patients did not increase after discharge. 2. The knowledge level daily activity of the experimental group was somewat higher than that of the control group, but there was no significant difference. The score .of the experimental group was 69.66 in 6 weeks after discharge much less than the top level score 112. 3. The correlation between knowledge and daily activities was not significant, suggesting the fact that the increase of knowledge did not influence the daily activities significantly. Recommendation was suggested that; 1) Further studies might be .needed with the increasing numbers of the subjects. 2) Daily activities of the patients with open heart surgery should be investigated for long term period until they recovered normal activities.

• Journal of Chest Surgery
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• 제50권6호
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• pp.467-470
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• 2017

Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova S OLO; LivaNova PLC, London, UK). Postoperative echocardiography showed that the prosthetic valve was in the correct position and there were no paravalvular leaks. A bailout open transcatheter valve implantation can be considered a safe and effective option in selected cases with an extensively calcified mitral valve.

• Journal of Chest Surgery
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• 제24권7호
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• pp.669-673
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• 1991

Fructose-l, 6-diphosphate as an additive to cold crystalloid cardioplegia [St. Thomas sol.] was studied prospectively in 60 patients undergoing open heart surgery from January 1, 1991, to June 30, 1991. Thirty patients received cardioplegia with FDP[group I ] and 30 patients received cardioplegia without FDP [group II ]. There were no differences between two groups pre-operatively with regard to age, heart disease, cross-clamp time, cardiac enzymes, or hemodynamic measurements [p>0.05]. Cardiopulmonary bypass was established using ascending aorta and vena cava cannulation employing moderate systemic hypothermia [30oC nasopharyngeal temperature] and hemodilution All patients received cardioplegia through the aortic root at aortic root pressure of 80mm Hg. The composition of the cardioplegic solution and its delivery were identical in both groups except for the addition of FDP[1.5 mg/mL] in group I. The cardioplegic infusate consisted of St. Thomas Hospital solution. The initial dose was infused through the aortic root. Topical myocardial cooling with saline slush was employed in all patients. Recorded operative data were cardiopulmonary bypass and cross-clamp times, amount of cardioplegic infusate. Blood samples for assessment of lactate dehydrogenase [LDH], creatine kinase [CK] and transaminases [GOT, GPT] were obtained before and at 1,2,3,7th postoperative period. Better myocardial protection effect was noted in group I than group II with respect to the % change of cardiac enzymes, although the differences were not significant. We conclude that FDP is a safe additive to crystalloid cardioplegia and may be beneficial in open heart surgery patients.

• Journal of Chest Surgery
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• 제36권11호
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• pp.834-838
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• 2003

배경: 개심술 후 공기 제거는 매우 중요한 시술이다. 그러나, 심장 내의 공기 분포, 시술로 인한 합병증, 심폐바이패스의 시간 연장으로 여전히 제한적이다. 인위적으로 동정맥루를 만들어 공기를 제거하고 그 효과를 경식도초음파로 확인하였다. 대상 및 방법: 심폐바이패스 완료 직전에 압력표준변환선을 동맥과 정맥회로에 설치해둔 마개에 연결하면 동맥과 정맥사이에 작은 동정맥루가 형성된다. 심장 내의 공기정도와 공기제거시간은 경식도 초음파와 압력표준변환선으로 확인하였다. 결과: 간단한 방법으로 심폐바이패스의 시간단축, 수분 내에 공기가 제거되는 것을 경식도초음파로 확인하였다. 결론: 동맥과 정맥 사이에 작은 연결관으로 동정 맥루를 만드는 것은 매우 간단하며 개심술 후 공기 제거와 공기색전증 예방에 효과적인 방법이다.

• Journal of Chest Surgery
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• 제12권2호
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• pp.127-134
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• 1979

During the 4 years period to be reported, 34 operations were performed on the mitral valve in the department of Thoracic and cardiovascular surgery, Korea University hospital, from Aug. 1975 to April 1979. At the first 1-year period, the closed technique was used in 12 patients. After that, open-heart surgery was used routinely; 8 patients had open mitral commissurotomy and 14 patients had valve replacement. There were 18 men and 16 women with sex ratio of 1.1: 1. The age of the patients varied widely from 18 years of the youngest to 46 years of the oldest-average aged of 32.5 years. All had symptoms and the mean duration of symptoms was 6 years and 1 month. Preoperative atrial fibrillation was 47% and embolizations were in 3 of 34 patients. The operative mortality was none for the closed and 14% for the open technique combined rate of 9 per cent which were valve thrombosis, brain embolism and left pulmonary vein rupture in deauriculization. But surviving patients undergoing open heart surgery enjoyed symptomatic benefits comparable to these of the patients of closed.

• Journal of Chest Surgery
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• 제11권4호
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• pp.422-427
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• 1978

Alterations in the serum and urine potassium were studied in twenty patients who underwent open heart surgery in National Medical Center during the period from Jan.1978 to June 1978. There were twelve cases congenital heart disease and eight acquired heart disease. Rigg-Kyvsgaad mark IV roller pump and Polystan bubble oxygenator were used in all patients. Hemodilution was carried out by priming the oxygenator with Hartmann`s solution. Measurements were made of the serum electrolyte, gas analysis and twenty four hour urine electrolytes. During the bypass, the serum potassium decreased Significantly from 4.2?.47 to 3.6?. 72 mEq. per liter. [p<0.05] Fifty seven miliequivalant of potassium chloride were added during operation-urine potassium was higher in the diuretic group than in the non diuretic group. Plasma potassium level in the diuretic group was more significantly reduced than nondiuretic group. In this series large amount of urine potassium loss was noted on the day of operation, the first and second post operative day.

• Journal of Chest Surgery
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• 제12권1호
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
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• 제22권1호
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• pp.50-58
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• 1989

The emergence and expansion of cardiac surgery over the past decade has resulted in an increasing number of patients undergoing cardiac operations but many kinds of heart surgery was realized only palliative, resulting in increasing numbers of secondary cardiac procedures. From 1978 to 1988, 10 cases of various congenital heart diseases and 17 cases of acquired heart diseases were reoperated at Hanyang University Hospital. The leading indication of second operation was residual shunt or valvular malfunction due to technical failure in congenital heart disease and primary valve failure, endocarditis, paravalvular leakage were for acquired heart disease. The mortality of reoperation was 0% for congenital heart disease and 11.7%[2 death among the 17 patients] for acquired heart disease. The leading causes of death were myocardial failure, sepsis with endocarditis, acute renal failure and congestive heart failure.

• Journal of Chest Surgery
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• 제34권3호
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• pp.240-242
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• 2001

임심 중 심폐바이패스를 사용하는 개심수술은 산모뿐 아니라 태아계에도 영향을 끼치기 때문에 중요하다. 임신 중 항응고제 투여을 부적절하게 하여 기계판막 기능부전이 초래된 임신 31주의 산모에서 심장 재수술에 앞서 제왈절개로 태아 출산 후 20시간 뒤 산모의 개시수술을 성공적으로 시행하였기에 보고하는 바이다.