• Journal of Chest Surgery
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• 제37권9호
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• pp.796-799
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• 2004

환아는 대동맥 축착을 동반한 Taussig-Bing기형으로 벽속 주행(intramural course)이 의심되는 관상동맥, 대혈관 크기의 현저한 차이, 호전되지 않는 폐렴과 심부전, 잠재적 대동맥하 협착으로 생후 52일에 대동맥궁 재건을 포함한 고식적 Damus-Kaye-Stansel (DKS) 술식을 시행받았다. 생후 45개월에 시행된 완전 교정술은 좌심실에서 폐동맥(신대동맥)으로의 심실중격결손을 폐쇄하고 DKS 술식해체 후관상동맥 전이를 통한 동맥전환술에서 자가 신폐동맥의 판막 기능을 유지한 채 우심실 유출로를 재건하였다. 완전 교정술 후 19개월째 외래 관찰 중으로 심장약은 복용하지 않으며 심초음파 검사에서 특이 소견은 관찰되지 않고 있다. 저자들은 DKS 술식을 받은 Taussig-Bing 기형 환자에서 인조 판막도관의 삽입이 필요한 Rastelli 술식을 피하고 DKS 술식해체과 동맥전환술로 양대혈관 판막을 모두 보존하는 완전 교정술을 시행하여 좋은 성적을 보였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제10권1호
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• pp.113-117
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• 1977

The tetralogy of Fallot is one of the most frequent and serious congenital cardiac malformation accompanied cyanosis. For relief of cyanosis, the Waterston operation is a successful, palliative procedure in infant & young child under age of five with obstructive lesions of the right: side of the heart who require a systemic-pulmonary arterial shunt for survival. A patient, aged 3 and weighing 13 kg., who had been cyanotic since one month after birth,. was admitted to the University of Severance Hospital under a diagnosis of tetralogy of Fallot, The side to side anastomosis between the right pulmonary artery & the ascending aorta was performed in March 1976. The anastomotic channel was made only 4 ram. in diameter, thereafter massive unilateral pulmonary congestion on the side of the anastomosis developed shortly after operation. And the. patient died of congestive heart failure within a hour. And so the purpose of this report is describe the immediate & late effect of systemic-pulmonary shunt for T.O.F. with review of literatures.

• Journal of Chest Surgery
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• 제10권1호
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• pp.106-112
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• 1977

Transposition of the great arteries is one of the commonest forms of severe congenital heart disease and produces severe cyanosis threatening survival from the day of birth. Anatomical anomalies which the aorta arises from the infundibulum of the right ventricle and the pulmonary artery arises from the outflow tract of the left ventricle make the deranged circulation. Survival is possible only if additional anomalies are present which allow mixing of the pulmonary and systemic circulations. Preoperative diagnosis as TGA was taken on the 15 day old female via the preoperative examination and the right cordioangiography. As palliative treatment for cyanosis, Blalock-Hanlon operation was performed in this patient. The results were good as 54 mmHg changed from 27 mmHg of $PO_2$ in aorta, but sudden cardiac arrest was developed in postoperative 12 hours. In order to confirm the cause of death and the cardiac anomalies, autopsy was performed on the date of death. The diagnosis of the autopsy showed; [1] Transposition of the Great Arteries. [2] Patent Ductus Arteriosus. [3] Patent Foramen Ovale. [4] Ventricular Septal Defect, 2 Muscular Type. [5] Double Ureter, Right. [6] Artificial Atrial Septal Defect. [7] Total Collapse of the left lung and Intraparenchymal hemorrhage of right lung.

• Journal of Chest Surgery
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• 제22권1호
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• pp.74-82
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• 1989

Ninety-six patients with tetralogy of Fallot have undergone either primary total correction [71], staged total correction [9], or an initial shunt [16], between January, 1984, and December, 1987 Their mean age was 9.5 years, mean body weight 24kg, and mean body surface area 0.86m2. Initial palliative shunt group had smaller size, smaller pulmonary artery, and higher hemoglobin [P value < 0.05 >. Modified Blalock-Taussig shunt was performed most commonly. Patch enlargement of right ventricle in 31 cases [38%], right ventricle and pulmonary artery in 7 cases [9%], transannular patch enlargement in 28 cases [35%], and valved conduit in 2 cases [2.5%] was performed for reconstruction of right ventricular outflow tract stenosis. Longer aorta cross clamp time was noted in case of separate patch enlargement of right ventricle and pulmonary artery, and dead patient with transannular patch enlargement [P value < 0.05]. There was no operative death in shunt group, but 7 deaths in total correction group [mortality rate 8.8%].

• Journal of Chest Surgery
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• 제12권3호
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• pp.197-206
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• 1979

The most common abnormal relationship between the great arteries and ventricle is transposition of great arteries, among which complete D-transposition is a common and lethal malformation. Without appropriate treatment, the infant born with transposition of the great arteries rarely survives the first year of life. In contrast to the grim hopelessness of only a few years ago, modern aggressive palliative and corrective surgical interventions can provide such infants with considerable hope for adolescent and adult life. Up until this time, intraatrial baffle technique for re-direction of venous return, which was proposed by Mustard originally, has been successfully applied to infants and children in many foreign clinics with decreasing trend of the operative risk. In this report, we present one case of a 4 year-old girl having complete D-transposition of the great arteries with atrial septal defect, and reviewed the relevant literatures.

• Journal of Chest Surgery
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• 제22권6호
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• pp.990-995
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• 1989

Since 1984, 24 patients underwent repair of atrioventricular septal defect. Nineteen had a partial defect and 5 had a complete atrioventricular septal defect. There were 9 men and 15 women, ranging in age from 1 to 50 years [mean age, 13.3 years]. Four patients had a Downs syndrome. Additional congenital heart defects were present in 11 patients. One patient had palliative operation prior to total correction. In partial defects, the primum atrial septal defect was closed with Xenomedica patch and the mitral valve was repaired with simple closure of the septal commissure. Central incompetence from annular dilatation was repaired by a local annuloplasty. In complete defect, the septal defects were closed with two patches except one. Operative mortality was 5% in partial defects and 60% in complete defects and low cardiac output was the commonest etiology. In a mean follow-up period of 27.9 months [range, 4 to 63 months] there were no late death and no instances of late-onset complete heart block. One patient required reoperation [MVR] for residual mitral regurgitation. The majority of patients were asymptomatic and mean postop. NYHA functional class was 1.2.

• Journal of Chest Surgery
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• 제21권2호
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• pp.326-333
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• 1988

The results of surgical experience of double outlet right ventricle with pulmonic stenosis in 14 patients are reported. Among the 14 patients, 8 underwent the intraventricular tunnel repair with the result of 3 hospital deaths, 5 had Fontan type operations due to the various anatomic reasons and resulted in one hospital death, and the remaining one patient had palliative pulmonary valvotomy. Besides the problems related to the effective relief of the pulmonic stenosis, double outlet right ventricle with pulmonic stenosis may present a surgical challenge because severe associated anomalies which definitely complicate their repair are not uncommon. We describe the anatomic details of our 14 cases of DORV with PS and the surgical results. The results having been unsatisfactory, more meticulous diagnostic studies for the detailed intracardiac morphologies and the strict indication for their repair with the refinement of surgical technique seem necessary for the better surgical results.

• 대한수의학회지
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• 제58권1호
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• pp.57-60
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• 2018

An 8-year-old, castrated, male Rottweiler was referred for evaluation of chronic right thoracic limb lameness and a progressively growing mass surrounding the right elbow joint. On admission, the dog's general health was good, without abnormalities detected on physical examination. The dog was diagnosed with periarticular histiocytic sarcoma. Although draining lymph nodes and lung metastases were suspected, palliative amputation was performed. Localized histiocytic sarcomas, with destructive lesions involving multiple bones of a joint and periarticular soft-tissue masses, are uncommon in dogs. This case report presents clinical findings, imaging characteristics, and histopathologic and immunohistochemical features of a periarticular joint histiocytic sarcoma.

• Journal of Chest Surgery
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• 제28권1호
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• pp.90-95
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• 1995

Effective relief of dysphagia in unresectable esophageal cancer patients not only prolong survival but also is prerequisite for other treatment modalities.We tried surgical resection in 4 patients who had unresectable esophageal cancer,managed initially with esophageal prosthesis then followed by chemotherapy with good response. Curative resection was possible in 2 patients and palliative resection in one and exploration only in one case.Curatively resected patients are alive without recurrence for 57 months,8 months,each.Other non-curatively resected patients died after 10 months,7 months. Above results suggest that initial esophageal prosthesis to relieve dysphagia followed by chemotherapy in unresectable esophageal cancer may provide another chances for curative resection that promise better survival and need more clinical experience and trial.

• Radiation Oncology Journal
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• 제38권2호
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• pp.148-150
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• 2020

Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm in children. Although surgery with or without chemotherapy mainly conducted, the response of radiotherapy (RT) has not been evaluated yet. For unresectable tumor, RT might be considered as one option to decrease tumor extent to relieve obstructing symptoms or to facilitate successive treatment. We report one child in whom PPB with DICER1 mutation recurred after surgery and lead to respiratory distress. She emergently received palliative RT with a relatively low dose (20 Gy), and symptoms sufficiently relieved. Even she showed an 84.3% reduction in diameter and maintained the remission status for 1 year. These might reflect possible radiosensitivity of PPB, and further investigations of RT might be necessary for unresectable PPB.