• 제목/요약/키워드: Pericardiectomy

검색결과 42건 처리시간 0.026초

만성 교약성 심낭염 (23례 수술 보고) (Surgical treatment of chronic constrictive pericarditis: Report of 23 cases)

  • 박영관
    • Journal of Chest Surgery
    • /
    • 제1권1호
    • /
    • pp.61-68
    • /
    • 1968
  • In the 10 years from 1958 through 1968, 23 patients have undergone 24 times of operation for constrictive pericarditis at this department. Follow-up data were available for periods varying several months to almost 10 years from examination at this department or follow-up letters. There were 21 males and 2 females in this series. Range of the age varied from 2 years to 53 years. Seven cases were below 15 years of age. There were two hospital death, one expired two weeks and another four weeks after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factors. Clinical and histological study showed tuberculous origin in 12 cases, non-specific chronic infiammatory changes in 8 cases and in 3 cases previous pyogenic pericardial infection by staphylococcus preceded to the constriction. In 11 cases bone tissue was noted microscopically in the pericardium: Sixteen patients[70 %]had pleural effusions, five cases had bilateral, 6 right, and 5 left. Calcification was seen along cardiac border in 9 cases. In 15 catheterized patients, 6 showed pressure gradients between vena cava and right atrium, ranging from 6 mmHg to 10 mmHg. One case was reoperated 3 months after the original operation resulting in marked improvement. In this reoperated case the original pericardiectomy seemed to be incomplete. In 21 cases. excluding 2 hospital death, symptoms and physical findings improved markedly in every patient

  • PDF

심막에 발생한 중피종의 수술적 치험 2예 (Surgical Experience of Pericardial Mesothelioma: 2 Cases)

  • 방정희;우종수;최필조;박권재;정상석;홍숙희;노미숙
    • Journal of Chest Surgery
    • /
    • 제43권4호
    • /
    • pp.437-440
    • /
    • 2010
  • 심장에서 발생한 중피종은 아주 드문 질환으로 초기에 비특이적인 증상으로 진단이 어렵다. 본원에서는 협착성 심막염으로 진단하여 심막 절제술을 시행후 중피종으로 확진된 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 4개월과 10년간의 호흡곤란을 호소하였고 흉부 전산화 촬영상 소량의 심낭 삼출액과 전체 심장을 둘러싸는 심막의 비후를 보였으나 뚜렷한 종괴의 소견은 보이지 않았다. 정중 흉골 절개하에 수술을 진행했으며 전반적으로 심막의 두께가 10 mm 이상 두꺼워져 있었다. 양측 횡격막신경을 경계로 하여 부분 심막 절제술을 시행하였다. 술후 조직검사상 악성 중피종으로 진단되었다. 첫번째 환자는 술후 7개월째 심막 주위로 재발하였으며 호흡 부전증으로 술후 11개월 째 사망하였고 두번째 환자는 항암치료후 술후 16개월째 생존하고 있다. 심막의 중피종은 아주 드문 질환이나 협착성 심막염과 비슷한 임상 양상으로 초기 감별 진단되어야 할 질환으로 보인다.

개심술후 유미심낭 (Chylopericardium) 합병증의 수술치험 1예 (One case of surgical treatment for chylopericardium following cardiac surgery)

  • 김삼현
    • Journal of Chest Surgery
    • /
    • 제19권4호
    • /
    • pp.695-698
    • /
    • 1986
  • Only five instances of chylopericardium following cardiac surgery have been reported in the literature previously. We encounted this complication in a patient who was operated on for secundum atrial septal defect. The patient readmitted one month after discharge because of large amount of chylous pericardial effusion. Conservative treatment of pericardiostomy drainage and parenteral hyperalimentation was continued for 3 weeks without improvement. Partial pericardiectomy and pericardiopleural window was done with success and no recurrence of chylopericardium was observed upto 3 months after surgery. We think this is the first case report of chylopericardium after open heart surgery in Korea.

  • PDF

윤상 교약성 심낭염의 외과적 치료 -2예 보고- (Annular Constrictive Pericarditis: Simulating Vavular Heart Disease : Case Report)

  • 유회성
    • Journal of Chest Surgery
    • /
    • 제13권3호
    • /
    • pp.280-284
    • /
    • 1980
  • This is report of two cases of annular constrictive pericarditis. Since January 1959 to December 1979 the authors experienced 48 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic and Cardiovascular Surgery, the National Medical Center in Seoul. These cases simulated valvular heart disease. One case, as mitral stenosis, revealed rumbling apical diastolic murmur [II/VI], atrial fibrillation and right ventricular hypertrophy pattern on E.C.G., the other, as infundibular pulmonic stenosis, presented pressure gradient between right ventricle and main pulmonary artery at infundibular level of 76 mmHg in systole. Both patients underwent operation successfully and one of them was assisted by E.C.C. during pericardiectomy and result was excellent. It is difficult to make the diagnosis of these conditions preoperatively so consideration about these might be important to make the diagnosis accurately.

  • PDF

A Case of Suspected Pericardial Effusion caused by Left Atrial Rupture due to Myxomatous Mitral Valve Degeneration

  • Han, Donghyun;Jung, Dong-In
    • 한국임상수의학회지
    • /
    • 제37권3호
    • /
    • pp.153-156
    • /
    • 2020
  • A 14-year-old intact female Cocker Spaniel dog, weighing 6.8 kg, presented with chief complaints of severe cough, dyspnea, anorexia, and exercise intolerance. It had the characteristics of a blood clot, the evidence of mitral regurgitation, a high left atrial/aortic root ratio, and pericardial effusion with a left atrial rupture due to myxomatous mitral valve degeneration (MMVD) was strongly suspected. Traditional therapy (pimobendan, furosemide, enalapril, and spironolactone) for heart failure with MMVD was provided twice a day orally, and partial pericardiectomy was performed for pericardial effusion. The medical prescriptions for MMVD were continued, and the patient's heart disease was well-controlled. However, it suddenly died 3 months after the operation.

만성 교약성 심낭염의 외과적 치료 -4례 보고- (Surgical Treatment of Chronic Constrictive Pericarditis -Report of 4 ases-)

  • 전희재
    • Journal of Chest Surgery
    • /
    • 제27권9호
    • /
    • pp.793-797
    • /
    • 1994
  • Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

  • PDF

결핵성 심낭염으로 오인되어 치료한 악성 심낭 중피종 (Malignant Pericardial Mesothelioma Misdiagnosed as Constrictive Pericarditis)

  • 곽재건;김경환
    • Journal of Chest Surgery
    • /
    • 제38권8호
    • /
    • pp.576-578
    • /
    • 2005
  • 38세 남자 환자가 호흡곤란과 좌측의 어깨 통증을 주소로 내원하였다. 심장 초음파 등의 검사로 이의 원인을 결핵성 심낭염으로 판단하고 약 1년 반 동안 내과 치료를 하였다. 내과 치료에 반응하지 않아 심낭 절제술을 시행하였고, 이를 통한 조직 검사 결과 악성 심낭 중피종으로 진단하였다. 종양은 심외막 및 심근에 심하게 유착되어 있어 완전 절제는 불가능하였으며, 환자는 현재 항암제 치료를 받고있다.

급성 화농성 심낭염의 외과적 고찰 (Clinical review of four patients of acute purulent pericarditis)

  • 김수성;김공수
    • Journal of Chest Surgery
    • /
    • 제17권2호
    • /
    • pp.263-268
    • /
    • 1984
  • Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

  • PDF

심낭삼출 환자의 임상적 고찰 (Clinical Experience of Pericardial Effusion)

  • 최덕영
    • Journal of Chest Surgery
    • /
    • 제28권5호
    • /
    • pp.487-490
    • /
    • 1995
  • We have experienced the 37 patients of pericardial effusion during last 8 years[1986-1993 . They were 17 male and 20 female patients, and their age range was 6months to 80 years.The causes of this pericardial effusion were 10 cases of tuberculosis, 7 cases of malignancy, 2 cases of acute pyogenic infection, 2 cases of postpericardiotomy pericardial effusion, 2 cases of trauma, 1 case of congenital heart disease, 1 case of SLE, and other 12 cases of unknown origin. All patients, except one, were managed by pericardiotomy with subxiphoid tube drainage. One case was managed by pericardiectomy. After operation, their symptoms and sign were dramaticaly improved. However, 3 patients were died postoperatively. Two of them were died of respiratory failure. One of them was died 28 months later with unrelated cause. They have already far advanced lung cancer. We conclude that the pericardiotomy with subxiphoid tube drainage was effective treatment in the patients with pericardial effusion.

  • PDF