• 제목/요약/키워드: Pulmonary Hypertension

검색결과 383건 처리시간 0.027초

대동맥판막 폐쇄부전증을 동반한 심실중격결손증 -7례 보고- (Ventricular Septal Defect with Aortic Insufficiency: A Report of 7 Cases)

  • 조대윤
    • Journal of Chest Surgery
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    • 제12권1호
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    • pp.50-55
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    • 1979
  • The development of aortic insufficiency radically alters the physical findings which are generally associated with ventricular septal defect that was not hemodynamically significant, and the combination of the two lesions produces a typical clinical picture, that may be serious and life-threatening when it is left untreated. Therefore, the selection of patients, type and timing of surgical treatment is considered to be important. Among 114 cases of ventricular septal defect treated surgically utilizing cardiopulmonary bypass in the Department of Thoracic Surgery, Seoul National University Hospital, 7 cases were associated with aortic insufficiency. 1. Five cases were male, and 2 cases were female. Ages were from 4 years to 24 years, and mean age was 11.9 years. 2. In all cases, ventricular septal defect was closed with Teflon patch. In a case, a aortic valvuloplasty and in another, a aortic valve replacement with Hancock valve 23 mm., 5 months after the closure of ventricular septal defect were done. 3. Four cases were type I ventricular septal defect by Kirklin`s classification, 3 cases were type II ventricular septal defect, and diameters of ventricular septal defect were from 3.5 cm. to 0.7 cm. A PDA. was combined to a type I ventricular septal defect. 4. In 5 cases, herniation of the aortic cusp through the ventricular septal defect and in a case, annulus dilatation on the aortic valve was noted. 5. Two cases with type I ventricular septal defect and severe pulmonary hypertension expired. A re-opened case with type II ventricular septal defect expired. 6. Four cases were alive, and all of them show decrease of pulse pressure and aortic insufficiency.

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1977년도 년간 개심술 100례 보고 (One Hundred Cases of Open Heart Surgery in 1977)

  • 이영균
    • Journal of Chest Surgery
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    • 제11권2호
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    • pp.213-226
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    • 1978
  • One hundred cases of open heart surgery were done at this Department in 1977. There were 65 congenital anomaly and 35 acquired diseases. Out of 65 cases of congenital malformation 35 acyanotic and 30 cyanotic cases were found. Fifteen cases of ventricular septal defect and 29 tetralogy of Fallot were noted eight patients expired out of 65 congenital anomaly [12.3%] , 4 out of 35 acyanotic [11. 4%] and 4 among 30 cyanotic anomaly[13.3%]. Among 35 cases of acquired heart disease 3 atrial myxoma [2 left and one right] and 32 valvular lesions were noted. In two cases open mitral commissurotomy, and in 30 valve replacement were done. Twenty-two single valve and 8 double valve replacement were done. Seven patients expired out of 30 patients [23.3%]. Among 22 single valve replacement cases 2 and among 8 double valve 5 died. ~ In eighteen mitral valve replacement cases 2 deaths occurred. One mitral insufficiency patient who expired suffered from severe pulmonary` hypertension [PA=120/67mmHg], tricuspid insufficiency and a large ventricular septal defect. The patient underwent mitral valve replacement, tricuspid annuloplasty and patch closure of ventricular septal defect. Over all mortality rate for 100 open heart surgery cases was 15%. Since 1977 open heart surgery cases were done routinely in this institution and cases are increasing rapidly. With present rapid improvement of economical status and introduction of medical insurance system, open heart surgery will be firmly established in Korea in the very near future.

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자연발증적 고혈압 흰쥐에서 무청 건조분말의 항고혈압 효과 (Antihypertensive Properties of Dried Radish Leaves Powder in Spontaneously Hypertensive Rats)

  • 김보람;박지호;김선희;조강진;장문정
    • Journal of Nutrition and Health
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    • 제43권6호
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    • pp.561-569
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    • 2010
  • The study aim was to investigate the antihypertensive effect after oral supplementation of dried radish leaves powder (DRLP). Angiotensin-converting enzyme (ACE) activity was measured by spectrophotometric assay. The systolic blood pressure (SBP) was measured in spontaneously hypertensive (SHR) and normotensive rats (Wistar) by the tail cuff method after a 4-week diet with DRLP at the level of 2.5% or 5%. The supplementation of DRLP decreased SBP of SHR although the 5% supplementation level did not show any more pronounced effect than the 2.5% level did. The decrease in the SBP observed for both 2.5% and 5% DRLP was accompanied by significant increases of the urinary Na and K excretion. The DRLP supplementation showed a potent ACE-inhibitory activity in pulmonary tissue from both hypertensive and normotensive rats. However, the DRLP supplementation did not affect the SBP in normotensive rats. These results indicated that DRLP exerted an antihypertensive effect in SHR due to the decreased ACE activity and increased urinary Na excretion.

후천성 삼첨판폐쇄부전증의 외과적 치료에 대한 연구 (Clinical Study of Surgical Treatment of Acquired Tricuspid Regurgitation)

  • 이형렬;김종원
    • Journal of Chest Surgery
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    • 제26권3호
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    • pp.196-203
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    • 1993
  • Fourty-five cases of operation were performed for the correction of tricuspid regurgitation [TR] in Pusan National University Hospital between 1982 and 1991.The mean age of the patients was 32.6 years and female was dominant[M:F=1:2.2].Isolated tricuspid regurgitation was rare and 43 patients underwent concomitant other valvular operation including mitral valve replacement. Functional cause was in 39 cases and organic lesions were found in 6 cases. Operative methods were Kay annuloplasty[29], De Vega annuloplasty[12], and tricuspid valve replacement[4]. Ring annuloplasty was not performed. Operative mortality rate was 11.1%[5/45] and late mortality rate was 6.7%[2/30]. The tricuspid valve surgery itself was not a serious risk factor for hospital death and no heart block nor thrombosis was complicated. By echocardiogram early[within 30 days] and late [mean:4.9years] changes of postoperative TR were evaluated. De Vega annuloplasty seemed to bring better late result than Kay annuloplasty[p<0.05]. In four patients with late severe TR,previously replaced tissue valve degeneration[2], pulmonary hypertension[1] and rheumatic TR[1] were the possible causes. This experience suggests that De Vega annuloplasty can be a reliable method in the majority of patients with moderate-to-severe functional TR.

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Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

  • Kim, Ha Eun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.203-206
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    • 2016
  • Patients with venoarterial extracorporeal membrane oxygenation (ECMO) frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA) decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

다발성 기형을 동반한 염색체 9번 단완 첨가 1례 (A Case of an Addition of Chromosome 9 Short Arm Associated with Multiple Congenital Anomalies)

  • 장승구;유재은;박문성;임윤주;윤수한;홍정
    • Neonatal Medicine
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    • 제15권2호
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    • pp.200-206
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    • 2008
  • 안면 기형, 삼각두, 뇌량 무형성, 감각 신경성 난청, 시각장애, 심기형, 심근병증, 폐동맥 고혈압, 배꼽 탈장과 생식기 기형이 있는 환아에게 동반된 9번 염색체 단완이질염색질 부위의 첨가를 발견하여 9번 염색체 p13 부위의 첨가와 연관된 다발성 기형의 발생을 보고하는 바이다.

개방성 승모판막 절개술에 관한 연구 (Open Mitral Commissurotomy: A Report of 21 Cases)

  • 이영균
    • Journal of Chest Surgery
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    • 제6권1호
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    • pp.69-88
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    • 1973
  • Twenty-one cases of open mitral commissurotomy were done between October 1963 and March 1973. 1] Preoperative embolism consists of 7 cerebral and 2 peripheral cases. Two operative cerebral embolism cases were noted. 2] There were two cases of restenosis, one associated valvular disease, three mitral insufficiency cases, and six cases of pulmonary hypertension. 3] Out of 21 cases, 13 cases of atrial fibrillation were found and two cases of atrial fibrillation were found postoperatively among 8 cases of preoperatively normal sinus rhythm. 4] During operation 10 cases of valvular calcification and 6 cases of left atrial thrombus were noted. 5] Complete blood count, electrolyte and acid base balance showed normal range of data. 6] Four helix reservoir whole blood total body perfusion and 17 cases of .hemodilution perfusion utilizing Rygg-Kyvsgaard bag oxygenator with sigma motor were performed. 7] EACA 125 mg/kg intravenous administration before cardiopulmonary bypass resulted in markedly diminished postoperative bleeding. 8] Post-perfusion urine amount was in satisfactory range. 9] There were 2 operative mortality due to coronary embolism and three cases of hospital death, 2 due to severe hepatic failure and one due to cerebral embolism. 10] Sixteen survival cases showed marked clinical improvements and almost all of them returned to their occupation satisfactorily after operation.

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한국 고혈압환자의 최적염미에 관한 연구 (A Study on Optimal Gustation of Salt in Hypertensive Patients in Korea)

  • 장수경;김영순;이성동;서순규;유세화
    • Journal of Nutrition and Health
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    • 제16권1호
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    • pp.21-26
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    • 1983
  • For the purpose of study on optimal gustation of salt 108 patients with hypertension(61 cases of male, 47 cases of female) were studied. And also 48 patients with non-hypertensive heart diseases and pulmonary diseases (20 cases of male, 28 cases of female ) and apparently healthy subjects (107 cases of male, 20 cases of female) were studied as control group. By adding salt into 3% rice boiled powder solution the 0.1%, 0.25% 0.5%, 0.75% and 1 % salt solutions were prepared respectively. Allowed subject to taste all above solution in landed and to point out the optimal salty taste of each subject. There were no significant difference in optimal gustation of salt among the hypertensive patients and control group. The optimal salt gustation of hypertensive patients with low salt diet was slightly lower than those with free diet The optimal salt gustation was higher in old aged persons regardless of diseases.

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성인 동맥관 개존증의 임상적 고찰 : 개심술과 결찰술과의 비교 (A Clinical Analysis of Patent Ductus Arteriosus in Adults - Comparison Between Open Heart Surgery and Ligation -)

  • 송현;김성호;안혁;채헌;김종환
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.8-14
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    • 1991
  • Methods for the operative management of patent ductus arteriosus are now well established, and in the vast majority of children the circulatory shunt can be safely and effectively abolished by dividing the ductus or by closing it in continuity with ligatures and transfixing sutures. In adults, however, closure of patent ductus arteriosus may pose important technical problems, particularly when there are associated pulmonary hypertension, calcification, aneurysm and infective endocarditis. Under these circumstance, division or ligation is unusually hazardous because the diseased vessels often fracture or tear when sutures are placed in them. Then we closed the patent ductus arteriosus by use of cardiopulmonary bypass in 18 patients and ligated the ductus via thoracotomy in 18 patients from Jan. 1986 to May 1990. And we compared the results between two different methods. We concluded that ligation of ductus had a problem of rupture and transpulmonary internal suture closure of PDA had a problem of injury of recurrent laryngeal nerve.

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1세이하 영아에서의 개심술 (Open Heart Surgery in Infancy)

  • 권영무
    • Journal of Chest Surgery
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    • 제24권10호
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    • pp.960-966
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    • 1991
  • From February 1984 through July 1991, 104 infants less than 1 year of age with congenital heart defects underwent open heart repair with conventional cardiopulmonary bypass which occupied 10.7% of all patients with congenital heart defects operated on during same period. There were 66 boys and 38 girls 7 days to 12 months [mean age, 8.2 months]. Four patients were neonates, 8 were 1 to 3 months, 23 were 4 to 6 months, and 69 were 7 to 12 months of age. Mean body weight at repair was 6.9kg and mean BSA, 0.36m2 Indications for operation were intractable congestive heart failure and severe pulmonary hypertension in patients with VSD and severe cyanosis and anoxic spells in patients with TOF. Conditions corrected were VSD[79], TOF[8], AVSD[4], PS[2], PA+IVS[2], TAPVC [2], MR[2], DOLV[l], Truncus arteriosus[1], D-TGA[1], and PA-VSD[1]. Twenty-three of 79 patients with VSD had associated cardiovascular anomalies which included PDA in 16 patients, PS in 9 patients, ASD in 5 patients, LSVC in 2 patients, MR in 1 patient, dextrocardia in 1 patient, and single coronary artery in 1 patient. The hospital mortality rate was 24.0% which was much higher than that of 6% in patients over 1 year of age. The greatest mortality occurred in babies of low weight under 6 months of age, There was no late death. Surviving infants showed marked symptomatic improvement and change in growth patterns. These surgical results were to be overcome with proper pre- and post-operative management and improvement of surgical technique

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