• Journal of Chest Surgery
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• v.27 no.7
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• pp.617-620
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• 1994

Approximately 10% of patients who have undergone atrial repair for transposition of the great arteries display easily identifiable RV dysfunction with or without TV incompetence by 10years. Treatment is difficult & the surgical options for this complication are limited. We experienced two cases of the reversal of atrial repair and conversion to an arterial switch after initial pulmonary artery banding. This surgical program is a realistic modality treating late failure of systemic right ventricle after atrial switch operation.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.688-694
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• 1986

Takayasu`s disease is an arteritis of unknown etiology involving larger elastic arteries such as aorta and its branches, pulmonary arteries and rarely coronary arteries. Especially, aortic root involvement with the valvular leaflets has been reported in several cases of Takayasu`s arteritis. Recently we have experienced one case of Takayasu`s arteritis involving left subclavian artery, descending aorta, left renal artery and multiple valvular leaflets. The patient was 33 year-old female and admitted with complaints of cough, dyspnea and general weakness. Aortogram revealed extensive type of arteritis showing dilatation of ascending aorta, segmental narrowing of thoracic aorta and Riolan`s anastomosis. Double valve replacement [mitral and aortic valve] and tricuspid valve annuloplasty were performed. The patient made an excellent postoperative recovery and has shown striking improvement in cardiac status, NYHA functional class II eight months after operation.

• Journal of Chest Surgery
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• v.14 no.2
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• pp.161-167
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• 1981

Mustard succeeded in the physiological correction of the circulation for transposition of the great arteries by redistribution of the pulmonary and systemic venous blood flow using pericardial baffle in the atrium. This procedure has become one of the most confirmative corrective operations for transposition. A six years old girl was performed mustard operation for complete transposition of the great arteries combined with hemodynamically insignificant ventricular septal defect in December 1979. The postoperative patient`s condition has been satisfactory and she is now enjoying a productive life.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.403-405
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• 2018

This case report concerns a young patient with an extremely rare combination of d-transposition of the great arteries (d-TGA) and anomalous origin of the right subclavian artery. In our patient, the right subclavian artery originated from the pulmonary artery, which is why he did not show reversed differential cyanosis. We conclude that the presence of an aortic arch anomaly should be considered in patients with d-TGA who do not present with reversed differential cyanosis. A further imaging work-up, including computed tomography or magnetic resonance imaging, might be helpful.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.861-866
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• 1998

Background: Pulmonary atresia (PA) with ventricular septal defect has various morphology of pulmonary arteries and pulmonary blood flow sources, so pulmonary arterial hypoplasia and arborization abnormality make this anomaly difficult to manage surgically. In cases associated with juxtaductal stenosis, we evaluated the change of the pulmonary arterial and juxtaductal stenotic site after shunt operations, and would like to find useful information in surgical planning and methodology of these patients. Material and Method: Among 59 cases diagnosed as PA with ventricular septal defect associated with juxtaductal stenosis, 29 cases who had cardiac catheterization before and after shunt operation were selected from July, 1991 to July, 1996. In 10 cases of right shunt operation(Group I) and 19 cases of left shunt operation (Group II), the diameters of the descending aorta, both pulmonary arteries, and the juxtaductal stenosis site were measured before and after the shunt operation. Result: In both Group I and II, the pre- and postoperative ratio of diameters of the ipsilateral pulmonary artery to the descending aorta was from 0.78${\pm}$0.31 units to 1.01${\pm}$0.26 units and from 0.67${\pm}$0.18 units to 0.84${\pm}$0.27 units respectively, showing a signigicant increase. The contralateral pulmonary artery index was increased from 0.92${\pm}$0.28 units to 1.05${\pm}$0.15 units and from 0.94${\pm}$0.27 units to 1.08${\pm}$0.37 units respectively, but could not be confirmed statistically. In both groups, the change of juxtaductal stenosis showed an aggravating tendency but of no statistical significance from 0.43${\pm}$0.27 units to 0.39${\pm}$0.25 units and from 0.32${\pm}$0.10 units to 0.30${\pm}$0.16 units respectively, and we experienced 2 total obstruction in Group II. Because the increased pulmonary blood flow by shunt operation has a favorable effect to the pulmonary arterial growth, the shunt operation is a recommended treatment in patients with hypoplastic pulmonary arteries. But in PA with ventricular septal defects, the change of juxtaductal stenosis is very important. In conclusion, the growth of ipsilateral (shunt site) pulmonary artery was promoted by shunt operation, but there is a tendency for the juxtaductal stenosis to be aggravated. And we experienced 2 total obstruction in Group II. Conclusion: Thus, in cases operated with shunt method, much careful postoperative follow up study including angiographic evaluation is needed, and after the shunt operation on the side of pulmonary artery associated with juxtaductal stenosis, early precise planning for total correction is recommended.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.306-312
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• 1986

The development of extracardiac valved conduits for establishment of RV-PA continuity has permitted repair of previously uncorrectable congenital heart anomalies and has facilitated the repair of other complex lesions. But the distressing problem of neointimal peel formation with eventual conduit obstruction in patients with Dacron valved conduits has led to the need for premature replacement in many patients. Therefore in the absence of pulmonary hypertension, hypoplastic pulmonary arteries, significant right ventricular dysfunction or unrepaired tricuspid regurgitation, preference of a valveless conduit to a valved conduit gives excellent results and may diminish the need for late reoperation. In our Hanyang University Hospital, the Rastelli operation was performed for the repair of pulmonary atresia with a valveless Gore-Tex conduit. The patient was operated on with good result. The CVP after operation was 8-13 mmHg at POD #0 and 4-6 mmHg from POD #3-4. Postoperatively the patient was acyanotic and had improved physical capacity compared with his preoperative status.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.159-164
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• 1973

Bronchopulmonary sequestration is a congenital malformation characterized by a cystic portion of the lung that derives its arterial blood supply through anomalous aberrant vessel directly of the systemic circulation. An aberrant systemic vessel supplying the lung was reported by Huber in 1777. Although this lesion is uncommon disorder, there are several reports on operative death caused by exanguinating hemorrhage from the aberrant arteries to the bronchopulmonary sequestration to that it has received a great deal of attention. Two type of bronchopulmonary sequestration have been identified: Intralobar pulmonary sequestration is usually contained within the visceral pleura of a pulmonary lobe and its venous drainage to the pulmonary venous system. Extrapulmonary sequestration is usually within the pleural sheath its own and its vasculature drains into the azygos or hemiazygos system. we presented one case of intralobar pulmonary sequestration which led to motor paralysis, chylothorax and hemorrhage that are consequent on postoperative complication.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.30-33
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• 1983

Truncus Arteriosus is an uncommon congenital anomaly which is now correctable surgically in patients with favorable anatomy. A case of a 9 month old male with truncus arteriosus, type II, is reported operation was done on cardiopulmonary bypass with deep hypothermia and circulatory arrest. The pulmonary arteries were not disconnected from the truncus, and the pulmonary common orifice was closed with a Dacron patch through anterior truncotomy and, for the distal anastomosis, the left pulmonary artery was opened near the common orifice. Continuity between the right ventricle and the left pulmonary artery was established with a valved conduit [Ionescu-Shiley, 14mm]. The postoperative course was excellent and uneventful.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.457-463
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• 1986

Truncus Arteriosus is uncommon, accounting for 0.4%-2.8% of all congenital cardiac malformations. Truncus arteriosus has a poor prognosis in early infancy and defined as "a single arterial trunk that leaves the heart by way of a single arterial valve and that gives rise to the coronary, systemic and one or both pulmonary arteries directly." Through antemortem study of patients with truncus arteriosus the development of surgical techniques for palliation and correction was established. Recently we had surgical experience of truncus arteriosus - Collett '||'&'||' Edwards type 2. The main pulmonary artery was originated from truncus at right posterolateral aspect. Truncal valve was tricuspid with good coaptation. Ventricular septal defect was subarterial type of 2.0 cm in diameter. After detachment of the main pulmonary artery from truncus, truncus was repaired directly. Ventricular septal defect was closed with Dacron patch. Extracardiac valved conduit [Carpentier-Edwards: 16mm] was employed for making continuity between right ventricular outflow tract and pulmonary artery. Postoperatively, incomplete right bundle branch block on electrocardiogram was continued. Patient was died due to respiratory failure in postoperative 40 days.s.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.478-482
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• 1989

Pulmonary sequestration is applied to the congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two cases of pulmonary sequestration were treated at the department of thoracic and cardiovascular surgery, college of medicine, Hallym University. One case was extralobar type, associated with the pneumothorax due to rupture of bulla. The other was intralobar type with symptom of massive and recurrent hemoptysis. The supplying arteries of both cases arose from the thoracic aorta. The venous return of the extralobar type was systemic into the hemiazygos vein, and that of the intralobar type was normal into the inferior pulmonary vein. Treatment for the former was resection of the sequestrated lung, and that for the latter was lobectomy of the left lower lobe. With the brief review of literature, we report the cases.