• Journal of Chest Surgery
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• 제22권2호
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• pp.256-264
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• 1989

Modified Blalock-Taussig operation remains the standard technique of systemic-to-pulmonary artery shunt in patients of congenital heart disease with decreased pulmonary blood flow. We reviewed the 41 patients who had been performed modified Blalock-Taussig operation from March 1985 to Feb. 1988, and angiographically measured pulmonary artery size before and after shunt, and calculated pulmonary artery index [PAI] and ratio of left and right pulmonary artery to descending aorta[[LPA+RPA]/dAo]. The mean duration of palliation after shunt operation was 624 days and mean age of the patient at shunt operation was 3.59 years. Mean PAI increased significantly from 131.15*67.11 mm2/M2 preoperatively to 232.70*84.46 mm2/M2 postoperatively. Mean ratio of right and left pulmonary artery to descending aorta also increased significantly from 1.48*0.40 preoperatively to 1.92*0.50 postoperatively. All patients manifested clinical improvement; there was mean decrease in hematocrit of 8.95%, mean increase in arterial oxygen saturation of 11.08%. Pulmonary arterial growth was not influenced by age at operation, initial pulmonary artery size, or graft size, but significantly influenced by antegrade flow. The patients who have some antegrade flow were in more increase of PAI. There were no linear correlation between change of PAI, change of [[LPA+RPA]/dAo], SaO2, and duration. But, according to Scatterplot between change of PAI and duration, some complex correlation was suggested and mean PAI was decreased after 2-year palliation. We concluded that modified Blalock-Taussig operation is excellent palliative surgery for pulmonary artery growth especially on the patient who have some antegrade flow, and the proper duration of palliation was about 2 years.

• Tuberculosis and Respiratory Diseases
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• 제83권1호
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• pp.31-41
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• 2020

Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, exsmokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.

• Journal of Chest Surgery
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• 제21권3호
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• pp.574-582
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• 1988

Endocardial cushion defects is a rare congenital heart disease. We experienced two complete endocardial cushion defects[ECD] and three partial ones, which were successfully repaired between 1986 and 1987. In a patient of complete ECD, associated with secundum ASD, Pulmonary stenosis and Down`s syndrome, the atrial and ventricular septal defects were closed separately with bovine pericardium and Dacron patches respectively, and then pulmonary stenosis was relieved by transannular patch widening in addition to valvotomy and infundibulectomy. In another patient with complete ECD, small interventricular communication was closed with simple suture with pledget and primum ASD was closed with pericardial patch. In first patient of partial ECD, primum atrial septal defect was closed with pericardial patch. In second patient of partial ECD, associated with secundum ASD, direct closure of secundum ASD and patch closure of primum ASD were performed. In third patient of partial ECD, associated with patent foramen ovale[PFO], primum ASD was closed with bovine pericardial patch and PFO was closed directly. In all patient except third patient of partial ECD, mitral clefts were closed with three or four 5-0 prolene interrupted sutures. Transient A-V dissociation developed postoperatively in two patients and transient nodal rhythm developed postoperatively in other two patients. Heart failure in complete ECD with Down`s syndrome was overcome with medical treatment.

• Journal of Chest Surgery
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• 제49권3호
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• pp.190-194
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• 2016

Double outlet right ventricle (DORV) and transposition of the great arteries (TGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS) are complex heart diseases, the treatment of which remains a surgical challenge. The Rastelli procedure is still the most commonly performed treatment. Aortic root translocation including an arterial switch operation is advantageous anatomically since it has a lower possibility of conduit blockage and the left ventricle outflow tract remains straight. This study reports successful aortic root transpositions in two patients, one with DORV with VSD and PS and one with TGA with VSD and PS. Both patients were discharged without postoperative complications.

• Journal of Chest Surgery
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• 제15권2호
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• pp.204-212
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• 1982

The presence of left atrial thrombus in mitral stenosis has been reported to be associated with several factors. These are age, sex, presence of atrial fibrillation, episodes of congestave heart failure, calcification of mitral valve, embolic episode, etc. Since none of these single factor has been always related to the presence of left atrial thrombus, related risk factors to left atrial thrombosis were studied in patients with mitral stenosis using chi square test. We had operated on 191 cases of mitral valvular heart disease from Jan. 1978 to June 1981 at Severance Hospital, Yunsei University College of Medicine. The left atrial thrombi were present in 41 cases among 191 cases of mitral valvular heart disease and it was present in 31 cases among 89 cases of pure mitral stenosis. Only 10 cases among 74 cases of mitral stenoregurgitation had left atrlal thrombi, whereas no left atrlal thrombus was found in patients with pure mitral regurgitation. Related risk factors studied herein were sex, episodes of congestive heart failure, atrial fibrillation, pulmonary capillary wedge pressure, mitral valve area calculated by Gorlin and Gorlin`s formula cardiac output and left atrial dimension by echocardiogram. In this study presence of atrial fibrillation was deemed to be one of the most potential risk factors and other factors of age, duration of symptoms, episode of embolization, calclfication of mitral valve, associated aortic and tricuspid valve disease, ejection fraction of left ventricle by cineangiocardiogram and echocardiogram were not significantly related to the presence of left atrlal thrombi in a statistical viewpoint.

• Journal of Chest Surgery
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• 제19권2호
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• pp.250-258
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• 1986

From Aug. 1984 to May 1986, 116 cases of cardiovascular surgery including 85 cases of open heart surgery were performed at Korea Veterans Hospital. There were 108 congenital anomalies and 8 acquired valvular heart diseases. Among 108 congenital malformations 92 operations were done for acyanotic group, and 16 operations for cyanotic group. Thirteen cases of open heart surgery for infants or small children under 10kg of body weight were performed, which occupied 15.3 percent of total open heart surgery done in the same period. Common congenital cardiovascular anomalies were ventricular septal defect [40.7%], patent ductus arteriosus [29.6%], tetralogy of Fallot [12.[%], atrial septal defect [11.1%], and pulmonary stenosis [1.9%] in order of frequency. Valve replacement using lonescu-Shiley or Carpentier-Edwards valve was performed for 8 cases of acquired mitral valve disease, and valve replacement using St. Jude valve was done for a case of patent ductus arteriosus with severe mitral insufficiency. There was no mortality in acyanotic congenital malformations and acquired valve lesions, and 5 cases of mortality in cyanotic congenital malformations. Overall mortality was 4.3 percent for total cases and 5.9 percent for 85 cases of open heart surgery.

• Journal of Chest Surgery
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• 제48권4호
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• pp.277-280
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• 2015

We report the case of a 37-year-old man who suffered from biventricular failure due to left isomerism, inferior vena cava interruption with azygos vein continuation, bilateral superior vena cava, double outlet of right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and isolated dextrocardia. Heart transplantation in patients with systemic venous anomalies often requires the correction and reconstruction of the upper & lower venous drainage. We present a case of heart transplantation in a patient with left isomerism, highlighting technical modifications to the procedure, including the unifocalization of the caval veins and reconstruction with patch augmentation.

• Journal of Chest Surgery
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• 제38권6호
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• pp.450-453
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• 2005

규폐증 환자에서 기관지 결석증은 드물게 발생판다. 특히 기관지 결석증의 합병증으로 기관지식도루가 발생한 예는 매우 드물어 국내에서는 1예 보고된 바 있다. 기관지 결석증과 기관지 식도루의 수술치료는 손상되지 않은 폐실질을 최대한 보존하고, 누공의 비혈관성 조직들을 완전히 제거하여 식도와 기관지 봉합 부위를 흉막 피판이나 늑간근 피판으로 완전히 감싸주는 것이 중요하다. 저자들은 규폐증 환자에서 기관지 결석증으로 인한 기관지식도루 1예를 수술 치험하였기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제42권3호
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• pp.361-363
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• 2009

호흡곤란을 주소로 내원한 17세 환자가 대동맥 및 폐동맥 사엽성 판막을 보이며 심방중격결손과 폐동맥 판막 협착증이 발전되어 소심막을 이용한 심방중격결손 봉합 및 폐동맥 판막 교련절개술을 시행하였다. 대동맥 판막과 폐동맥 판막이 모두 사엽성 판막을 보이는 경우는 매우 드문 선천성 기형으로 폐동맥 사엽성 판막이 대동맥 사업성 판막보다 9배정도 많다. 본 증례는 Hurwitz and Roberts 분류법상 대동맥판막은 A형, 폐동맥판막은 B형이었으며 대동맥 판막기능은 정상적이었고 폐동맥 판막 협착증을 보였다.

• Journal of Chest Surgery
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• 제29권3호
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• pp.292-296
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• 1996

총폐정맥환류이상증은 모든 폐정 맥혈이 좌심방 대신 직간접적으로 우심방으로 환류되는 선천성 심기 형으로 떼 내에 수술을 시 행치 않을 경우 80%의 높은 사망율을 나타내는 질환이다. 1984년 5월부터 1995년 5월까지 7례의 총폐정맥환류이상증에 대한 교정수술을 시행하였다. 환자의 연령분포는 15일부터 11세 까지로 평균 연령은 27.1개 월이 었다. 남녀 비는 남자가 5례, 여자가 2례 였다. 형태는 심장상부형이 5례, 심장형이 2례였다. 5례는 통상적인 체외순환하에서 수술하였고2례의 경우 초저 체온 및 완전혈류차단하에서 수술하였다 술후 합병증은 호흡부전 1례, 부정맥 2례, 창상감염이 1례 있었다. 수술사망은 2례 였으며 생존자들은 외래 추적 조사상 특이 증상없이 잘 지내고 있다.