• 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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• 제32권3호
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• pp.303-306
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• 1999

본 증례는 Ross 술식에서 동종판막이나 이종판막을 쓰지않고 자가 대동맥 조직과 심낭으로 우심실 유출로를 성공적으로 재건한 보고이다. 선천성 대동맥판막 협착증을 진단 받은 8세 환아에서 시행한 폐동맥 자가 이식편을 이용하여 대동맥판을 교체하고 자가 대동맥 조직과 심낭편으로 단엽 판막을 만들어 우심실 유출로를 재건하였다. 술후 검사에서 심실과 새로운 대동맥판의 기능이 좋아 투약없이 19개월째 외래 추적관찰 중이다.

• Journal of Chest Surgery
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• 제35권8호
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• pp.590-593
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• 2002

온전한 심실중격을 가진 폐동맥판막무형성증(absent pulmonary valve syndrome with intact ventricular septum, APVS with IVS)은 매우 드문 선천성 심장 질환이다. 신생아의 경우 확장된 폐동맥에 의한 기도폐쇄와 이로 인한 심한 호흡곤란증으로 높은 사망률을 유발한다. 이에 대한 해결책으로 여러 약물치료 및 여러 고식적 수술, 폐동맥 판막 삽입, 폐동맥 축소술(reductive angioplasty of pulmonary artery) 등이 사용되었다. 본원에서는 동맥관 결찰술, 폐동맥 축소술, 폐동맥 판막 재건술(pulmonary valve reconstruction) 및 심방중격결손 봉합술을 시행하여 좋은 결과를 얻었다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1327-1336
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• 1992

Between Jan. 1986 and Aug. 1992. 72 patients underwent Rastelli procedure. There were 43 male and 29 female, aged 46 days to 16 years [mean age, 5.2 years] with 18 patients less than 2 years of age. All patients had complex defect, 27 pulmonary atresia with ventricular septal defect, 18 corrected transposition of great arteries with pulmonary atresia or punmonary stenosis, 10 truncus arteriosus, 10 double outlet right ventricle with pulmonary atresia or stenosis, 7 complete transposition of great artersia with pulmonary atresia or pulmonary stenosis. The types of extracardiac valved conduit used were prosthetic valve[n=47, 24 car-bomedics, 19 Ionescu-Shiley, 4 Bjork-shiley] and hand-made trileaflet valve using pericardium. [n=23, 20 bovine pericardium, Z autologous pericardium, 1 equine pericardium] The mean size of valved cinduit was 5.25mm larger in diameter than the size of main pulmonary artery. [normalized to the patient`s body surface area] There were 17 hospital death[24%] and 4 late deaths[5.6%]. Postoperative complication rate was 38.9%a, none of which was conduit-related. All patients were followed pos-toperatively for 1 to 73 months. [mean 25.8 months] During follow-up period, reoperation was done in 6 patients due to stenosis of valved conduit. Mean interval between intial repair and reoperation was 20.3 months. In our experience, li recently extracardaic valved conduits between right ventricle [or pulmonary ventricle] and pulmonary artery were inserted with increasing frequency in infants less than 2 year, but hospital mortality was decreased, 2] Risk of reoperation due to conduit stenosis is low, so that the effect of graft failure on overall survival is minimized. 3] Nevertheless, because any type of extracardaic valved conduit is not ideal in children, we recommended that Lecompte should be done if cardiac anatomy is permitted.

• Journal of Chest Surgery
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• 제17권4호
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• pp.625-631
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• 1984

A modified Fontan procedure was performed on two patients with Univentricular heart. The first patient had UVH of right ventricular type with trabecular pouch and had various associated anomalies, such as common atrium, common atrioventricular valve and combined pulmonary stenosis. The second patient had UVH of left ventricular type with outlet chamber and the associated anomalies were atrial septal defect, tricuspid stenosis and combined pulmonary stenosis. Postoperative hemodynamic insufficiency, fluid retention and renal insufficiency were occurred in the first patient, but relieved with the aid of inotropics and vasodilators. We thought that the good postoperative course and surgical result were gained from the widely patent atriopulmonary anastomosis.

• 한국임상수의학회지
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• 제34권4호
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• pp.268-271
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• 2017

A 1.3 year-old Castrated male Bedlington terrier (10.0 kg of body weight) was presented with heart murmur and occasional coughing. Diagnostic imaging studies revealed supravalvular pulmonic stenosis (maximal velocity 2.91 m/s) from abnormal membranous structure (aperture) distal to the pulmonary valve in the main pulmonary artery. Further study also revealed pulmonic regurgitant (1.82 m/s of peak velocity, 13.2 mmHg of pressure gradient) jets started from the abnormal membranous structure. Since the dog had no obvious clinical signs related to heart failure, no interventional therapy including balloon dilation was considered in this case. Instead, medical treatment for preventing further deterioration of clinical signs related to PS was done with enalapril. This case report described a rare case of type III supravalvular PS in a dog, which has never been reported. Further deterioration of clinical signs has yet been recognized after medical treatment.

• Journal of Chest Surgery
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• 제12권3호
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• pp.225-232
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• 1979

A 15-year-old girl underwent successful surgical correction of double-outlet right ventricle [S.D.L.] subaortic ventricular septal defect, patent foramen ovale, and pulmonary hypoplasia with valvular stenosis. The operation consisted of an internal baffling connecting the left ventricle to the aorta through the ventricular septal defect. The pulmonary stenosis was corrected with the method of connection the right ventricle to the pulmonary artery bifurcation using the Hancock valve[18mm] contained conduit. This rare type of DORV seemed to be suitable for corrective surgery, and the patient`s condition is very good until present time (post operative 7 months).

• Journal of Chest Surgery
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• 제23권6호
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• pp.1256-1262
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• 1990

Percutaneous pulmonary valvuloplasty was performed in 19 patients of congenital pulmonary valve stenosis. Pulmonary annulus diameter was estimated by cross sectional echocardiography and right ventricular cineangiography. The size of balloon dilatation catheter was chosen by the same size of the estimated pulmonary annulus in the first 3 patients and 20 \ulcorner30% greater than the annulus in the last 17 patients. After valvuloplasty a satisfactory results was obtained in most patients. Before dilatation, the right ventricular systolic pressure was 91.7 mmHg[range 58-150 mmHg] and it fell to 49.2mmHg[25-85 mmHg] after dilatation. The transvalvular gradient was 67.7 mmHg[33 \ulcorner120 mmHg] before dilatation and it fell to 23.7mmHg [5 \ulcorner62] after dilatation. Repeat cardiac catheterization has been scheduled in all patients 3 months after the initial valvuloplasty but follow up recatheterization was performed in only two patients; in one of them residual gradient of 50 mmHg was reduced to 30 mmHg by repeat valvuloplasty. The other patient showed no evidence of restenosis with transvalvular gradient of 20 mmHg The balloon used for valvuloplasty was single balloon for the first 10 cases and for the later 10 cases it was replaced by Trefoil balloon which was easier for inflation and deflation. There were no significant complications during and after the procedure. From our results, we conclude that balloon valvuloplasty for congenital pulmonary valve stenosis is the treatment of choice in most patients.

• Journal of Chest Surgery
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• 제30권4호
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• pp.423-427
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• 1997

객혈은 승모판막협착증의 영향으로 흔히 발생되지만,많은 양으로 지속적이며 치명$\boxUl$101 곤출친으 확 실히 드물다. 한양대 학교 흉부외과학교실에서는 지속적인 대량 폐출혈로 응급이중판막 재치환술 시행받은 30대 여자의 예를 보고하고자 한다. 환자는 1984년 류마치스성 승모판막 폐쇄부전증으로 판막치환술을(lonescu Shilcy 27mm) 받았으며, 그후 2년후에 삼첨판윤 성형술(Carpcntier's ring 30mm)을 받았다. 1995년 12월 26일 환자는 대량 객혈과 심한 호흡곤란으로 입원하였다. 객혈에 대한 동맥색전술을 포함한 내과적 치료를 시행 받았지만 효과는 없었다. 환자는 응급 이중판막 재치환술(승모판 : St. Jude 29mm, 삼첨판; St. Jude 33mm)을 시 행 받았으며. 술후 24시간이 경과된 후 객혈은 극적으로 조절되었다.

• Journal of Chest Surgery
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• 제33권3호
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• pp.262-264
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• 2000

We report a successful biventricular repair of D-transposition of great arteries, pulmonary stenosis and remote muscular inlet ventricular septal defect, after modifie Blalock-Taussing shunt early in infant. A long left ventricle-to-aorta intraventricular rerouting tunnel was created without stenosis by transferring the medial papillary muscle of the tricuspid valve to the tunnel, obliterating the trabeculation of right ventricle in the course of tunnel and excising the secondary chordae of the tricuspid valve.