• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.468-472
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• 2013

A 12-year-old intact female mixed dog (weighing 6.2 kg) was referred with primary complaints of severe abdominal distension, persistent coughing and exercise intolerance. Diagnostic studies found ascites, jugular distension, loud left and right apical systolic (grade 4/6) murmur, generalized cardiomegaly with caudal vena cava distension and left atrial dilation. Echocardiographic findings were consistent with degenerative mitral and tricuspid valve endocardiosis and bi-ventricular congestive heart failure. There was also a left to right shunting patent foramen ovale. The LV systolic function is depressed relative to the degree of volume overload. Based on diagnostic findings, this case was diagnosed as PFO complicated with mitral and tricuspid valve endocardiosis with ISACHC IIIa heart failure. The dog was treated with furosemide (2 mg/kg, q12hr, PO), sildenafil (1 mg/kg, q8hr, PO), pimobendan (0.3 mg/kg, q12hr, PO), enalapril (0.5 mg/kg, q12hr, PO) and spironolactone (1 mg/kg, q12hr). The clinical signs were gradually improved after medical therapy.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.404-410
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• 1987

An 18-day-old male neonate with hypoplastic left heart syndrome underwent surgical intervention by modification of the Norwood procedure on September 23, 1986. Hypoplastic left heart syndrome is a serious congenital cardiac anomaly that has a fatal outlook if left untreated. Included in this anomaly are [1] aortic valve atresia, and hypoplasia of the ascending aorta and aortic arch, [1] mitral valve atresia or hypoplasia, and [3] diminutive or absent left ventricle. Patent ductus arteriosus is essential for any survival, and there is usually a patent foramen ovale. Coarctation of the aorta is frequently associated with the lesion.z With a limited period of cardiopulmonary bypass, deep hypothermia, and circulatory arrest, the ductus arteriosus was excised. The main pulmonary artery was divided immediately below its branches, and the distal stump of the divided pulmonary artery was closed with a pericardial patch. The aortic arch was incised, and a 1 5mm tubular Dacron prosthesis was inserted between the main pulmonary artery and the aortic arch. A 4mm shunt of polytetrafluoroethylene graft was established between the new ascending aorta and the right pulmonary artery to provide controlled pulmonary blood flow. Following rewarming, the heart started to beat regularly, but the patient could not be weaned from cardiopulmonary bypass. At autopsy, the patient was found to have hypoplasia of the aortic tract complex with mitral atresia and aortic atresia. A secundum atrial septal defect was noted. Right atrial and ventricular hypertrophy was present, and the left ventricle was entirely absent. Although unsuccessful in this case report, continuing experience with hypoplastic left heart syndrome will lead to an improvement in result.

• Journal of Electrical Engineering and Technology
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• v.8 no.1
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• pp.53-63
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• 2013

To guide the decision making of the expert engineer specialized in power system operation and control; the practical OPF solution should take in consideration the critical situation due to severe loading conditions and fault in power system. Differential Evolution (DE) is one of the best Evolutionary Algorithms (EA) to solve real valued optimization problems. This paper presents simple Differential Evolution (DE) Optimization algorithm to solving multi objective optimal power flow (OPF) in the power system with shunt FACTS devices considering voltage deviation, power losses, and power flow branch. The proposed approach is examined and tested on the standard IEEE-30Bus power system test with different objective functions at critical situations. In addition, the non smooth cost function due to the effect of valve point has been considered within the second practical network test (13 generating units). The simulation results are compared with those by the other recent techniques. From the different case studies, it is observed that the results demonstrate the potential of the proposed approach and show clearly its effectiveness to solve practical OPF under contingent operation states.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.305-312
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• 2008

Background: Anatomic and functional abnormalities of the systemic atrioventricular (AV) valve are common in single ventricle. pathologies and continue to be associated with poor early and late outcomes in surgically palliated single. ventricle patients. We aggressively performed valvuloplasty for atrioventricular valve regurgitation (AVVR) during the course toward a Fontan operation. Material and Method: Between January 1995 and December 2004, 209 patients underwent a Fontan operation in our institution. We retrospectively evaluated the prevalence of AVVR and the influence of AV valve repair on outcome, and we analyzed the progression of AVVR after the Fontan operation for 168 patients where echocardiographic follow up results for more than 6 months after the Fontan operation were available. During the course toward a Fontan operation, 25 patients underwent 30 procedures for AVVR. These procedures. were. carried out during placement of a bidirectional cavopulmonary shunt (BCPS) for nine patients, between the time of placement of a BCPS and the Fontan operation for four patients, and during the Fontan operation for 17 patients. Five patients underwent procedures for AVVR twice. Result: The late mortality rate after the Fontan operation was 4.2% (n=7), with a median follow-up duration of 52 months (range, $6{\sim}123$ months). Seven patients (4%) had unfavorable outcomes such as significant (moderate or severe) AVVR in six patients, and significant AV valve stenosis in one patient was determined at the last follow up after the Fontan operation. Among the seven patients, four patients underwent AV valve repair after the Fontan operation, and one patient underwent subsequent AV valve replacement. Progression to AVVR of equal to or greater than grade 2 was noted in 30 patients (18%) at the last follow up after the Fontan operation, including 12 patients that underwent previous AV valve procedures. Initial grading of AVVR, a previous AV valve operation, and specific AV valve morphology such as a common AV valve or mitral atresia were significant risk factors for the progression of AVVR after the Fontan operation. Conclusion: In our surgical series, a small percentage of patients showed unfavorable outcomes. related to AVVR during the course toward a Fontan operation. However, a closer follow-up is required to evaluate the progression of the AVVR after a Fontan operation, especially for patients showing poor AV valve function at the first presentation and specific AV valve morphology.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.218-222
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• 1987

Unroofed coronary sinus syndrome is an uncommon anomaly, Unroofed coronary sinus syndrome is caused by incomplete formation of the left atriovenous fold, and it usually is associated with Left SVC. If it is not diagnosed, a residual reversed or bidirectional shunt will result, and its complications will reduce life expectancy. We experienced 3 cases of unroofed coronary sinus syndrome which combines TOF with PLSVC, partial ECD, primum type ASD. In case of Unroofed coronary sinus syndrome which combines TIF with PLSVC, preoperative diagnosis was not made. In corrective operation for TOF of this case, pump weaning was failed due to hypoxia and cardiac arrest, and he expired at operation room. At autopsy of this case, complete unroofed coronary sinus was found. In the other 2 cases, partial unroofed coronary sinus syndrome was found in operation field and corrective operation was performed successfully. We report these 3 experiences with its review. ^u ++ Noninvasive Assessment of Pressure Gradients across Prosthetic Heart Valve by Doppler Ultrasound - A comparative study of the Duromedics Bileaflet Valves in mitral position and Normal Mitral Valves -with its review.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1280-1287
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• 1990

A seven month old female infant with isolated ventricular inversion and anatomically corrected malposition of the great arteries in situs solitus, associated with ventricular septal defect, patent ductus arteriosus, right-sided juxtaposition of left atrial appendage, is reported. The patient showed usual atrial arrangement with somewhat superoinferior relation, a discordant atrioventricular connection, and a concordant ventriculoarterial connection with aorta in the right-sided position. A normal sized left atrium was connected to the left superiorly positioned morphologic right ventricle through a tricuspid valve, which crossed the left ventricular outflow tract anteriorly. Well developed bilateral[subaortic and sub-pulmonary]conus was documented at operative field. successful surgical repair was done by performing the Senning procedure and by closing the ventricular sepal defect with a patch through the right ventriculotomy. The infant’s postoperative course was uneventful with normal sinus rhythm. Postoperative cardiac catheterization revealed no hemodynamic obstruction or residual shunt.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.50-58
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• 1989

The emergence and expansion of cardiac surgery over the past decade has resulted in an increasing number of patients undergoing cardiac operations but many kinds of heart surgery was realized only palliative, resulting in increasing numbers of secondary cardiac procedures. From 1978 to 1988, 10 cases of various congenital heart diseases and 17 cases of acquired heart diseases were reoperated at Hanyang University Hospital. The leading indication of second operation was residual shunt or valvular malfunction due to technical failure in congenital heart disease and primary valve failure, endocarditis, paravalvular leakage were for acquired heart disease. The mortality of reoperation was 0% for congenital heart disease and 11.7%[2 death among the 17 patients] for acquired heart disease. The leading causes of death were myocardial failure, sepsis with endocarditis, acute renal failure and congestive heart failure.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.559-563
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• 1996

We have experienced a patient, 16 year-old male, with ventricular septal defect with tricuspid recur- gitation due to blunt chest trauma. He suffered from congestive heart failure after the trauma. Echocardiogram and cardiac catheterization revealed left to right shunt at the ventricular level (muscu- far portion of interventricular septum) and tricuspid regurgitation. At the time of the operation, marked systolic thrill was palpable over the rlght ventricle near the apex and a chorda tendina was seen sharply ruptured just near the medial papillary muscle. We repaired the ventricular septal defect with a Dacron patch and chordal reconstruction with autologous pericardium. The postoperative course was uneventful and the patient was discharged in good condition.

• Journal of Veterinary Clinics
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• v.19 no.1
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• pp.110-113
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• 2002

An atrial septal defect (ASD) is a congenital hole in the atrial septum that allows flow between the two atria. Small ASDs are usually well-tolerated defects and do not result in significant clinical abnormalities. In large ASDs or in the presence of other cardiac defects, clinically significancy is increased. Atrial septal defects in 2 Dogs with cardiac and respiratory signs were diagnosed at seoul animal medical center. In ascultation, systolic murmur and the splitting of second heart sound were heard at pulmonary or tricuspid valve region. In radiograph, right-sided cardiomegaly, pulmonary artery dilation, increased pulmonary vasculature makings, and pleural effusion or pulmonary edema signs were observed. In echocardiography, the region, location and size of septal defect was identified. Also, the direction and degree of shunt was measured. These dogs were treated with medicine for cardiac failure. One dog is well-tolerated, the other dog died.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.633-636
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• 2005

Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.