• Title/Summary/Keyword: Tricuspid Valve, repair

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Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

  • Oh, Hyun Kong;Kim, Nan Yeol;Kang, Min-Woong;Kang, Shin Kwang;Yu, Jae Hyeon;Lim, Seung Pyung;Choi, Jae Sung;Na, Myung Hoon
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.283-286
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    • 2014
  • A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.

Biventricular Repair of Double Outlet Right Ventricle with Non-Committed Ventricular Septal Defect by Arterial Switch -Report of 1 case - (비상관성 심실중격결손증을 동반한 양대혈관우심실기시증 환자에서의 동맥전환술을 이용한 양심실성 교정 - 1예 보고 -)

  • Kim, Jae-Hyun;Kim, Woong-Han;Chang, Yun-Hee;Na, Chan-Young;Oh, Sam-Se;Baek, Man-Jong;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Jo, Won-Min;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.687-690
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    • 2003
  • Although surgical options for double outlet right ventricle (DORV) with non-committed ventricular septal defect (VSD) are vary in accordance to the morphological characteristics, it is very difficult to use biventricular repair technique when there is tricuspid chordae originating from conal septum or when the distance between the tricuspid valve and the pulmonic valve is too short. We report our clinical experience of biventricular repair of DORV with non-committed VSD by VSD rerouting to the pulmonary artery and arterial switch in case of a presence of conal tricuspid chordae and short distance between the tricuspid valve and the pulmonic valve.

Effects on Surgical Repair of VSD by TATV (막성주위형 심실중격결손중의 봉합시 경삼첨판륜 절개방법의 외과적 치료효과)

  • Gwak, Mong-Ju;Kim, Bo-Yeong
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.869-875
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    • 1997
  • Perimembranous ventri ular septal defects(PMVSDS) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is luiown to a versatile approach to PMVSDS and even malaligunent defects can be repaired by this method. Although transatrial exposure can be improved by taking down'the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transamlular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was fr m 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(QPIQS) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore TATV is especially a good method in PMVSn where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.

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Severe Tricuspid Insufficiency after Correction of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery(ALCAPA) (ALCAPA 교정후 발생한 심한 삼첨판 폐쇄부전)

  • 백만종;김웅한;오삼세;류재욱;공준혁
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.724-728
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    • 2001
  • We report a case of an 8 years and 11 month-old male patient who had developed severe tricuspid insufficiency(TI) after correction of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Transthoracic echocardiogram and coronary angiography confirmed ALCAPA, ischemic mitral regurgitation and trivial TI. He underwent direct reimplantation of the left coronary artery to the aortic root by using additional cannulation at the main pulmonary artery for arterial inflow and cardioplegia delivery to the left coronary artery. After the correction of ALCAPA, transesophageal echocardiogram(TEE) revealed good antegrade flow at the aortic implantation site of the left coronary artery and severe TI(Gr III-IV/IV). Cardiopulmonary bypass was reestablished and tricuspid valve was repaired with Kay-type annuloplasty, artificial chordae formation and chordal shortening plasty. The postrepair TEE revealed trivial to mild TI.

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Ebstein's Anomaly -A Case Report- (엡스타인 심기형 -1례 보고-)

  • 전찬규
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.57-59
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    • 1994
  • Ebstein`s anomaly, a rare congenital cardiac anomaly, is characterized by downward displacement of abnormal tricuspid valve. Indication for surgical repair and the optimal surgical approach are still controversy. Recently, we experience a case of Ebstein anomaly, which was treated by atrilized right ventricular plication and annuloplasty. The patient was discharged with good result on 17th post-operative day.

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Surgical Treatment of Ebstein`s Anomaly Report of a case (Ebstein 심기형의 개심술 1례)

  • Park, Guk-Yang;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.436-439
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    • 1985
  • A patient of Ebstein`s anomaly underwent surgical repair on Oct. 24th, 1984. Tricuspid valve was replaced by 31mm St. Jude mechanical valve without plication of atrialized right ventricle. The annulus has been placed below the coronary sinus, with care not to damage the conduction system. But postoperatively complete heart block developed. Permanent pacemaker was implanted on his 12th POD. Now he has been followed up for 9 months. There was no hemodynamic problems yet.

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Operative Treatment of Ebstein's Anomaly (Ebstein기형의 외과적 치료)

  • 조준용;허동명
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.381-385
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    • 1996
  • From April 1984 to April 1990, seven patients with Ebstein's anomaly underwent surgical repair. Mean age at operation was 18.6 years (range, 2 to 46 years). Operations were performed using hypothermic cardiopulmonary bypass. Surgical procedures included tricupid valve replacement (n:6) and tricuspid valve reconstruction (n: 1). There were two hospital deaths. There have been no late death. All survivors are in New York Heart Association class I or II with a median follow-up of 6.2 years(range, 4 to 8.3 years).

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Transposition of great arteries with pulmonary stenosis and remote muscular inlet ventricular septal defect (원거리근육입구형심실중격결손과 폐동맥협착이 동반된 대혈관전위)

  • 김웅한;이택연;김수철;전홍주;한미영;김수진;이창하;정철현;오삼세
    • Journal of Chest Surgery
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    • v.33 no.3
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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.

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Combined Surgery in a Dog with Heartworm Infection and Complex Fractures

  • Kang, Jin-Su;Kwon, Yong-Hwan;Cho, Hyoung-Sun;Kim, Young-Ung;Lee, Ki-Chang;Kim, Nam-Soo;Kim, Min-Su
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.269-272
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    • 2018
  • A 4-year-old, 6.1 kg intact female dachshund was referred to the Animal Medical Center with acute right hind limb lameness. Radiographs revealed fractures of iliac body and tibia in the right limb. In addition, the dog exhibited tricuspid valve regurgitation and moderate heartworm infection in the right ventricle and main pulmonary artery on echocardiogram. To obtain stable anesthetic conditions for operation, an adult heartworm removal procedure was previously followed by repair of the complex fractures. All surgical procedures were done without complication and with stable patient conditions. At a one month postoperative follow-up, the dog was doing well with normal ambulation and no tricuspid valve regurgitation as well.

Mid-term Results of Neonatal Surgical Management of Pulmonary Atresia with Intact Ventricular Septum (온전한 심실 중격을 가진 폐동맥 폐쇄증의 신생아기 수술 치료의 중기 성적)

  • Kwak Jae Gun;Kim Woong-Han;Kim Dong Jin;Lee Chang Ha;Lee Jeong Ryul;Kim Yong Jin;Rho Joon Ryang
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.815-820
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    • 2005
  • Background: Pulmonary atresia with intact ventricular septum is a rare congenital cardiac disease. There have been various surgical options, but there are still controversies. Material and Method: Fourteen neonates who were operated on between 1999 and 2000 were enrolled in this study. We measured Z-value of tricuspid valve by echocardiography. We performed right ventricular outflow tract transannular patch in 9 patients. Modified Blalock-Taussig shunt was placed according to the condition of patients. Mean follow up period was 46.0 months. Result: There were 2 operative mortality and 1 late mortality. Biventricular repair was possible in 7 patients. One and a half ventricular repair were done in 3 (tricuspid valve Z-value was -2, -2.5 and -3) and single ventricular repair in 2 patients (tricuspid z-value was -4.6, -4.5) The tricuspid valve Z-value for the patients who had biventricular repair and one and a half ventricular repair were -0.8$\pm$1.50 (-3.2$\∼$1.2) and -2.5$\∼$0.5 (-3$\∼$ -2) respectively. All patients who survived had fair to good right ventricular function, good left ventricular function and good clinical states. Conclusion: Neonatal surgical management of pulmonary atresia with intact ventricular septum has a good surgical outcome, z-value of tricuspid may be helpful for the determination of surgical options.