• Journal of Chest Surgery
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• v.24 no.4
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• pp.390-396
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• 1991

From July 1984 to September 1990, 316 patients of congenital heart diseases were operated and 15 patients died. Hospital mortality was 4.75%. Five patients of 73 PDA had residual shunt after operation: 4 were ligated under support of Dacron patch, 1 was closed through the pulmonary arteriotomy under CPB. 3 patients were reoperated. No patient had residual shunt or reopening among the patients of simple ligation or division and suture. During the ligation of PDA, Dacron patch for protection from tearing may disturb the complete interruption of shunt. If the tissue around the ductus arteriosus looks weak or fragile, division and suture may be more reliable other than ligation with supporting patch. If the septal leaflet of tricuspid valve is adherent around the VSD, remained opening of VSD may be closed with simple suture directly. In these cases, the incidence of postoperative residual shunt is as high as the incidence of more large VSD closed with patch [10.9%: 9.6%]. During the direct closure of remained opening of VSD, another leaking route should be looked for carefully beneath the septal leaflet of tricuspid valve.

• Mycobiology
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• v.44 no.3
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• pp.180-186
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• 2016

Trichoderma species are able to persist on living sapwood and leaves of cacao (Theobroma cacao) in an endophytic relationship. In this research, we evaluated the ability of Trichodema asperellum introduced at the incision site in the bark for side grafting with the concentration of 4 g/10 mL, 4 g/100 mL, and 4 g/1,000 mL (suspended in water) in suppressing vascular streak dieback (VSD) incidence and promoting growth of side grafts in the field. The incidence of VSD in two local clones of cacao, MCC1 and M04, without application of T. asperellum was 71.2% and 70.1% at 21 wk after grafting, respectively. However, when the two clones were treated with a concentration of 4 g/10 mL T. asperellum, the incidence was 20.6% and 21.7%, respectively, compared to 29.1% and 20.9% at 4 g/100 mL and 18.2% and 15.6% at 4 g/1,000 mL. By comparing to the control, the treatment with the same concentrations of T. asperellum listed above, the total number of stomata in MCC1 decreased by 41.9%, 30.2%, and 14.0% and in M04 by 30.5%, 21.9%, and -2.5% (exception), respectively. Otherwise, the total area of stomata opening increased by 91.4%, 99.7%, and 28.6% in MCC1 and by 203.8%, 253.5%, and 35.9% in M04, respectively. Furthermore, the number of buds and branches treated with a mixture concentration on the the two clones increased by 90.7% and 21.7%, respectively. These data showed that the application of T. asperellum to cacao scions while grafting can decrease VSD incidence in side grafts and increase growth of grafts in addition to decreasing total number of stomata, increasing total area of opened stomata, and increasing number of buds and branches.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1238-1243
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• 1990

Bacterial endocarditis has been well recognized as an important complication of congenital heart disease. The most common. form of congenital heart disease is the VSD, of which natural history is spontaneous closure, pulmonary vascular disease, symptoms, and endocarditis. The incidence of endocarditis is relatively low. But endocarditis is almost universally fatal if untreated. Two cases of VSD with endocarditis, 4 \ulcorneryear male and 17 \ulcorneryear female, were treated at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University. In the First case, the VSD was perimembranous type and vegetation located on the septal leaflet of the tricuspid valve. After 7 week medical treatment, simple closure of the VSD, removal of vegetation, and tricuspid annuloplasty were performed. In the second case. the VSD was subpulmonic type and the pulmonic valve was destructed due to vegetation. So the VSD was closed with interrupted 4 \ulcorner0 Prolene sutures and the pulmonic valve was excised. Postoperative course of all cases was uneventful.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.595-603
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• 1993

We analysed 60 consecutive patients who got Senning operation for transposition of the great arteries [TGA] with or without ventricular septal defects [VSD]. There were 41 simple TGA [group I] and 19 TGA with VSD [Group II], the operative mortality was 20 % [in group I 4.9 %, group II 52.6 %]. Among the survivors [n=48], the mean follow-up period was 7 years [range, 1 year to 13.5 years] and the actuarial survival rate at 13 years were 95 % in group I and 42 % in group II. Preoperative high left ventricular pressure and high pulmonary arterial pressure affected the surviving [p<0.01]. There occurred various type of arrhythmia like junctional rhythm, first degree atrioventricular [AV] block, sick sinus syndrome and complete AV block, and we inserted 2 permanent pacemakers for these patients. The incidence of arrhythmia were 28.2 % [11/39] in group I and 55.6 % [5/9] in group II, and the actuarial freedom from arrhythmia at 13 years after operation was 66 % [71 % in group I, 44 % in group II]. Increased aortic cross clamping time had affected the development of arrhythmia [p<0.05] which meant the complexity of the operation. The total incidence of left ventricular outflow tract obstruction [LVOTO] was 31.3 % [15/48], but only 3 patients [6.25 %] showed the significant gradient requiring reoperation. The pulmonary venous pathway obstruction [PVO] were found in 3 patients, all in group I, and among them only one required the reoperation. The estimated freedom from PVO was 89 % at 13 years [87 % in group I, 100 % in group II], but we couldn`t find any significant systemic venous obstruction in our series. There occurred 27.1 % [13/48] mild degree tricuspid valve regurgitation without necessary surgical correction. We experienced 14.6 % [7/48] reoperation rate: 3 residual VSD, 3 LVOTO, 1 PVO, 3 atrial baffle leakage. For this high incidence of complication rate after Senning operation and high mortality in TGA with VSD, We do not use this kind of surgical modality any more and do the Jatene operation for all the TGA patients since several years ago.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.418-421
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• 1980

During the period from August 1959 to end of July 1980, 69 cases of Type I VSD were noted among 235 cases of ventricular septal defect who were operated utilizing cardiopulmonary bypass in the Department of Cardio-thoracic Surgery, College of Medicine, Seoul National University(29.4%). During the same period 1162 open heart surgery cases were experienced among whom 778 cases were congenital anomalies. There were no significent differences between Type I '||'&'||' other tvpo:s of VSD in sex and age distribution. In Type I VSD frequency of aortic regurgitation association was much higher than rest of the types. (8.7% to 2.6%). Necessity of patch closure in Type I was not different from other types. The high incidence of Type I VSD is quite similar to Japanese references which show quite higher ratio compared with from Euroamerican caucasian patients materials. All cases were operated on with bubble type oxygenator mainly Shiley**" oxygenator utilizing hypothermic hemodilution perfusion technique.echnique.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.17-25
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• 1981

In 1980, 416 cases of open heart surgery were done in this Department with over all operative mortality of 12.3%. 1. There were 288 congenital anomalies consisting of 174 acyanotic and 114 cyanotic varieties, which showed operative mortality of 6.9% and 25.4% respectively. 2. There were 128 cases of acquired lesions, 124 valvular disease and 3 myxoma being the main lesions. 3. There were 128 cases of valve replacement with operative mortality of 7.8%. 4. The most frequently operated anomaly was VSD, 90 pure VSD and 21 cases were associated with one or 2 cardiac anomalies. Over all operative mortality in 111 VSD cases was 8.1% but in 90 pure VSD cases it was 6.7%. 5. Tetralogy of Fallot showed the highest incidence in cyanotic group with 88 cases, consisting of 68 pure and 20 with other cardiac anomalies. Over all mortality in 88 cases was 19.3% but in pure form 16.2%. 6. In 128 valve replacement cases over all mortality was 9.4%. There were 85 mitral, 11 aortic, 2 tricuspid, 21 mitral with aortic, 6 mitral with tricuspid, 3 mitral, aortic, and tricuspid valve replacement cases. For mitral valve replacement operative mortality was 5.9%. 7. Twenty-one cases of babies under 10kg body weight were operated on with over all operative mortality of 28.6%. Sixteen cases of VSD were found with operative mortality of 25%. 8. Among 128 cases of valve replacement 7 were under the age of 15 years and 12 were between 15 and 20 years old. Five pediatric cases underwent mitral valve replacement without mortality, 9 year old boy was the youngest among them. In this Department open heart surgery for infancy and complex anomalies showed still hip operative risk which should be improved in the coming years. For open heart surgery Shiley oxygenators and 2 sets of A-O de-lux 5 head roller pump were utilized exclusively. For valve replacement Ionescu-Shiley bovine pericardial xenografts were mainly used. In pediatric and rural patients Persantin with aspirin regimen was satisfactorily administered for anticoagulation after valve replacement. Routinely Coumadin was administered for one year after valve replacement* In patients who had thrombus on valve sites, chronic atrial fibrillation, and giant left atrium Persantin-Aspirin regimen was used when one year coumadin administration was discontinued.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.129-134
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• 1993

We compared postoperative results according to the different surgical approach in 180 cases of isolated ventricular septal defects operated at the department of Thoracic and Cardiovascular Surgery in Kyungpook University Hospital from January 1987 to December 1991. Of the 180 cases, 109 were males and 71 females, age ranging from 6 months to 15 years (mean: 5.6 years) and body weight ranging from 6 to 52㎏(mean : 20㎏). According to Soto's classification, perimembranous types were comprised of 119 cases (66％), doubly committed subarterial type 49 cases(27％), and muscular type 12 cases(7％). Patients were divided into three groups according to the incision methods: right atriotomy group (39％), right ventriculotomy group (47％), and pulmonary arteriotomy group (14％). The mean aortic cross clamp time was shorter in right atriotomy group (39 min.) than right ventriculotomy group (79min.) in the cases of large perimembranous VSD (P＜0.001). Spontanous recovery rate of cardiac rhythm after VSD closure was higher in right atriotomy group (51％) than right ventriculotomy group (32％) in the cases of perimembranous VSD (P＜0.05). The incidence of postoperative RBBB was 17.6％ with no statistical differences between right atriotomy group(17.9％) and right ventriculotomy group(19.2％). Overall mortality rate was 5.6％(10 cases) with no significant differences according to surgical approach.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1482-1486
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• 1992

Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.448-454
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• 1980

The juxtaposition of atrial appendage may possibly be diagnosed by angiography recently, and it is widely regarded as an ominous sign of severe cyanotic congenital heart disease. However, it is apparently rare congenital cardiac anomaly in which the atrial appendages lie side by side, both to the left or right of the great arteries, known as left or right juxtaposition of the atrial appendages. Juxtaposition of the atrial appendages has no functional significance, since it does not, itself, cause any hemodynamic disturbance. But it`s presence always indicates the coexistence of other major cardiac anomalies. In review of literatures TGA and VSD are invariable present, and ASD is common. Other anomalies, such as, tricuspid atresia, pulmonary outflow that, obstruction bicuspid pulmonic valve, persistent SVC etc. are relatively high incidence. In this report, we present one case of 6 year old female child having left juxtaposition of atrial appendage combined with TGA [D-looping, D-transposition], TAPVD, large ASD, small VSD, and vertical vein.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.116-121
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• 1986

Patients over 15 years of age who have undergone a surgical correction of a congenital cardiac malformation during period of January 1958 through January 1986 have been reviewed. During this period there were 3957 congenital cardiac lesions consisting of 2712 acyanotic and 1245 cyanotic cases. Among them, a total of 725 adults [18.3%] with a variety of congenital heart lesions, 548 acyanotic group and 177 cyanotic group were operated on. 372 patients were male and 252 patients were female. There were 280 patients under 20 years of age, 206 between 20-24 years, 102 between 25-29 years, 48 between 30-34 and 89 over 35 years. The most common defects were atrial septal defect which accounted for 207 cases [28.6%] and other common anomalies were VSD [140 cases, 19.3%], TOF [136 cases, 18.6%], PDA [120 cases, 16.6%] and PS [33 cases, 4.6%] in order of incidence. Overall operative mortality for this series was 3.6% [1.8% of a cyanotic group and 9.0% of cyanotic group] compared with 2.8% of total cases of congenital heart disease [acyanotic group 1.1% and cyanotic group 6.5%]. This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.