• Journal of Chest Surgery
• /
• v.27 no.9
• /
• pp.752-758
• /
• 1994

From July 1983 to December 1992, 145 patients with mitral valvular disease underwent open heart surgery at Chonbuk National University Hospital. Of these patients, 89 patients[61.4%] required mitral valve replacement. 56 patients [38.6 %] had mitral valve repair. There were 32 women and 24 men and the mean age was 34.3 years[range 6 years to 62 years].There were 23 cases of pure mitral stenosis, 19 cases of mitral regurgitation and 14 cases of mixedmitral valvular disease. The mean duration of symptom was 4.53 years and mean mitral valvularorifice diameter[in cases of pure stenosis and mixed mitral valvular lesion] was 0.96 cm. According to the NYHA classification, the distribution of patients preoperatively was as follows; class IIa, 15 patients; class lib, 17 patients; class III, 22 patients; class IV, 2 patients. Four patients[7%] had an embolic history preoperatively. 24 patients[ 43 %] were in atrial fibrillation. In cases of pure mitral stenosis, the technique used included open mitral commissurotomy[21atients], open mitral commissurotomy with mitral annuloplasty[2 patients]. In mixed mitral valvular disease, open mitral commissurotomy[ll patients] and open mitral commissurotomy with mitral annuloplasty[l patient] were performed. In cases of mitral regurgitation, mitral annuloplasty[5 patients], mitral valvuloplasty[6 patients], mitral annuloplasty with valvuloplasty [3 patients] and ring annuloplasty [5 patients] were performed.There was one perioperative death related to acute renal failure and sepsis. One late death was occurred related to heart failure after 10 months postoperatively. One patient required reoperation due to restenosis and no embolic episode was occured. After operation, 34 patients were in NYHA functional class I, 20 patients were in class IIa.

• Journal of Chest Surgery
• /
• v.16 no.1
• /
• pp.10-17
• /
• 1983

Valve replacement in children, aging up to 15 years [Mean 11.g years], has been done at Seoul National University Hospital over the past 14 years since 1968. Fifty-one patients have received 59 artificial valves: 55 bioprosthetic and 4 prosthetic valves. Thirty-one patients [60.8%] had rheumatic heart disease and the remainder [39.2%] had congenital heart disease. Forty-two patients [82.4%] survived operation: 9 patients [17.7%] died within one monfi3 postoperatively and 4 patients [7.8%]during the follow-up period with the overall mortality rate of Thromboembolic complication occurred in 3 patients with 2 deaths: 5.9% embolic rate or 4.68% emboli per patient-year. One patient who had been on coumadin anticoagulation died from cerebral hemorrhage. One mitral Ionescu-Shiley valve failed 19 months after first replacement and this was successfully re-replaced with the same kind of valve. Actuarial survival rate was 59.9% at 4 years after surgery. Thromboembolism-free and valve failure-free survivals were 80.0% and 93.1% respectively. These clinical results in the pediatric age group suggested that valve replacement in children was a serious undertaking with a higher mortality rate than in adults. However, the main superiority on the low thrombogenecity of the xenograft valve over the mechanical one warrants its continuing use until the question of its durability would otherwise be answered by a further study of clinical follow-up.

• Journal of Chest Surgery
• /
• v.46 no.1
• /
• pp.60-62
• /
• 2013

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.

• Journal of Chest Surgery
• /
• v.28 no.12
• /
• pp.1122-1131
• /
• 1995

One hundred eighty-eight patients[August.23,1988,through July.30,1994 underwent aortic[AVR , mitral[MVR , or double [DVR valve replacement with the St.Jude Medical prosthesis. The author analyzed 100 patients with valvular heart disease,who underwent valve replacement with the St.Jude Medical prothesis from 1990 to 1994, at Hanyang University hospital Cardiovascular department. Information on volume and functional change of the heart chamber can be obtained by cardiac echocardiography and cartheterization. Out of 100 patients, 40 patients were male[40% and 60 patients were female [60% . Age ranged from 13 years to 68 years, with mean age of 42.6 years. Mean height was 160.3cm and mean body weight was 54.9Kg. According to NYHA functional classification, class III is most frequent and 60 patients could be classfied under it. MVR [involved Redo MVR was performed in 40 patients, AVR [involved Redo AVR was performed in 18 patients, and DVR [involved Redo DVR was performed in 42 patients. Warfarin [Coumadin anticoagulation was recommended for all patients. Life long warfarin anticoagulation was necessary to all patients who underwent valve replacement with St.Jude Medical prosthesis. Ideal prothrombin time was maintained about 30% during warfarinization. There were no case of mechanical failure. It followed a comparison of echocardiography before and after valve replacement at Hanyang University hospital [30 patients and a preoperative evaluation of cardiac catheterization and angiography [64 patients . The St.Jude Medical cardiac valve is a viable alternative in the surgical therapy of valvular heart disease.

• Journal of Chest Surgery
• /
• v.46 no.4
• /
• pp.249-255
• /
• 2013

Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

• Journal of Chest Surgery
• /
• v.17 no.1
• /
• pp.3-11
• /
• 1984

Prosthetic valve replacement has resulted in marked improvement in the functional status of many patients with valvular heart disease. But valve failure from various causes has necessitated re-replacement of prosthetic valve in some of these patients. This selective group of patients has many inherent problems. This report presents our experience with seven patients who received re-replacement of prosthetic valve in the Seoul National University Hospital from 1981, to 1983. The patients included one woman and six men in the range of 9 and 49 years old. As the first valve operations, there were five MVR using tissue valves, one DVR [Bjork-Shiley and Ionescu-Shiley valve] and one case of modified Bentall operation with composite graft [Ionescu-Shiley valve]. Reoperations on prosthetic valve failure were performed 17 to 54 months after the first operation [mean 34 months]. Amon8 seven patients, there were two cases of prosthetic valve endocarditis and five cases of primary tissue failure. Gross calcification of the xenograft was found in two children with Ionescu-Shiley valve. All except one had relatively successful operative results. The unsuccessful one died intraoperatively from low output syndrome.

• Journal of Chest Surgery
• /
• v.23 no.6
• /
• pp.1238-1243
• /
• 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 Veterinary Clinics
• /
• v.38 no.1
• /
• pp.16-20
• /
• 2021

Recently, a new method of evaluating left atrial size called vertebral left atrial size (VLAS) was introduced in dogs. Total 155 dogs were examined at the Veterinary Medical Teaching Hospital of Chungnam National University. In this study, myxomatous mitral valve disease (MMVD) stage and VLAS showed a significant correlation in those dogs. Also, the relationship between C-reactive protein (CRP) and VLAS has yet to be examined. We found a strong positive correlation between VLAS and CRP-a significant increase in CRP was observed with increasing VLAS values. Thus, it would be beneficial to measure VLAS besides employing the current radiological and echocardiographic methods when evaluating heart size. Measuring VLAS could be an additional diagnostic tool for diagnosing MMVD in dogs.

• Journal of Chest Surgery
• /
• v.57 no.1
• /
• pp.1-24
• /
• 2024

• Journal of Chest Surgery
• /
• v.28 no.4
• /
• pp.409-411
• /
• 1995

One patient developing left main coronary stenosis following double valve replacement is reviewed. Angina pectoris developed 5 months postoperatively. Coronary perfusion with a balloon tip perfusion catheter was performed during previous operation and was considered technically satisfactory. Coronary angiography confirmed stenosis of the left main coronary artery. There was no further coronary arterial disease. An anterior approach between the aorta and pulmonary artery to expose the left main coronary artery was used and patch angioplasty was done. Repeat coronary angiography showed a widely patent left main coronary artery with excellent runoff. A careful search for coronary arterial injury should be made in all symptomatic patients following aortic valve replacement.