• Journal of Chest Surgery
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• 제27권9호
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• pp.752-758
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• 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
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• 제27권7호
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• pp.624-627
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• 1994

Congenital coronary arteriovenous fistula is a rare cardiac defect that causes coronary arterial flow to drain into the right cardiac chambers, the pulmonary artery, the coronary sinus, or the left cardiac chambers. The most frequently involved vessel is the right coronary artery. We experienced a case that had a coronary arteriovenous fistula associated with valvular heart disease. With the cardiopulmonary bypass done under hypothermia, mitral valve replacement was accomplished and the fistulas of both proximal and distal portions of the right coronary artery were closed with 3-0 prolene. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제30권12호
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• pp.1205-1213
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• 1997

가톨릭대학교 의과대학 부속 성바오로 병원에서 1996년 1월부터 7월까지 개심술시 경식도심초음파를 이용하여 수술 중 관찰한 61명의 증례를 분석하여 다음과 같은 결과를 얻었다. 61명의 환자 중 질병 분류는 심장 판막 질환 25명, 관상동맥 질환 22명, 선천성 심질환 13명, 심장 판막 질환과 관상동맥 질환이 병발한 경우가 1명 이었다. 1. 경식도심초음파를 이용하여 선천성 심질환 1예(심실중격결손증 재수술)와 대동맥 판막 치환술을 시행한 환자 1예에서 일차 심정지에 의한 수술 후 잔존 단락과 판막 주위 누출이 확인되어 재심정지를 유도하여 수술을 완료하였다 2. 공기색전증의 발생을 전 예에서 방지할 수 있었다. 3. 경식도심초음파로 측정한 심박출량과 온도희석법으로 측정한 심박출량은 통계학적으로 의미있는 상관관계를 보여 경식도 초음파를 이용한 심박출량 감시가 의미 있음을 시사하였다(Linear regression analysis, p<0.001). 4. 관상동맥우회로술을 시행한 23명의 환자에서 수술 중 경식도 초음파도상 이상 벽운동을 보이는 분절의 도부타민 투여 전후와 관상동맥우회로술 후의 반응을 비교 관찰하였다. 저 용량 도부타민 검사는 통계적으 \ulcorner유의하였다(민감도 76%, 특이도 94.7%, 양성 예측율 95%, 음성 예측율 75%).

• Journal of Chest Surgery
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• 제24권10호
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• pp.967-972
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• 1991

Between Feb. 1982 and July 1990, 173 patients [male: 89, female: 84] Who underwent heart valve replacement for acquired valvular heart disease on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University, were reviewed for return to work after heart valve replacement. The replaced valve were mitral [128, 74.0%], aortic[10, 5.8%], mitral & aortic[35, 20.2%]. Two tricuspid valve replacement were excluded. Several important factors influencing the return to work were age, the employment status before surgery, the number of replaced valve, the pre - op NYHA functional class and cardiac function [ejection fraction]. These factors were closely related to the optimal time of heart valve replacement. It can be concluded that the rate of return to work and the quality of life would be improved if valve replacement were performed at an earlier stage of valvular heart disease.

• 한국임상수의학회지
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• 제21권1호
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• pp.83-86
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• 2004

A 4 year old mixed female dog was presented dyspnea, anorexia and syncope. In blood smear test, a lot of heartworm larvae were observed. In thoracic radiography, "reverse D" shape was observed. So, this case was considered with heartworm disease. In echocardiography, marked left heart hypertrophy was presented. In M-mode view, aortic valvular stenosis was found. After mongrel dog died, aortic valvular stenosis was reconfirmed in necropsy. After all, the dog died of pulmonary edema because of aortic valvular stenosis caused left heart failure.t failure.

• Journal of Chest Surgery
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• 제19권1호
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• pp.25-34
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• 1986

Recently, radionuclide angiocardiogram is one of the most common procedure for assessment of ventricular performance due to its distinctive advantages such as safety, accuracy, and ease of repeated studies. Also, measurement and comparison between pre and postoperative left ventricular ejection fraction [LVEF] are meaningful for assessing the severity of myocardial damage which occurred during open heart surgery and the status of myocardial recovery. We obtained pre and post operative LVEF using radionuclide angiocardiogram on 30 patients composed of atrial septal defect, ventricular septal defect, cyanotic congenital heart disease, and valvular heart disease who undergone the open heart surgery from March to august 1984. The study revealed that ventricular septal defect and mitral valvular heart disease showed 8.1% and 6.2% decreases of postoperative LVEF, respectively. But, there are little increases of postoperative LVEF in the atrial septal defect and cyanotic congenital heart disease. In ventricular septal defect, each group of Qp/Qs over 2.0 and systolic pulmonary artery pressure over 50mmHg showed significant 17% and 14.7% decreases of postoperative LVEF, respectively. Considering the duration of the aortic cross clamping times and closing methods of VSD, each group of duration over 30 min. and of patch closure showed 13.9% and 14.2% decreases of LVEF between pre and postoperative status respectively which was significant finding statistically.

• Journal of Chest Surgery
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• 제27권11호
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• pp.914-921
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• 1994

From May 1977 to November 1993, 1, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. In 1500 cases of open heart surgery 975 cases[65%] were congenital heart disease and 525 cases[35%] were acquired heart disease. In 975 cases of congenital heart disease, there were 812 cases[83%] of acyanotic congenital heart anomaly and 163 cases of cyanotic congenital anomaly. In 525 cases of acquired heart disease, most cases were valvular heart disease in which 557 valves were implanted. The each operative mortality of congenital and acquired disease was 7.7% and 7.4% respectively and then overall mortality rate was 7.6%. There has been increasing incidence of open heart surgery in infants in recent years. After 1990, 28 cases of infant open heart surgery below the 12month were performed. Most lowest weight was 2, 200g[15 days]. Operative mortality of open heart surgery in infant with weight below the 10kg was very high as a 25.7%.

• Journal of Chest Surgery
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• 제16권3호
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• pp.289-294
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• 1983

The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

• Journal of Chest Surgery
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• 제16권1호
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• pp.75-82
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• 1983

This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

• 한국임상수의학회지
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• 제18권3호
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• pp.273-278
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• 2001

Chronic mitral valvular insufficiency (CMVI) is the most common heart disease in dogs. The prevalence of CMVI is age-dependent. CMVI is usually affected to small to medium size breeds. It is more prevalent in males than females. The characteristic lesions of CMVI are caused by an acquired chronic structural degeneration of the mitral valve defined as endocardiosis or myxomatous degeneration. The main clinical signs are cough, respiratory distress, weakness and pleural effusion and ascites by secondary right-sided heart failure. The most prominent clinical finding is a systolic heart murmur. The thoracic radiography and echocardiography are useful methods in diagnosis of CMVI. Thoracic radiographic findings are left atrial enlargement, left main stem bronchial compression and pulmonary edema. Echocardiography is confirmed to increased left atrial and ventricular dimension, mitral regurgitation, mitral valve thickening and abnormal movement. Thoracic radiography and echocardiography are used to obtain a definite diagnosis of CMVI, and then to study the progression of the condition.