• Journal of Chest Surgery
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• v.17 no.3
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• pp.389-397
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• 1984

Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.148-155
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• 1987

From May 1977 to June 1986, 500 cases of open heart surgery were performed under the cardiopulmonary bypass. There were 278 male and 222 female patients ranging from 6 months to 69 years. 363 cases[73.6%] were congenital heart diseases, and 137 cases[27.4%] were acquired heart diseases, which were 33 valvular diseases, 3 myxomas and 1 IVC obstruction. There were 363 congenital heart anomaly with 35 operative deaths[9.6%], consisting of 279 acyanotic cases with 12 deaths [4.3%] and 85 cases of cyanotic cases with 23 deaths[28.4%]. In 133 patients of acquired valvular disease, 124 valves were implanted and operative death of valvular disease was 12%. Finally the operative mortality was 9.6% in congenital anomaly, and 12.4% in acquired heart disease, overall mortality rate was 10.4%.

• Journal of Chest Surgery
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• v.16 no.1
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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.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.276-282
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• 1988

Surgery is now the usual mode of therapy in patients with severe valvular heart disease. Until recently, clinicians and pathologists attributed nearly all acquired valvular heart diseases to a rheumatic origin, except some obviously resulting from acute infection and syphilis. Although many clinicians and pathologists describe that the origin of aortic valvular disease is a nonrheumatic origin, we recognize the major origin of aortic valvular disease in Korea as a rheumatic origin. We excised 47 cardiac valves from valvular heart diseased patients and performed anatomical and pathological analysis for its origin and underlying pathology. The purpose of this article is to provide an update for the clinicians of evolving issues related to the pathology of valvular heart disease. But myxomatous origin and infective endocarditis valvulitis will not be covered in detail.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.115-121
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• 1993

Between March, 1988 and July, 1992, 114 patients underwent Open Heart Surgery under hypothermic cardiopulmonary bypass. There were 29 cases of congenital heart anomalies (25％), and 85 cases of acquired heart diseases (75％) consisting of 53 cases of valvular heart disease, 31 cases of ischemic heart disease, and a case of left atrial myxoma. The age distribution of 114 cases was 4 to 73 years, and mean age was 43 years old consisting of mean age of congenital heart disease 23, valvular heart disease 47, and ischemic heart disease 57 years old. Overall operative mortality was about 7.9％.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.59-66
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• 1984

After open heart surgery, the patient must be carefully observed and adequately managed for his survival. This report reviewed 10 cases of ventricular septal defect and 12 mitral valvular diseases as hemodynamics early after open heart surgery. For postoperative 24 hours, clinical status was evaluated for left atrial pressure, central venous pressure,DP[LAP-CVP], peak systolic pressure, heart rate, urine amount, and other clinical findings. Especially, on postoperative fourth hour, cardiac output was most decreased, when the changes of monitoring were compared with two groups with or without using cardiotonics. Finally, we concluded as followings; 1.Postoperatively, variation of CVP was noted in VSD, but mitral valvular disease was more variable change of LAP. 2.DP was 1.3\ulcorner.4 cmH2O in VSD, and 6.4\ulcorner.2 cmH2O in mitral valvular disease. 3.Parameter using cardiotonic was CVP in VSD, and LAP in mitral valvular disease.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.804-810
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• 1984

Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.65-74
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• 1983

Fifty cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Busan National University Hospital during 16 months from July, 1981 to October, 1982. The clinical data were analyzed and summerized as follows. 1. There were 34 cases (68%) of congenital anomalies and 16 cases (32%) of acquired heart diseases. Among the congenital cases, 27 were acyanotic and 7 were cyanotic. All of the acquired heat diseases, 16 cases were valvular diseases and they had valvular replacement surgery. 2. The age distribution of the congenital anomalies ranged from 6 to 27 years with mean age of 14.2 years, and the acquired heart diseases from 18 to 44 years mean age of 27.5 years. The difference of sex distribution was no significance. 3. The clinical minifestations in acyanotic congenital anomalies were exertional dyspnea (81.5%), recurrent respiratory infection (55.6%) and palpitation (22.2%), and in cyanotic congenital anomalies were exertional dyspnea (100%), syncope(57.1%) and growth retardation(57.1%), and in acquired heart diseases were dyspnea(100%), edema (62.5%) and general weakness (62.5%) 4. During the cardiopulmonary bypass, mild to moderate core cooling was performed and added topical cooling for more accurate myocardial preservation. 5. Two kinds of cardioplegic solution used in our institute were Bretschneider solution for the first 7 cases and mixed Harmann's solution 1 L with glucose 5gm, potassium chloride 26 mEq and sodium bicarbonate 24 mEq, making 376 mosmol/L and pH 8.3 at $25^{\circ}C$, for the rest 43 cases. 6. Various kinds of postoperative complications occurred in 14 cases (28%) and showed overall mortality 12%. The mortality along with each disease was 7.4% in congenital acyanotic cases, 42.9% in congenital cyanotic cases and 6.3% in acquired valvular diseases. 7. Pre-and postoperative diagnostic incompatibility was seen in 6 cases (12%). 8. The artificial valves used in the replacement surgery were lonescu-Shiley bovine xenograft in 6 cases and Carpentier-Edwards porcine xenograft in 10 cases.

• Journal of Chest Surgery
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• v.27 no.6
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• pp.460-471
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• 1994

Between Feb. 1990 and Aug. 1993, 180 cases of the open heart surgery were performed under cardiopulmonary bypass in the Department of Thoracic & Cardiovascular surgery, Gil General Hospital. There were 83 cases with congenital heart diseases [CHD] and 97 cases with acquired heart diseases [AHD]. The CHD consisted of 78 acyanotic[mortality: 3.8 %] and 5 cyanotic cases with heart anomaly[mortality:l case]. The AHD were 97 cases, which contained 53 valvular, 27 ischemic heart diseases, 10 aortic diseases, 5 cases with myxoma, 1 case with post-infarct VSD, and 1 case with removal of infected pacing wire in right ventricle. In the 53 valvular heart diseases, there were 45 cases with valve replacement[MVR 27, AVR 9,MVR + AVR 9] and 8 cases with valvuloplasty. The number of the implanted prosthetic valves were 53. In MVR, 25 St. Jude, 6 Sorin, 3 Carpentier-Edward and 2 Intact medical valves were used. In aortic position, 13 St. Jude, 3 Sorin and 1 Intact medical valves were applied. The operative mortality was 5.6 % [3/53]. The annuloplasty applying artificial ring was performed in 17 patients[4 cases associated with MVR] and the number of the implanted ring was 19, which included 14 Duran ring[10 mitral, 4 tricuspid] and 5 Carpentier ring [3 mitral, 22 tricuspid]. In the 27 ischemic heart diseases, there were 9 cases with left main coronary artery lesions, 7 one vessel, 5 two vessels, and 6 three vessels. Average number of anastomosis was 2.8 per patient. The operative mortality was 14.3 % [4/27]. Among the 10 patients with aortic diseases, 7 cases were aortic dissection[type A: 5, type B: 2] and 3 cases were descending thoracic aortic aneurysm. The operative morality occurred in 3 cases. The overall mortality and the operative mortality of congenital and acquired heart disease was 7.8 %, 4.8% and 10.4%, respectively.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.641-648
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• 1988

Between April 9, 1986 and September 2, 1987, 134 patients underwent open heart surgery with hypothermic cardiopulmonary bypass and cold blood cardioplegia. There were 65 patients[48.5%] of acyanotic congenital cardiac anomalies, 19 patients[14.2%] of cyanotic congenital cardiac anomalies, and 50 patients[37.3%] of acquired heart diseases, which included 49 valvular diseases and 1 myxoma. In 84 congenital cardiac anomalies, 44 patients were male and 40 patients were female ranged in age from 2 years to 57 years. In 50 acquired heart diseases, 18 patients were male and 32 patients were female ranged in age from 10 years to 65 years. The common congenital defects operated were VSD in acyanotic cardiac patients, and Tetralogy of Fallot in cyanotic cardiac patients. Among 50 acquired heart diseases, 49 patient underwent operation for cardiac valvular lesions. 33 patients had mitral valve replacement and 7 patients had aortic valve replacement. 1 patient underwent aortic valvuloplasty and 8 patients had double valve replacement. The operative mortality rate was 3.1%[2 out of 65 patients] in acyanotic cardiac patients, 5.3%[1 out of 17 patients] in cyanotic cardiac patients, and 12.0%[6 out of 50 patients] in acquired cardiac patients, with overall mortality rate of 6.7%[9 out of 134 patients].