• Title/Summary/Keyword: Vena cava superior

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Analysis of Ventricular Septal Defect (심실중격결손증의 외과적 고찰)

  • 신제균
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.151-156
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    • 1985
  • A clinical analysis was done on 50 cases of ventricular septal defect, operated from April 1981 to March 1984 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. Among 50 cases, 34 cases were males and 16 cases were females. Their age ranged from 1 to 26 years and the mean age was 9.7 years. The main symptoms at admission were frequent upper respiratory infection [50%], exertional dyspnea [42%] and palpitation [34%]. In anatomical classification by Kirklin, type I constituted 20%, type II 76%, type IV 4%. Associated congenital cardiac lesions were pulmonic stenosis [6 cases], patent foramen ovale [5 cases], aortic insufficiency [3 cases] and persistent left superior vena cava [1 case]. When a normal electrocardiogram pattern was present, Qp/Qs, Rp/Rs and pulmonary artery systolic pressure and Pp/Ps were relatively low. Among cases of above 1 cm2/M2 BSA in size of defect, Pp/Ps and pulmonary artery systolic pressure were increased than the cases of below 1 cm2/M2 BSA [P=0.01]. The postoperative right bundle branch block was occurred in 21 cases [75%] among 28 cases of right ventriculotomy approach. The operative mortality was 2% [1 case] among 50 cases and complication rate was 14% [7 cases].

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Palliative Radiotherapy (증상완화목적의 방사선치료)

  • Lee, Chang-Geol
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.1-4
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    • 2009
  • The aim of palliative radiotherapy (RT) is to control cancer-related local symptoms with minimal radiation reaction. About one third of all radiation treatments are given with palliative intent. Indications for RT in symptom palliation are as follows: Pain from bone metastasis, pressure symptom from brain and spinal cord, obstruction of bronchus, esophagus, superior vena cava and malignant cancer bleeding from bronchus, urinary tract, uterine cervix and rectum. In hospice palliative care, RT is very effective for symptom palliation and improvement of quality of life without influence on survival.

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Analysis of 182 cases of the ventricular septal defect (심실 중격 결손증 수술 치험 182례에 대한 임상적 고찰)

  • 김철훈
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.871-880
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    • 1990
  • We clinically evaluated 182 cases of the ventricular septal defect that we experienced at the Department of Thoracic and Cardiovascular Surgery, Maryknoll Hospital from March 1986 through June 1990. Of the 182 cases, 95 patients were male and 87 patients were female. Their age distribution ranged from 8 month to 37 years and their mean age was 8.1 years. The most common chief complaint was frequent upper respiratory infection. Among them, 46 patients had associated cardiac anomalies, which were subdivided as follow; 9 cases of patent foramen ovale, 8 cases of infundibular stenosis, 6 cases of pulmonary valvular stenosis, 4 cases of left superior vena cava, and etc. The most common preoperative abnormal EKG finding was left ventricular hypertrophy in 22 cases. Ninety-three patients[51.1%] underwent simple closure of the VSD and the rest[48.0%] underwent patch closure. In anatomical classification by Kirklin type I constituted 24.2%; type II, 74.8%, type III, 0.7%, and the mixed type of type I and II, 0.5%, The important postoperative EKG changes were noted in 38 cases[20.9%], 18 cases of which were incomplete right bundle branch block. Thirty-three patients[18.1%] developed minor and major complications, and five patients died, overall operative mortality being 2.7%.

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Primary Intracardiac Hemangioma -1 case report- (원발성 심장 혈관종 -1례 보고-)

  • 임상현;장병철;이문형;조상호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.735-738
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    • 1998
  • Intracardiac hemangiomas are very rare primary cardiac tumor and there have been at least 37 reports of surgically resected cardiac hemangiomas. Most cardiac hemangiomas are asymptomatic. In symptomatic patients, symptoms are related to the location of tumor and outflow tract obstruction or obstruction of inferior and/or superior vena cava. Sudden death may occur due to conduction disturbances. The principle of treatment is surgical resection, and the prognosis is dependent upon the size, location and multiplicity of the tumor. A 40 year old man was admitted due to chest contusion and was found to have an intracardiac mass during echocardiographic examination. The mass was successfully removed and pathologic examination showed benign hemangioma. The patient was recovered uneventfully in postoperative period and was followed up for 1 year without evidence of recurrence.

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Patent ductus arteriosus associated with cardiovascular anomalies and severe pulmonary hypertension: Preoperative hemodynamics and surgical observation in 51 patients. (개방성동맥관의 술전혈역학적상태와 외과적치료에 대하여)

  • 서경필
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.85-92
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    • 1974
  • During the years 1959 to 1974, 99 patients with patent ductus arteriosus were admitted to National University Hospital. These includes 5 patients with additional cardiovascular and 5 patients with severe pulmonary hypertension. All were operated upon except three refused operation. In all instances, the diagnosis was made by history and physical, roentgenological and electrographic examinations. In addition, in 53 patients, special diagnostic procedures were carried out either for diagnosis or for evaluation of pulmonary hypertension and associated cardiovascular anomalies. Right cardiac catheterization was resorted to in 51 patients. In one of these patients catheterization was incorrectly interpreted [ventricular septal defect]. Retrograde aortogram was performed in two patients. In both cases the ductus itself was visualized on the x-ray film. An additional vascular anomaly, namely the persistent left superior vena cava, was confirmed by retrograde angiogram in one of them. In 5 cases the pulmonary arterial pressure was elevated well over 80 mmHg. In these instances,the operative mortality was 80% [4 out of 5 patients]. The management of patent ductus arteriosus when associated with severe pulmonary hypertension. and/or other cardiac anomalies is controversial. Opinions differ as to how to close the ductus and to repair the cardiac anomalies as well as to whether a one-staged or two-staged procedure should be resorted to. The author is of the that each case must be evaluated individually before any specific surgical treatment is ou.tlined. The literature on the subject is reviewed in this paper.

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Surgical Treatment of Cor Triatriatum (삼방심의 외과적 치료 -수술치험 24례-)

  • Kim, Yeong-Tae;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.259-265
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    • 1994
  • Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

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Subclavian Vein Thrombotic Occlusion Secondary to Hemodialysis Catheterization (혈액투석 카테터에 의한 쇄골하정맥 혈전성 폐쇄증의 수술치험 1례)

  • Kim, Kwan-Mien;Chee, Hyun-Keun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.73-77
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    • 1995
  • We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

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A Solid Anterior Mediastinal Mass (전종격동 고형성 종괴)

  • You, Young-Kyu;Ahn, Young-Soo;Rha, Dong-Jib;Kim, Do-Jin;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.747-750
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    • 1993
  • A 51-year-old male was admitted due to mediastinal mass. Chest PA showed a $4{\times}5$ cm sized round mass on right lower paratracheal area. The chest computerized tomogram showed cystic mass located between superior vena cava and trachea. This cystic mass was composed of variable internal architecture with Hounsfield unit(HU) from -44.4 to +25.5. The resected cystic mass revealed ectodermal, mesodermal, and endodermal structures. We report a case of anterior mediastinal cystic teratoma confirmed by open thoracotomy.

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A Case of Endobronchial Urokinase for Relief of Bronchial Obstruction by Blood Clots (좌측 주기관지 피덩이를 우로키나아제 기관내 국소주입으로 제거한 1예)

  • Choi, Jung;Lee, Sa Ra;Kwak, Choong Hwan;Pae, Hyun Hye
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.297-302
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    • 2003
  • Background : Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occurred.

Placement of a Subclavian Tunneled Hemodialysis Catheter with the Patient's Arm Raised May Reduce the Risk of Complications: Two Cases Report (쇄골하정맥을 통한 매립혈액투석카테터 삽입시 상지 거상법의 유용성: 2예 보고)

  • Jimin Yoo;Dong Jae Shim;Doyoung Kim;Seung Hwan Baek;Chang Suk Park;Jeong Whee Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.477-482
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    • 2023
  • The subclavian vein is an uncommon route for tunneled hemodialysis catheter (tHDC) placement because of its potency for future dialysis access. However, when favored access routes have been exhausted because of repeated catheterization or limited life expectancy, the subclavian vein can be used for urgent hemodialysis. A subclavian catheterization has a technical problem. The subclavian vein often forms a right angle with the vena cava, and advancing stiff peel-away sheath can cause a vascular injury. However, raising the patient's arm can alter the position of the guidewire and, therefore, change the angle of the vein favorable for tHDC placement. Herein, we report two patients who underwent subclavian catheterization; one experienced an injury to the superior vena cava after undergoing the conventional procedure, whereas the other patient with raised arm during the catheterization procedure had safe catheter placement.