• Title/Summary/Keyword: Ventricles

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Cor triatriatum with left superior vena cava[Report of a case] (좌측 상공정맥을 동반한 삼심방증 1례 보고)

  • 박병순
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.293-298
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    • 1985
  • Cor triatriatum is a rare congenital malformation of the heart in which a septum stretches in a transverse plane through the left atrium, thus creates two left atrial subchambers. The upper one connects with the pulmonary veins, and the lower connects with the left ventricles. Due to the rarity of, and difficulty in diagnosing car triatriatum, data on the surgery of the disease are of necessity and very limited. A case of cor triatriatum combined with atrial septal defect and persistent left superior vena cava was experienced in November, 1984 in Chonnam University Medical School. There was a transverse septum in the left atrium below atrial septal defect, all pulmonary veins were drained into the upper chamber of the left atrium which connected with the right atrium via atrial septal defect and the lower chamber via an oval opening[8mm] in the abnormal septum and the lower chamber was connected with the left atrial appendage, and the left ventricle via mitral valve. There was persistent left superior vena cava drained to left atrium and coronary sinus. The abnormal transverse septum within the left atrium was completely excised and the atrial septal defect was repaired with Woven Dacron patch. The post-operative course was not eventful and the patient was discharged to home with good result on the 15th postoperative day, and has been in good condition upto now.

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Left Ventricular Hypertrophy and Prelude to Hypertensive Cardiovascular Diseases: from the Pediatric Cardiologist's Point of View (좌심실 비대와 고혈압성 심혈관 합병증: 소아 심장 의사의 관점)

  • Cho, Min-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.14-21
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    • 2011
  • Although left Left ventricular hypertrophy (LVH) is not only an adaptive response of the heart to increased cardiac workload in hypertension, it surelybut also is the most potent risk factor of overt cardiovascular complications such as coronary heart disease, heart failure, arrhythmia and stroke in the hypertensive population. Also it has become generally accepted that subclinical cardiovascular disease begins in childhood and LVH is the most readily assessed marker for that. As LVH can be seen in children and adolescents with even mild blood pressure elevation with the reported prevalence of 10 to 47%, aggressive antihypertensive treatment is critical in preventing the development of hypertensive heart disease in that those cases.

Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report (삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보)

  • Kim, Chi-Gyeong;Na, Beom-Hwan;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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A Clinical Study of Bidirectional Cavopulmonary Shunt (양방향성 상대정맥-폐동맥 단락술의 임상적 연구)

  • 지현근
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.759-765
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    • 1995
  • We reviewed our experiences on 33 patients who underwent a bidirectional cavopulmonary shunt[BCPS from February 1992 to July 1994. There were 19 male an 14 female patients, and their weight ranged from 4.4 to 13.3 Kg[mean weight 8.4 $\pm$2.9 Kg . The age ranged from 2 to 55 months [mean age 16.7 $\pm$15.5 months . Their diagnosis included single ventricle group in 16, unbalanced ventricles in 8 whose associated anomalies were double outlet right ventricle, transposition of great arteries and total anomalous pulmonary venous return, tricuspid atresia in 7, hypoplastic left heart syndrome in 1 who underwent a Norwood procedure and double outlet right ventricle with pulmonic stenosis and tricuspid stenosis in 1 who underwent biventricular repair. Among them 10 patients had received other palliative operation before [Norwood procedure 1, pulmonary artery banding 3, modified Blalock-Taussig shunt 6 . The BCPS operations were performed under the cardiopulmonary bypass. 16 patients underwent unilateral BCPS and 17 patients who had bilateral SVC underwent bilateral BCPS. Three patients whose associated anomalies were interruption of IVC underwent total cavopulmonary shunt. There were 5 operative deaths [mortality rate 15.1 % and 2 late deaths. The risk factor for the operation was high mean pulmonary artery pressure [p value<0.05 . The survivors showed good postoperative course and their postoperative oxygen saturation was increased significantly compared to that of preoperative status[p value<0.05 .Conclusively, BCPS operation is effective and safe palliative procedure for the many cyanotic complex congenital anomalies with decreased pulmonary blood flow especialy for the patients who have the high risk factors for Fontan operations.

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The Role of Aquaporin-4 in Cerebral Edema Formation after Focal Cerebral Ischemia in Rats

  • Song, Young-Jin;Bae, Hae-Rahn;Ha, Se-Un;Huh, Jae-Taeck
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.30-38
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    • 2007
  • Objective : To elucidate the role of aquaporin-4[AQP4] in cerebral edema formation, we studied the expression and subcellular localization of AQP4 in astrocytes after focal cerebral ischemia. Methods : Cerebral ischemia were induced by permanent middle cerebral artery[MCA] occlusion in rats and estimated by the discoloration after triphenyltetrazolium chloride[TTC] immersion. Change of AQP4 expression were evaluated using western blot. Localization of AQP4 was assessed by confocal microscopy and its interaction with ${\alpha}-syntrophin$ was analyzed by immunoprecipitation. Results : After right MCA occlusion, the size of infarct and number of apoptotic cells increased with time. The ratio of GluR1/GluR2 expression also increased during ischemia. The polarized localization of AQP4 in the endfeet of astrocytes contacting with ventricles, vessels and pia mater was changed into the diffuse distribution in cytoplasm. The interactions of AQP4 and Kir with ${\alpha}-syntrophin$, an adaptor of dystrophin complex, were disrupted by cerebral ischemia. Conclusion : The deranged spatial buffering function of astrocytes due to mislocalized AQP4/Kir4.1 channel as well as increased assembly of $Ca^{2+}$ permeable AMPA receptors might contribute to the development of edema formation and the excitotoxic neuronal cell death during ischemia.

Depression masquerading as chest pain in a patient with Wolff Parkinson White syndrome

  • Madabushi, Rajashree;Agarwal, Anil;Tewari, Saipriya;Gautam, Sujeet KS;Khuba, Sandeep
    • The Korean Journal of Pain
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    • v.29 no.4
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    • pp.262-265
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    • 2016
  • Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology.

Adult Dirofilaria immitis in the Aorta of a Dog (개에서 심장사상충증의 대동맥 이소기생)

  • Wang, Ji-Hwan;Choi, Ho-Jung;Lee, Young-Won;Park, Ki-Tae;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.303-306
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    • 2008
  • Unknown age, spayed female mixed dog was presented with a severe lethargy. Radiography, ultrasonography, and blood screen test were performed to make a diagnosis. There were no specific radiographic findings. On the ultrasonography, small amount of ascites was found around gallbladder and hepatic vein was dilated approximately 6.1 mm. Blood screen test revealed a severe anemia. Result of heartworm ELISA kit was positive. At necropsy, parasites were in the left atrium, right ventricles, aorta, pulmonary artery, right renal artery.

Massive Thromboembolism Owing to the Left Ventricular Thrombus Associated with the Hypereosinophilic Syndrome

  • Kim, Ji Seong;Park, Samina;Kim, Hyung-Kwan;Jeon, Yun-Seok;Min, Seung-Kee;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.478-482
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    • 2014
  • A 39-year-old man presented with cough, chest discomfort, and weight loss. On the basis of the patient history and laboratory findings, he was diagnosed with the hypereosinophilic syndrome. Transthoracic echocardiography revealed a large thrombus in the left ventricle. Medical treatment with anticoagulation and immunosuppression was commenced immediately. Fourteen days after the initial diagnosis, the patient presented with acute pain in his right leg. Computed tomographic angiogram showed embolic occlusion of the infrarenal abdominal aorta and bilateral iliac (including common, external, and internal iliac) arteries. Emergent thromboembolectomy and left ventricular thrombectomy were performed. The postoperative course was uneventful, and the patient has undergone follow-up for 2 months without any evidence of recurrence of thromboembolism.

A Life-Threatening Bronchogenic Cyst

  • Han, Sung Joon;Cho, Hyun Jin;Kang, Min-Woong;Yu, Jae Hyeon;Na, Myung Hoon;Kang, Shin Kwang
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.69-71
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    • 2018
  • A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.

Numerical Study of Effect of counter-pulsation on Hemodynamic Response in the ECLS (체외생명구조장치에서 역박동 방법이 혈류역학 응답에 미치는 영향에 대한 수치적 연구)

  • Kim, In-Su;Lim, Ki-Moo;Choi, Seoung-Wook;Jun, Hyung-Min;Shim, Eun-Bo
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.1660-1664
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    • 2008
  • Extra-corporeal Life Support System (ECLS) is the device used in emergency cases to substitute a extracorporeal circulation in open heart surgery, cardiac arrest or in acute cardiopulmonary failure. To obtain the effect of counter-pulsation on hemodynamic response in the ECLS quantitatively, we developed cardiovascular model which consists of 12 compartment model of heldt et al. and 3 compartment model of Schreiner et al. based on windkessel approximation. We compared coronary perfusion, arterial pulse pressure, cardiac output, and left ventricular pressure-volume diagram according to flow configuration such as counter-pulsation, copulsation, and continous flow. When counter-pulsation was applied, 5% higher coronary perfusion, 26% lower pulse pressure, and 2% higher cardiac output than copulsation condition were calculated. We conclude that counter-pulsation configuration in the ECLS is hemodynamically more stable than copulsation and influences the positive effect to recover ventricles.

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