• Journal of Chest Surgery
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• 제56권6호
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• pp.456-459
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• 2023

Penetrating chest trauma may result in significant intracardiac injury. A traumatic ventricular septal defect is a rare complication that requires surgical management, particularly if heart failure ensues. We report a case of delayed repair of an outlet-type ventricular septal defect and perforation of the aortic and pulmonary valve leaflets following a stab wound. This report highlights diagnostic and surgical considerations and also presents an opportunity to review the conotruncal anatomy, which may be relatively unfamiliar to many adult cardiac surgeons.

• Journal of Chest Surgery
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• 제12권1호
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Journal of Chest Surgery
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• 제18권2호
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• pp.157-164
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• 1985

Our series comprised 68 patients of ventricular septal defect who underwent open heart surgery at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from January, 1980 to September, 1984. Of the 68 patients, 47 patients were male [69.1%] and 21 patients were female [30.9%]. Their age ranged from 3 years to 27 years, and the mean age was 10.1 years. Upon Kirklin`s anatomical classification, type I constituted 29.4%, type II 69.1%, type III 1.5%, and type IV 1%. The cardiac anomalies associated with ventricular septal defect were 21 in all; 5 PS, 4 Aortic insufficiency, 2 ASD, 4 Patent foramen ovale, and 1 Patent ductus arteriosus. Upon the data of cardiac catheterization, most of the patients had Qp/Qs of 1.4-1.8, Pp/Ps of 0.25 or less and Rp/Rs of 0.25 or less. There was no significant correlationship between the rate of operative complication & mortality and the increase of Qp/Qs, Pp/Ps, and Rp/Rs. The values of Qp/Qs, Pp/Ps and Rp/Rs were correspondingly increased according to increment of the defect size. 20 patients developed postoperative complications, such as 4 acute respiratory failure, 3 reexploration due to massive bleeding, 1 low cardiac output, 1 patch detachment, and 2 air embolism. Operative mortality rate was 7.4% [5 cases] among 68 patients.

• Clinical and Experimental Pediatrics
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• 제54권2호
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• pp.86-89
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• 2011

Traumatic ventricular septal defect (VSD) resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

• Journal of Chest Surgery
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• 제35권8호
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• pp.580-583
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• 2002

배경: 선천성 심장병 환자들의 교정 수술 후 정확한 형태학적 혹은 혈역학적변화를 아는 것이 술 후 추가적으로 내과적 혹은 외과적인 치료가 필요로 하는가를 결성하는데 매우 중요하다. 심실중격결손 봉합술 후 잔류단락의 발생 빈도와 소량의 포편 주위 단락의 변화를 조사하였다. 대상 및 방법: 1995년 3월부터 1999년 12월까지 영남대학교의료원 흉부외과에서 영아기에 단순 심실중격결손으로 포편봉합술을 시행한 43명의 환자들을 대상으로 수술 후 심초음파를 시행하여 잔류단락 유무를 조사하였다. 결과: 전체 43례의 환자 중 수술 직후 잔류단락이 관찰된 환자는 11례로 26%에서 잔류단락이 발견되었으나 혈역학적으로 유의한 단락으로 재수술을 시행한 경우는 없었다. 단락의 발생빈도는 심실중격결손의 형태와 봉합을 위해 사용한 포편의 종류와는 무관하였다. 잔류단락이 발견된 환자 중 9명에서 단락의 소실을 확인할 수 있었으며 2례는 추적관찰에서 탈락하였다. 단락이 소실된 9명의 환자들의 단락이 마지막 확인된 기간은 평균 $4.2{\pm}3.6$개월 이었다. 결론: 수술 직후 포편 주위의 잔류단락은 종종 발견될 수 있으며 혈역학적으로 유의하지 않은 잔류단락은 대부분 6개월 이내에 자연 소실되었다.

• Journal of Chest Surgery
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• 제44권2호
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• pp.183-185
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• 2011

Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonateswith very low birth weight (${\leq}$1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.

• Journal of Chest Surgery
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• 제49권5호
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• pp.374-378
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• 2016

A multistage plan and multidisciplinary approach are the keys to successful repair in patients with pulmonary atresia (PA) with ventricular septal defect (VSD) and major aortopulmonary collateral arteries (MAPCAs). In this article, we present a multidisciplinary approach adopted to treat a patient with PA with VSD and MAPCAs associated with left pulmonary artery interruption.

• Journal of Chest Surgery
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• 제23권1호
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• pp.41-48
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• 1990

Thirteen patients underwent repair of atrioventricular septal defect [AVSD] from January 1980 to July 1989 at Kyungpook National University Hospital. Two patients had complete AVSD [Rastelli type A] and eleven patients had partial AVSD [ostium primum atrial septal defect and cleft of anterior mitral leaflet]. In all the patients of partial AVSD, atrial septal defect was closed with Dacron patch and the mitral cleft was approximated with interrupted simple sutures. In one patient of complete AVSD, one patch technique was used to close the atrial and ventricular septal defect, and in the other patient of complete AVSD, two patch technique was used. In six patients, there were associated anomalies; four had isolated ostium secundum ASD, two had patent foramen ovale. Postoperative complete A-V block was noted in a patient of partial AVSD, but it was returned to 1st degree A-V block 30 months later and in another case of partial AVSD, severe congestive heart failure [NYHA functional class IV] due to residual mitral insufficiency was developed postoperatively, but this patient was recovered to the state of functional class I after receiving mitral valve replacement. There was one hospital death [8 %] resulting from low cardiac output.

• Journal of Chest Surgery
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• 제36권9호
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• pp.633-637
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• 2003

일시적인 삼첨판 절개법은 좋은 시야를 제공하고 심실을 열지 않고 심실중격결손의 폐쇄수술을 할 수 있다. 그러나 대부분의 외과의는 삼첨판막의 폐쇄부전의 염려로 주저하게 된다. 특히 최근의 교과서에서는 일시적인 삼첨판 절개법은 장기성적의 발표가 예외적인 방법으로만 기술되어 있고 더 이상의 분석이나 기술이 되어 있지 않다. 대상 및 방법: 1985년부터 1994년까지 수술받은 11명으로부터 술 전의 자료, 술 후 경과, 최근 심초음파와 심전도를 토대로 후향적 연구를 시행하였다. 결과: 심초음파에서 삼첨판폐쇄부전은 없는 경우가 9명, 미세한(trivial) 경우가 2명이었고, 심전도상 의미있는 심전도블록은 없었다. 결론: 삼첨판 절개법은 심실중격결손의 폐쇄수술을 시행하는 데 안전하며 향상된 시야를 제공하는 데 효과적인 방법이며, 삼첨판 이상이나 심전도상에 나쁜 영향을 끼치지 않는다.

• Journal of Chest Surgery
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• 제37권10호
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• pp.856-860
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• 2004

심내기형을 동반한 대동맥궁 단절은 매우 중한 자연경과를 갖고 있는 희귀한 선천성 심장 기형이다. 식도 폐쇄증과 기관 식도루를 동반한 심첨부 근육성 심실 중격 결손과 대동맥궁 단절을 생후 3일된 체중 2.6 kg의 신생아에서 단계적 수술법으로 치료한 경험을 보고한다. 1차 수술로서 우측 개흉술을 통한 식도 폐쇄증의 교정과 함께 좌측 개흉술에 의한 대동맥궁 광범위 단-단 문합술 및 폐동맥 교약술을 시행하였다. 1차 수술 후 87일째 정중 흉골 절개를 통해 심첨부 근육성 심실 중격 결손을 폐쇄하였다. 심실 중격 결손 폐쇄 전 유문부 근육절개술, 대동맥 전방고정술, 대동맥 풍선확장술 등의 추가 시술이 필요하였다. 최종 수술 후 3개월째 양호한 추적 결과를 경험하였기에 보고하는 바이다.