• Journal of Chest Surgery
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• 제18권1호
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• pp.7-12
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• 1985

The frequency of intraventricular conduction disturbance [IVCD] following right ventriculotomy and right atriotomy approach for ventricular septal defect [VSD] closure was compared in various conditions. Of the 170 isolated VSD patients, 114 patients were repaired via right ventriculotomy and 56 patients were repaired via right atriotomy. The results were as follows; 1. The frequency of IVCD was 45.6% in right ventriculotomy, and 21.2% in right atriotomy group [P<0.01]. The frequency of IVCD following transverse ventriculotomy and vertical ventriculotomy was not significantly different. 2. The frequency of IVCD in subarterial VSD following right ventriculotomy and right atriotomy was not significantly different. But the frequency of IVCD in perimembranous VSD was 50.8% in right ventriculotomy and 27.5% in right atriotomy group [P<0.01]. 3. The frequency of IVCD was higher in groups with larger VSD and it was more significant in right ventriculotomy group. 4. The frequency of IVCD was higher in patch graft closure and it was more significant in right ventriculotomy group. 5. Overall frequency of IVCD was lower in right atriotomy than right ventriculotomy group.

• Journal of Chest Surgery
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• 제26권2호
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• pp.129-134
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• 1993

We compared postoperative results according to the different surgical approach in 180 cases of isolated ventricular septal defects operated at the department of Thoracic and Cardiovascular Surgery in Kyungpook University Hospital from January 1987 to December 1991. Of the 180 cases, 109 were males and 71 females, age ranging from 6 months to 15 years (mean: 5.6 years) and body weight ranging from 6 to 52㎏(mean : 20㎏). According to Soto's classification, perimembranous types were comprised of 119 cases (66％), doubly committed subarterial type 49 cases(27％), and muscular type 12 cases(7％). Patients were divided into three groups according to the incision methods: right atriotomy group (39％), right ventriculotomy group (47％), and pulmonary arteriotomy group (14％). The mean aortic cross clamp time was shorter in right atriotomy group (39 min.) than right ventriculotomy group (79min.) in the cases of large perimembranous VSD (P＜0.001). Spontanous recovery rate of cardiac rhythm after VSD closure was higher in right atriotomy group (51％) than right ventriculotomy group (32％) in the cases of perimembranous VSD (P＜0.05). The incidence of postoperative RBBB was 17.6％ with no statistical differences between right atriotomy group(17.9％) and right ventriculotomy group(19.2％). Overall mortality rate was 5.6％(10 cases) with no significant differences according to surgical approach.

• Journal of Chest Surgery
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• 제19권2호
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• pp.232-237
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• 1986

The intraventricular conduction disturbances have been documented after correction of ventricular septal defects by any surgical route but debated its etiology. And so the frequency of conduction disturbances following right ventriculotomy, right atriotomy and pulmonary arteriotomy for closure of ventricular septal defects was compared in various conditions. The present series consists of 218 patients with ventricular septal defects. They had the surgical repair at the Seoul National University Hospital from January 1983 to October 1984. Conduction disturbances were studied with conventional 12 leads electrocardiogram. Of the 218 VSD`s 139 patients were repaired via vertical right ventriculotomy, 45 patients via right atriotomy, 34 patients via pulmonary arteriotomy. 1] Of 218 patients the frequency of RBBB was 26.1% and the frequency of RBBB + LAH was 6.0%. 2] There is no statistical difference between right ventriculotomy group [30.2%] and right atriotomy group [24.4%]. But there is significant difference between right ventriculotomy group and pulmonary arteriotomy group [11.8%] [P<0.05]. 3] In respect to anatomical classification by Kirklin`s method, the frequency of RBBB was higher in type II [32.1%] than in type I [14.9%]. [P<0.05] But in each anatomical type, there is no influence of the various surgical approach on the incidence of postoperative RBBB. 4] The frequency of RBBB was 31.8% in patch closure group and 14.3% in direct closure group. [P<0.05] Although the result suggests that there is no significant difference in various surgical approaches on the incidence of postoperative conduction disturbances, it may be reduced by a new-ventricular approach or a limited incision at right ventricular outflow tract in right ventricular approach.

• Journal of Chest Surgery
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• 제20권2호
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• pp.411-415
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• 1987

We have experienced a rare case of traumatic ventricular septal defect caused by fall down injury. The patient suffered from congestive heart failure after trauma and represented new developing typical murmur. Cardiac catheterization revealed a large left-to-right shunt at the ventricular level and a 4.4:1 ratio of pulmonary to systemic flow. Left ventricular angiogram also showed ventricular septal defect low in the muscular septum. At operation, the right ventricle and pulmonary artery were found to be moderately dilated. A marked systolic thrill was palpable over the right ventricle near the apex. Through a small left ventriculotomy an oval defect, 2x.3 cm with a firm scarred margin, was found in the lower muscular ventricular septum. This defect was repaired using Dacron patch and ventriculotomy was closed with long strip of Teflon felt. Postoperative course was uneventful and discharged in good condition.

• Journal of Chest Surgery
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• 제26권10호
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• pp.804-807
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• 1993

We experienced a case of cardiac rhabdomyoma,which is incidentally found at perinatally checked sonography.The cardiac rhabdomyoma is the most common cardiac tumor of infants & children, and second most common cardiac tumor of all age groups, which is usually multiple in the case of 90%, invariably involves the ventricles affecting the left & right side equally. In more than fifty percents, the size of cardiac rhabdomyoma is enough large to threatening the life of newborn within 24hrs of birth. Cardiac rabdomyoma is actually a myocardial harmatoma rather than a true neoplasm,because of the finding of complete lack of mitotic activities. Recently,more advanved instruments such as ultrasonography or echocardiography allows to us early detection & surgical intervention of this tumor. In our case, the tumor was found at both ventricles, which occupied nearly total chambers of both ventricles. The patient was operated on 3 day after birth. The operation was removal of the tumor through left ventriculotomy and right ventriculotomy respectively. He expired in the immediate postoperative period due to low cardiac output syndrome, despite of massive inotropic agents.

• Journal of Chest Surgery
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• 제43권1호
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• pp.63-66
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• 2010

심실중격결손증 중 심첨부 근육형은 드문 심기형이다. 특히 소아에서는 시야확보가 어려워 심방실을 통한 접근은 치료가 힘들다. 좌심실을 통한 치료는 장기적으로 좌심실 기능부전을 가져온다. 혈관 중재술을 통한 치료는 아직 만족스런 결과를 얻기 힘들며 어린 소아에서는 가능하지도 않다. 심첨부 근육형 심실중격결손증의 수술 시 우심첨부 절개술이 시야확보가 용이하며 심실기능에 손상을 주지 않고 안전하고 성공적인 교정술이 가능하였음을 보고한다.

• Journal of Chest Surgery
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• 제24권9호
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• pp.913-917
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• 1991

Ventricular septal defect complicating myocardial infarction is rare but fatal condition which requires early surgical intervention before end-organ failure ensues from cardiogenic shock. Since the first successful repair by Cooley et al in 1956, surgical skills and strategies were developed and modified to a great extent, and we adopted the new repair technique in our case which stresses that minimal or no part of the infarcted septum and left ventricular wall be resected. This technique obviates the need to resect the infarcted part of the septum and prevents recurrence of an even larger VSD, and provides adequate size and shape of the left ventricle after of transinfarction left ventriculotomy.

• Journal of Chest Surgery
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• 제17권2호
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• pp.184-188
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• 1984

As OHS is prevalent on whole world, LV-RA shunts once thought as quite rare congenital heart disease are reported frequently. Two cases of LV-RA shunts were operated at N.M.C. in 1983: One of them combined VSD, the other membranous ventricular septal aneurysm protruding into right atrial chamber. In case 1, which was diagnosed correctly, right atriotomy was enough to close the defect under ECC, but in case 2, which was misdiagnosed as ASD preoperatively, atriotomy was added to ventriculotomy. The LV-RA defects were closed by U-shaped direct suture with Teflon felt pledget. Postoperative course was uneventful in both of them.

• Journal of Chest Surgery
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• 제12권2호
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• pp.113-118
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• 1979

The muscular variety of congenital ventricular septal defect [Type IV VSD] comprises from 2 to 18% of the total number of patients and has multiple defects. It is difficult to diagnose by usual angiographic study. Out of 116 cases of isolated ventricular septal defects repaired at this hospital in 20 years period from 1959 and to May 8, 1979, 2 cases had muscular defect which was treated through vertical right ventriculotomy without any problems. Single defect was found in both cases and in one case PDA was associated with Type IV VSD.

• Journal of Chest Surgery
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• 제18권4호
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• pp.589-597
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• 1985

Congenitally corrected transposition of great arteries is a rare congenital heart anomaly. We experienced two case of corrected transposition of great arteries, one [S,L,L] and one [I, D,D] associated with patent foramen ovale, ventricular septal defect and pulmonary stenosis. The patent foramen ovales were closed directly under right atriotomy, the ventricular septal defects were closed with Dacron patch under morphological left ventriculotomy and the pulmonary valvular and subvalvular stenosis were corrected under pulmonary arteriotomy. The postoperatively course was uneventful in case I, the permanent pacemaker was implanted in case ll.