• Journal of Chest Surgery
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• v.13 no.4
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• pp.405-413
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• 1980

A total of 63 patients [42 males and 21 females] underwent multiple valve replacement with artificial valves between January 1975 and August 1980 at Seoul National University Hospital. There were 38 patients with aortic and mitral valve replacement, 22 with mitral and tricuspid, and 3 with aortic, mitral and tricuspid valve replacement. The valve lesions varied from trivial to severe and most aortic and mitral valves had mixed stenosis and insufficiency, while tricuspid valves had only insufficiency. The patients were severely symptomatic in majority of the cases, and belonged to the Classes III and IV [III:45, IV:16] of the NYHA functional criteria. Hemodynamic studies were performed on all the patients. The mean pulmonary wedge pressure was remarkably increased to 19.8 mmHg in aortic and mitral valve lesions and 18.0 mmHg in mitral and tricuspid valve lesions. The mean pulmonary arterial pressure was also increased, while the cardiac index was reduced. In 1977, the average perfusion time was 245.5 minutes for aortic and mitral valve replacement and 181.6 minutes for mitral and tricuspid valve replacement. It has progressively declined to 169.2 minutes for aortic and mitral valve replacement and 123 minutes for mitral and tricuspid valve replacement in 1980. The average period of aortic occlusion also declined after the use of cardioplegic solution. Twenty deaths occurred among the 63 patients operated upon, an overall mortality rate of 30.8%. The operative mortality has declined with successive year from a level of 66.7% before 1977 to 21.1% in 1980. Fourteen patients suffered from a list of postoperative complications, which eventually resolved with adequate treatment. All the survivors were enjoying the levels of daily life activities greater than those existing before the operation.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.233-237
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• 2007

A 10-month-old intact male Labrador Retriever dog was referred with the primary complaint of exercise intolerance, especially after vigorous exercise. Physical examination revealed split S1 and grade III/VI diastolic regurgitant murmur at the left apex and base, respectively. ECG finding was normal sinus rhythm at rest, but supraventricular tachycardia with bundle branch blocks after exercise. Thoracic radiography revealed dilated ascending aorta with normal range of cardiac silhouette (VHS 10.2). Echocardiography revealed abnormal valvular structures just above the aortic valvular cusps causing aortic regurgitation with a reduction of left ventricular ejection fraction (LVEF). Based on those findings, the case was diagnosed as congenital aortic regurgitation caused by abnormal valvular structures. The dog was managed with diltiazem and exercise restriction. This is a rare case of aortic deformity in dogs.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1036-1041
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• 1994

Emergency operation was performed in a patient with severe aortic insufficiency caused by type A acute aortic dissection with aberrant high take-off origin of single coronary artery. The single coronary artery was found to arise from an unusual position high in the ascending aorta. Dissection was begun in the aortic root and involved the single coronary ostium. Valve competance was restored by resuspension of the commissures. the false lumen was obliterated with strips of Teflon felt and surgical glue. The aortic tissues were firmly reinforced and sutured. The proximal aortic stump was anatomically reconstructed, and fortunately the aortic valve was preserved and coronary reimplantation avoided. The patient was discharged at postoperative 13 days without specific complications. Postoperative course during the 18 months follow-up was uneventful.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.353-356
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• 2013

A 74-year-old man was diagnosed with aortic root aneurysm and two-vessel coronary disease. Echocardiographic assessment revealed an enlarged sinus of Valsalva 60 mm in diameter with mild aortic regurgitation. Florida sleeve repair was performed using a vascular graft combined with coronary artery bypass grafting. The postoperative course was uncomplicated and follow-up echocardiographic evaluations showed an aortic root diameter of 38 mm without aortic insufficiency up to 1 year after surgery.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1084-1087
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• 1989

Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.

• Korean Circulation Journal
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• v.48 no.11
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• pp.964-973
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• 2018

The burden of valvular heart disease (VHD) is increasing with age, and the elderly patients with moderate or severe VHD are notably common. When to operate in asymptomatic patients with VHD remains controversial. The controversy is whether early surgical intervention should be preferred, or a watchful waiting approach should be followed. The beneficial effects of early surgery should be balanced against operative mortality and long-term results. Indications of early surgery in each of the VHD will be discussed in this review on the basis of the latest American and European guidelines.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.455-461
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• 1980

This is one case report of surgically treated ventricular septal defect [VSD] with aortic insufficiency [AI] at department of thoracic and cardiovascular surgery, Hanyang university hospital. He had had progressive dyspnea on exertion and palpitation for 3 years prior to admission to our hospital. On examination, the blood pressure was 120/0 mmHg and the pulse rate 88 times/min. Bobbing motion of the head, Water hammer pulse, Corringan`s pulse, Quincke`s pulse and to and fro murmur were present. The heart murmur was consistent with .VSD and AI. Cardiomegaly was seen in chest X-ray. EKG, echocardiogram, aortogram and right heart catheterization was performed. On Sep. 9, 1980, open heart surgery was performed under the impression of VSD with AI. Infracrystal type VSD measuring 2 x 1.5 cm in diameter was closed with Teflon patch graft through the transverse ventriculotomy. AI was due to prolapsed, elongated right coronary and noncoronary cusp, especially noncoronary cusp. The prolapsed, elongated aortic leaflets were plicated by placing three 8-figure sutures between the free edge and the base of the leaflet [Frater`s method] through a transverse aortotomy. Postoperatively, he made an uneventful recovery, his blood pressure was 120/70 mmHg and showed no signs AI or residual shunt at discharge.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.238-242
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• 1982

The incidence of annuloaortic ectasia has known rare, and approximately 5-10% of aortic regurgitation. The patient was 44 years old male who complained exertional dyspnea and left anterior chest pain. He had done Lt. side 2 stage thoracoplasty for pulmonary tuberculosis about 20 years ago at Dept.of Chest surgery of National Medical Center. At that time, there was no abnormal findings in cardiovascular system. The preoperative aortic cineangiogram showed pear shaped dilatation [7.3 cm x 6.8 cm] of aortic mot with aortic valve regurgitation but left ventricular ejection function was fair. Preop. ventilatory function test showed mixed type pulmonary insufficiency. Recently, we corrected surgically, by AVR with Carpentier-Edwards Bioprosthesis [29mm] & supracoronary Woven Dacron graft [29mm x 5cm] replacement, with good clinical result for follow up 6 months.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.31-35
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• 1994

Dissecting aortic aneurysm is a life threatening condition which necessitates prompt diagnosis and management. Between January 1987 and September 1993,58 patients was admitted to our department. Mean age at admission was 53 years.[range 25-82]. Clinical findings included chest pain in 48 cases[83%],renal failure in 12[20%],aortic insufficiency in 11[19%] and stroke in 9[15%]. Predisposing factors were hypertension in 50 cases[86%],Marfan`s syndrome in 6[10%] and diabetes melitus in 1 [2%]. 23 patients[ type A 13,type B 10 ] underwent surgical treatment. Surgical technique for type A included graft replacement of ascending aorta in 7 cases,graft replacement and aortic valve resuspension in 3,and Bentall`s operation in 3 cases. Type B patients were operated when specific indications applied. There were three [Two in type A and 1 in type B] deaths in the operation group and nine [ 5 in type A and 4 in type B] deaths in the medical group. These results support our current policy in the treatment of dissecting aortic aneurysm.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.31-36
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• 1995

Between January 1984 to June 1994, fourteen patients from 37 to 80 years of age [mean 66.42 11.71 years of age have undergone surgical treatment of abdominal aortic aneurysm in Kyung Hee Univ. Hospital. There were 11 males and 3 female patients. All but one were infra-renal type. The etiology of the aneurysm consisted of twelve atherosclerotic, one inflammatory and one traumatic abdominal aortic aneurysm.Two patients were operated on for ruptured abdominal aortic aneurysm. We performed dacron graft interposition in all patients and one patient was also performed aorto-renal end to side anastomosis. Two patients died of postoperative complications which was a pulmonary insufficiency in one, acute renal failure in another patient.Remaining twelve patients were discharged with good condition and followed up from 2 months to 87 months.[mean $34.58{\pm}29.79$ months.