• Journal of Convergence for Information Technology
• /
• v.8 no.5
• /
• pp.131-135
• /
• 2018

The heart disease taking the second place of the cause of the death of modern people is a terrible disease that makes sudden death without noticing. To judge the aortic valve disease of heart diseases a name of disease was diagnosed using psychological data provided from physioNet. Aortic valve is a valve of the area that blood is spilled from left ventricle to aorta. Aortic stenosis of heart troubles is a disease when the valve does not open appropriately in contracting the left ventricle to aorta due to narrowed aortic valve. In this paper, 3126 samples of cardiac sound data were used as an experiment data composed of 180 characteristics including normal people and aortic valve stenosis patients. To diagnose normal and aortic valve stenosis patients, NEWFM was utilized. By using an average method of weight as an feature selection method of NEWFM, the result shows 91.0871% accuracy.

• Korean Journal of Clinical Laboratory Science
• /
• v.51 no.2
• /
• pp.270-275
• /
• 2019

The incidence of degenerative valve disease also increasing with the increasing life expectancy of the elderly population. Rheumatic valve disease is decreasing gradually and the incidence of calcified degenerative aortic stenosis (AS) is growing. Echocardiography is a very important tool for evaluating the prognosis and treatment method as well as the time of operation and diagnosis of heart valve disease. When evaluating valvular heart disease, 2-dimensional echocardiography, which observes all heart valves in detail, should take precedence. Understanding the clinical findings of degenerative valve disease and performing precise echocardiography are extremely important. In addition, an assessment of the severity of aortic stenosis is necessary to determine the surgical indications. An assessment of the severity by echocardiography was explained with three cases of degenerative aortic stenosis. To perform echocardiography accurately, it is necessary to understand degenerative valve disease and its clinical findings accurately.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.727-733
• /
• 1988

Two cases of the discrete membranous subaortic stenosis were experienced at the Department of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. Case I was 31 years old male with a history of aortic valve replacement[Ionescu-Shiley, 19mm] at the other hospital in 1980. Heart failure was noticed 6 years later. On cardiac catheterization, pressure gradient between left ventricle 4 aorta was 104 mmHg, but subvalvular aortic stenosis was not detected by preoperative 2-D echo <% left ventriculogram. Above case revealed stenoinsufficiency of the prosthetic valve. Under the diagnosis of the prosthetic valve failure, re-do aortic valve replacement[Bjork-Shiley, 23 mm] was done. During operation, the discrete membranous subaortic stenosis was incidentally found, and it was completely resected. So we thought that above discrete membranous subaortic stenosis was not detected at first operation, and it was progressed during 6 years, and accelerated the degeneration of the prosthetic valve. Case II was 20 years old female. Her complaints were exertional dyspnea, angina, syncope, which were aggravated since 5 years ago. 2-D echo <% left ventriculogram revealed the discrete membranous subaortic stenosis. Pressure gradient was 20 mmHg, but her symptoms were serious. Associated cardiac anomaly was the persistent left superior vena cava without connection with right superior vena cava. Complete excision of the membranous tissue was done. Post-operative pressure gradient between left ventricle & aorta was absent, and her complaints were nearly subsided. Both cases were type I according to the Newfeld classification of the discrete subvalvular aortic stenosis, and complete excision of the membranous tissue was done without myotomy or mymectomy. And short-term follow-up results[Case I:2 years, Case II: 1 ~ years] were good except soft systolic murmur[grade II/VI] at the aortic area in both cases.

• Journal of Chest Surgery
• /
• v.25 no.7
• /
• pp.739-744
• /
• 1992

Discrete membranous subaortic stenosis[DMSS] is one of the subtype of congenital left ventricular outflow obstruction and can be associated with aortic regurgitation, infective endocarditis, ventricular obstruction. DMSS should be removed early, when diagnosed, and completely before secondary myocardial changes occur. Recently we experienced a case of DMSS with aortic regurgitation, and its left ventricular outflow tract obstruction[LVOTO] peak systolic gradient was 10lmmHg. Resection of membrane and aortic valve replacement is adequet for LVOTO and postoperative pressure gradient was 26mmHg. Postoperative echocardiogram shows no obstuctive membrane and well functioning aortic valve.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.780-784
• /
• 1996

The localized form of subaortic stenosis shows a spectrum of pathological lesions varing from dis- crete membrane to a thickened flbromuscular collar. Aortic valve is commonly involved late in the pro- cess resulting in regurgitation. Because of the likelihood o the progressive obstruction and aortic regurgitation, early elective oper- ation should be considered for the patient with subaortic stenosis. We experienced a case of localized fibromuscular subaortic stenosis associated with aortic regurgi- tation. Excision of the fibromuscular ridge and septal myectomy-myotomy relieved the subaortic seen- osis. Regurgitant aortic valve was repaired by peeling away the Hbrotic tissue on the cusps and subcommissural annuloplasty at the each commissural area. On postoperative echocardiographic examination, the systolic pressure gradient between left ventricle and aorta decreased markedly and the aortic regurgitation was not detected at all.

• Journal of Chest Surgery
• /
• v.51 no.5
• /
• pp.322-327
• /
• 2018

Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

• Journal of Chest Surgery
• /
• v.21 no.1
• /
• pp.164-168
• /
• 1988

Between November, 1984, and May, 1986, 93 patients underwent combined valvular and coronary artery operation. They were 70 male and 23 female, the age ranging from 29 to 82. From this population 89 patients underwent single valve replacement and 4 patients underwent double valve replacement. Patients with mitral valve disease were in the majority present in the age group between 50 till 70, where as in the group after 60 years, patients with aortic valve disease were dominant. The main indication for aortic valve replacement was aortic stenosis and the indication for mitral valve replacement was equal between mitral stenosis and mitral incompetence, the later was due to papillary dysfunction after myocardial infarction. Dyspnea was a very frequent symptom and it was found in nearly all patients. 28 patients had a previous myocardial infarction and severe left ventricular dysfunction. The grafts were placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. It is our opinion that simultaneous valve replacement and myocardial revascularization does not increase the risk of cardiac valve replacement substantially.

• Journal of Chest Surgery
• /
• v.23 no.3
• /
• pp.532-536
• /
• 1990

We experienced surgical correction of 2 cases of discrete membranous subaortic stenosis. Case 1 was 19 years old male patient. His complaints were fatigue, exertional dyspnea, syncope and angina for 8 years. Ejection. systolic murmur was heard at the second right intercostal space and diastolic murmur was heard at the apex. A thrill was palpated over the second right intercostal space and area of the carotid artery. 2-D echo, cardiac cath and left ventriculogram revealed discrete membranous subaortic stenosis and VSD. Complete excision of discrete membrane without mymectomy was done. VSD was closed with dacron patch and aortic valve was replaced with St. Jude medical valve. Case 11 was 16 years old female whose complaints were exertional dyspnea and syncope. Ejection systolic murmur was heard at second right intercostal space, but diastolic murmur was not heard. A thrill was palpated over the second right intercostal space and the area of carotid artery. 2-D echo, cardiac cath and left ventriculogram revealed discrete membranous subaortic stenosis. Complete excision of fibrous tissue and myotomy were made and aortic valve was replaced with St. Jude medical valve. Operative finding was followed: both aortic valves showed deformity of leaflets. Subaortic region had a thickened central fibrous body from which the ridge protruded. Both patient`s postoperative course were uneventful and short-term follow-up results were good except soft systolic murmur at the aortic area.

• Journal of Chest Surgery
• /
• v.57 no.3
• /
• pp.255-262
• /
• 2024

Background: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results: The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion: The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.

• Journal of Chest Surgery
• /
• v.53 no.3
• /
• pp.144-146
• /
• 2020

Supravalvar aortic stenosis (SVAS) is a rare congenital cardiac disease that usually co-occurs with Williams syndrome. In the adult population, a few SVAS cases have been reported in patients affected by homozygous familial hypercholesterolemia. However, because of the rarity of this disease entity, there is no standard surgical treatment for SVAS. Here, we present a case of successful surgical treatment using an autologous excised aortic patch in a 65-year-old patient with SVAS.