• 제목/요약/키워드: atrial

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심방중격결손증의 임상적 고찰 (Clinical Evaluation of Atrial Septal Defect)

  • 장동철
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.106-111
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    • 1987
  • Twenty eight patients with atrial septal defect operated on from May, 1983, to July, 1986 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, were analyzed retrospectively. Among the 28 patients of atrial septal defect, 8 were male and 20 were female. Their ages ranged from 4.6 years to 52.5 years old with the mean of 15.3 years. The main clinical symptoms on admission were exertional dyspnea [82%], frequent respiratory infection [75%], palpitation [54%] and easy fatigability [25%]. Electrocardiographic findings were as follows: Regular sinus rhythm [100%], RVH [54%], RBBB [25%] and first degree of A-V block [4%]. Hemodynamic studies were performed in all cases and mean pulmonary systolic arterial pressure was 34.1*11.8mmHg. and mean Qp/Qs was 2.6*0.9. All 28 patients were operated under direct vision using extracorporeal circulation. 23 cases were secundum type defect and a single hole was found in 22 cases. The associated cardiovascular anomalies were found in 11 patients: ventricular septal defect in 3, patent ductus arteriosus in 1, partial anomalous pulmonary venous drainage in 2, mitral regurgitation in 2, tricuspid regurgitation in 1, anomalous left atrial septation in 1 and valvular pulmonary stenosis in 1. The defect closed directly in 22 cases and with patches in 6 cases. Postoperative complications were wound infection, arrhythmia bleeding, intracardiac patch detachment, pneumothorax and urethral injury. But there was no operative mortality.

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좌심방혈전증을 동반한 승모판막질환의 임상적 고찰 (Left atrial thrombus in mitral valve disease)

  • 김원곤;노준량
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.666-671
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    • 1984
  • During a fire-year period from March 1979 to February 1984, 559 patients underwent surgical treatment for rheumatic mitral valve disease at Seoul National University Hospital. Left atrial thrombus was found at surgery in 74 of these patients, an incidence of 13.2%. This report outlines the surgical experience with these seventy-four patients. They were 32 men and 42 women, and their age ranged between 23 and 57 with mean of 42 years old. All except one had the findings of atrial fibrillation on the preoperative electrocardiogram. Ten [13.5%] had experienced embolic events before surgery. A history of one or more episodes of cardiac failure requiring digitalis and diuretics was noted in all patients Nineteen were associated with the aortic and/or tricuspid valve disease and closed mitral commissurotomy had been performed previously in four patients. The average cardiac index was 2.68L/min/M2 [1.59 to 3.47 L/min/M2] The mean systolic pulmonary artery pressure was 57mmHg [26 to 120 mmHg]and pulmonary capillary wedge pressure 21.5 mmHg [12 to 40 mmHg]. There were no significant hemodynamic findings to suggest the presence of the left atrial thrombus. Operative mortality was acceptable with two early deaths [2.7%]. The follow-up of the hospital survivors has shown excellent functional status.

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폐정맥 환류이상을 동반한 삼중방심 치험 1 (Cor triatriatum associated with partial anomalous pulmonary venous drainage: one case report)

  • 김영호;김공수
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.381-388
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    • 1984
  • Cor triatriatum is rare congenital cardiac anomaly first described by Church in 1868. The anomaly consists of an abnormal partitioning of the left atrium by a fibromuscular membrane that divides the atrium into an upper chamber, which receives the pulmonary veins, and a lower chamber, which contains the atrial appendage and the mitral valve. The upper and lower chambers communicate through a stenotic fenestration in the membrane, which has the hemodynamic consequence of pulmonary venous obstruction. Recently we experienced cot triatriatum associated with partial anomalous pulmonary drainage to right atrium. The upper chamber was connected to right atrium through a sinus venous type of ASD and received left superior and both inferior pulmonary vein, whereas the lower chamber so called true left atrium communicated with right atrium through foramen ovale type of ASD, left atrial appendage and mitral orifice. And the anomalous membrane has no fenestrations which permit blood flow. The operation was made right atrial approach under the CPB. We excised completely the anomalous septum and reconstructed atrial septal defect with pericardial patch to drain the right upper pulmonary vein to the left atrium. The postoperative course has been good during follow up.

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Higenamine이 단일심근세포의 Ca-전류 및 활동전압에 미치는 효과 (Effects of Higenamine on the Calcium Current and the Action Potential in the Guinea-pig Myocytes)

  • 김영덕;서인석;엄융의
    • The Korean Journal of Physiology
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    • 제21권2호
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    • pp.169-177
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    • 1987
  • The effects of higenamine were investigated in the single atrial and ventricular myocyte of the guinea pig by using patch clamp method. The results obtained were as follows: 1) Isoprenaline which is known to be ${\beta}-agonist$ increased the duration of action potential and calcium current in ventricular cells. 2) Higenamine also increased the duration of action potential and calcium current in ventricular myocytes. And its effect was blocked by propranolol. 3) In the atrial cells, isoprenaline showed ${\beta}-agonist$ effects, which were increasing the duration of action potential and calcium current same as in ventricular cells. 4) Higenamine, however, showed the opposite effects of ${\beta}-agonist$ which were decreasing the duration of action potential and calcium current. The above results suggest that higenamine has the typical ${\beta}-agonist$ effect in ventricular cells but inhibitory effect in atrial cells and this effect on atrium could be due to the reduction of calcium current.

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가토 신장기능에 미치는 Pro-Atrial Natriuretic Peptide의 영향 (Effects of Intrarenal Arterial Infusion of Pro-Atrial Natriuretic Peptides on Renal Function in Unanesthetized Rabbits)

  • 이정은;조경우;김선희
    • The Korean Journal of Physiology
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    • 제24권1호
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    • pp.131-144
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    • 1990
  • It is well known that the atrial natriuretic peptide (ANP) has a prepro-hormone of 151 amino-acids which loses their hydrophobic signal peptide to form 126 amino acid prohormone. The whole prohormone is released and then cleaved by proteases into more than one circulating forms. Recently, Winters et al. (1988a, b) reported that high concentrations of N-terminal fragments of prepro-ANP $(26{\sim}55),\;(56{\sim}92)\;and\;(104{\sim}123)$ were detected in human plasma. However, their physiological roles have not been established. The present study was conducted to determine whether the N-terminal fragments of pro-ANP have any effect on the renal function and to compare the effect with those of G-terminal fragments of pro-ANP The results indicate that intrarenal arterial infusions of prepro-ANP $(26{\sim}41),\;(26{\sim}55),\;(56{\sim}92)\;and\;(104{\sim}123)$ induced no significant changes in renal function. Whereas ${\alpha}-human$ ANP $(prepro-ANP,\;124{\sim}151)$ and pro-ANP caused a significant increase in urine volume, renal plasma flow, glomerular filtration rate, urinary excretions of sodium, chloride and potassium, and fractional excretion of sodium. These results suggest that the N-terminal fragments of pro-ANP are ineffective, while the C-terminal fragments retain the natriuretic and diuretic activities.

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Giant Right Atrial Thrombi Formation Associated with Hemodialysis Catheter Placement in a Dog

  • Shin, Du-Ree;Yang, Hyuck-Joo;Kim, Hye-Young;Song, Kun-Ho;Seo, Kyoung-Won
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.478-480
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    • 2017
  • A Cocker spaniel (7-year-old, female) was presented with one week of anorexia, halitosis, oral ulcer, intermittent vomiting, acute weight loss and 3-day history of oliguria. The patient was diagnosed with acute on chronic kidney disease and pancreatitis. Hemodialysis was continued three times a week (total 7 sessions) with improved clinical signs and kidney panel, but presented with another episode of abdominal distention, respiratory distress, and large bowel diarrhea. Echocardiography revealed nearly totally occlusive thrombus in the cranial vena cava, as well as a right atrial mass of approximately $2cm{\times}1cm$. The patient was treated with catheter removal, thrombolysis and anticoagulation therapy with recombinant tissue plasminogen activator. During anticoagulation therapy, size of atrial thrombus was not changed and heart function was not improved after treatment. Since clinical signs were deteriorated, the patient was euthanized by owner's request. Catheter-related giant thrombus in right atrium is a rare complication and treatment guideline for atrial thrombus does not exist. This case is first report of hemodialysis catheter-induced thrombus in Korea.

심방세동치료에 적용된 심외막극초단파차단술 -1예 보고- (Epicardial Microwave Ablation of Atrial Fibrillation)

  • 박정식;이정환;안영찬;황여주;이재익;현성렬;전양빈;이창하;박철현
    • Journal of Chest Surgery
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    • 제37권7호
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    • pp.609-612
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    • 2004
  • Cox-Maze III 술식이 심방세동의 전형적인 수술요법이지만 탁월한 수술성적임에도 불구하고 수술의 복잡성, 장시간의 체외순환, 술 후 출혈의 위험부담으로 보편적이지는 못하다. 최근 들어서 심방세동의 병리기전에 대한 이해와 절개 및 봉합의 대안으로 여러 가지 에너지원의 개발로 인하여 Cox-Maze의 변형술식이 급격하게 발전되고 있다. 본원에서는 심폐기를 사용하지 않고 극초단파(microwave)를 이용하여 심방세동을 교정한 후 33개월 현재 양호한 상태로 동율동을 보이고 있어 문헌 보고하는 바이다.

Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

  • Kim, Ha Eun;Jung, Jo Won;Shin, Yu Rim;Park, Han Ki;Park, Young Hwan;Shin, Hong Ju
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.203-206
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    • 2016
  • Patients with venoarterial extracorporeal membrane oxygenation (ECMO) frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA) decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

Enhancement of Ca2+ Current Does Not Regulate the Speed of Depolarization-induced Ca2+ Propagation Wave in Rat Atrial Myocytes

  • Woo, Sun-Hee;Hwang, Seon-Hwa;Kim, Joon-Chul;Morad, Martin
    • Biomolecules & Therapeutics
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    • 제15권4호
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    • pp.212-217
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    • 2007
  • In atrial myocytes, lacking t-tubules, $Ca^{2+}$ current ($I_{Ca}$)-initiated $Ca^{2+}$ release at the peripheral junctional sites propagates into the interior of the cell by diffusion of $Ca^{2+}$. We have previously reported that time of activation of the central sites is independent of $I_{Ca}$. In the present study we have probed the effects of Bay K 8644 on $Ca^{2+}$ propagation wave to the center of the myocyte using rapid 2-D confocal $Ca^{2+}$ imaging in the rat atrial myocytes. Enhancement of $I_{Ca}$ by Bay K 8644 accelerated the rate of peripheral $Ca^{2+}$ release, but did not affect the speed of propagation of central release. In contrast, enhancement of $I_{Ca}$ by intracellular cAMP reduced the magnitude of peripheral and central $Ca^{2+}$ transients, but significantly accelerated the speed of central $Ca^{2+}$ release. Our data suggest that the speed of central $Ca^{2+}$ propagation triggered by $I_{Ca}$ is not regulated by the magnitude of either $I_{Ca}$ or local cytosolic $Ca^{2+}$ releases.

심방이뇨호르몬의 분비조절에 있어서 superoxide anion의 영향 (Effect of superoxide anion in the regulation of artrial natriuretic peptide (ANP) secretion)

  • 강창원;김남수;이호일
    • 대한수의학회지
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    • 제36권1호
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    • pp.65-74
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    • 1996
  • Atrial Natriuretic Peptide(ANP) is a hormone with potent natriuretic, diuretic and relaxing properties of vascular smooth muscle. Specific chemical modulator responsible for the ANP secretion has not yet been found. Although atrial stretch of stretch-release is to be a major stimulus for the secretion of ANP, the precise mechano-molecular transduction mechanism responsible for its evoked secretion remains to be elucidated. It is interested to clarify the effect of superoxide anion in the stretch-induced ANP secretion. In order to investigate the effectg of $H_2O_2$ in the regulation of ANP secretion, a perfused model of left atrium of rats was used. The results obtained were as follows; 1. The ANP secretion and the extracellular fluid(ECF) translocation were accentuated by the effect of repetitive atrial distension-reduction volume at atrial pressure($4cmH_2O$). 2. The dilution curve showed to be in parallel between pure atriopeptin III (AP III) and perfusated buffer. 3. $H_2O_2(5{\times}10^{-4}M)$ accenturated a strectch-release induced increase of the ANP secretion. The amount of released ANP was significantly(p<0.01) increased. These results suggest that the superoxide anion may be involved in the regulatory mechanism of mechanically activated ANP release.

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