• Title/Summary/Keyword: cardiac approach

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Ruptured Aneurysm of Sinus Valsalva A report of 5 cases (대동맥동 동맥류 파열 5례 보고)

  • 박만실
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.407-413
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    • 1985
  • Ruptured aneurysms of the sinus Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Five patients underwent operative treatment in Catholic Medical Center in recent 2.5 year period. Three patients were male and two patients were female, ages ranged from 20 to 54 years. Bacterial endocarditis was suspected or proved in 3 patients. In 3 patients in our series had a ruptured congenital aneurysms and in 2 patients acquired aneurysms by bacterial endocarditis. Associated cardiac lesions were common; such as aortic insufficiency in 3 patients, atrial septal defect in 2 patients, mitral stenoinsufficiency in 1 patient and tricuspid insufficiency in 1 patient. All aneurysmal ruptures of the sinus Valsalva arose from right coronary sinus and in 4 patients ruptured into right ventricle and in 1 patient into right atrium. Surgical techniques consisted of direct closure 4 in patients and closure with Dacron patch in 1 patient. And we preferred double approach, that is, through both the aorta and the involved cardiac chamber in cases in whom aortic insufficiency was present. So additional aortic valve replacement performed in 2 patients due to severe aortic insufficiency and aortic valvuloplasty performed in 1 patient. One patient who underwent direct closure of ruptured sinus Valsalva and double valve replacement died due to low cardiac output syndrome just after the operation. Operative results were relatively good in remainders.

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Pulmonary Artery Banding for Ventricular Septal Defect: Report of 2 Cases (심실중격결손의 Pulmonary Banding: 2 치험례)

  • 조범구
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.29-34
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    • 1972
  • Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

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A Clinical Analysis of Ventricular Septal Defect Infants Weighting Less Than 10kg of Body Weght (체중 10kg이하 심실중격결손증 환아의 임상적 고찰)

  • 손제문
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.650-655
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    • 1994
  • The author analyzed 99patients with VSD weighting less than 10kg of body weight who underwent surgical correction from 1981 to 1992 at cardiovascular department of Hanyang University hospital. Patients occupied 29.3% of total cases who were underwent surgical corrections for congenital heart diseases during that time. Of the 99 patients, 51 patients were male [52%] and 48 patients[48%] were female. Age ranged from 28 days to 36 months with mean age of 13.6 months. Mean body weight was 7.53kg. According to Kirklin`s anatomical classification, type II defect was most common [61.6%]. Associated anomaly was found in 48 patients [48.5%]. Patent foramen ovale was most commonly associated cardiac anomaly [14.1%] and followed by atrial septal defect [12.1%], patent ductus arteriosus [10.1%]. Cardiac catheterization data were analyzed. The most common range of Qp/Qs, Rp/Rs, Pp/Ps were above 3.0, 0.1 - 0.25, and above 0.75 respectively. Among the indications of surgical correction, there were pulmonary hypertention in 69 patients, congestive heart failure in 44 patients, frequent respiratory infection in 47 patients, growth retardation in 33 patients. The most common surgical approach and method for VSD closure were right atriotomy[48.3%] and dacron patch closure[93.3%]. Complication rate was 13.1% [13 cases], and overall mortality was 17.1% [17 cases]. The cause of death consisted of low cardiac output syndrome[11 cases], acute renal failure[3 cases], sepsis[2 cases] and pulmonary insufficiency[1 case] in order of frequency.

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Suction Detection in Left Ventricular Assist System: Data Fusion Approach

  • Park, Seongjin
    • International Journal of Control, Automation, and Systems
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    • v.1 no.3
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    • pp.368-375
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    • 2003
  • Data fusion approach is investigated to avoid suction in the left ventricular assist system (LVAS) using a nonpulsatile pump. LVAS requires careful control of pump speed to support the heart while preventing suction in the left ventricle and providing proper cardiac output at adequate perfusion pressure to the body. Since the implanted sensors are usually unreliable for long-term use, a sensorless approach is adopted to detect suction. The pump model is developed to provide the load coefficient as a necessary signal to the data fusion system without the implanted sensors. The load coefficient of the pump mimics the pulsatility property of the actual pump flow and provides more comparable information than the pump flow after suction occurs. Four signals are generated from the load coefficient as inputs to the data fusion system for suction detection and a neural fuzzy method is implemented to construct the data fusion system. The data fusion approach has a good ability to classify suction status and it can also be used to design a controller for LVAS.

Ruptured Sinus of Valsalva Aneurysm - A Case Report - (대동맥동 동맥류 파열 - 1례 보고 -)

  • Kim, Seong-Su;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.687-692
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    • 1989
  • Aneurysm of the sinus of Valsalva is an uncommon cardiac anomaly, usually congenital in origin, which may occur as an isolated defect or in conjunction with other cardiac malformation. This report is a case of a ruptured sinus of Valsalva aneurysm with ventricular septal defect in a 18-year-old female patient who complained progressive exertional dyspnea. She underwent operative management using total cardiopulmonary bypass. The fistula originated from the right coronary sinus and ruptured into the right ventricle and coexistent lesion was supracristal ventricular septal defect. The repair was done through aortic and right ventricular approach. The ruptured sinus of Valsalva was closed with pledget suture and the ventricular septal defect was closed with patch. The postoperative result was good.

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Reconstructive Surgery for Mitral Incompetence Report of 10 Cases (승모판 폐쇄부전에 대한 판막성형술의 성적: 10례 보고)

  • O, Sang-Jun;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.62-68
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    • 1985
  • 10 patients with mitral regurgitation associated with various congenital cardiac anomalies were treated by reconstructive techniques in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the period of 2 years from 1982 to 1984. There were mitral valvular cleft in one case, chordae tendineae rupture associated with congenital multiple cardiac-anomalies [VSD, PDA, prolapse of aortic non-coronary cusp through VSD] in one case, elongated chordae tendineae after removal of left atrial myxoma in one case, and mitral annular dilatation associated with VSD in 3 cases, large PDA in 2 cases, aortic regurgitation [bicuspid valve] in one case, and unknown origin in one case. Owing to the various pathology above mentioned, reconstructive surgical approach to mitral incompetence is accordingly complicated and a combination of the following different procedures were properly used case by case, that is, suture of chordae tendineae, shortening of elongated chordae tendineae, closure of VSD, ligation of PDA, aortic valvuloplasty, mitral annuloplasty with mattress suture, etc. All patients were survived and they have been excellent postoperative results.

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First Results of the Single Heartstring Aortotomy for Multiple Off-Pump Vein Grafts: A Case Series

  • Santos, Rafael Freire dos;Niclauss, Lars
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.403-407
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    • 2020
  • To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

Effect of Drugs on the Cardiac Transport, Metabolism and Action of Idarubicin: Pharmacokinetic and Pharmacodynamic Modeling

  • Kang, Won-Ku
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.212-213
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    • 2002
  • Using the isolated perfused rat heart this study investigated 1) the cardiac uptake of idarubicin (IDA), 2) the role of P-glycoprotein (P-gp) in the uptake process, 3) the formation of IDOL from IDA in the heart, and 4) the effect of P-gp inhibitors (verapamil, amiodarone, PSC 833), doxorubicin, hypothermia, xanthine derivatives (caffeine, theophylline) and metabolism inhibitors (rutin, phenobarbital) on the pharmacokinetics and pharmacodynamics of IDA using a mathematical modeling approach. A minimal model was constructed; the differential equations were numerically solved and fitted to the data using the ADAPT II-software package using maximum likelihood estimation assuming that the measurement error has a standard deviation which is a linear function of the measured quantity[1]. (omitted)

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Clinical Experience of Cardiac Myxoma (심장 점액종의 임상적 고찰)

  • 나국주
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1168-1173
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    • 1990
  • From 1981 to 1990, we performed operation on 6 patients with cardiac myxomas, which were located in the left atrium in 5, in the biatrium in 1. There were 3 male and 3 female patients ranging in age from 13 years to 69 years. Symptoms included exertional dyspnea, palpitation and signs of systemic illness. Diagnosis was accomplished by angiography[3 patients] and echocardiography [3 patients]. In all cases, myxomas were excised successfully through incision of interatrial septum There were no operative deaths or intraoperative embolic episode. Follow-up has been 40.0\ulcorner40.6 months[ranging from 1 month to 9 years], results of each patient were excellent We suggested that excision of intracardiac myxomas is curative and follow-up results are excellent. The transseptal approach provides adequate exposure and allows complete removal of the tumor regardless of its location.

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Application of a Pediatric Advanced Life Support in the Situation of a Dental Treatment (치과진료 시 소아고급생명구조술의 적용)

  • Kim, Jongbin
    • The Journal of the Korean dental association
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    • v.53 no.8
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    • pp.538-544
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    • 2015
  • In a dental treatment, a dentist has to know the possibility to happen all kinds of the emergency and to prepare for managing that situation. Especially, the cardiac arrest is the most serious emergent problem. If the accident were happened, most dentists got embarrassed. The American Heart Association (AHA) is offering the Basic Life Support (BLS), Advanced Cardiopulmonary Life Support (ACLS) and Pediatric Advanced Life Support (PALS) programs for the healthcare who need to prepare the life threatening situation. The PALS is specialized to someone who participate in pediatric health-care field. This program is composed of three major emergency problems, such as respiratory emergencies, shock and cardiac arrests. The main concepts of the PALS are early recognition and systemic team approach. The purpose of this study was to introduce about PALS and to prepare response system for emergencies in the dental environment.