• Title/Summary/Keyword: cardiac failure

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Clinical Experiences of St. Jude Medical Cardiac Valve Replacement (St. Jude Medical valve의 임상적 고찰)

  • 김종원
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.518-525
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    • 1992
  • 50 months experience with St-Jude Medical Cardiac Valve Prosthesis The St. Jude Medical valve has become our mechanical valvular prosthesis of choice because of favorable hemodynamic results that associated with marked clinical improvement and low incidence of thromboembolism. The data for this study was collected from April 1986 to May 1990, four years period. There were total of 110 patients[female 53, male 58] in this series with 22 isolated aortic valve, 66 isolated mitral valve, 20 double valve, 2 tricuspid valve replacement. The mean follow up time was 23 months. Postoperatively, 77% of cases were in New York Heart Association[NYHA] functional class I, and mild and moderate symptoms[NYHA II ] were present in 20% and there were very few patients remaining in higher functional classifications. In postoperative echocardiographic study showed marked improved cardiac function. The overall early mortality was 5.4% and was higher after double[13.3%] and mitral valve replacement[5.6%] and the late mortality was one case after mitral valve replacement due to endocarditis. The cause of death in early mortality was attributed to heart failure, acute renal failure, sepsis, etc.

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Pediatric heart transplantation: how to manage problems affecting long-term outcomes?

  • Kim, Young Hwue
    • Clinical and Experimental Pediatrics
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    • v.64 no.2
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    • pp.49-59
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    • 2021
  • Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500-550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart transplantations were comparable to those of adults. Issues affecting long-term outcomes include acute cellular rejection, antibody-mediated rejection, cardiac allograft vasculopathy, infection, prolonged renal dysfunction, and malignancies such as posttransplant lymphoproliferative disorder. This article focuses on medical issues before pediatric heart transplantation, according to the Korean Network of Organ Sharing registry and as well as major problems such as graft rejection and cardiac allograft vasculopathy. To reduce graft failure rate and improve long-term outcomes, meticulous monitoring for rejection and medication compliance are also important, especially in adolescents.

Traumatic Tricuspid Regurgitation as a Cause of Failure to Wean from Mechanical Ventilation

  • Jeon, Yang Bin;Park, Chul Hyun;Ma, Dae Sung
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.264-268
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    • 2020
  • A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.

N-Terminal Pro-B-type Natriuretic Peptide Is Useful to Predict Cardiac Complications Following Lung Resection Surgery

  • Lee, Chang-Young;Bae, Mi-Kyung;Lee, Jin-Gu;Kim, Kwan-Wook;Park, In-Kyu;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.44-50
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    • 2011
  • Background: Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. Material and Methods: Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. Results: Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. Conclusion: An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery.

Parallel Venovenous and Venoarterial Extracorporeal Membrane Oxygenation for Respiratory Failure and Cardiac Dysfunction in a Patient with Coronavirus Disease 2019: A Case Report

  • Eun Seok Ka;June Lee;Seha Ahn;Yong Han Kim
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.225-229
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    • 2024
  • Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a lifesaving technique for patients experiencing respiratory failure. When VV ECMO fails to provide adequate support despite optimal settings, alternative strategies may be employed. One option is to add another venous cannula to increase venous drainage, while another is to insert an additional arterial return cannula to assist cardiac function. Alternatively, a separate ECMO circuit can be implemented to function in parallel with the existing circuit. We present a case in which the parallel ECMO method was used in a 63-year-old man with respiratory failure due to coronavirus disease 2019, combined with cardiac dysfunction. We installed an additional venoarterial ECMO circuit alongside the existing VV ECMO circuit and successfully weaned the patient from both types of ECMO. In this report, we share our experience and discuss this method.

Proteasome inhibitors attenuated cholesterol-induced cardiac hypertrophy in H9c2 cells

  • Lee, Hyunjung;Park, Jinyoung;Kim, Eunice EunKyeong;Yoo, Young Sook;Song, Eun Joo
    • BMB Reports
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    • v.49 no.5
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    • pp.270-275
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    • 2016
  • The Ubiquitin proteasome system (UPS) plays roles in protein degradation, cell cycle control, and growth and inflammatory cell signaling. Dysfunction of UPS in cardiac diseases has been seen in many studies. Cholesterol acts as an inducer of cardiac hypertrophy. In this study, the effect of proteasome inhibitors on the cholesterol-induced hypertrophic growth in H9c2 cells is examined in order to observe whether UPS is involved in cardiac hypertrophy. The treatment of proteasome inhibitors MG132 and Bortezomib markedly reduced cellular surface area and mRNA expression of β-MHC in cholesterol-induced cardiac hypertrophy. In addition, activated AKT and ERK were significantly attenuated by MG132 and Bortezomib in cholesterol-induced cardiac hypertrophy. We demonstrated that cholesterol-induced cardiac hypertrophy was suppressed by proteasome inhibitors. Thus, regulatory mechanism of cholesterol-induced cardiac hypertrophy by proteasome inhibitors may provide a new therapeutic strategy to prevent the progression of heart failure.

Reoperation for Mitral valvular disease - Clinical analysis of 21 cases - (승모판막질환에 대한 재수술: 21례 보고)

  • 유병하
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.649-654
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    • 1985
  • After first successful mitral valvotomy by Harken and Bailey in 1948, improvement of surgical technique and cardiac device may last rapidly for several years, but there after many patients deteriorate because of various causes, so incidence of reoperation for cardiac valvular disease has increased time by time. This paper is concerned with 21 patients in whom a second operation has been carried out from Jan. 1963 to Aug. 1984 at the department of Thoracic and Cardiovascular department, National Medical Center. Of 21 patients, 7 were male and 14 were female, and ages ranged from 14 to 37 years The second operation are classified into groups of secondary closed mitral commissurotomy [3 cases], open commissurotomy following closed mitral commissurotomy [1 case], Valve replacement following closed mitral commissurotomy [14 cases] or bioprosthetic valve replacement [3 cases]. Main cause of reoperation was restenosis or steno insufficiency, and that of bioprosthetic valve failure was bacterial endocarditis [1 case], fibrous tissue overgrowth on the Xenograft [1 case] and technical failure [1 case]. Early operative mortality was absent, but during follow-up, 4 patients died, so late mortality was 19.0%, and main cause of death was congestive heart failure.

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Application of Cardiac Electromechanical FE Model for Predicting Pumping Efficacy of LVAD According to Heart Failure Severity (심부전 정도에 따른 좌심실보조장치의 박동효율예측을 위한 심장의 전기역학적 유한요소 모델의 응용)

  • Jung, Dae Hyun;Lim, Ki Moo
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.38 no.8
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    • pp.715-720
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    • 2014
  • In order to maximize the effect of left ventricular assist device (LVAD) on ventricular unloading, the therapy should be begun at appropriate level of heart failure severity. We predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used 3 dimensional finite element model of ventricle coupled with 6 Wind-kessel compartmental model of vascular system. Using the computational model, we predicted cardiac responses such as contractile ATP consumption of ventricle, left ventricular pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous LVAD. Contractile ATP consumption, which indicates the ventricular energetic loading condition decreased maximally at the $5^{th}$ level heart-failure under LVAD therapy. We conclude that optimal timing for LVAD treatment is $5^{th}$ level heart-failure when considering LVAD treatment as "bridge to recovery".

Clinical Efficacy of Pimobendan on Dogs with Chronic Mitral Valvular Diseases (만성 이첨판 폐쇄부전증 이환된 견에서 피모벤단의 임상적 효과)

  • Nam, So-Jeong;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.17-22
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    • 2009
  • Pimobendan is a recently developed cardiac drug which is useful to control moderate to severe congestive heart failure (CHF) from chronic mitral valvular diseases (CMVI). Because of controversy related to the efficacy and safety of pimobendan in dogs, the optimal efficacy and safety of pimobendan was assessed in 20 dogs with CMVI in this study. Scores for quality of life, respiratory failure, circulatory failure and heart failure were evaluated along with radiographical and echocardiographical assessments for about 2 months period after the addition of pimobendan into the regular cardiac medications. This study proved clear evidence that pimobendan had beneficial therapeutic effects in dogs with advanced CMVI, without particular adverse effects. However, further studies are warranted to address the drug interaction with other cardiac therapeutics and to assess therapeutic effects in CHF from other type of heart diseases in dogs and other animals.