• Title/Summary/Keyword: cardiac murmur

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Clinical Application and its Result of Modified Blalock-Taussig Shunt Using Polytetrafluoroethylene in Congenital Cyanotic Heart Disease (청색심기형환자에서 PTFE 인조혈관을 이용한 쇄골하-폐동맥 단락술의 임상적 적용과 그 결과)

  • 나명훈
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.55-61
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    • 1988
  • This report provides follow-up data on 116 patients with congenital cyanotic heart disease, aging 1 month to 13 years [median: 1.8 years], who underwent the modified Blalock-Taussig shunt using polytetrafluoroethylene graft at Seoul National University Hospital between September, 1984 and June, 1987. Among 116 patients complete follow-up studies were done on 95 patients. The mean preoperative arterial oxygen tension was 36 torr. Thirty-Six patients [38%] underwent operation in infancy. Conduit diameters included 4mm [15 cases], 5mm [47 cases], and 6mm [33 cases] sizes. The mean postoperative arterial oxygen tension was 52 torr [P<0.001]. The effectiveness of shunts was evaluated clinically and by shunt murmur, echocardiography and cardiac catheterization with angiography 1 to 31 months after operation. The incidence of shunt occlusion was 9.5% and the mortality was 14.8%. The actuarial patency rate was 83.1 * 6.4% and the actuarial survival rate was 82.5 * 4.5% at 30 months` follow-up for all patients. The effectiveness of the 4mm diameter conduit may be limited. Blalock-Taussig procedure is an effective alternative to the classic B-T shunt in congenital cyanotic heart disease.

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Transcatheter Closure of Patent Ductus Arteriosus with a Amplatzer$^{(R)}$ Vascular Plug in Two Dogs (개에서 Amplatzer$^{(R)}$ vascular plug를 이용한 동맥관개존증의 폐쇄 2 증례)

  • Kang, Min-Hee;Kim, Jung-hyun;Moon, So-Jeung;Kim, Seung-gon;Yeo, Jung-Jin;Lee, Chang-Min;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.591-594
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    • 2011
  • A 9-month-old, intact female Maltese dog and one-year-old, intact female beagle dog were presented with continuous heart murmur. These 2 dogs were diagnosed as patent ductus arteriosus (PDA) based on the two-dimensional echocardiography and angiography. Due to the large shunt size, commercially available ductal occlude device was used for transcatheter occlusion of PDA. After Amplatzer$^{(R)}$ vascular plug placement, cardiac murmur was abruptly disappeared in Maltese dog and mildly decreased in beagle dog. Complications and safety after the procedure were evaluated regularly in these 2 dogs. This is first clinical application of Amplatzer$^{(R)}$ vascular plug for transcatheter closure of PDA in two dogs in Korea.

Transcatheter Closure of Patent Ductus Arteriosus with a Coil Embolization in a Dog (개에서 Coil색전술을 이용한 동맥관개존중의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Jung-Hyun;Moon, So-Jeung;Kim, Seung-Gon;Yeo, Jung-Jin;Lee, Chang-Min;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.236-239
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    • 2011
  • A 10 month-old female (intact) Maltese dog was presented due to continuous heart murmur. The dog was diagnosed with patent ductus arteriosus (PDA) based on two-dimensional echocardiography, computed tomography (CT) and angiography. Transarterial coil embolization was used for transcatheter occlusion of the PDA. A single coil was placed successfully and effectively occluded the blood flow through the ductus. Continuous heart murmur disappeared immediately the coil placement and no residual flow was detected. Complications and safety following the procedure were evaluated regularly based on clinical signs, cardiac examinations and serum troponin-I concentrations. This is the first clinical application of coil embolization for transcatheter closure of PDA in a dog in Korea.

Isolated Aortic Valve Replacement with the Ionescu-Shiley Xenograft Valve (대동맥판 치환수술의 임상성적)

  • 김종환
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.46-53
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    • 1985
  • A single aortic valve replacement using the lonescu-Shiley bovine pericardial xenograft valve was performed in 66 consecutive patients during the period from February, 1979 to June, 1984. They were 49 males and 17 females with ages ranging from 9 to 61 [mean, 31.113.1] years, and 9 of them were children younger than 15 years of age. Twenty-seven patients [40.9%] required the combined operative procedures to either other valvular lesions or congenital defects. There were 9 early deaths within 30 days of surgery [operative mortality rate, 13.6%] and 2 late deaths thereafter [late mortality rate, 3.0%; or 1.75%/patient-year]. The 57 early survivors were followed for a total duration of 114.2 patient-years [mean, 24.016.0 months]. Four patients experienced thromboembolic complication with no death [3.50%/patient-year]; one died from intracranial bleeding related to anticoagulation [0.88%/patient-year]; one recovered from prosthetic valve endocarditis [0.88%/patient-year]; and four developed aortic regurgitant murmur with none or minimal cardiac symptoms and they were classified into cases of tissue valve failure [3.50%/patient-year]. The actuarial survival rate was 82.34.7% at 6 years, and the actuarial probabilities of freedom from thromboembolism and valve failure were 93.33.9% and 89.15.8% at postoperative 6 years respectively Symptomatic improvement was excellent in most late survivors at the follow-up end with the mean of NYHA Classes of 1.040.19 while the one was 2.290.67 at the time of operation. Excluding the higher operative mortality rates, these clinical results are fully comparable with the ones of reports from the major institutions using the porcine aortic or the bovine pericardial tissue valves and warrants the continued use of the xenograft valve in the aortic position. The importance of more detailed preoperative evaluation of the myocardial function and the need of improved myocardial preservation during surgery for the improved early clinical results were discussed.

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Balloon dilation of double chambered right ventricle in a dog (우심실 양분증 이환견에 대한 풍선확장술 시술 증례)

  • Kim, Jin-Wook;Yoon, Byung-Gook;Park, Jun-Seok;Kim, Jung-Kuk;Lee, Ki-Ho;Park, Hyung-Jin;Hur, Chan;Seo, Kyoung-Won;Song, Kun-Ho
    • Korean Journal of Veterinary Service
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    • v.40 no.1
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    • pp.67-70
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    • 2017
  • A 4 months old, intact male Shih-tzu was referred to the Veterinary Medical Teaching Hospital of Chungnam National University for evaluation of the cause of cardiac murmur and syncope. Thoracic radiography revealed right-sided cardiomegaly. Echocardiography showed marked hypertrophy of right ventricular free wall and obstruction of right ventricular outflow tract, indicating double chambered right ventricle (DCRV). The dog was medicated with atenolol and sildenafil for DCRV, however, clinical signs did not control by medication. Balloon dilation for DCRV was performed to ameliorate patient's clinical signs. The peak systolic pressure gradient across the obstruction region was decreased and clinical signs was improved by balloon dilation procedure. This is the first case report of balloon dilation for the treatment of canine DCRV in South Korea.

Double-outlet Right Ventricle with Pulmonary Stenosis [DORV: S.D.D.,subaortic VSD with ps]: One Operative case Report (양대혈관 우심실 기시증: 폐동맥협착 동반례의 수술 치험)

  • Kim, Hyeong-Muk;Lee, Nam-Su;Song, Yo-Jun
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.148-155
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    • 1977
  • The clinical findings with cardioangiography and successful surgical treatment of a 10 year old girl with double-outlet right ventricle is reported at The Dept. of Thoracic and Cardiovascular Surgery, Korea University Hospital, College of Medicine. The patient has been suffered from intermittent cyanosis, palpitation, and exertional dyspnea since 1 year after NFSD, and a holosystolic ejection murmur of grade 4 at the left 3rd intercostal space with mild cyanosis of the lips was the only physical findings at the time of this admission. Cardiac catheterization revealed ventricular septal defect with left to right shunt of 43% and right to left shunt of 10.2%. On cardioangiography from the left ventricle revealed all of the left ventricular outflow shunted into the right ventricle through the large ventricular septal defect, and the aorta originated from the infundibular chamber of the right ventricle with left, anterior sided pulmonary artery. The atria, viscera, and ventricles were normally located, and right ventricular out-flow was narrowed with infundibular hypertrophy and pulmonary valvular stenosis. Surgical correction was accomplished by closure of the ventricular septal defect in such a way that left ventricular outflow was routed via a Teflon felt prosthetic tunnel to the aorta, and pulmonary valvulotomy with infundibulectomy Was done to pass Hegar`s dilator No. 15 for reconstruction of the right ventricular outflow tract. The patient tolerated complete repair and has continued to improve over a period of three months after operation with normal school life. Details of the disease and method of repair are presented with related references.

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Operative Correction of Total Left Anomalous Pulmonary Venous Return - A Report of one case - (좌측 총폐정맥 환류이상의 수술 교정 - 1례 보고 -)

  • 류한영
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.962-967
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    • 1990
  • The anomalous pulmonary venous return of the entire left lung was an extremely rare congenital anomaly. The reported surgical experience with correction of this disorder was limited. The 3-year-old female patient underwent an operation upon the unilateral total anomalous pulmonary venous return from the left lung, in which the left superior pulmonary vein drained into innominate vein and the left inferior pulmonary vein into the coronary sinus, in Yeungnam University Hospital. The symptoms were nonspecific except frequent upper respiratory infection. Cyanosis was not seen. On auscultatory findings, a grade 2/6 systolic ejection murmur was audible over left second intercostal space of left sternal border and second heart sound had an increased pulmonary component which was widely splitted. The electrocardiogram demonstrated a right ventricular hypertrophy and right axis deviation and chest X-ray showed slightly increased pulmonary vascularity and bulged pulmonary conus. The echocardiogram demonstrated increased right atrial, ventricular, and pulmonary arterial dimension, and also secundum atrial septal defect and enlarged coronary sinus. The cardiac catheterization confirmed the left-to-right with a Qp/Qs of 2.0: 1 and oxygen step-up was seen in pulmonary artery, right ventricle, right atrium, and left innominate vein, and the catheter was not been introduced into the left pulmonary vein. A median sternotomy incision was done. Left superior pulmonary vein was drained to the innominate vein through anomalous vertical vein and the left inferior pulmonary vein drained to right atrium through the coronary sinus. The diversion of the left inferior pulmonary vein to posterior wall of left atrium was done after division in the proximity of coronary sinus. The anomalous vertical vein was diverted to base of left atrial auricle and then a atrial septal defect was sutured directly. The postoperative course was uneventful and she was discharged on the eleventh postoperative day. In the postoperative follow-up-2 months, she has been well without specific problems.

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ORAL CHARACTERISTIC OF ALAGILLE SYNDROME - A CASE REPORT (Alagille 증후군을 가진 환자의 구강내 특징에 대한 증례보고)

  • Kim, Tae-Wan;Kim, Young-Jin
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.17-21
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    • 2007
  • Alagille syndrome is an autosomal dominant genetic disorder and occurs in approximately 1 in 100,000 live births. Diagnostic criteria was established by Alagille. It is mainly caused by a mutation in the Jagged1 gene. Major clinical features of this syndrome are paucity of intrahepatic bile duct with cholestasis, characteristic facies, cardiac murmur, defects of vertebrae, and embryotoxon. And minor clinical features are mental retardation, renal involvement, growth retardation, other skeletal abnormalities, a high-pitched voice. The surviving prognosis of Alagille syndrome patients depends on the severity of cardiovescular malformation in the early ages of infant. However, with the increasing years, it depends on the severity of the liver disease. Cholestasis causes congenital jaundice, malnutrition and growth retardation. Also, the increase of serum cholesterol level cause xanthoma and pruritus. Even though the severity of these problems are reduce with age, there is cases where there is no way but liver transplantation. For oral features of Alagille syndrome patients, green discoloration of entire dentition, induced by bilirubin infiltration into dentinal tubules, is especially. Also, xanthoma on gingiva and partial hypodontia have been reported. This report is on the oral features of an Alagille syndrome patient who visited to Kyung-Pook University Hospital.

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Echocardiographic Diagnosis of Mitral Valve Dysplasia Concurrent with Mitral Stenosis and Tricuspid Valve Dysplasia in a Dog (개에서 승모판 이형성증과 병발한 승모판 협착증 및 삼첨판 이형성증의 심초음파적 특징 1례)

  • Choi, Soo-Young;Lee, Jung-Woo;Lee, Young-Won;Choi, Ho-Jung
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.101-104
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    • 2015
  • A 4-years-old, intact male Golden retriever dog was presented with abdominal distension and dyspnea. Physical examination revealed arrhythmia and cardiac murmur. Generalized cardiomegaly, pleural effusion and ascites were shown on thoracic and abdominal radiographs. Two-dimensional echocardiography revealed abnormal mitral and tricuspid valve motion, mitral and tricuspid regurgitation, left ventricular eccentric hypertrophy and left atrial dilation. Color-flow Doppler imaging revealed turbulent flow extending into the left ventricle during diastole from the mitral valve orifice, and into the left atrium during systole. Spectral Doppler recordings revealed highly increased early diastolic mitral valve inflow and prolonged pressure half-time of mitral inflow. Based on the echocardiographic examination, the diagnosis was made as the mitral valve dysplasia concurrent with mitral valve stenosis and tricuspid valve dysplasia.

A case of canine patent ductus arteriosus showed favorable therapeutic response by surgery combined with needle-acupuncture therapy

  • Kim, Kwang-Shik;Kim, Byung-Young;Kim, Tae-Hwa;Kim, Won-Bae;Liu, Jianzhu;Lee, Jung-Yeon;Kim, Duck-Hwan;Rogers, Philip A.M.
    • Korean Journal of Veterinary Research
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    • v.45 no.4
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    • pp.575-579
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    • 2005
  • A 6-month-old male Poodle was referred with chief complaint of dysponea and cough. Cyanosis was not detected. This dog was diagnosed as a case of canine patent ductus arteriosus (PDA) by X-ray and ultrasonography. Diuretics and bronchodialators were administered for 4 weeks. Clinical symptoms were not improved. Thoracotomy was done at right recumbent position. The length of ductus arteriosus was 8 mm and the diameter was 6 mm, respectively. Double ligation was performed in surgery. Continuous cardiac murmur, cough and strong femoral pulsation were disappeared after surgery. The diameters of the pulmonary artery and vein found to normal by X-ray on 10 days after operation. The diameter of the aorta measured to be larger than that of the main pulmonary artery by ultrasonography. The fractional shortening (FS) on 10 days after surgery was 17.32% by ultrasonography. The needle-acupuncture therapy was used in acupoints BL-15 as local point plus PC-6, HT-7 and HT-5 as distant points for 3 days (15 min/once/a day). The FSs were increased to 21.31% and 29.44% at 1 and on 3 days after acupuncture, respectively. The present patient was a case of typical canine PDA that showed favorable therapeutic responses by surgery combined with needle-acupuncture treatment.