• Journal of Chest Surgery
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• v.48 no.6
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• pp.407-410
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• 2015

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.50-58
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• 1989

The emergence and expansion of cardiac surgery over the past decade has resulted in an increasing number of patients undergoing cardiac operations but many kinds of heart surgery was realized only palliative, resulting in increasing numbers of secondary cardiac procedures. From 1978 to 1988, 10 cases of various congenital heart diseases and 17 cases of acquired heart diseases were reoperated at Hanyang University Hospital. The leading indication of second operation was residual shunt or valvular malfunction due to technical failure in congenital heart disease and primary valve failure, endocarditis, paravalvular leakage were for acquired heart disease. The mortality of reoperation was 0% for congenital heart disease and 11.7%[2 death among the 17 patients] for acquired heart disease. The leading causes of death were myocardial failure, sepsis with endocarditis, acute renal failure and congestive heart failure.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.147-156
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• 1983

Over a period from May, 1977 to SEptember, 1982, 101 cases ofopen heart surgerywere done under cardiopulmonary bypass. There were 50 male and 51 female patients, and the ages of the patients ranged from 19 months to 48 years. Sixty-nine cases were congenital heart disease and 32 cases were acquired heart disease, which consisted of 30 valvular disease, 1 IVC obstruction, and 1 myxoma. Among the 30 cases of valvular disease, 12 MVR, 4 MVR+TAP, 2 MVT+AVR, 1 MAP, and 11 OMC were done. There were 3 operative deaths (17.5%) in 16 MVR, 1 in 2 MVR+AVR, and 1 in 11 OMC. Operative mortality in 69 congenital heart disease was 13.0% ; 3 deaths (6.7%) in 45 acyanotic and 6(25.0%) in 24 cyanotic cases. The overall mortality for 101 cases was 14.8%; 13.0% for congenital and 18.8% for acquired heart disease.

• Journal of Chest Surgery
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• v.13 no.3
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• pp.167-173
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• 1980

From 1976 through June 1980, 75 patients underwent Open heart operation at Korea University Hospital.Of the 75 patients, 39 were congenital heart cases and 36 were acquired heart disease cases. 39 cases of congenital heart disease were consisting of 16 T.O.F.,4 A.S.D., 10 V.S.D., 3 P.S., 1 P.D.A., 1 V.S.D. + Mi, 1 Truncus arteriosus, 1 Ebstein, 1 D.C.R.V., 1 Single ventricle. Among 36 valvular replacement cases, 18 cases of MVR, 3 cases of AVR, 6 cases of Double valve replacement, and 10 cases of Open Mitral commissurotomy, were performed. Postoperative mortality rate of congenital heart disease was 25.6% and that of acquired heart disease was 8.3%. Overall mortality rate of open heart surgery was 17.3%. Among 16 cases of postoperative death cases, 5 cases of autopsy were performed. Postoperative cause of death of our series were intracranial bleeding, pacemaker failure, low output syndrome, protamine anaphylaxis, bleeding, prosthetic valve embolism, C V A, miliary tuberculosis, hypothermia due to pump failure.

• Journal of Chest Surgery
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• v.17 no.2
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• pp.305-314
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• 1984

From May 1977 to April 1984, 204 cases of open heart surgery were performed under cardiopulmonary bypass. There were 99 male and 105 female patients ranging in age from 19 months to 58 years. 136 cases [66.7%] were congenital heart disease, and 68 cases [33.3%] were acquired heart disease, which were 66 valvular disease [97.1%], 1 IVC obstruction, and 1 myxoma. There were 136 congenital heart anomaly with 16 operative deaths [11.8%], consisting of 94 acyanotic cases with 7 death [7.4%] and 42 cases of cyanotic cases with 9 deaths [21.4%]. In 66 patients of acquired valvular disease, 52 valves were implanted; 47 mitral valve replacement with 4 death [8.5%] and 5 double valve replacement [MVR+AVR] with 1 death [20%]. Postoperative, warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 11.8% in congenital anomaly, and 11.8% in acquired heart disease, overall mortality rate was 8.5%.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.711-717
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• 1985

Over a period from July 1984 to June 1985, 39 cases of open heart surgery were done under cardiopulmonary bypass. There were 23 male and 16 female patients, ranging in age from 18 months to 58 years. Thirty cases were valvular disease. The most common of congenital heart disease is VSD. Among the 9 cases of acquired valvular diseae,1 MAP, 5 MVR, 2 MVR+TAP, and 1 MVR+AVR were done. There were 1 operative death[11%] which was done MVR+TAP. Operative mortality in 30 congenital heart disease was 7%; 1 death [5%] in 22 acyanotic and 1[13%] in 8 cyanotic cases. Finally, overall mortality for 39 cases was 8%; 7% for congenital heart disease and 11% for acquired heart disease.

• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.183-191
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• 2011

Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened Widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.633-643
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• 1986

Five hundred cases of open heart surgery were operated in the Dept. of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1986. The clinical data were summarized as follows: 1. The age distribution of congenital heart disease patients was 2 to 41 years old and mean age was 13.4 years and of acquired heart disease was 11 to 57 years old and mean age was 32.7 years. 2. There were 319 cases [63.8%] of acyanotic congenital heart anomalies, 56 cases [11.2%] of cyanotic anomalies and 125 cases [25.[%] of acquired heart disease. 3. For myocardial protection, Bretschneider and potassium glucose solution had been used as cardioplegic solution and since 1983, GIK solution is being used repeatedly every 30 to 40 minutes time interval with excellent results. 4. The ingredient of the priming solution is Hartmann`s solution, mannitol, sodium bicarbonate, potassium, chloride, fresh ACD whole blood, calcium chloride, heparin and dexamethasone. 5. There were 94 cases of mild hypothermia, 280 cases of moderate hypothermia and 126 cases of intermediate hypothermia. 6. The overall mortality was 8.2%. And the mortality rate in each disease entity is 2.5% in acyanotic congenital cases, 33.9% in cyanotic congenital cases and 11.2% in acquired heart disease.

• Clinical and Experimental Pediatrics
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• v.49 no.9
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• pp.917-929
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• 2006

Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.383-390
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• 1985

108 cases of open heart surgery were done at our department in 1984. There were 58 male and 50 female patients ranging in age from 20 months to 52 years. 75 cases were congenital heart disease, and 33 cases were acquired heart disease. There were 75 congenital heart anomalies with 5 operative deaths [6.7%], consisting of 62 acyanotic cases with 2 deaths [3.2%] and 13 cases of cyanotic cases with 3 deaths [23.1]. In 33 patients of acquired valvular disease, 29 valves were implanted; 20 mitral valve replacement with 2 death [10%], 2 aortic valve replacement with 1 death [50%], 2 double valve replacement [MVR+AVR] and 2 open mitral commissurotomy plus aortic valve replacement with no death. Postoperative, Warfarin sodium was medicated with checking prothrombin time. Finally, the operative mortality was 9.2% in congenital anomaly, and 9.1% in acquired heart disease, overall mortality rate was 9.3%.