• Journal of Chest Surgery
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• 제21권6호
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• pp.996-1002
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• 1988

A clinical analysis was performed on 115 cases of -patent ductus arteriosus treated surgically during the period of 11 years from Aug. 1977 to Jul. 1988. at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. Among 115 cases, male was 38 and female was 77 and ages ranged 12 days to 27 years old with the average of 8 7/12 years. The major clinical symptoms on admission were frequent URI attack[77.4%], dyspnea on exertion[32.2%] and palpitation[13%]. On auscultation, continuous machinery murmurs were detected in 97 cases[84.3%] and loud systolic murmurs were detected in 18 cases[15.7%]. Preoperative electrocardiographic findings were as follows: LVH 59[51.3%], RVH 12[10.4%], BVH 16[13.9%] and WNL 28[24.3%]. Radiologically, there were increased pulmonary vascularity in 104[90.4%] and cardiomegaly 62[53.9%]. Cardiac catheterization were performed in 101 cases and mean systolic pulmonary arterial pressure was 49.84*29.7mmHg and mean Qp/Qs was 2.95k1.8. Methods of operation were multiple ligation in 96, division in 11 and transpulmonary arterial repair using cardiopulmonary bypass in 8. Complication were recannalization in 2, temporary hoarseness due to left recurrent laryngeal nerve paralysis in 3 and respiratory distress in 1 and overall mortality rate was 1.7%[2 cases].

• Journal of Chest Surgery
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• 제30권9호
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• pp.927-931
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• 1997

신생아에서 선천적 삼첨판 폐쇄부전은 자주 보고되지만 건삭파열에 의한 이차성 삼첨판 폐쇄부전은 아주 드물다. 환아는 생후 1일의 남아로 출생 직후부터 심한 호흡곤란, 청색증 및 산혈증이 관찰되었고, 무호흡과 함께 서맥이 빈번히 나타났다. 심초음파도 검사를 시행하여 폐동맥 판막을 통한 우심유출로 혈류가 관찰되지 않아서 폐동맥 폐쇄증으로 진단되었다. 수술 소견에서 폐동맥 및 폐동맥 판막의 기형은 전혀 없었고, 삼첨판의 전방 유두근 건삭파열이 새로이 확인되었다. 삼첨판 폐쇄부전은 건삭 형성술을 실시하여 성공적으로 교정하였으며, 술전 심초음파도에서 주폐 동맥에 폐혈류가 관찰되지 않았던 것은 심한 삼첨판 폐쇄부전 때문이었던 것으로 판단되었다.

• Journal of Chest Surgery
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• 제27권11호
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• pp.902-906
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• 1994

Between May 1991 and August 1993, 16 patients underwent repair of complete atrioventricular septal defect without another major anomaly at Cardiovascular Center,Yonsei University College of Medicine. Ages of the patients ranged from 3 months to 38 years with a mean of 42 months. Among 16, 10 patients[63%] are associated with Down`s syndrome. All patients underwent primary repair except and one who received had been repaire of coactation of aorta and patent ductus arteriosus 2 month before. Preoperative mitral valve regurgitation [MR] was evaluated with Doppler echocardiography and angiography which revealed absent or grade I in 1, grade II in 8, grade III in 4, and grade IV in 3. Operative technique was performed under the moderate hypothermic cardiopulmonary bypass with crystalloid cardioplegia. Intraoperative echocardiography was performed epicardial approach [n=7] in the operative table or transthoracic approach [n=9] at intensive care unit. In all patients except 3, MR were improved. But in 3 patients, was not improved or exagerated comparing preoperative one. All of them were died.One patient was showed MR grade IV in intraoperative echocardiography, we re-repaired atriventricular valve with cardiopulmonary bypass. During follow-up period [at a mean of 11 months after repair], doppler echocardiography was performed in all patients. The follow up echocardiography revealed that the degree of MR in immediate postoperative period was not changed except in two patients in whom it was aggravated. Thus it seems that intraoperative and early postoperative echocardiography was employed important role of survival and can be predictable for long term results.

• 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.

• Journal of Chest Surgery
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• 제20권3호
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• pp.528-535
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• 1987

A clinical study was performed on 164 cases of PDA experienced at the Dept. of Thoracic and Cardiovascular Surgery of Pusan National University Hospital during 6 years from Jan. 1981 to Dec. 1986. It was shown that the PDA was a female-dominant heart disease [male to female ratio, 1:2.8] and two most common symptoms were frequent URI [45.6%] and exertional dyspnea [36.7%]. Continuous machinery murmurs were detected in 143 cases [87.2%], increased pulmonary vascularities [89.0%] and cardiomegalies [63.4%] by chest X-ray. The signs of LVH [43.9%], RVH [3.7%] and BVH [4.9%] were noted on the EKG. Cardiac catheterizations were performed on 67 out of 164 patients and the mean systolic pulmonary artery pressure was 48mmHg [range: 18-131mmHg] and the mean Qp/Qs was 3.1 [range:1.2-8.5] and Rp/Rs below 0.25 was 83.6%. Associated cardiac anomalies were VSD [7.9%], ASD [3.0%], pulmonary valvular stenosis [2.4%] and left persistent SVC [2.4%]. Operative methods were as follows; ligations [145; 88.4%] and divisions [6;3.7%] were performed through the left posterolateral thoracotomies without mortality and the remained cases [13;8.0%] were managed under the cardiopulmonary bypass because of the associated cardiac anomalies. Atelectasis [4.9%] and pneumonia [4.3%] were most frequent postoperative complications and the overall mortality rate was 2.4% [4 out of 164 cases].

• Journal of Chest Surgery
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• 제28권8호
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• pp.747-753
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• 1995

Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

• Journal of Chest Surgery
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• 제47권6호
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• pp.529-532
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• 2014

An eight-day-old neonate was diagnosed with dextro-transposition of the great arteries, atrial septal defect, patent ductus arteriosus, and a single sinus origin of the coronary arteries. The single coronary artery originated from the left sinus (sinus 2), had a proximal left circumflex arterial branch, and passed anteriorly to the right side of the aorta, further branching into the right coronary and left anterior descending arteries. We successfully performed an arterial switch operation and coronary transfer by tube graft reconstruction with autologous aortic tissue to treat the dextro-transposition of the great arteries and atrial septal defect with a single-sinus origin of the coronary arteries.

• Journal of Chest Surgery
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• 제35권9호
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• pp.664-667
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• 2002

선천성 심질환에 대한 개심술후 발생한 폐동맥 고혈압 위기증이 혈관확장제 등의 내과적 치료에 반응하지 않는 경우에 체외막 산소화 장치를 사용함으로써, 안정적인 산소공급의 확보를 통한 폐혈관 저항의 상승 방지, 심박출량의 상당 부분의 바이패스를 통한 폐관류압의 감소, 우심실의 용적 부하 감소 및 심실보조 기능을 통한 우심부전 및 저심박출의 예방 등의 치료 효과를 기대할 수 있다. 본 증례의 경우, 동맥관 개존증과 이차성 폐동맥 고혈압이 합병되어 있었던 37세 남자에서 수술후 발생한 폐동맥 고혈압 위기증에 대한 치료시 체외막 산소화 장치를 함께 사용하여 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제32권6호
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• pp.584-587
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• 1999

DiGeorge증후군은 드문 선천성 기형으로 3번째와 4번째 인후낭의 발생과정 이상에 의한 흉선과 부갑상선의 형성부전과 관련이 있다. 이 증후군은 흔히 선천성 심장기형과 안면기형을 동반한다. 저자들은 DiGeorge증후군을 동반한 선천성 심장기형을 1례 수\ulcorner 치험하였다. 환아는 생후 1개월된 남아로 몸무게는 3.5kg이었다. 동반된 선천성 심장기형은 심실중격결손증, 심방중격결손증, 대동맥축착증 및 동맥관 개존증이었다. 수술은 좌측방 개흉 및 흉골 정중절개를 통하여 일차에 거쳐 시행하였고 환아는 수술 후 별다른 문제없이 회복하였다. 현재 6개월 째 외래 추적관찰 중에 있으며 양호한 상태로 성장하고 있다.

• Neonatal Medicine
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• 제15권2호
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• pp.200-206
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• 2008

안면 기형, 삼각두, 뇌량 무형성, 감각 신경성 난청, 시각장애, 심기형, 심근병증, 폐동맥 고혈압, 배꼽 탈장과 생식기 기형이 있는 환아에게 동반된 9번 염색체 단완이질염색질 부위의 첨가를 발견하여 9번 염색체 p13 부위의 첨가와 연관된 다발성 기형의 발생을 보고하는 바이다.