• 제목/요약/키워드: ductus arteriosus, patent

검색결과 248건 처리시간 0.022초

선천성 심장 질환 환자의 폐 생검 (Lung Biopsy in Congenital Heart Disease)

  • 김광호
    • Journal of Chest Surgery
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    • 제14권1호
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    • pp.9-16
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    • 1981
  • Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

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대동맥폐동맥 중격결손증, 개방성 대동맥관 및 우측 쇄골하동맥 이상기시를 동반한 대동맥궁 결손증 (Interrupted Aortic Arch Associated with AP Window, PDA, and Aberrant Origin of the Right Subclavian Artery from Proximal Descending Aorta [A Case Report])

  • 이정렬;노준량
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.360-370
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    • 1985
  • A case of complete interruption of aortic arch with aortopulmonary window, patent ductus arteriosus, and aberrantly originated right subclavian artery from proximal descending aorta, in a four year old boy is reported in detail. This is the only reported case in Korea, who has had a successful one-stage total anatomical correction of this combination of defects. Under deep hypothermia and total circulatory arrest, aortic continuity was established using patent ductus arteriosus and anterior wall of pulmonary artery, which was anastomosed obliquely to anteromedial side of ascending aorta. Aortopulmonary window was closed using Impra patch via pulmonary arteriotomy. Then pulmonary arteriotomy was reconstructed primarily except at the junction of right pulmonary artery and main pulmonary artery, where a small piece of pericardium was used to close the defect to prevent kinking and narrowing of right pulmonary artery. Postoperative cardiac catheterization demonstrated a good reconstruction.

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동맥관개존증을 동반한 관상동맥루 1례 치험 (Coronary Artery Fistula, associated with Patent Ductus Arteriosus)

  • 김기봉
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.793-797
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    • 1987
  • Coronary artery fistula is an uncommon congenital heart defect that is readily amenable to surgical treatment. This fistula usually originates from the right coronary artery, but may arise from the left coronary artery, both coronary arteries, or single coronary artery. And the fistulous communication is most often to right ventricle, right atrium or pulmonary artery. Recently we experienced one case of congenital coronary artery fistula which was associated with patent ductus arteriosus. The fistulous communication, forming aneurysmal dilatation, was noted between the left anterior descending coronary artery and the right ventricular outflow tract. Cardiopulmonary bypass was employed in this case. After an arteriotomy was made on the aneurysmal coronary artery, both the proximal opening and the termination site of the fistulous tract were directly closed with partial aneurysmorrhaphy. The right ventricular chamber was also opened to evaluate the fistulous termination site. Postoperative hospital course of the patient was uneventful and she was discharged without problems.

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Persistent left cranial vena cava with congenital heart defect in two dogs

  • Hwang, Yawon;Oh, Hyejong;Chang, Dongwoo;Kim, Gonhyung
    • 대한수의학회지
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    • 제56권3호
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    • pp.193-195
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    • 2016
  • The purpose of this report is to introduce persistent left cranial vena cava (PLCVC) with persistent right aortic arch (PRAA) and patent ductus arteriosus (PDA). Case 1 was a Cocker Spaniel with PRAA and case 2 was a Maltese with PDA. PLCVC was enclosed at the sites of PRAA and PDA surgery; therefore, it was lifted dorsally during PDA and PRAA surgery. Surgery to repair congenital heart defects including PRAA and PDA is recommended for dogs that do not die of PLCVC at a young age.

세균성 동맥내막염을 동반한 개방성 동맥관의 치험예 (Surgery of the Infected Patent Ductus Arteriosus with Teflon Wrapping)

  • 조범구
    • Journal of Chest Surgery
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    • 제5권1호
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    • pp.25-28
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    • 1972
  • Patent ductus arteriosus is one of the most common congenital heart diseases, which treated operatively has excellent results. Treatment by surgical means is common and invariably successful. However,infected PDA cases present problems and surgeons operating must face the possibility of adhesions,aneurysmal dilatation and friabiilty of tissue with tearing of the pulmonary arterial end, especially, which causes a fatal hemorrhagic ccmplication. In the earlier days of cardiac surgery, many surgeons deferred operative treatment infected PDA because of frequent complications, high postoperative morbidity and mortality. This continued until Touroff et al. successfully divided the infected PDA in 1940. In 1944, Harper et aI. have used Cellophane for the wrapping of the infected PDA. This surgical procedure has become a single, simple and safe method for treating infected PDA, since that time. In the Teflon wrapping technique, a cardiothoracic team of Yonsei University Severance Hospital used Teflon felt instead of Cellophane in one case of infected PDA and this method proved intractable to antibiotic treatment for 40 days.

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A rare case of intramural patent ductus arteriosus in a dog: anatomic, histopathologic, and radiographic features

  • Kim, Jung-Hyun;Kim, Su-Min;Kim, Ja-Young;Han, Hyun-Jung
    • 대한수의학회지
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    • 제60권2호
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    • pp.89-92
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    • 2020
  • A 5-year-old dog was evaluated for a lethargy and respiratory distress. Radiograph revealed cardiomegaly with pleural effusion, and the dog died during a thoracocentesis. At necropsy, the descending aorta and pulmonary trunk were dilated and in close contact, but there was no external evidence of a patent ductus arteriosus (PDA). When the descending aorta was opened however, an ostium opening into the pulmonary trunk was evident. Histopathological investigation revealed that the intramural PDA resembled vascular tissue with a structure and architecture. The diagnosis was an intramural PDA, an extremely rarely reported type of PDA in the dog.

단일화수술 후 분리되어 남은 체폐동맥 부행혈관에 의한 기관지 압박 (External Compression of Bronchus by Aneurysm from Divided Major Aortopulmonary Collateral Artery after Unifocalization)

  • 이현성;박영환;홍유선;조범구
    • Journal of Chest Surgery
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    • 제32권12호
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    • pp.1135-1139
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    • 1999
  • Multistage unifocalization and complete repair have been performed for pulmonary atresia ventricular septal defect and major aortopulmonary collateral arteries. We reported a case that divided major aortopulmonary collateral artery was changed into an aneurysm that compressed the left main bronchus. A 1-year-8-month old boy was operated. The Rastelli operation with left pulmonary artery reconstructuion ligation of patent ductus arteriosus and take-down of right Blalock-Taussing shunt was performed on the patient who had pulmonary atreisia ventricular septal defect patent ductus arteriosus and MAPCA at 1 year and 8 months of his age. He previously underwent the unifocalization and right B-T shunt at 9 months of age,. He repeatedly had difficulty in weaning from the mechanical ventilator, After removing the aneurysm from the divided MAPCA that compressed the left main bronchus externally it was possible to wean him from the mechanical ventilator.

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Successful Opening of Ductus Arteriosus with Milrinone in a Newborn with Tetralogy of Fallot and Pulmonary Atresia

  • Won, Chong-Bock;Kim, Min-Young;Choi, Duk-Young;Cho, Hye-Jung;Shim, So-Yeon;Son, Dong-Woo
    • Neonatal Medicine
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    • 제18권2호
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    • pp.365-369
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    • 2011
  • 폐동맥폐쇄가 동반된 팔로네증은 팔로네증 중에 가장 심한 형태이다. 이런 종류의 선천성 심질환에서 폐혈액 순환을 지속하기 위하여 동맥관 개존을 유지하는 것은 생명을 구하는 매우 중요한 치료이다. Milrinone은 선택적 인산이에스테르효소 3 억제제이며 강력한 혈관 확장제로 알려져 있다. 저자들은 폐동맥 폐쇄가 동반된 팔로네증 신생아에서 폐순환을 지속시키기 위하여 동맥관 개방을 유지하는 치료로 milrinone을 성공적으로 사용한 증례를 보고한다. Milrinone은 동맥관 개방효과뿐 아니라, 심근수축 촉진, 이완 촉진, 폐혈관 확장 효과가 있으며 부작용은 심하지 않아 더 이로운 치료방법이 될 가능성이 있다. Milrinone의 치료효과를 밝히기 위하여 더 많은 치료증례 조사와 타 약제와의 비교 연구 등이 필요하다.

세균성 심내막염에 의한 폐색전증이 동반된 동맥관 개존증의 수술치험 -1례 보고- (Surgical Treatment of Persistent Ductus Arteriosus Complicated by Bacterial Endocarditis with Pulmonary Artery Embolism 1 case report)

  • 오정우;오봉석;이동준
    • Journal of Chest Surgery
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    • 제30권2호
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    • pp.209-212
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    • 1997
  • 15세 남자환자가 갑자기 발생한 흉통과 각혈, 호흡곤란을 주소로 본원 응급실로 내원하였다. 환자는 동맥관 개존증 및 감염성 심내막염띠 합병된 폐색전증으로진단되었다. 3주간 적절한 항생제 치료를 한 후 체외순환하에 동맥관 개존증 패취봉합 및 폐동맥 판막 성형술을 시행하였다. 이후 환자는 순조롭게 회복되어 퇴원 하였다. 동맥관 개존증에 합병된 급성심내막염으로 폐동맥 혈전증이 발생한 환자를 수술 치험하여 좋은 결과를 얻었기 에 보고하는 바이다.

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동맥관 개존증의 임상적 고찰 (A retrospective clinical study of isolated patent ductus arteriosus)

  • 곽영태
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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