• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.241-242
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• 1998

For the aritificial heart valve, two types of valves-polymer and mechanical valve- are generally used. The polymer valve is used as a new low-cost artificial valve. Among the several properties of the artificial valve, the low-regurgitation property is important because it can provide better cardiac output characteristic. So in this study we analyzed and compared the regurgitation property of the mechanical valve which is generally used nowdays and the polymer valve which was made in our group. As results, the polymer valve showed the better regurgitation property compared to the mechanical valve approximately by 3 times, and increased the cardiac output by 10%.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.793-797
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• 1994

Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.557-564
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• 1987

From September 1980 to July 1986, 135 cases of cardiac valve surgery were performed under the cardiopulmonary bypass. Out of 135 cases, single valve surgery was 114 cases including open mitral commissurotomy 17, mitral annuloplasty 2, mitral valve replacement 85, and aortic valve replacement 10 and double valve surgery was 21 cases. There were 68 males and 67 females ranging from 9 to 57 years of age. Early death within 30 days after operation was 17 cases [12.6%] and caused of death were ventricular arrhythmia 5, low cardiac output syndrome 4, excessive bleeding 3, pulmonary complication 2, and so on. Among 118 early survivors, 5 cases [5.1%] of late death were developed over a period of 2 to 72 months, and main cause of death was fatal bleeding complication associated with anticoagulation therapy. Symptomatically, 91.8% of patients were in NYHA functional class I or II at the end of the follow-up.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.309-316
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• 1987

Since the first report of successful ligation of patent ductus arteriosus in 1939, it`s surgical intervention has become a routine and relatively safe procedure. During the past ten years from Aug. 1975 to Aug. 1985, 107 cases were operated on for a patent ductus arteriosus at the Department of thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University. Clinical analysis of these cases was performed. Mean age at operation was 9.4 years, ranging from 20 months to 32 years. Sex ratio of female to male was 1.8;1. Most common symptoms were frequent respiratory infection, exertional dyspnea, and palpitation. Diagnosis was made by auscultation, 2 dimensional echocardiography, cardiac catheterization, and cineangiocardiography. A moderate to severe pulmonary hypertension was found in 42 cases [49.4%] in cardiac catheterization. Operative methods were multiple ligation of paten`. ductus arteriosus with or without Dacron or Teflon wrapping in 72 cases [68%], and division and suture in 34 cases [32%]. There were three operative deaths [2.8%]. The causes of death were hemorrhage from tearing of aorta, low cardiac output, and arrhythmia. All of these cases had moderate degree of pulmonary hypertension.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1111-1114
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• 1999

Cor triatriatum is a rare congenital heart disease that is often lethal in children if not correctly identified and properly managed, Characteristically an anomalous membrane divides the left atrium into two chambers one located posterosuperiorly which is connected to the common pulmonary venous trunk and the other anteroinferiorly which is connected to the left atrial appendage and the mitral valve. Eight patients with Cor triatriatum were been seen at our hospital from 1984 to 1999. The clinical presentation diagnostic evaluation and surgical results are outlined in this retrospective review. Resection of the obstructing anomalous atrial membrane was performed using a hypothermic cardiopulmonary bypass in all cases. Right atriotomy was performed in all patients and left atriotomy was performed in a patient who had poor preoperative general conditions and serious cardiac defects(TAPVR & hypoplastic left ventricle) died of low cardiac output during the immediate postoperative period. The postoperative course has been excellent in the remaining. Cor triatriatum is amenable to surgical repair with excellent results when diagnosed early and in those who are not complicated by other complex cardiac anomalies.

• Journal of Chest Surgery
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• v.14 no.4
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• pp.381-387
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• 1981

Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

• Journal of Chest Surgery
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• v.14 no.4
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• pp.388-398
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• 1981

Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.701-711
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• 1991

We experienced 6 cases of primary cardiac tumor, all received operation for removal of tumor. Mean age was 43.8 years-old ranging from 17 years-old to 66 years-old. Five cases were female, one case was male. Five cases were benign, myxoma, all located within left atrium. One case was malignant, angiosarcoma within right atrium. All patient showed cardiac manifestations. One case was in NYHA functional class II, two were in III, three were in IV. Four patients showed constitutional symptoms, but no one showed evidence of embolic phenomenon. All case of myxoma showed cardiomegaly except one malignancy. Only one case was regular sinus rhythm, three were sinus tachycardia 8z two were atrial fibrillation. The most common site of tumor origin was fossa ovalis limbus[four of all]. Two of five myxomas received emergency operation, one patient died postoperatively. Lived four patients showed no evidence of recurrence[mean follow-up, 3,5 years], but one patient has Grade II /IV mitral regurgitation & in OPD follow-up now, One malignant case, 17 years-old cerebral palsy female, was angiosarcoma occupied most of right atrial chamber originated from anterior wall of right atrium, received emergency operation which was removal of mass & reconstruction of right atrium with artificial pericardial patch. This patient died on postoperative 36th day due to persistent LCOS[low cardiac output syndrome] with combined sepsis.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.664-667
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• 2002

Extracorporeal membrane oxygenation(ECMO) provides stable oxygenation to prevent elevation of pulmonary vascular resistance and bypasses a significant part of cardiac output to the pulmonary vascular bed to reduce pulmonary perfusion pressure. In addition, ECMO prevents right heart failure and low cardiac output by means of ventricular assist and reduction in volume load to right ventricle. As a result, ECMO can be used for the treatment of pulmonary hypertensive crisis after surgery for congenital heart disease, especially when it is refractory to conventional measures. We report a case of postoperative pulmonary hypertensive crisis, developed in a 37-year-old male with patent ductus arteriosus with secondary pulmonary hypertension, which was successfully managed including ECMO.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.213-221
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• 1990

We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.