• Journal of Chest Surgery
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• 제21권6호
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• pp.1099-1102
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• 1988

A vertical skin incision with median sternotomy for open heart surgery usually leaves an unsightly hypertrophic scar, and it makes cosmetic and psychic problems especially in young female patients. Since November 1986, we have used a bilateral submammary skin incision with dissection of a fasciocutaneous flap in 5 young female patients with uncomplicated acyanotic congenital heart disease. The exposure of the operative field was excellent. And we had good results without any significant complication associated with this type of incision.

• Journal of Chest Surgery
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• 제17권2호
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• pp.205-211
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• 1984

Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. We have presented six patients with surgically treated vascular rings at Seoul National University Hospital during the period June 1970 through May 1984. Two patients had double aortic arches and four patients had right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Four patients had symptoms relating vascular ring and two patients were detected incidentally during diagnostic evaluation of symptomatic intracardiac defects. Associated congenital malformations were seen in four patients. The operative approach was through left thoracotomy in three patients and median sternotomy in remaining three patients associated with congenital cardiac defects. There were no postoperative deaths with excellent result in preoperative symptomatic patients. To our knowledge, successful surgical repair of vascular ring has been reported only once in the Korean literature.

• Journal of Chest Surgery
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• 제20권1호
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• pp.139-147
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• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• Journal of Chest Surgery
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• 제20권1호
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• pp.101-105
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• 1987

A clinical evaluation was performed on 17 cases of the cardiac and great vessel injuries above the subclavian vessel at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital from April, 1980 to September, 1986. The results were as follows: 1. Sex distribution were 13 cases in male and 4 cases in female. In age range, second and third decades occupied in about 65% of total cases. 2. Modes of injury were penetrating wound is 14 cases and nonpenetrating wound in 3 cases. The stab wounds by knife were most frequent. 3. Time interval from injury to operation was mean 103 minutes. 4. Surgical approaches were performed with thoracotomy in 9 cases, median sternotomy in 3 cases and direct incision above the wound. 5. Sites of injury were heart in 10 cases and great vessel in 7 cases. The right ventricular injury was most common as 7 cases. 6. Operative procedures were performed with simple closure, vascular graft anastomosis and ligation. There was no postoperative death.

• Journal of Chest Surgery
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• 제11권2호
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• pp.170-174
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• 1978

A case of mediastinal seminoma is presented. A male driver, 27 years old Korean, has been suffered from substernal pain, cough and moderate swallowing difficulty since 5 months prior to this admission. At the time of onset, he visited at a local clinic to find some mass in his anterior mediastinum on chest P-A and lateral X-ray check. Recently, intermittent hiccups with much aggravated dysphagia forced him to visit our hospital, and admitted for radical resection under the impression of anterior superior mediastinal tumor of thymus origin. Median sternotomy was done and total resection of the tumor of 8.0X11.0X3.5cm was done without any specific complication and biopsy of the tumor revealed as primary mediastinal seminoma of the mediastinum. Supplementary prophylactic irradiation therapy was done with a tumor dose of 4,000 rad in 4 weeks after operation. Postoperative hospital course was uneventful and patient was joyful with his occupation for 3 months after discharge.

• Journal of Chest Surgery
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• 제11권2호
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• pp.175-180
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• 1978

A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.

• Journal of Chest Surgery
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• 제26권3호
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• pp.204-208
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• 1993

The review of 68 patients, who were diagnosed as spontaneous pneumothorax during the period from Dec, 1991. to Jul, 1992. were performed thoracoscopy of 70 cases under local anesthesia with 1% lidocaine at the department of thoracic & cardiovascular surgery, HanYang University Hospital. Clinical data on distribution of Age & Sex, Location, Frequency of Reccurrence and other aspects of pneumothorax were summerized.37 cases were treated by thoracoscopic management and closed thoracostomy. As thoracoscopic management, Electrocauterization of bullae or blebs[37 cases], Endo-clip application [2 cases], Removal of foreign body[1 case] were performed. 31 cases were cured by open thoracotomy. The thoracotomy indications under thoracoscopic finding were followed as: 1. Severe pulmonary adhesion and destroyed lung parenchyme 2. multiple bullae or blebs on several areas 3. finding of pulmonary tuberculous caseous lesion 4. persistant air leakage after 7 days from thoracoscopic management Excision, wedge resection of bullae or blebs was performed in most cases [22 cases], 2 cases by median sternotomy and Segmentectomy of 7 cases were carried out depending on the pathologic change of lung.There was no operative mortality and Follow-up for all patients were showed good results.

• Journal of Chest Surgery
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• 제20권2호
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• pp.317-322
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• 1987

Records of 15 patients who underwent operation for constrictive pericarditis at this department from 1976 through 1984 were reviewed. All had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. There were 12 males and 3 females in this series. Range of age varied from 7 years to 51 years. Clinical and histological study revealed granulomatous pericarditis compatible with the diagnosis of tuberculosis in 5 patients, non-specific chronic inflammatory changes in 6 patients and pyogenic pericarditis in 2 patients. Pericardiectomy was performed through a median sternotomy [11 cases] or bilateral anterior thoracotomy [4 cases]. The postoperative complications were observed in 4 patients. Low cardiac output was the most common complication [2 patients]. In 13 cases, excluding 2 operative deaths, preoperatively all were in New York Heart Association Class III or IV. At the time of discharge II [85%] were in Class I or II. 4 Cases were reoperated after original pericardiostomy and all resulted in marked improvement. Early surgical intervention is advisable in all patients in whom cardiac constriction is caused by either a thickened pericardium or a pericardial effusion before myocardial dysfunction occurs.

• Journal of Chest Surgery
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• 제28권6호
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• pp.610-618
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• 1995

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

• Journal of Chest Surgery
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• 제35권5호
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• pp.397-401
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• 2002

대동맥궁단절과 대동맥폐동맥창이 합병된 기형은 심기형 중 희귀한 형태로서 조기 진단과 외과적 치료가 요구되는 기형이다. 정중흉골절개를 통한 일차 완전교정을 체중 2.46kg, 생후 10일된 신생아에서 성공적으로 시행하였기에 문헌고찰과 함께 보고하는 바이다.