• 대한족부족관절학회지
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• 제15권2호
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• pp.79-85
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• 2011

Purpose: The purpose of the present study was to compare and analyze the clinical outcomes of the percutaneous and open repair of acute Achilles tendon ruptures. Materials and Methods: We performed a retrospective study on 24 patients (group 1) managed with percutaneous repair, and 21 patients (group 2) managed with open repair for acute Achilles tendon rupture. The postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. Postoperative overall satisfaction and cosmetic satisfaction were also evaluated. Results: By Arner-Lindholm scale and AOFAS score, there was no difference between two groups (p<0.05). As for postoperative overall satisfaction, 5 cases were very satisfied, 16 cases were satisfied and 3 cases were fair in group 1. In group 2, 12 cases were very satisfied, 9 cases were satisfied. For postoperative cosmetic satisfaction, 13 cases were satisfied, 11 cases were fair in group 1. In group 2, 9 cases were very satisfied, 12 cases satisfied. In open repair group, a case of deep wound infection and three cases of skin necrosis were reported as complication. 2 cases of sural nerve injury were seen in percutaneous repair group and were recovered within 3 months. Conclusion: Percutaneous repair of acute Achilles tendon ruptures have high level of cosmetic satisfaction compared with open repair without any significant difference in clinical outcomes.

• Journal of Chest Surgery
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• 제48권5호
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• pp.328-334
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• 2015

Background: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. Methods: In this study, we assessed 15 patients (mean age, $47.7{\pm}9.7years$; 11 female and 4 male) who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was $13.5{\pm}7years$. The mean preoperative Wilkins score was $9.4{\pm}2.6$. Results: The mean mitral valve area obtained using planimetry increased from $1.16{\pm}0.16cm^2$ to $1.62{\pm}0.34cm^2$ (p=0.0001). The mean pressure half time obtained using Doppler ultrasound decreased from $202.4{\pm}58.6ms$ to $152{\pm}50.2ms$ (p=0.0001). The mean pressure gradient obtained using Doppler ultrasound decreased from $9.4{\pm}4.0mmHg$ to $5.8{\pm}1.5mmHg$ (p=0.0021). There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period ($39{\pm}16months$). The 5-year event-free survival was 56.16% (95% confidence interval, 47.467-64.866). Conclusion: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.

• 대한족부족관절학회지
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• 제15권3호
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• pp.144-148
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• 2011

Purpose: To investigate the results of percutaneous repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: We retrospectively analyzed the outcomes of 73 patients with ruptured Achilles tendon from October 1995 to September 2009. 28 patients were excluded due to short follow up period. 34 patients were male and 11 patients were female. The mean patient age was 37.19 (10~62) years. The location of rupture site was 6.58 cm proximal to the tendon insertion into the calcaneus on average. Mean follow up period was 55 months and All patients were surgically repaired using percutaneous technique with sural nerve isolation. Results: Arner-lindholm score were excellent in 32 (71%), good in 12 (27%), poor in 1 (2%) case. 44 cases (98%) had the score more than good. Mean American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot function score was 92.93 (67~100). We had 1 case of superficial infection, 1 case of soft tissue irritation by suture knot. Conclusion: Percutaneous repair with sural nerve isolation in treating ruptured Achilles tendon showed low complication rate and reliable clinical outcome.

• Journal of Chest Surgery
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• 제46권2호
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• pp.135-137
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• 2013

An atrial septal defect is the most common type of congenital heart disease among adults. Surgical repair or percutaneous closure of the defect is the treatment options. Even though percutaneous closure seems to be less risky than surgical repair, it may result in fatal complications like device embolism, cardiac perforation and tamponade. Herein we report a case of the embolism of a device into the pulmonary artery after one hour of percutaneous closure in which the embolized device was surgically removed and the defect was closed with a pericardial patch.

• 대한족부족관절학회지
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• 제22권2호
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• pp.68-73
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• 2018

Purpose: This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications. Results: No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2. Conclusion: Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

• 대한족부족관절학회지
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• 제4권2호
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• pp.61-66
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• 2000

Purpose: To evaluate the clinical validity of percutaneous screw fixation in Maisonneuve fracture. Material and Methods: Out of 5 Maisonneuve fracture patients hospitalized in the department of orthopedic surgery of Seigang hospital from February 1995 to May 1998, 4 patients were treated with percutaneous screw fixation and 1 patient was treated with percutaneous screw fixation and repair of deltoid ligament altogether. The results were evaluated on the clinical and radiological finding. Results: In all cases, the range of motion of ankle joint was normal, the complication such as postoperative pain and post-traumatic arthritis were not found. Widening of medial clear space or talar shift were not found in the follow up X-ray and tibiofibular distance, compared with normal ankle joint was same on follow up CT. Conclusion: Percutaneous screw fixation is simple, less invasive and more effective method in the treatment of Maisonneuve fracture.

• Journal of Chest Surgery
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• 제51권4호
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• pp.277-279
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• 2018

A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

• Journal of Chest Surgery
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• 제42권4호
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• pp.524-527
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• 2009

Stent graft는 점차 대동맥질환에 대해 수술적 치료를 대체하거나 수술 범위를 줄여줄 수 있을 것으로 기대된다. 저자들은 상행대동맥과 하행대동맥에 각각 독립된 대동맥류를 가진 80세 남자환자에서 수술적 치료와 스텐트 삽입을 동시에 시행하였기에 문헌 고찰과 함께 증례보고를 하는 바이다.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.469-475
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• 2007

목 적 : 이차공 심방 중격 결손의 Amplatzer 기구를 이용한 경피적 폐쇄의 안정성, 효용성 및 임상 결과를 수술적 폐쇄법과 비교하기 위하여 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2006년 6월까지 가천의과학대학교 길병원에서 이차공 심방 중격 결손으로 진단 받은 환자 115명을 대상으로 하였다. 그 중 70명에게 결손의 수술적 폐쇄술을 시행하였고, 45명의 환자에게 Amplatzer 기구를 이용한 경피적 폐쇄술을 시행하였다. 수술군과 시술군의 사망율, 합병증, 입원기간과 효용성을 조사하여 결과를 비교분석하였다. 결 과 : 전체 남녀 비는 1:2.4였다. 두 환자군에서 평균 연령과 결손크기는 유의한 차이가 없었다. 성공율은 시술군에서 97.8%, 수술군에서 100%였다. 전체 합병증은 수술군에서 시술군보다 많이 발생하였다(64.0 vs. 15.6%, P<0.05). 입원기간은 시술 군이 수술군보다 짧았다($4.2{\pm}1.2$ vs. $12.4{\pm}4.7days$, P<0.0001). 잔류단락은 시술군(8.9%)에서 수술군(4.3%)에 비해 더 많이 발생하였는데, 3개월후 추적 검사에서는 모두 소실되었다. 결 론 : 이차공 심방 중격 결손증의 Amplatzer 기구를 이용한 경피적 폐쇄는 수술을 대체할 수 있는 안전하고 효과적인 방법이다. 경험이 축적되고 기구가 발전하면서 경피적 폐쇄술의 적용 범위가 점차 확대되고 있다.

• Journal of Chest Surgery
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• 제44권4호
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• pp.285-287
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• 2011

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.