• Journal of Chest Surgery
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• v.22 no.2
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• pp.234-245
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• 1989

Between January 1984 and December 1986, sixty nine patients, aged 16 months to 25 years [mean age 10.05*6.40 years], underwent total correction of tetralogy of Fallot in Kyungpook national university hospital. In 66 hospital survivors, 30 patients were followed up for 12 to 48 months [mean 30.10*10.26 months]. These 30 patients were classified in two groups, TAP [transannular patch] and Non-TAP group. There were 9 patients in TAP group, and 21 in Non-TAP group. There were no significant differences between two groups in terms of age at operation, follow up duration, ACC time, and bypass time. All patients were evaluated by two dimensional echocardiography, Doppler echocardiography, standard 12-lead electrocardiography, and plain chest X-ray. Right ventricular systolic pressure, pulmonary arterial systolic pressure, pressure gradient between the right ventricle and the pulmonary artery, presence or absence of pulmonary regurgitation and its grading, fractional shortening of the left ventricle, and Qp/Qs in case of remnant ventricular septal defect were obtained by echocardiographic examination. Cardiothoracic ratio was measured by plain chest film, and ventricular dysrrhythmia was detected by electrocardiogram. Comparing the data between two groups, there was significant difference in incidence of postoperative pulmonary regurgitation [p< 0.05], 100%[9/9] in TAP group and 47.6 %[10/21] in Non-TAP group, but all the regurgitations were not severe. There were no significant differences in other comparisons, despite of higher incidence of cardiomegaly in TAP group [CT ratio: 59.3*5.3% VS 54.7*6, 4 %].

• Journal of Chest Surgery
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• v.27 no.6
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• pp.509-512
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• 1994

Congenital coronary arteriovenous fistula is a ~are condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography is being recognized with increasing frequency. Surgical correction is strongly recommended to prevent the development of congestive heart failure,angina, subacute bacterial endocarditis, myocardial infarction, and pulmonary hypertension, as well as coronary aneurysm formation with subsequent rupture or embolization. I report a case of congenital coronary arteriovenous fistula of the left main coronary artery to the fight atrium in a 23 year old female, which is associated with bacterial endocarditis with right atrial vegetation.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.495-503
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• 1996

The bidirectional cavopulmonary shunt may be useful as an intermediate procedure before Fontal oper- ation in high-risk patients, because it provides adequate relief of cyanosis and relief of ventricular volume overload. But there are no established theory about the effects of bidirectional cavopulmonary shunt on pulmonary arterial development. The purpose of this article is a study of changes of pulmonary artery size after bidirectional cavopulmonary shunt. Ca diac catheterization and angiography procedures were done on 19 patients who underwent bidirectional cavopulmonary shunt from February 1992 to July 1994, their results were reviewed. Preoperative cardiac catheterization and angiography procedures were performed at a mean interval of ).8 $\pm$4.8($\pm$SEM) months before surgery and following catheterization at a mean postoperative interval of 19.6 $\pm$4.8 months. Pulmonary arterial sixte measurement were standardized for body surface area(Pulmon- arty artery index), and for diameter of descending thoracic aorta(McGoon ratio). Patient's age, body stir- face area, pulmonary angioplasty, preoperative McGoon ratio and follow-up intervals were considered as variables. Before bidirectional cavopulmonary shunt, patient's mean age, body surface area, arterial 02 saturation, diameter of right pulmonary artery, diameter of left pulmonary artery, pulmonary artery Index, McGoon ratio were 13.7$\pm$15.6 months, 0.40$\pm$0.12m2, 71.4$\pm$12.4m2, 7.1$\pm$1.7mm, 6.2$\pm$1 , 191.8$\pm$82.7mm21m2, 1.73 $\pm$0.49, respectively. After bidirectional cavopulmonary shunt, the values were changed to 39.9 $\pm$ 16.2 months, 0.58$\pm$0.07 m2, 83.0$\pm$3.8m2, 9.0$\pm$ 1.5 mm, 7.7$\pm$2.0, 197.3$\pm$57.1 mm2/m2, 1.76$\pm$0.32, respect- ively With patients'development (age, body surf'ace area), diameters of pulmonary arteries were increased, but pulmonary artery indices and McGoon ratios were not changed. And there were no effects of age, body surf'ace area, amount of increased 02 saturation, pulmonary angiography and follow-up duration on the increment of pulmonary ar- tery size. But when the McGoon ratio was as low as 1.2, there were significant increase in postoperative pulmonary artery sizes. There was a significant correlation between preoperative pulmonary artery index (PAI) and McGoon ratio (MGR) ; PAI : MGRxl18.0-12.4 In conclusion, bidirectional cavopulmonary shunt provides adequate increment of arterial 02 saturation and does not increase the pulmonary artery size. Further investi ation is mandatory to evaluate the effect of pulsatile bidirectional cavopulmonary shunt on pulmonary artery growth.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.316-318
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• 2013

Thoracoscopic needle aspiration is a good alternative for a centrally-located solitary pulmonary nodule (SPN) suspected of being lung cancer without severe pleural adhesion. The authors report the technique of thoracoscopic needle aspiration biopsy in a SPN just in the medial aspect of the truncus anterior pulmonary artery and the right upper lobe bronchus.

• Journal of Veterinary Clinics
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• v.19 no.1
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• pp.110-113
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• 2002

An atrial septal defect (ASD) is a congenital hole in the atrial septum that allows flow between the two atria. Small ASDs are usually well-tolerated defects and do not result in significant clinical abnormalities. In large ASDs or in the presence of other cardiac defects, clinically significancy is increased. Atrial septal defects in 2 Dogs with cardiac and respiratory signs were diagnosed at seoul animal medical center. In ascultation, systolic murmur and the splitting of second heart sound were heard at pulmonary or tricuspid valve region. In radiograph, right-sided cardiomegaly, pulmonary artery dilation, increased pulmonary vasculature makings, and pleural effusion or pulmonary edema signs were observed. In echocardiography, the region, location and size of septal defect was identified. Also, the direction and degree of shunt was measured. These dogs were treated with medicine for cardiac failure. One dog is well-tolerated, the other dog died.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.566-568
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• 2014

A 51-year-old woman visited our hospital with massive hemoptysis. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe. We successfully performed a right lower lobectomy. The histological study of the resected specimen showed a vegetable foreign body and clumps of Actinomyces, indicating actinomycosis, which was suggested to be the cause of the hemoptysis. This was a very rare case of hemoptysis caused by a vegetable foreign body and actinomycosis.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1121-1124
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• 1997

This is a report of a successful, rapid two-stage arterial switch operation in an infant with dextrotransposition of great arteries with an intact ventricular septum beyond the appropriate time for arterial switch operation.'A 4-month-old female infant was admitted due to severe cyanosis, respiratory insufficiency, and frequent dia rhea secondary to ischemic colitis. Echocardiographic examination presented marked leftward deviation of the interventricular septum, and left and right ventricular pressures as measured by cardiac catheterization were 40/4 mmHg and 85/2 mmHg, respectively. Fifteen days after a preparatory operation (pulmonary artery band with modified right Blalock-Taussig shunt), left ventricular-right ventricular systolic pressure ratio increased to 105/90. Arterial switch operation associated with the division of the right Blalock-Taussig shunt and the removal of pulmonary artery band was performed. A(leer the operation, the infant showed normal cardiac function with no postoperative complication.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.816-827
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• 1988

Since 1978, We have experienced 87 cases of Fontan operations and the candidates of that increased in numbers recently with the improvement of the diagnostic and operative technique. We studied the prerequisite factors and hemodynamics of 22 cases of Fontan operations, done during the last one year period, which were 3 tricuspid atresia, 16 functional single ventricle and 3 anatomic single ventricle. The mean age was 68 months and the mortality rate 24%, and 9 patients of under 4 years of age were operated with 22.2% mortality rate, but the youngest, 16 months of age, patient survived well without problems. The preoperative pulmonary artery pressure[PAP], pulmonary vascular resistance[PVR] and postoperative right atrial pressure[RAP], left atrial pressure[LAP] value influenced the mortality, but age, preoperative Hb, preoperative PaO2 and pulmonary artery index[PAI] did not. There were favorable survival tendency in under 15mmHg of preop. PAP, 2a of preop. PVR and under 25cmHyO of postop. RAP, under 15cmHyO of postop LAP. The younger, the more pleural effusion and the longer postoperative admission days. The higher preop. Hb related to the higher postop. transpulmonary pressure gradient and the lower preop. PaO2 and PAI. The higher preop. PaO2, the less pleural effusion and postop. admission days. Preop. PAP closely related to preop. PVR and postop. LAP and high PVR increased the pleural effusion and postop. admission days. The larger PAI, the larger CI. We concluded that there were so many factors influencing the postoperative condition, but preop. PAP, PVR, Hb, postop. RAP and LAP were the most ones.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.754-758
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• 1995

Between February 1987 and April 1994,30 modified Blalock- Taussing shunts[MBTS were carried out at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Dongsan Medical Center.The operation consists of interposing between the subclavian artery and the pulmonary artery a polytetrafluoroethylene graft.There were 19 boys and 11 girls.The average age at the time of shunt construction was 14 months [range 4 days to 5 years .Seventy-six percent [23/30 were less than 1 year of age.Cardiac defects treated with MBTS included tetralogy of Fallot[10 , pulmonary atresia with ventricular septal defect[8 , pulmonary atresia with intact ventricular septum[4 , uni-ventricular heart[3 , and other complex cardiac anomalies[5 .Prosthesis of 4mm were used in 13 cases, and 5mm in 17.Of the 30 operations, 21 were performed on the right side and 9 on the left side.The hemoglobin level decreased from 21.1 gm/dl preoperatively to 16.3 gm/dl postoperatively and systemic oxygen saturation level increased from 60.5 % preoperatively to 85.4 % postoperatively.In the 30 patients who recieved MBTS, there were one early [3% and three late deaths [10% .Seven patients have had an corrective operation and two patient required second palliative procedure.The remaining patients are awaiting further operation with ingestion of aspirin [5 mg/kg/day as an antiplatelet agent.These results indicate that the MBTS provide excellent palliation at a low operative mortality for most patients.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.659-667
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• 2006

Background: Experimental studies of vascular remodeling in the pulmonary arteries have been performed actively. These models required a persistent vascular insult for intimal injury induced by chronic hypoxia, monocrotaline intoxication or chronic air embolism and characterized medial hypertrophy and neointimal formation by active synthesis of the extracellular matrix protein. The purpose of this study was to determine the pattern of pulmonary vascular remodeling after obstruction of the pulmonary vein. Material and Method: Obstruction of the right pulmonary vein with a metal clip was performed in Sprague-Dawley rats $(352{\pm}18g,\;n=10)$ to cause pulmonary vascular disease. Fifteen days later, experimental studies were done and finally the both lungs and hearts were extirpated for experimental measurement. Pulmonary arterial pressure, weight ratio of right ventricle (RV) to left ventricle (LV) and ventricular septum (S) (RV/LV +S weight ratio), and pulmonary artery morphology (percent wall thickness, %WT) were evaluated and compared with normal control groups. Result: Pulmonary hypertension $(38{\pm}12mmHg\;vs\;13{\pm}4mmHg;\;p<0.05)$ and right ventricular hypertrophy (right ventricular/left ventricular and septal weight ratio, $0.52{\pm}0.07\;vs\;0.35{\pm}0.04;\;p<0.05$) with hypertrophy of the muscular layer of the pulmonary arterial wall (percent wall thickness, $22.4{\pm}6.7%\;vs\;6.7{\pm}3.4%;\;p<0.05$) were developed by 15 days after obstruction of the pulmonary vein. Conclusion: Obstruction of the pulmonary vein developed elevation of pulmonary blood pressure and medial hypertrophy of the pulmonary artery. These results are a part of the characteristic vascular remodeling. Theses results demonstrate that obstruction of the pulmonary vein can develope not only high pulmoanry blood flow of contralateral lung but also intima injury inducing vascular remodeling.