• Journal of Chest Surgery
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• v.47 no.6
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• pp.541-544
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• 2014

Pseudoaneurysm of the right ventricular outflow tract (RVOT) has been reported as a rare complication of RVOT reconstruction performed using conduit replacement or patch repair. Rarely, it may present alongside symptoms secondary to the compression of adjoining mediastinal structures. We report the case of a patient who developed a symptomatic RVOT pseudoaneurysm one month after a total correction of tetralogy of Fallot. In the present case, superior vena cava syndrome was caused by compression of the superior vena cava, which was a very unusual presentation.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.832-836
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• 1992

A 25-month-old patient with complete atrioventricular septal defect and Tetralogy of Fallot underwent repair of both anomalies. The diagnosis was established preoperatively by 2D-echocardiography, cardiac catheterization and cardioangiogram, Repair was accomplished using cardiopulmonary bypass and profound hypothermia to 18C, Closing of the atrioventricular septal defect was achieved with the use of two Dacron patchs by an atrial approach alone. Infundibulectomy and outflow tract reconstruction with the transannular pericadial patch containing a monocusp were performed. Upon the postoperative evaluation by 2D-echocardiography, mitral regurgitation was absent, but a tiny dehiscence of ventricular patch and minimal tricuspid regurgitation were noticed.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.308-323
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• 2021

An increasing number of adult congenital heart disease (ACHD) patients continue to require life-long diagnostic imaging surveillance using cardiac CT and MRI. These patients typically exhibit a large spectrum of unique anatomical and functional changes resulting from either single- or multi-stage palliation and surgical correction. Radiologists involved in the diagnostic task of monitoring treatment effects and detecting potential complications should be familiar with common cardiac CT and MRI findings observed in patients with repaired complex ACHD. This review article highlights the contemporary role of CT and MRI in three commonly encountered repaired ACHD: repaired tetralogy of Fallot, transposition of the great arteries after arterial switch operation, and functional single ventricle after Fontan operation.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.101-108
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• 1988

Between July, 19S4. and July, 1987, 9 two-stage repair of symptomatic tetralogy of Fallot were carried out at the department of thoracic and cardiovascular surgery, Kyungpook national university hospital. Their age ranged from 5 years to 18 years [mean age 9.4 years] at the time of total correction, and there were improvement of systemic oxygen saturation values by 10% and decrease of hemoglobin by 1.6gm/dl after shunt procedures. The interval between the initial shunting procedure and total correction ranged for 7 to 101 months with a mean of 32.7 months. Four of these patients required patching of the infundibulum alone, three required patching of the right ventricular outflow tract across the pulmonary annulus, and valved conduit was used in one due to coronary artery anomaly. Aortic cross clamping time averaged 122.2minutes [range from 60minutes to 150minutes], and cardiopulmonary bypass time averaged 174.4 minutes [range from 80minutes to 300minutes]. The operative mortality rate was 22% [2/9].

• Journal of Chest Surgery
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• v.19 no.2
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• pp.243-249
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• 1986

Thirty-two cases of tetralogy of Fallot corrected totally using extracorporeal circulation in this department are presented during the period from April 1983 to Feb. 1986. Types of right ventricular outflow tract obstruction were a case of pulmonic valvular stenosis, 3 cases of infundibular stenosis, and 28 cases of combined type. There were associated anomaly such as 3 cases of pulmonary arterial hypoplasia, 7 cases of atrial septal defect, a case of left superior vena cava, and 2 cases of right side aortic arch. Transannular patch for right ventricular outflow tract reconstruction was necessary in 12 cases. Operative death was 6 cases and late death was a case, but other remaining cases followed up over 2 months carried out normal life.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.428-435
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• 1985

Tetralogy of Fallot associated with a single pulmonary artery is a rare cardiac anomaly. In previously reported cases, left pulmonary arteries were absent except 2 cases. Congenital absence of the pulmonary valve is a rare anomaly too. In the majority of cases, this lesion is associated with TOF. TOF associated with a single pulmonary artery and absent pulmonary valve is a very rare anomaly and only less than 20 cases were reported in the literatures. We have operated on one patient with TOF associated with absent right pulmonary artery and rudimentary pulmonary valve, a variant of absent pulmonary valve, and report this case with review of the literatures.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.74-82
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• 1989

Ninety-six patients with tetralogy of Fallot have undergone either primary total correction [71], staged total correction [9], or an initial shunt [16], between January, 1984, and December, 1987 Their mean age was 9.5 years, mean body weight 24kg, and mean body surface area 0.86m2. Initial palliative shunt group had smaller size, smaller pulmonary artery, and higher hemoglobin [P value < 0.05 >. Modified Blalock-Taussig shunt was performed most commonly. Patch enlargement of right ventricle in 31 cases [38%], right ventricle and pulmonary artery in 7 cases [9%], transannular patch enlargement in 28 cases [35%], and valved conduit in 2 cases [2.5%] was performed for reconstruction of right ventricular outflow tract stenosis. Longer aorta cross clamp time was noted in case of separate patch enlargement of right ventricle and pulmonary artery, and dead patient with transannular patch enlargement [P value < 0.05]. There was no operative death in shunt group, but 7 deaths in total correction group [mortality rate 8.8%].

• Journal of Chest Surgery
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• v.9 no.2
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• pp.198-206
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• 1976

A Total of Forty eight patients underwent open-heart surgery for correction of tetralogy of Fallot at the Seoul National University Hospital from January 1974 to October 1976, with an overall survival rate of 77 per cent. Operative mortality varied according to severity of the lesion, age of the patient, nature of previous surgical treatment and presence or absence of an outflow tract patch across the pulmonary valve ring. Eleven patients died in the early postoperative period and thirty seven patients were discharged from the hospital alive. A patch of the right ventricular outflow tract and pulmonary annulus was required to relieve pulmonic stenosis in 24 patients. There were 10 deaths in this group (42%) as compared to 1 death in the group of 24 patients who were corrected without a patch. Operative mortality was especially higher when an inlay patch was placed across the pulmonary valve ring. This may be related to the possibly greater anatomic severity of these cases and to the longer operating time when a patch was used. The electrocardiogram showed right ventricular hypertrophy in 35 cyanotic patients. Intraventricular conduction was normal in 34 patients before operation. It was normal postoperatively in only 5 of 34 patients in this group who survived surgery. Complete right bundle branch block appeared at operation in 21 patients, and 8 patients developed incomplete right bundle branch block. Major causes of death were progressive cardiac failure (4), Complete atrioventricular dissociation (3), bleeding (2), cardiac tamponade (1), and sudden cardiac arrest (1)

• Journal of Chest Surgery
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• v.20 no.1
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• pp.71-80
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• 1987

Twenty six patients were operated a total correction of tetralogy of Fallot between Jan., 1984 and July, 1985 at the Dept. of thoracic and cardiovascular surgery, Chonnam University Medical School, and a comparison between the survived group [n = 18] and the dead group [n = B was performed to detect factors influencing laboratory data, cineangiographic findings, operative findings and methods, and pump time. Following results were obtained, 1. There was no significant difference between two groups in the preoperative P.O2 and hematocrit level. 2. The size of the interventricular defect was not related to the operative mortality. 3. There was a significant difference in mortality rate between combined type of stenosis of pulmonary artery, valve and infundibulum and other types of right ventricular outflow tract stenosis. 4. There was a significant difference in mortality rate between the transannular patch reconstruction and other types of operative procedure. 5. There was no significant difference between two groups in total bypass time and aortic time. 6. There was no significant difference between two groups in left ventricular end diastolic volume and right ventricular end diastolic volume. 7. The operative mortality was related to the ratio of the diameter of the pulmonary valve annulus or each pulmonary artery to the ascending or descending aorta in cineangiographic findings, but there was no statistical significance of which probably is due to the lack of the total number of patients.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.10-16
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• 1988

Ten patients with tetralogy of Fallot were studied angiocardiographically before a modified Blalock-Taussig shunt and again 25*3.2 months after the previous shunt. All of ten patients had patent previous shunt at the time of follow up examination. Pre-and postoperative diameters of left and right pulmonary artery and descending aorta were measured and pulmonary artery index [the sum of the crossectional areas of the right and left pulmonary arteries standardized by the body surface area] was calculated. The ratio of mean diameter of left and right pulmonary arteries to the diameter of the descending aorta [LPA+RPA/2xDA] was increased postoperatively by 0.20*0.068 [p=0.020]. Mean PAI [pulmonary artery index] increased from 283.8*178.4 mm/m2 BSA to 345.8~144.5 mm/m2 BSA after shunt operation [p=0.019]. This results suggested that the modified Blalock-Taussig shunt was effective to help growth of the pulmonary arteries in most cases of the study populations but the ones with the PAI>233mm*/m* BSA appeared less benefited by Blalock Taussig shunt. Calculation of PAI could be an aid to making a decision whether to perform a one stage corrective surgical procedure or a palliative shunt procedure in the patient with small pulmonary arteries.