• Journal of Chest Surgery
• /
• 제22권6호
• /
• pp.1036-1043
• /
• 1989

Seventy eight patients underwent operation for combined multiple valve disease, with an overall early mortality of 14.1 % from January, 1983 to September, 1988 in the department of thoracic and cardiovascular surgery of Pusan National University Hospital. All of the above cases had combined multiple valve procedures. There were 33 mitral valve replacements and tricuspid annuloplasties, 33 aortic and mitral valve replacements, 5 aortic and mitral valve replacements with tricuspid annuloplasties, 3 aortic valve replacements and mitral annuloplasties, 1 open mitral commissurotomy and tricuspid annuloplasty and, 1 mitral valve replacement and primary closure of tricuspid valve cleft, 1 mitral valve replacement and aortic commissurotomy, 1 mitral, aortic and tricuspid valve replacement were done. 44 were male and 34 were female and the age distribution was from 14 to 57 with mean 38 year old. According to NYHA[New York Heart Association] classification, 49 patients were class I, 19 patients were class Il and 10 were class IV. Average perfusion time was 205.3 minutes. The live patients perfusion time was 178.7 minutes while that of dead ones was 272.0 minutes. Early deaths within 30 days from operation were 11 cases, 6 of which were due to low cardiac output, 3 were acute renal failure and 2 were cardiac rupture. The 65 patients were followed up from 2 to 30 months for a total 20.6 patient years. 1 patient committed suicide because of postoperative depression 1 year after operation. All of the survivors were enjoying their daily life and their NYHA class was superior to the preoperative ones.

• Journal of Chest Surgery
• /
• 제14권3호
• /
• pp.247-253
• /
• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• Journal of Chest Surgery
• /
• 제56권1호
• /
• pp.56-58
• /
• 2023

Untreated severe tricuspid regurgitation (TR) is associated with poor outcomes. Functional TR occurs secondary to dilatation of the annulus and tethering of the leaflets. Ring annuloplasty alone can correct most cases, but is insufficient in cases of severe annular dilatation due to severe leaflet tethering. In such cases, a tricuspid edge-to-edge technique may be an option. However, stitching of the leaflet tips alone is likely to result in tearing of the leaflets. Approximation of the durable chordae tendineae is considered helpful for this problem. Herein, we present the case of a 39-year-old man who had undergone open-heart surgery for acute type A aortic dissection 13 months earlier. A right mini-thoracotomy approach with a beating-heart strategy was used, which did not require unnecessary pericardial adhesiolysis and dissection. This technique had the advantage of reducing the operation time and the risk of bleeding. To summarize, we present a case of tricuspid valve repair in a high-risk patient with severe leaflet tethering that was successfully managed using these methods.

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.936-943
• /
• 1990

The Fontan operation for tricuspid atresia was first performed in 1968[Fontan and Baudet 1971] and several technical modifications of procedure were developed. We have experienced a case of modified Fontan operation for tricuspid atresia type Ic who was 5 years old female. She had previous palliative procedure \ulcornerpulmonary artery banding due to excessively increased pulmonary blood flow. The modified Fontan operation was right atrium to right ventricle connection with valve-bearing conduit. The result was good and the patient was discharged 20 days after operation.

• Journal of Chest Surgery
• /
• 제18권4호
• /
• pp.549-556
• /
• 1985

Since the first report on a successful method of correcting tricuspid atresia by Fontan and Baudet in 1971, several alternative surgical techniques have been described. Bjrk`s modification was performed three patients, 3, 8, and 9 years of age, in our Hanyang University Hospital. The diagnoses were tricuspid atresia type lb, tricuspid atresia type lib and d-TGA with huge VSD and valvular PS. None had previous palliative procedures. The patients were operated on with good results. The CVP after operation was 10-14 mmHg and early extubation was done. Postoperatively, none had peripheral edema or ascites. Postoperatively, all three were acyanotic and had improved physical capacity compared with their preoperative status.

• Journal of Chest Surgery
• /
• 제21권4호
• /
• pp.700-705
• /
• 1988

A case of congenital tricuspid stenosis in 24 year old male patient is presented. The lesion was successfully corrected with prosthetic valve replacement and closure of atrial and ventricular septal defects. Especially, this is the first reported case of successful large prosthetic valve replacement to a small annulus in tricuspid valve.

• Journal of Chest Surgery
• /
• 제21권5호
• /
• pp.889-893
• /
• 1988

We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

• Journal of Chest Surgery
• /
• 제18권3호
• /
• pp.391-397
• /
• 1985

Ebstein`s anomaly is a rare congenital cardiac malformation and characterized by downward displacement of an abnormal tricuspid valve cusps. But until now, the ideal surgical correction is still controversial. We present a case of Ebstein`s anomaly experienced lately. The patient was 13 year old girl with the complaints of dyspnea on exertion, fatigability and cyanosis. Echocardiography revealed downward displacement of septal leaflet of tricuspid valve and atrialized right ventricle. Cardiac catheterization and cineangiography revealed ASD and large right atrium. During operation, the atrialized right ventricle was plicated and tricuspid annuloplasty was done. And the two secundum type ASD`s were closed by direct suture closure. The patient`s postoperative course was uneventful and discharged on the 24th postoperative days.

• Journal of Chest Surgery
• /
• 제29권5호
• /
• pp.559-563
• /
• 1996

We have experienced a patient, 16 year-old male, with ventricular septal defect with tricuspid recur- gitation due to blunt chest trauma. He suffered from congestive heart failure after the trauma. Echocardiogram and cardiac catheterization revealed left to right shunt at the ventricular level (muscu- far portion of interventricular septum) and tricuspid regurgitation. At the time of the operation, marked systolic thrill was palpable over the rlght ventricle near the apex and a chorda tendina was seen sharply ruptured just near the medial papillary muscle. We repaired the ventricular septal defect with a Dacron patch and chordal reconstruction with autologous pericardium. The postoperative course was uneventful and the patient was discharged in good condition.

• Journal of Chest Surgery
• /
• 제18권4호
• /
• pp.643-648
• /
• 1985

Tricuspid atresia is the third most common cause of cyanotic heart disease, following T.O.F. and T.G.A. It is seen in about 30% of patients with congenital heart disease on postmortem examination. Recently, we experienced a case of tricuspid atresia, who had received Blalock-Taussig Shunt operation 10 years ago. The Patient was 15 year-old girl with the complaints of persistent cyanosis and exertional dyspnea. Cineangiography revealed Keith type lib tricuspid atresia, so, RA appendage was anastomosed to the right pulmonary artery and ASD was also closed using patch. Postoperative course was very difficult because of persistent right heart failure and weak respiratory power, but from postoperative 15th day, all cardiac and respiratory problems were resolved. We followed up this patient for about 1 year, and her condition is excellent up to now.