• 한국임상수의학회지
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• 제35권6호
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• pp.269-272
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• 2018

A 4-year-old, 6.1 kg intact female dachshund was referred to the Animal Medical Center with acute right hind limb lameness. Radiographs revealed fractures of iliac body and tibia in the right limb. In addition, the dog exhibited tricuspid valve regurgitation and moderate heartworm infection in the right ventricle and main pulmonary artery on echocardiogram. To obtain stable anesthetic conditions for operation, an adult heartworm removal procedure was previously followed by repair of the complex fractures. All surgical procedures were done without complication and with stable patient conditions. At a one month postoperative follow-up, the dog was doing well with normal ambulation and no tricuspid valve regurgitation as well.

• Journal of Chest Surgery
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• 제56권5호
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• pp.304-310
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• 2023

Background: The late progression of tricuspid regurgitation (TR) after mitral valve surgery is well known. However, few reports have described the progression of TR after aortic valve surgery. We investigated the incidence of and risk factors for the development of significant TR after isolated aortic valve replacement (AVR). Methods: This study analyzed patients with less than moderate TR who underwent isolated AVR at Seoul National University Hospital from January 1990 to December 2018. Significant TR was defined as moderate or higher. Echocardiographic follow-up was performed in all patients. The Fine-Gray model was used to identify clinical risk factors for the development of significant TR. Results: In total, 583 patients (61.7±14.2 years old) were included. Operative mortality occurred in 9 patients (1.5%), and the overall survival rates at 10, 20, and 25 years were 91.1%, 83.2%, and 78.9%, respectively. Sixteen patients (2.7%) developed significant TR during the follow-up period (13 moderate; 3 severe). The cumulative incidence of significant TR at 10, 20, and 25 years was 0.77%, 3.83%, and 6.42%, respectively. No patients underwent reoperation or reintervention of the tricuspid valve. Hemodialysis or peritoneal dialysis for chronic kidney disease (hazard ratio [HR], 5.188; 95% confidence interval [CI], 1.154-23.322) and preoperative mild TR (HR, 5.919; 95% CI, 2.059-17.017) were associated with the development of significant TR in the multivariable analysis. Conclusion: TR progression after isolated AVR in patients with less than moderate TR is rare. Preoperative mild TR and hemodialysis or peritoneal dialysis for chronic kidney disease were significant risk factors for the development of TR.

• Journal of Chest Surgery
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• 제56권5호
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• pp.311-312
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• 2023

• Korean Circulation Journal
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• 제53권11호
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• pp.787-789
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• 2023

• Journal of Chest Surgery
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• 제33권3호
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• pp.207-211
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• 2000

Backgroud: Conventional cardiac transplantation with each atrial anastomosis designed by Shumway and associates has been used widely in cardiac transplantation because of its simplicity and efficiency. There have been many reports about the postoperative atrioventricular value regurgitation resulting from the alteration in atrial geometry after cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was introduced to overcome the those problems. We performed this study to test the feasibility of this new surgical technique prior to application to clinical practice. Material and Method: Conventional cardiac transplantation was performed on 12 mongrel dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data, and echocardiographic findings between two groups. Result : The cardiopulmonary bypass time and graft ischemic time were 119.0$\pm$4.4 minutes, 162.0$\pm$4.5 minutes respectively in group I, and 140.0$\pm$7.1 minutes, 180.5$\pm$5.4 minutes respectively in group II. The cardiopulmonary time and graft ischemic time in group II were longer than those of group I (p<0.05). There were 3 cases of failure to weaning from cardipulmonary bypass onein group I and two in group II, and this difference was not significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and 82%(group II), without statistical significant between 2 groups. Postoperative echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral regurgitation in group I, and no regurgitation of atrioventricular value in group II. Conclusion: Although these was no statistically significant difference between 2 groups, there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in group II. We suggested that the new surgical technique could be a useful strategy in heart transplantation, especially in the case of size mismatching between donor and recipient.

• Journal of Chest Surgery
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• 제46권1호
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• pp.60-62
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• 2013

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.

• Journal of Chest Surgery
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• 제45권1호
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• pp.19-23
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• 2012

Background: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. Materials and Methods: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. Results: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from $123.7{\pm}69.2mL$ to $74.5{\pm}37.4mL$, and the mean right atrial pressure was lowered from $18.7{\pm}12.2mmHg$ to $8.9{\pm}5.5mmHg$. Conclusion: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.

• Journal of Chest Surgery
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• 제24권6호
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• pp.616-624
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• 1991

Recently, cardiac injury due to blunt thoracic trauma appears to be increasing in frequency. The rising incidence of this mishap may relate to the absolute increase in automobile accidents as well as to more universal recognition that cardiac damage may have been sustained. We have experienced a rare case of ventricular septal defect caused by non-penetrating thoracic trauma. Of further interest is the history of chest trauma, clearly resulting in rupture of the chordae tendineae of the tricuspid valve successfully treated by operation-re-placement with two, 6 - 0, double-armed, expanded polytetrafluoroethylene sutures-2 months later. The unique combination of ventricular septal defect and rupture of the chordae tendineae of the tricuspid valve secondary to non-penetrating thoracic trauma is presented below to emphasize another variety of cardiac injury.

• Journal of Chest Surgery
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• 제35권11호
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• pp.817-821
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• 2002

Ebstein기형은 수술적 교정을 위한 여러 가지 변형된 방법들이 소개되고 있지만 수술 후 잔존하는 삼첨판막 역류와 우심부전에 대한 문제는 여전히 남아있다. 본원에서는 심방조동이 동반된 Ebstein기형을 가지고 있는 19세의 남자 환자에 있어서 주름 성형술 없이 간단한 방법으로 삼첨판막 성형술을 시행하였고 양 방향성 상대정맥 -폐동맥 단락술 및 하대정맥 삼첨판 협부의 냉동절제 등을 성공적으로 시행하였기에 문헌고찰과 더불어 증례 보고하는 바이다.

• Journal of Chest Surgery
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• 제36권9호
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• pp.633-637
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• 2003

일시적인 삼첨판 절개법은 좋은 시야를 제공하고 심실을 열지 않고 심실중격결손의 폐쇄수술을 할 수 있다. 그러나 대부분의 외과의는 삼첨판막의 폐쇄부전의 염려로 주저하게 된다. 특히 최근의 교과서에서는 일시적인 삼첨판 절개법은 장기성적의 발표가 예외적인 방법으로만 기술되어 있고 더 이상의 분석이나 기술이 되어 있지 않다. 대상 및 방법: 1985년부터 1994년까지 수술받은 11명으로부터 술 전의 자료, 술 후 경과, 최근 심초음파와 심전도를 토대로 후향적 연구를 시행하였다. 결과: 심초음파에서 삼첨판폐쇄부전은 없는 경우가 9명, 미세한(trivial) 경우가 2명이었고, 심전도상 의미있는 심전도블록은 없었다. 결론: 삼첨판 절개법은 심실중격결손의 폐쇄수술을 시행하는 데 안전하며 향상된 시야를 제공하는 데 효과적인 방법이며, 삼첨판 이상이나 심전도상에 나쁜 영향을 끼치지 않는다.