• Journal of Chest Surgery
• /
• v.21 no.6
• /
• pp.1117-1123
• /
• 1988

Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.

• Journal of Chest Surgery
• /
• v.12 no.4
• /
• pp.339-345
• /
• 1979

Mitral valve disease is the most common disease of the acquired heart diseases, and atrial septal defect is also one of common congenital heart diseases. Coexistence of these two lesions is rare, but of great hemodynamic interest. Among 443 cases with mitral valve disease and 90 cases with atrial septal defect experienced in the Department of Thoracic Surgery, Seoul National University Hospital, there were 6 cases with atrial septal defect complicated by mitral valve disease. 1. Of the 6 patients, four were female and two were male. The age was ranged from 18 to 46. 2. Atrial septal defect was ostium secundum type in all cases, and the mitral valvular lesions were regurgitation in four and stenosis in two. Type II ventricular septal defect was also combined in one of the cases. 3. The atrial septal defect was corrected by, primary closure and the mitral valve was replaced with the prosthetic or bioprosthetic valve in all cases. The combined ventricular septal defect was closed using Teflon felt patch. 4. The operative result was good except in one who was expired of bacterial endocarditis 4 months after hospital discharge.

• Smart Structures and Systems
• /
• v.23 no.1
• /
• pp.71-79
• /
• 2019

In general, it may be advantageous to measure the pressure pulsation near a valve to detect a valve defect in a linear compressor. However, the acceleration signals are more advantageous for rapid classification in a mass-production line. This paper deals with the performance improvement of fault classification using only the compressor-shell acceleration signal based on the relation between the refrigerant pressure pulsation and the shell acceleration of the compressor. A transfer function was estimated experimentally to take into account the signal noise ratio between the pressure pulsation of the refrigerant in the suction pipe and the shell acceleration. The shell acceleration signal of the compressor was modified using this transfer function to improve the defect classification performance. The defect classification of the modified signal was evaluated in the acceleration signal in the frequency domain using Fisher's discriminant ratio (FDR). The defect classification method was validated by experimental data. By using the method presented, the classification of valve defects can be performed rapidly and efficiently during mass production.

• Journal of Chest Surgery
• /
• v.12 no.1
• /
• pp.50-55
• /
• 1979

The development of aortic insufficiency radically alters the physical findings which are generally associated with ventricular septal defect that was not hemodynamically significant, and the combination of the two lesions produces a typical clinical picture, that may be serious and life-threatening when it is left untreated. Therefore, the selection of patients, type and timing of surgical treatment is considered to be important. Among 114 cases of ventricular septal defect treated surgically utilizing cardiopulmonary bypass in the Department of Thoracic Surgery, Seoul National University Hospital, 7 cases were associated with aortic insufficiency. 1. Five cases were male, and 2 cases were female. Ages were from 4 years to 24 years, and mean age was 11.9 years. 2. In all cases, ventricular septal defect was closed with Teflon patch. In a case, a aortic valvuloplasty and in another, a aortic valve replacement with Hancock valve 23 mm., 5 months after the closure of ventricular septal defect were done. 3. Four cases were type I ventricular septal defect by Kirklin`s classification, 3 cases were type II ventricular septal defect, and diameters of ventricular septal defect were from 3.5 cm. to 0.7 cm. A PDA. was combined to a type I ventricular septal defect. 4. In 5 cases, herniation of the aortic cusp through the ventricular septal defect and in a case, annulus dilatation on the aortic valve was noted. 5. Two cases with type I ventricular septal defect and severe pulmonary hypertension expired. A re-opened case with type II ventricular septal defect expired. 6. Four cases were alive, and all of them show decrease of pulse pressure and aortic insufficiency.

• Journal of Chest Surgery
• /
• v.13 no.1
• /
• pp.1-12
• /
• 1980

In 1979 during the period of about 10 months 320 cases of open heart surgery were done in Seoul National University Hospital. There were 220 Congenital anomaly cases consisting of 113 acyanotic and 107 cyanotic varieties, and 1 O0 acquired cardiac lesions. Out of 100 acquired lesions 96 were valvular cues. Among 97 valve replacement cases 3 were Ebstein anomaly treated with plication and tricuspid valve replacement. Operative mortality rate for congenital anomaly was 10.6%, with 2.7% for acyanotic and 22.4% for cyanotic group. For acquired lesions over all operative mortality was 7%. Tetralogy of Fallot, ventricular septal defect, and atrial septal defect were the 3 main congenital anomalies, with 88 cues, 69 cases, and 27 cues respectively. In 61 simple ventricular septal defect without other anomalies operative mortality rate was 1.6%, in 27 atrial septal defect no death and, in tetralogy of Fallot 12.2%. Among 69 ventricular septal defect cases 19[27.5%] type I VSDs, after Kirklin-Becu classification, were found, rather high relative incidence of type I compared with Caucasian patients. Among 97 valve replacement cases 20 double valves were replaced-11 mitral with aortic and 9 mitral with tricuspid valves. Over all operative mortality rate for valve replacement was 8.2% with 3.3% in 61 mitral valve replace-merit. The over all operative mortality rate for 320 open heart surgery cases was 10.6%. Bubble type oxygenator and xenograft bioprosthetic valves were utilized In almost all cases.

• Journal of Chest Surgery
• /
• v.27 no.3
• /
• pp.234-237
• /
• 1994

We report a case of double orifice mitral valve complicating a partial atrioventricular septal defect.The preoperative diagnosis was suggested by a characteristic angiographic and echocardiographic findings but the correct diagnosis of double orifice mitral valve itself was proven by open heart surgery. The smaller accessory mitral orifice was located in the left lateral leaflet and was left untouched. The A-V septal defect was closed with Gore-Tex patch and localized tricuspid annuloplasty was done using Gore-Tex tubular graft for correction of severe tricuspid regurgitation. The anterior mitral cleft left intact had mild mitral regurgitation on postoperative echocardiography.Postoperative course was uneventful and the patient was discharged 2 weeks later.

• Journal of Chest Surgery
• /
• v.48 no.6
• /
• pp.404-406
• /
• 2015

Gebode defect, that can accurately be treated surgical repair, is defined as a true communication between left ventricle and right atrium. A 74-year-old woman with a worsening history of ortophnea and peripheral edema was hospitalised. A communication between right atrium and left ventricle was diagnosed using transeusophageal echocardiography. The defect was repaired and mitral valve was replaced with a biologic valve. It would be beter to tailor surgical strategy for each case with atrioventricular canal defect after preoperative transeusophageal echocardiography and peroperative direct sight.

• Journal of Chest Surgery
• /
• v.28 no.9
• /
• pp.822-828
• /
• 1995

This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.

• Journal of Chest Surgery
• /
• v.11 no.2
• /
• pp.213-226
• /
• 1978

One hundred cases of open heart surgery were done at this Department in 1977. There were 65 congenital anomaly and 35 acquired diseases. Out of 65 cases of congenital malformation 35 acyanotic and 30 cyanotic cases were found. Fifteen cases of ventricular septal defect and 29 tetralogy of Fallot were noted eight patients expired out of 65 congenital anomaly [12.3%] , 4 out of 35 acyanotic [11. 4%] and 4 among 30 cyanotic anomaly[13.3%]. Among 35 cases of acquired heart disease 3 atrial myxoma [2 left and one right] and 32 valvular lesions were noted. In two cases open mitral commissurotomy, and in 30 valve replacement were done. Twenty-two single valve and 8 double valve replacement were done. Seven patients expired out of 30 patients [23.3%]. Among 22 single valve replacement cases 2 and among 8 double valve 5 died. ~ In eighteen mitral valve replacement cases 2 deaths occurred. One mitral insufficiency patient who expired suffered from severe pulmonary` hypertension [PA=120/67mmHg], tricuspid insufficiency and a large ventricular septal defect. The patient underwent mitral valve replacement, tricuspid annuloplasty and patch closure of ventricular septal defect. Over all mortality rate for 100 open heart surgery cases was 15%. Since 1977 open heart surgery cases were done routinely in this institution and cases are increasing rapidly. With present rapid improvement of economical status and introduction of medical insurance system, open heart surgery will be firmly established in Korea in the very near future.

• Journal of Chest Surgery
• /
• v.11 no.2
• /
• pp.175-180
• /
• 1978

A rare form of tetralogy of Fallot, in which large ventricular septal defect was located at subpulmonary position rather than beneath a well developed crista supraventricularis was operated in this Department. This case satisfied the criteria for the diagnosis of tetralogy of Fallot, having large ventricular septal defect beneath the aortic valve with overriding of aorta, pulmonary stenosis and right ventricular hypeFtrophy. The operation was done through a median sternotomy using cardiopulmonary bypass. A vertical right ventriculotomy was extended to the pulmonary valve ring. Pulmonary and aortic valve were adjacent to each other, in contrast to the situation of classic tetralogy of Fallot. Pulmonary valvulotomy was done and ventricular septal defect was closed. with Teflon, and right ventricular outflow tract was reconstructed with woven Dacron covered by pericardial patch after minimal resection of septal band. The post-operatiove courses was uneventful except wound infection. The patient was discharged 15 days after open heart surgery.