• Journal of Chest Surgery
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• v.21 no.1
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• pp.17-25
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• 1988

This study was undertaken to evaluate the efficacies for myocardial protective effect of retrograde right atrial perfusion [RRAP] of cardioplegia compared with antegrade aortic root perfusion [AARP]. Myocardial distribution of perfusate [using methylene blue] with RRAP was less poor to AARP. Myocardial protective effect was estimated with myocardial temperature and electron microscopy. Cooling protection of right ventricle with RRAP was similar to AARP. On the other hand, cooling protection of left ventricle with RRAP was slight poor to AARP. The electron microscopic ischemic change of right and left ventricle with RRAP was similar to AARP. RRAP was thought to be a good alternative method to perfuse cardioplegia and protect both ventricle.

• Journal of Veterinary Clinics
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• v.33 no.5
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• pp.307-309
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• 2016

A 10-month-old intact male Scottish Fold was presented with cardiomegaly. The cat showed exercise intolerance after birth. Radiographs showed cardiomegaly with bulging of the main pulmonary artery and dilation of pulmonary arteries. Echocardiogram revealed abnormally arisen aortic root toward right ventricle with left-to-right shunted perimembraneous ventricular septal defect located underneath the aortic root. Based on imaging studies, the cat was diagnosed as subaortic type of double outlet right ventricle (DORV) without concurrent abnormalities.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.292-295
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• 2006

Isolated fourth ventricle[IFV] is a rare entity producing symptoms of a progressive posterior fossa mass lesion. It is mainly reported in a patient who undergo shunt placement as its late complication. However, its surgical management has been difficult and its optional treatment remains controversial. We had an occasion to admit 19-year-old female to our hospital due to hydrocephalus : she had a history of meningitis when she was 2 years old. Ten years later she was diagnosed as hydrocephalus and managed by lateral ventriculo-peritoneal shunting procedure. Seven years after the procedure, the patient presented with headache, nausea, truncal ataxia and nystagmus. Computed tomography and magnetic resonance image scan demonstrated markedly enlarged fourth ventricle : and thus, neuroendoscopic aqueductoplasty and aqueductal stent insertion was performed. The authors present a case of an IFV after lateral ventriculo-peritoneal shunting for hydrocephalus, which was treated successfully with a neuroendoscopic surgery. The technique of this procedure is described below.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.735-739
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• 2010

An 8 month old female Maltese (body weight 3.6 kg) was referred with primary complaints of dyspnea and exercise intolerance. Diagnostic imaging studies revealed marked cardiomegaly and prominent main pulmonary trunk dilation on thoracic radiography, abnormally arisen aortic roots (toward right ventricle) with left-to right shunted perimembraneous ventricular septal defect located underneath of aortic root, aortic root was located to predominantly to the right ventricle and pulmonary regurgitation (peak velocity 4.7 m/s, pressure gradient ~88 mmHg) from pulmonary over-circulation and hypertension on echocardiography, indicating double outlet right ventricle (DORV). The dog was treated with furosemide (1 mg/kg, BID) for reducing volume overload at right ventricle, spironolatcone (1 mg/kg) and enalapril (0.5 mg/kg) for minimizing deleterious cardiac remodeling, and sildenafil (1 mg/kg) for lessening pulmonary over-circulation and hypertension. The clinical condition of this dog was improved after 1 week of medical treatment. The dog is currently survived and regularly monitored.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.241-249
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• 1985

Twenty-one patients with Double Chambered Right Ventricle [DCRV] associated with Ventricular Septal Defect [VSD] were treated by open heart surgery under cardiopulmonary bypass with moderate hypothermia in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital between June 1982 and October 1984. The following results were obtained 1. The symptoms and physical signs, specific for DCRV, could not be identified. 2. The radiologic findings on simple chest X-ray, specific for DCRV, could not be identified. 3. Electrocardiographic findings, specific for DCRV, could not be identified. 4. Cardiac catheterization was found to be the most important diagnostic method, revealing pressure gradient between proximal chamber and distal chamber in the right ventricle. The average pressure gradient between two chambers showed 48.1523.29 mmHg[varying from 15mmHg to 94mmHg]. 5. Cardiac angiography was found to visualize the anomalous muscle bundles in right ventricle [in 17 cases, 81%] but the evidence of pressure gradient between two chambers within right ventricle is considered necessary for the diagnosis of DCRV. 6. Via surgical observation, anatomical and pathologic findings of the anomalous muscle bundles, associated DCRV were identified. 7. As the direct pressure was measured on the operating table before and after surgery, the average pressure gradient across the muscle bundles showed 40.5219.75mmHg [varying from 16 to 89mmHg] preoperatively and 8.909.72mmHg [varying from 0 to 32mmHg] postoperatively, indicating significant surgical correction of the obstruction present. 8. The presence of anomalous muscle bundles, dividing the right ventricle into two separated chambers, and the presence of the pressure gradient over 15mmHg are considered necessary for the diagnosis of DCRV.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.61-66
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• 1982

The present study was performed to evaluate hemodynamic effects on the pericardial patch graft for stenosis of right ventricle outflow tract in 19 patients of tetralogy of Fallot. The stenosis of right ventricle outflow tract was associated with or without pulmonary annular nar-rowing, pulmonary valvular stenosis, and hypoplastic narrowing of pulmonary artery. Total correction of tetralogy of Fallot was performed under cardiopulmonary bypass with moderate hypothermia and cardioplegic cardiac arrest. Ventricular septal defects were closed with Teflon patch graft. The chamber pressures in the heart were measured before and after a total correction of tetralogy of Fallot. The data of pressure measurement and the results of postoperative observation of pericardial patch were as followings: 1. Systolic and diastolic pressure of right ventricle was decreased after operation from $96.0{\pm}14.7/10.0{\pm}14.4mmHg$ to $61.0{\pm}13.1/8.0{\pm}9.3mmHg$. 2. Systolic and diastolic pressure of pulmonary artery was increased after operation from $18.0{\pm}5.6/10.0{\pm}5.5mmHg$ to $31.0{\pm}10.7/14.0{\pm}4.9mmHg$. 3. Preoperative pressure gradient between right ventricle and pulmonary artery was decreased immediately after operation from 78.0mmHg to 30.0mmHg. 4. It was observed that excellent widening effects of right ventricle outflow tract was resulted from pericardial patch graft. 5. No postoperative bleeding from pericardial patch graft was observed. 6. Aneurysm formation of pericardial patch was not be observed during 1 to 6 years postoperative periods.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1118-1127
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• 1990

Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

• Korean Journal of Veterinary Research
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• v.51 no.3
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• pp.227-231
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• 2011

This study was undertaken to assess the lateral ventricle, which was some portion of brain and related to congenital anomalies, from 1, 2, 4, and 8 months of age in healthy micropigs. They were induced general anesthesia and performed magnetic resonance imaging (MRI) with a 0.3 Tesla magnet. Each age group was evaluated by three subjects such as lateral ventricular volume, ventricular volume ratio and asymmetry. T1 weighted transverse images were acquired for calculation of lateral ventricular and corresponding brain parenchyma areas. The ratio of bilateral ventricle areas used to analyze the asymmetry. The mean ventricular volumes of each month were $676.74{\pm}25.58mm^3$ (1 month-old), $630.64{\pm}143.84mm^3$ (2 month-old), $992.12{\pm}106.03mm^3$ (4 month-old) and $1172.62{\pm}237.57mm^3$ (8 month-old), respectively. The ventricular volume ratio was the smallest at 2 month-old and re-increased from that age. The ratio was significantly different between 2 month-old and other age groups (p < 0.05). The value of bilateral area ratio showed within 1.5 in all experimental animals. Consequently the lateral ventricle showed a positive correlation with aging and symmetric shapes in both sides. The developmental pattern of the lateral ventricle provides basic data in micropigs as an experimental animal model for physiological and neurosurgical approach.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.518-521
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• 2010

A one-day-old baby was transferred for cyanosis and heart murmur. Echocardiographic evaluation revealed that he had severe neonatal Ebstein's anomaly (Carpentier type C), pulmonary atresia, and pulmonary circulation via patent ductus arteriosus. Because the wall of the atrialized right ventricle was very thin, showed decreased contractility, and the small right ventricle showed pulmonary atresia, we decided that a two-ventricular repair was impossible. When the patient was one-month-old, he underwent right atrium reduction-plasty, a right ventricular exclusion procedure (including atrialized right ventricle resection and functional right ventricle plication), and right modified Blalock-Taussig shunt. He was discharged without specific problems. He received a bidirectional cavopulmonary shunt successfully at 4 months later.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.167-171
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• 2018

Background: Heart transplantation (HTx) can be a life-saving procedure for patients in whom single ventricle palliation or one-and-a-half ($1\text\tiny{1/2}$) ventricle repair has failed. However, the presence of a previous bidirectional cavopulmonary shunt (BCS) necessitates extensive pulmonary artery angioplasty, which may lead to worse outcomes. We sought to assess the post-HTx outcomes in patients with a previous BCS, and to assess the technical feasibility of leaving the BCS in place during HTx. Methods: From 1992 to 2017, 11 HTx were performed in patients failing from Fontan (n=7), BCS (n=3), or $1\text\tiny{1/2}$ ventricle (n=1) physiology at Asan Medical Center. The median age at HTx was 12.0 years (range, 3-24 years). Three patients (27.3%) underwent HTx without taking down the previous BCS. Results: No early mortality was observed. One patient died of acute rejection 3.5 years after HTx. The overall survival rate was 91% at 2 years. In the 3 patients without BCS take-down, the median anastomosis time was 65 minutes (range, 54-68 minutes), which was shorter than in the patients with BCS take-down (93 minutes; range, 62-128 minutes), while the postoperative central venous pressure (CVP) was comparable to the preoperative CVP. Conclusion: Transplantation can be successfully performed in patients with end-stage congenital heart disease after single ventricle palliation or $1\text\tiny{1/2}$ ventricle repair. Leaving the BCS in place during HTx may simplify the operative procedure without causing significant adverse outcomes.