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Traditional oriental herbal medicine, Jukyeoondam-tang, occludes aconitine-induced ventricular arrhythmia in hearts

  • Ha, Ki-Chan;Chae, Han-Jung;Piao, Cheng-Shi;Chae, Soo-Uk;Kim, Hyung-Ryong;Chae, Soo-Wan
    • Advances in Traditional Medicine
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    • v.4 no.3
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    • pp.157-161
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    • 2004
  • We showed the effects of the traditional herbal medicine, Jukyeoondam-tang (JO-T, Zhu-ru-Wen-Dan-Tang in Chinese), on ventricular arrhythmia induced by aconitine. Electrophysiological experiments with conventional microelectrode techniques revealed that JO-T potently suppressed the aconitine-induced arrhythmias in ventricular strips of the rat. In the aconitine-induced arrhythmia model of the rat, pretreatment with JO-T $(100\;{\mu}g/ml)$ completely occluded the appearance of ventricular tachyarrhythmia (VT) or ventricular fibrillation (VF) induced by aconitine. Furthermore, the aconitine-induced ventricular arrhythmia was occluded by $Na^+$ channel blocker quinidine but was not occluded by $K^+$ channel blocker glibenclamide $(3\;{\mu}mol/L)\;and\;Ca^{2+}$ channel blocker nifedipine $(10\;{\mu}mol/L)$. We also confirmed the effect of JO-T in the ischemia-reperfusion (I/R)-induced arrhythmia model of the rat. JO-T did not affect the I/R-induced arrhythmias in rats. JO-T may alleviate the risk of ventricular arrhythmias following aconitine. These results suggest that JO-T is a potent antiarrhythmic drug having a$Na^+$ channel-blocking action.

The effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline-induced right ventricular failure

  • Bae, Hyun Kyung;Lee, Hyeryon;Kim, Kwan Chang;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.59 no.6
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    • pp.262-270
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    • 2016
  • Purpose: Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF. Methods: The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the sildenafil (S) group (MCT 60 mg/kg+ sildenafil 30 mg/kg/day for 28 days). Masson Trichrome staining was used for heart tissues. Western blot analysis and immunohistochemical staining were performed. Results: The mean right ventricular pressure (RVP) was significantly lower in the S group at weeks 1, 2, and 4. The number of intra-acinar arteries and the medial wall thickness of the pulmonary arterioles significantly lessened in the S group at week 4. The collagen content also decreased in heart tissues in the S group at week 4. Protein expression levels of B-cell lymphoma-2 (Bcl-2)-associated X, caspase-3, Bcl-2, interleukin (IL)-6, matrix metalloproteinase (MMP)-2, endothelial nitric oxide synthase (eNOS), endothelin (ET)-1 and ET receptor A (ERA) in lung tissues greatly decreased in the S group at week 4 according to immunohistochemical staining. According to Western blotting, protein expression levels of troponin I, brain natriuretic peptide, caspase-3, Bcl-2, tumor necrosis factor-${\alpha}$, IL-6, MMP-2, eNOS, ET-1, and ERA in heart tissues greatly diminished in the S group at week 4. Conclusion: Sildenafil alleviated right ventricular hypertrophy and mean RVP. These data suggest that sildenafil improves right ventricular function.

Complicatons and Residual Defects After Correction of Noncomplicated Ventricular Septal Defect (단순 심실중격결손증 수술 후 합병증 및 잔존 결손)

  • Jun, Tae-Gook;Hwang, Kyung-Hwan;Lee, Ho-Seok;Huh, Jung-Hee;Park, Kay-Hyun;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.139-145
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    • 2000
  • Background: The purpose of this study is to review the clinical course after the correction of noncomplicated ventricular septal defect and to analyze the morbidity and risk factors of postoperative complications and evaluate residual defect during the follow-up period. Material and Method: From September 1994 to June 1998 24 patients(median age 10 months) underwent surgery under the diagnosis of ventricular septal defect. We made a retrospective review of the clinical records including the operation notes critical care unit records echocardiography results and the follow-up records. Result: There was no early mortality nd late mortality. There was no postoperative complete conduction block. Respiratory complication was the most common complication. The body weight age type of ventricular septal defect associated anomalies and operative procedure were not related to the incidence of complications. residual ventricular septal defects aortic valve regurgitation and tricuspid valve regurgitation were insignificant in postoperative hemodynamics, Conclusions: Correction of the noncomplicated ventricular septal defect was done without mortality and complete heart block. Aggressive preoperative medical treatment and early surgical treatment may decrease postoperative complications. Postoperative residual shunt and tricuspid regurgitation were not problematic during the follow-up

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Evaluation of Right Ventricular Function with Radionuclide Cardiac Angiography: Right Ventricular Ejection Fraction in Chronic Obstructive Lung Disease (방사선동위원소 심혈관촬영술을 이용한 우심실기능 측정에 관한 연구 -만성폐쇄성 폐질환에서의 우심실 Ejection Fraction-)

  • Sohn, In;Shin, Seong-Hae;Chung, June-Key;Lee, Myung-Chul;Cho, Bo-Youn;Lee, Young-Woo;Han, Yong-Cheol;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.1
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    • pp.1-6
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    • 1982
  • To evaluate the usefulness of radionuclide cardiac angiography in the assessment of right ventricular function, we measured right ventricular ejection fraction (RVEF) using single pass method. In 12 normal persons, RVEF averaged $52.7{\pm}5.9%(mean{\pm}S.D.)$. In 25 patients with chronic obstructive lung disease, RVEF was $37.2{\pm}10.6%$ and significantly lower than that of normal persons (p<0.01). All 10 patients with right ventricular failure had abnormal RVEF, which was significantly lower than that of 14 patients without right ventricular failure ($27.6{\pm}5.7%,\;43.9{\pm}8.5%$, respectively. p<0.01). It concluded thal RVEF measured by single pass radionuclide cardiac angiography was a useful, noninvasive method to assess right ventricular function.

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Computational analysis of the electromechanical performance of mitral valve cerclage annuloplasty using a patient-specific ventricular model

  • Lee, Kyung Eun;Kim, Ki Tae;Lee, Jong Ho;Jung, Sujin;Kim, June-Hong;Shim, Eun Bo
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.1
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    • pp.63-70
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    • 2019
  • We aimed to propose a novel computational approach to predict the electromechanical performance of pre- and post-mitral valve cerclage annuloplasty (MVCA). Furthermore, we tested a virtual estimation method to optimize the left ventricular basement tightening scheme using a pre-MVCA computer model. The present model combines the three-dimensional (3D) electromechanics of the ventricles with the vascular hemodynamics implemented in a lumped parameter model. 3D models of pre- and post-MVCA were reconstructed from the computed tomography (CT) images of two patients and simulated by solving the electromechanical-governing equations with the finite element method. Computed results indicate that reduction of the dilated heart chambers volume (reverse remodeling) appears to be dependent on ventricular stress distribution. Reduced ventricular stresses in the basement after MVCA treatment were observed in the patients who showed reverse remodeling of heart during follow up over 6 months. In the case who failed to show reverse remodeling after MVCA, more virtual tightening of the ventricular basement diameter than the actual model can induce stress unloading, aiding in heart recovery. The simulation result that virtual tightening of the ventricular basement resulted in a marked increase of myocardial stress unloading provides in silico evidence for a functional impact of MVCA treatment on cardiac mechanics and post-operative heart recovery. This technique contributes to establishing a pre-operative virtual rehearsal procedure before MVCA treatment by using patient-specific cardiac electromechanical modeling of pre-MVCA.

Semiautomatic Three-Dimensional Threshold-Based Cardiac Computed Tomography Ventricular Volumetry in Repaired Tetralogy of Fallot: Comparison with Cardiac Magnetic Resonance Imaging

  • Hyun Woo Goo
    • Korean Journal of Radiology
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    • v.20 no.1
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    • pp.102-113
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    • 2019
  • Objective: To assess the accuracy and potential bias of computed tomography (CT) ventricular volumetry using semiautomatic three-dimensional (3D) threshold-based segmentation in repaired tetralogy of Fallot, and to compare them to those of two-dimensional (2D) magnetic resonance imaging (MRI). Materials and Methods: This retrospective study evaluated 32 patients with repaired tetralogy of Fallot who had undergone both cardiac CT and MRI within 3 years. For ventricular volumetry, semiautomatic 3D threshold-based segmentation was used in CT, while a manual simplified contouring 2D method was used in MRI. The indexed ventricular volumes were compared between CT and MRI. The indexed ventricular stroke volumes were compared with the indexed arterial stroke volumes measured using phase-contrast MRI. The mean differences and degrees of agreement in the indexed ventricular and stroke volumes were evaluated using Bland-Altman analysis. Results: The indexed end-systolic (ES) volumes showed no significant difference between CT and MRI (p > 0.05), while the indexed end-diastolic (ED) volumes were significantly larger on CT than on MRI (93.6 ± 17.5 mL/m2 vs. 87.3 ± 15.5 mL/m2 for the left ventricle [p < 0.001] and 177.2 ± 39.5 mL/m2 vs. 161.7 ± 33.1 mL/m2 for the right ventricle [p < 0.001], respectively). The mean differences between CT and MRI were smaller for the indexed ES volumes (2.0-2.5 mL/m2) than for the indexed ED volumes (6.3-15.5 mL/m2). CT overestimated the stroke volumes by 14-16%. With phase-contrast MRI as a reference, CT (7.2-14.3 mL/m2) showed greater mean differences in the indexed stroke volumes than did MRI (0.8-3.3 mL/m2; p < 0.005). Conclusion: Compared to 2D MRI, CT ventricular volumetry using semiautomatic 3D threshold-based segmentation provides comparable ES volumes, but overestimates the ED and stroke volumes in patients with repaired tetralogy of Fallot.

Role of Catecholamines in Ventricular Fibrillation (Catecholamines에 관(關)하여 -제4편(第四編) : 심실전동발생(心室顫動發生)에 있어서의 catecholamines의 의의(意義)-)

  • Lee, Woo-Choo
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.15-35
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    • 1983
  • Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

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Increase of L-type Calcium Current by cGMP-dependent Protein Kinase Regulates in Rabbit Ventricular Myocytes

  • Han, Jin;Kim, Na-Ri;Kim, Eui-Yong;Ho, Won-Kyung;Earm, Yung-E;Kim, Han-Kyoun
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.6
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    • pp.733-742
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    • 1998
  • Background: We have previously reported that not only cGMP but also 8-Br-cGMP or 8-pCPT-cGMP, specific and potent stimulators of cGMP-dependent protein kinase (cGMP-PK), increased basal L-type calcium current $(I_{Ca})$ in rabbit ventricular myocytes. Our findings in rabbit ventricular myocytes were entirely different from the earlier findings in different species, suggesting that the activation of cGMP-PK is involved in the facilitation of $I_{Ca}}$ by cGMP. However, there is no direct evidence that cGMP-PK can stimulate $I_{Ca}}$ in rabbit ventricular myocytes. In this report, we focused on the direct effect of cGMP-PK on $I_{Ca}}$ in rabbit ventricular myocytes. Methods and Results: We isolated single ventricular myocytes of rabbit hearts by using enzymatic dissociation. Regulation of $I_{Ca}}$ by cGMP-PK was investigated in rabbit ventricular myocytes using whole-cell voltage clamp method. $I_{Ca}}$ was elicited by a depolarizing pulse to +10 mV from a holding potential of -40 mV. Extracellular 8-(4-Chlorophenylthio)-guanosine-3',5'-cyclic monophosphate (8-pCPT-cGMP), potent stimulator of cGMP-dependent protein kinase (cGMP-PK), increased basal $I_{Ca}}$. cGMP-PK also increased basal $I_{Ca}}$. The stimulation of basal $I_{Ca}}$ by cGMP-PK required both 8-Br-cGMP in low concentration and intracellular ATP to be present. The stimulation of basal $I_{Ca}}$ by cGMP-PK was blocked by heat inactivation of the cGMP-PK and by bath application of 8-(4-chlorophenylthio)-guanosine-3',5'-cyclic monophosphate, Rp-isomer (Rp-pCPT-cGMP), a phosphodiesterase-resistant cGMP-PK inhibitor. When $I_{Ca}}$ was increased by internal application of cGMP-PK, IBMX resulted in an additional stimulation of $I_{Ca}}$. In the presence of cGMP-PK, already increased $I_{Ca}}$ was potentiated by bath application of isoprenaline or forskolin or intracellular application of cAMP. Conclusions: We present evidence that cGMP-PK stimulated basal $I_{Ca}}$ by a direct phosphorylation of L-type calcium channel or associated regulatory protein in rabbit ventricular myocytes.

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Intracranial Pressure and Cerebral Blood Flow Monitoring after Bilateral Decompressive Craniectomy in Patients with Acute Massive Brain Swelling (급성 중증 뇌종창 환자의 양측성 감압개두술 후 뇌압 및 뇌혈류 측정)

  • Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyoung-Suck;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.295-306
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    • 2001
  • Objectives : The management of massive brain swelling remains an unsolved problem in neurosurgical field. Despite newly developed medical and pharmacological therapy, the mortality and morbidity due to massive brain swelling remains high. According to many recent reports, surgical decompression with dura expansion is superior to medical management in patients with massive brain swelling. We performed surgical treatment on the first line of treatment, and followed medical management in case with refractory increased intracranial pressure(ICP). To show the quantitative effect of decompressive surgery on the intracranial pressure, we performed ventricular puncture and checked the ventricular ICP continuously during the decompressive surgery and postoperative period. Materials and Methods : Fifty-one patients with massive brain swelling, undergoing bilateral decompressive craniectomy with dura expansion, were studied in this study. In all patients, ventricular puncture was performed at Kocher's point on the opposite side of massive brain swelling. The ventricular pressure was monitored continuously, during the bilateral decompression procedures and postoperative period. Results : The initial ventricular ICP were varied from 13mmHg to 112mmHg. Immediately after the bilateral craniectomy, mean ventricular ICP decreased to $53.1{\pm}15.8%$ of the initial ICP(ranges from 5mmHg to 87mmHg). Dura opening decreased mean ICP by additional 36.7% and made the ventricular pressure $16.4{\pm}10.5%$ of the initial pressure (ranges from 0mmHg to 28mmHg). Postoperatively, ventricular pressure was lowered to $20.2{\pm}22.6%$(ranged from 0mmHg to 62.3mmHg) of the initial ICP. The ventricular ICP value during the first 24 hours after decompressive surgery was found to be an important prognostic factor. If ICP was over 35mmHg, the mortality was 100% instead of additional medical(barbiturate coma therapy and hypothermia) treatments. Conclusion : Bilateral decompression with dura expansion is considered an effective therapeutic modality in ICP control. To obtain favorable clinical outcome in patients with massive brain swelling, early decision making on surgical management and proper patient selection are mandatory.

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Postoperative Assessment of Residual Oefects Following Surgical Closure of Ventricular Septal Defects (심실중격결손의 개심술 후 잔류단락에 관한 임상적 고찰)

  • 조준용;허동명
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.147-152
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    • 1996
  • his study was undertaken to assess the residual interventricular shunt following surgical closure of the isolated ventricular septal defect. From January 1989 through December 1993, 211 patients underwent surgical closure of the isolated ventricular septal defect. All patients had 2D-Echocardlo-graphic study after operation to rule out residual ventricular septal defect. There was a 9.5% incidence of a definite residual shunt. The type of ventricular septal defect, closure method of the defect and cardiopulmonary bypass time showed no significant differences between two groups. The sue of ventricular septal defect (6.3 $\pm$ 3.7mm versus 10.6 $\pm$ 5.8mm : p : 0.0034), aortic cross-clamping time(32.6 $\pm$ 15.0 minutes versus 48.5 $\pm$ 20.0 minutes, p : 0.0003), pulmonary-to-systemic pressure ratio(0.31 $\pm$ 0.22 versus 0.51 $\pm$ 0.33, p=0.019) and mean pulmonary artery pressure(20.3 $\pm$ 11.9 mmHg versus 29.1 $\pm$ 16.2 mmHg, p : 0.009) were meaningfully different between two groups. There were 9 insta ces of spontaneous closure of the residual shunts at mean 21 months of following up (ranged 1 ~43 months). In conclusion, we suggest that the size of ventricular septal defect, aortic cross-clamping time and mean pulmonary artery pressure may play an important role in occurance of residual ventricular septal defect.

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