• Journal of Chest Surgery
• /
• 제33권10호
• /
• pp.777-784
• /
• 2000

Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. Material and Method: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. Result: After surgical correction peak aortic gradient fell from 58.4${\pm}$17.6, to 23.7${\pm}$17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6${\pm}$24.3 to 143.7${\pm}$27.1 mmHg and from 1.78${\pm}$0.4 to 1.76${\pm}$0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10${\pm}$0.2, to 1.27${\pm}$0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2${\pm}$24.9 to 57.1${\pm}$27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. Conclusion ; We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.

• 대한핵의학회지
• /
• 제17권2호
• /
• pp.25-33
• /
• 1983

Left ventricular wall motion was observed with EKG gated cardiac blood pool scan in 71 various cardiac diseases and 10 normal controls to evaluate its diagnostic and clinical significance in them. 1) In the presence of left ventricular dysfunction, visual evaluation of the left ventricular wall motion was useful to determine whether it was due to localized or diffuse abnormalities. In cardiomyopathy, marked left ventricular dilatation and severe hypokinesia were noted. 2) In myocardial infarction, regional wall motion abnormalities well represented the location of infarcted areas in majority of cases. Patients with inferior wall infarction had smaller decrease of the left ventricular ejection fraction and wall motion grade than anterior or combined groups. In whom persistent left ventricular failure was present, wall motion analysis with gated cardiac scan provided valuable information for the detection of ventricular aneurysms. 3) Evaluation of the left ventricular wall motion and its grading provided a reliable estimate of the left ventricular function. In conclusion, visual evaluation of left ventricular wall motion and its grading provided valuable information for analyzing the characteristics of regional and global left ventricular dysfunction.

• Journal of Chest Surgery
• /
• 제16권2호
• /
• pp.175-183
• /
• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

• 대한중풍순환신경학회지
• /
• 제13권1호
• /
• pp.13-23
• /
• 2012

Object : The aim of this study was to assess the relationship between left ventricular hypertrophy and Dampness-Phlegm diagnosis in cerebral infarction patients. Methods : Among 227 of the total recruited patients, 59 patients were diagnosed as left ventricular hypertrophy. We assessed their general characteristics, risk factors, lab findings and Korean medical diagnosis. We compared the assessed variables between left ventricular hypertrophy group and non left ventricular group. We analyzed the relationship between left ventricular hypertrophy and risk factors. And we also analyzed the relationship between left ventricular hypertrophy and dampness-phlegm diagnosis. Results : 1. The rate of left ventricular hypertrophy in female patients was larger than the rate of male patients. 2. There were more patients finally diagnosed hypertension in left ventricular hypertrophy group. 3. According to the analysis about the rate of Dampness-phlegm related Index for Pattern Identification by left ventricular hypertrophy, Sallow complexion and obesity were significantly higher in the left ventricular hypertrophy than in the non left ventricular hypertrophy group. 4. In multivariate analysis, Dampness-phlegm group showed close relationship with left ventricular hypertrophy. Conclusions : According to the analysis, significance between dampness-phlegm diagnosis diagnosed group and left ventricular hypertrophy were clarified. These results can be utilized in the future as a basic material to be used for diagnosis and management of dampness-phlegm diagnosis on cardiovascular diseases.

• 대한전기학회논문지:시스템및제어부문D
• /
• 제53권11호
• /
• pp.780-785
• /
• 2004

In this paper, we proposed a ventricular fibrillation detection algorithm based on wavelet transform and artificial neural network. we selected RR intervals, the 6th and 7th wavelet coefficients(D6, D7) as features for classifying ventricular fibrillation. To evaluate the performance of the proposed algorithm, we compared the result of the proposed algorithm with that of fuzzy inference and fuzzy-neural network. MIT-BIH Arrhythmia database, Creighton University Ventricular Tachyarrhythmia database and MIH-BIH Malignant Ventricular Arrhythmia database were used as test and learning data. Among the algorithms, the proposed algorithm showed that the classification rate of normal and abnormal beat was sensitivity(%) of 96.10 and predictive positive value(%) of 99.07, and that of ventricular fibrillation was sensitivity(%) of 99.45. Finally. the proposed algorithm showed good performance compared to two other methods.

• Journal of Chest Surgery
• /
• 제56권4호
• /
• pp.290-293
• /
• 2023

Pulmonary atresia with intact ventricular septum (PAIVS) is a rare congenital heart disease that often needs a critical decision on whether to open the right ventricular outflow tract (RVOT). Significant morbidity and considerable mortality might preclude the safe use of percutaneous or surgical right ventricular decompression in patients with muscular PAIVS. We report the case of a 21-day-old neonate weighing less than 3 kg who underwent hybrid RVOT stent insertion as initial palliation for muscular PAIVS and subsequent anatomical correction at 5 months of age, with 6 years of follow-up.

• Journal of Chest Surgery
• /
• 제13권3호
• /
• pp.233-236
• /
• 1980

Left Ventricular-Right atrial canal, which permits a communication between the left ventricle and right atrium has been reported with increasing frequency. Kirby made the first successful surgical correction in 1957. Recently we experienced 3 cases of left ventricular-Right atrial canal, which were corrected surgically. In one patient the diagnosis of left ventricular-Right atrial canal had been suggested before operation. Preoperative diagnosis had been incorrect in 2 cases; one as an atrial septal defect and the other as combined atrial septal defect and ventricular septal defect. The entire patients were discharged with good results within 2 weeks after operation.

• Journal of Chest Surgery
• /
• 제26권7호
• /
• pp.548-551
• /
• 1993

Calcified right ventricular thrombi are very rare.One case of large clacified thrombus in right ventricle being seen in a 65-year old man, is presented. He had dyspnea and generalized edema.The chest film showed a large calcified mass in cardiac shadow especially in lateral view.On echocardiography and chest computed tomography, large calcified mass density occupied nearly entire right ventricular outflow tract.The mass removal was performed through right ventriculotomny.The mass was whitish, stony hard, measured 4 cm x 4.5 cm x 8 cm, tightly attached to right ventricular infundibular septum and ventriculoinfundibular fold.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제21권4호
• /
• pp.363-367
• /
• 2021

During the perioperative period, anesthesiologists frequently observe cardiac tachyarrhythmia. Ventricular tachycardia is very rare in non-cardiac surgeries. However, it can be fatal when it occurs. Therefore, anesthesiologists should be watchful so as to not to miss ventricular tachycardia and take the appropriate steps to manage it promptly. We present a case, with a review of related literature, in which a non-sustained ventricular tachycardia was observed in a patient who visited the hospital for dental treatment.

• 대한핵의학회지
• /
• 제19권2호
• /
• pp.43-50
• /
• 1985

With the improvement of hemodialysis, the course of the disease in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (early and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis. 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe due to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.