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Lung/Heart Uptake Ratio and Transient Dilation Ratio of the Left Ventricle During Thallium-201 Imaging with Dipyridamole (Dipyridamole 부하를 T1-201 심근스캔에서 폐/심장 섭취율과 일과성 좌심실 확장율에 관한 연구)

  • Lee, Jae-Tae;Chung, Byung-Chun;Kim, Sang-Hyun;Lee, Kyu-Bo;Chae, Sung-Chull
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.177-185
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    • 1991
  • Dipyridamole thallium imaging is one of the most widely accepted means of evaluating patients with suspected or known coronay artery disease. The results of thallium imaging help diagnose coronary artery disesse (CAD), determine the hemodynamic significance of coronary stenosis, evaluate viability of myocardium, assess the outcome of therapeutic interventions and stratify patients according to their risk for luther cardiac events. An increased lung thallium uptake and transient LV dilation has been reported as poor prognostic indicator and associated with extensive and severe coronary artery disease. We quantitated lung/heart uptake ratio (l/HUR) and transient left ventricular dilation ratio in 44 patients and 17 controls undertaking dipyridamole thallium-201 scintigraphy. The results are as follows: 1) The lung/heart uptake ratio was high in patients with CAD and which became higher according to increasing number of diseased vessel. The L/HUR of patients with low LVEF (<35%) was lower than those with normal LVEF. 2) Transient left ventricular dilation ratio of CAD patients had no close relation between numbers of diseased vessels and was not higher than normals. But transient left ventricular dilation ratio of patients with myocardial infartion was higher than normals. We concluded that lung/heart uptake ratio seems to be sensitive marker for severity of CAD and myocardial function, but transient left ventricular dilation ratio alone is not sufficient to be a marker for severe and extensive CAD.

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Echocardiograpyhic Assessment and Clinical Application of Cardiac Disease in Korea Jin-do Dog III. Detection of Heartworm (진돗개에서 심장초음파 측정치와 평가와 임상적 응용)

  • 박인철;강병규;손창호
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.194-204
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    • 2000
  • Echocardiography was performed to obtain the optimal planes for diagnosis of canine heartworm disease in 11 dogs. Imaging planes were taken the left ventricular outflow tract long-axis view, 4-chamber long-axis view, chordae tendineae level short-axis view and modified pulmonary arteries level short-axis view in the right parasternal window, and aptical 4-chamber long-axis view in hte left parasternal window. After echocaridography, the pulmonary artery valve pat was ligated with double 1-0 silk under the general anesthesia to prevent heartworm moving from pulmonary artery to right ventricle. The dogs were euthanized and examained for heartworms in heart and great vessels. Many adult heartworms were identified ultrasonographically within main pulmonary artery, bifurcation of pulmonary artery and right pulmonary artery, but not identified within right ventricle and atrium. At necropsy, adult heartworms were mainly found in pulmonary artery in 11 days, and also found in right ventricular outflow tract and right ventricle in 2 of 11 dogs. The modified pulmonary arteries level short-axis view was the best imaging plane for identifiying heartworms because the main pulmonary artery, branches of pulmonary artery and right pulmonary artery could be showed. The aortic root internal dimension (AOID) and right pulmonary atery internal dimension (RPAID) were measured from the modified pulmonary ateries level short-axis view and left ventricular outflow tract long-axis view. The RPAID and RPAID/AOID was higher in heartworm infected dogs than normal Korea Jin-do dogs in modified pulmonary arteries level short-axis view, and the AOID, RPAID and RPIAID/AOID was higher than in left ventricular outflow tract long-axis view, respectively. These results indicate that the pulmonary arteries were the major habitat of adult heartworm in canine heartworm disease and the modified pulmonary arteries level short-axis view was the best imaging planes for identifying heartworms because the main pulmonary arteries could be showed. Therefore the modified pulmonary arteries level short-axis view can be used for diagnosing heartworm disease and for monitoring dilation of pulmonary artery.

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Surgical Rrepair of Ebsteins Anomaly with Ventricular Septal Defect in the Infant (영아에서 시행한 심실중격결손이 동반된 Ebsein's 기형의 삼첨판막 성형수술)

  • 유지훈;박표원;성기익;박계현;이영탁;전태국
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.890-893
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    • 2002
  • Ebsteins anomaly is a rare congenital cardiac malformation that is the downward displacement of the septal and posterior leaflets of the tricuspid valve into the ventricular apex, aresulting in the formation of an atrialized portion of the right ventricle. In most patients, symptoms such as cyanosis and progressive heart failure occur during the adolescence or young adulthood. The associated anomalies include ventricular septal defect, transposition of the great arteries, and malformation of the mitral valve. An 8-months-old male with Ebsteins anomaly, ventricular septal defect, and duplication of the mitral valve orifice successfully underwent operation with VSD patch closure. Postoperatively, cardiac size was significantly reduced and tricuspid regurgitation was trivial in echocardiography He has been doing well without any cardiac medication during the 18 months follow up after operation.

Surgical Treatment of Postinfarction Posterobasal Left Ventricular Aneurysm - Report of 2 cases- (심근경색 후 발생한 후기저부 좌심실류의 외과적 치험 -2예 보고 -)

  • Kim, Jae-Hyun;Na, Chan-Young;Kim, Woong-Han;Oh, Sam-Sae;Baek, Man-Jong;Whang, Sung-Wook;Kang, Chang-Hyun;Lee, Cheul;Chang, Yun-Hee;Jo, Won-Min;Seo, Hong-Ju;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.975-978
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    • 2003
  • At least 88 percents of ventricular aneurysms result from anterior infarction, while the remainder follow inferior infarction. Posterior infarction that produce a distinct left ventricular aneurysm is unusual. We report two operative cases of postinfarction posterobasal left ventricular aneurysms, one with a true aneurysm and the other with a false one.

A Study of Electrocardiographic Change and Tricuspid Competence after Temporary Detachment for Closure of Ventricular Septal Defect (삼첨판막절개아 심실중격결손증의 수술 이후의 삼첨판막의 기능에 대한 연구)

  • 정성운;박준호;김종원
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.633-637
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    • 2003
  • Sometimes temporary tricuspid valve detachment is applied for closure of ventricular septal defect to facilitate good exposure and avoiding ventriculotomy, but most surgeons hesitate to do it in the fear of tricuspid incompetence. Moreover in recent textbooks the technique of temporary tricuspid detachment is only described for exceptional situations and is not further analysed or commented on. Material and Method: Retrospective study was carried out in all 11 patients operated between 1985 to 1994, with preoperative data and postoperative course and recent echocardiographic and electrocardiographic data. Result: On the basis of the area of the color flow jet, tricuspid valvular regurgitation was graded as none in 9 and trivial in 2, and significant electrocardiographic heart block did not developed in any patients. Conclusion: Takedown and attachment of the tricuspid valve is a safe and effective technique that improves exposure for ventricular septal defect, and does not adversely effect tricuspid valve competence and electrocardiography.

Redo-left Ventricular Volume Reduction Surgery in a Patient with Left Ventricular Aneurysm -1 case- (급성 심근경색 후 좌심실류절제술을 받은 환자에서 재 좌심실용적감소술의 시행)

  • Lee Sak;Lee Chang Young;Lee Kyo Jun;Yoo Kyung-Jong
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.63-66
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    • 2005
  • Surgical anterior ventricular endocardial restoration (SAVER) is a technique that improves hemodynamic status by excluding akinetic or dyskinetic portions of the left ventricle, restores the ventricle to normal elliptical shape and reduces ventricular wall tension to normal level in patients with acute anterior wall myocardial infarction that accompanies aneurysm. We performed redo-SAVER procedure in a 40-year old man with remodeled dilated ventricle who had already underwent LV aneurysmectomy 12 years earlier, and the results were satisfactory.

Mass Reduction and Functional Improvement of the Left Ventricle after Aortic Valve Replacement for Degenerative Aortic Stenosis

  • Shin, Su-Min;Park, Pyo-Won;Han, Woo-Sik;Sung, Ki-Ick;Kim, Wook-Sung;Lee, Young-Tak
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.399-405
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    • 2011
  • Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

Pharmacological action of Zizyphi Semen extract on heart (산조인(酸棗仁)의 심장(心臟)에 대한 약리작용(藥理作用))

  • Cho, T.S.;Ro, J.Y;Hong, S.S.
    • The Korean Journal of Pharmacology
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    • v.12 no.2 s.20
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    • pp.13-19
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    • 1976
  • A fluid extract of Zizyphi Semen was employed in this experiment. The cardiac effects of Zizyphi Semen were examined on isolated rabbits atria and heart in situ of anesthetized cats and rabbits. The adrenergic blocking activity and refractory period of cardiac muscle were measured after administration of this drug. In rabbits and cats the antiarrhythmic action of Zizyphi Semen on atrial and ventricular arrhythmias produced by epinephrine or ouabain was examined. The results were following: 1. Zizyphi Semen produced a decrease in rate and contractile amplitude of the isolated rabbit atria and had a week blocking effect on epinephrine acceleration of atrial movement. 2. Zizyphi Semen effectively abolished the spontaneous arrhythmia occurring in the isolated rabbit atria ana the atrial arrhythmia induced by ouabain. 3. Zizyphi Semen produced a marked prolongation of the refractory period in isolated atrial muscle of rabbit. 4. Zizyphi Semen prevented the induction of ventricular arrhythmia arising from excessive dose of epinephrine in anesthetized rabbits and cats. 5. With regard to the ventricular arrhythmia induced by a continuous infusion of ouabain, Zizyphi Semen exerted suppressive effect and produced a marked prolongation of cardiac arrest time in anesthetized rabbits and cats. From the above results, it may be concluded that Zizyphi Semen is effective against atrial and ventricular arrhythmias. The antiarrhythmic effect of this drug may be the result of direct myocardial depressive and partially adrenergic beta receptor blocking activities including prolongation of the refractory period of cardiac muscle.

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Surgical Outcomes of a Modified Infarct Exclusion Technique for Post-Infarction Ventricular Septal Defects

  • Kim, In Sook;Lee, Jung Hee;Lee, Dae-Sang;Cho, Yang Hyun;Kim, Wook Sung;Jeong, Dong Seop;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.381-386
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    • 2015
  • Background: Postinfarction ventricular septal defects (pVSDs) are a serious complication of acute myocardial infarctions. The aim of this study was to analyze the clinical outcomes of the surgical treatment of pVSDs. Methods: The medical records of 23 patients who underwent operations (infarct exclusion in 21 patients and patch closure in two patients) to treat acute pVSDs from 2001 to 2011 were analyzed. Intra-aortic balloon counterpulsation was performed in 19 patients (82.6%), one of whom required extracorporeal membrane support due to cardiogenic shock. The mean follow-up duration was $26.2{\pm}18.6months$. Results: The in-hospital mortality rate was 4.3% (1/23). Residual shunts were found in seven patients and three patients required reoperation. One patient needed reoperation due to the transformation of an intracardiac hematoma into an abscess. No patients required reoperation due to recurrence of a ventricular septal defect during the follow-up period. The cumulative survival rate was 95.5% at one year, 82.0% at five years, and 65.6% at seven years. Conclusion: The use of a multiple-patch technique with sealants appears to be a reliable method of reducing early mortality and the risk of significant residual shunting in patients with pVSDs.

Repair of a Post-infarction Ventricular Septal Defect and Left Ventricular Pseudoaneurysm Rupture by the "Sandwich Technique" - A case report - ("Sandwich Technique"을 이용한 심근경색 후 발생한 심실 중격 결손과 가성 좌심실류 파열의 수술 - 1예 보고 -)

  • Kim, Hyung-Tae;Kim, Wook-Sung;Park, Pyo-Won;Lee, Young-Tak;Sung, Ki-Ick;Lee, Mi-Na
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.516-519
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    • 2009
  • Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".