• Title/Summary/Keyword: ventricular

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The Senning Operation for Transition of the Great Arteries -a 7-year prospective study - (대혈관전위증의 Senning 수술요법)

  • Kim, Gi-Bong;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.753-759
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    • 1989
  • Recently, the arterial switch operation has received more interest and increased application for many patients with TGA [Transposition of the Great Arteries]. Not all patients, however, are suitable candidates for this approach, and its success will be measured against the Senning procedure. From June 1982 through June 1989, 48 consecutive patients underwent correction of TGA by a modification of the Senning procedure in our hospital. 34 were males and 14 females, with ages ranging from 3 months to 99 months [mean age 14 months]. The patients were divided into two groups, group I [TGA with intact ventricular septum or without significant pulmonary hypertension] and group II [TGA with significant pulmonary hypertension]. The hospital mortality was 9.5 % in group I and 55.6 % in group lI. 31 patients were discharged from the hospital after a Senning operation and have been followed a mean of 31.2 months. There were 5 late deaths, 3 in group I and 2 in group II. All patients were followed up with EKG, echocardiogram, and in several cases, Holter monitor and cardiac catheterization and angiography were also performed. There have been arrhythmias in 7, superior vena caval obstruction in 5, pulmonary venous obstruction in 2 and tricuspid insufficiency and/or right ventricular dysfunction in 16 patients. The Senning operation for Simple TGA can be performed with a low operative mortality and morbidity, but tricuspid insufficiency and/or depressed right ventricular function can be a problem with prolonged follow up.

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The Clamshell Incision for the Complete Repair in Pulmonary Atresia with Ventricular Septal Defect, and Major Aortopulmonary Collaterals (주대동맥폐동맥간 부행혈관이 동반된 폐동맥 형성부전 환아에서의 Clamshell 절개를 통한 완전교정술 -1례 보고-)

  • 차대원;박표원;전태국;강이석;이흥재
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.823-826
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    • 1999
  • A 6-month old girl who had pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals underwent one-stage complete repair with unifocalization through a bilateral thoracosternotomy(clamshell incision). There were no serious postoperative compli cations, and the postoperative echocardio-graphy showed no residual ventricular septal defect or significant pulmonary artery stenosis. In this condition, great surgical variability exists regarding the sources of pulmonary blood flow. Recent clinical work has focused on a one-stage complete repair. The potential advantages of the clamshell incision are apparent in terms of mediastinal approach, postoperative results, and safety.

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Surgical Treatment of Double Chambered Right Ventricle (이강우심실의 수술요법)

  • Park, Jong-Ho;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.353-363
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    • 1994
  • From January 1978 to December 1992, 59 patients of double chambered right ventricle were repaired. Surgical correction consisted of closure of the ventricular septal defect and resection of anomalous muscle bundles through right ventriculotomy [Group I ; 34 patients] or right atriotomy [Group II ; 25 patients]. Between these two groups, there was no difference in the operation time and the postoperative results. All patients survived. In group I, hemodynamically significant residual ventricular septal defect was found in three and reoperations were necessary. In one patient, subacute bacterial endocarditis developed postoperatively. In group II, complete atrioventricular block developed in one and mediastinitis in two. Follow-up period was from 2 to 75 months [mean 17.1 months]. There was no late death. All patients have remained in sinus rhythm except one patient. Careful evaluation of echocardiographic and catheterization data preoperatively and careful examination of the anatomy intraoperatively are necessary so that double chambered right ventricle should not be overlooked, because most ventricular septal defects are now closed through the right atrium. Repair of double chambered right ventricle is also easily performed through the atrial approach. Transatrial repair should be considered as an alternative to the transventricular approach in patients with this congenital heart defect. Successful surgical correction of double chambered right ventricle is expected with excellent long term results.

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A Clinical Evaluation of Tetralogy of Fallot (활로사징증의 수술성적에 관한 임상적 고찰)

  • 이재필
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.777-784
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    • 1992
  • The 67 patients who were operated as a tetralogy of Fallot during the period from 1985 to 1991 at the Department of Thoracic and Cardiovascular Surgery, Hanyang University were reviewed retrospectively. The age ranged from 3 month to 43 years old[mean 10.4 years old]. 39 patients were male and 25 patients were female. The body surface area ranged 0.4m2~1.6m2[mean 0.77m2] and body weight ranged 5.2kg~57kg[mean 20.2kg]. The 22 patients have history of previous shunt operation and average interval between shunt and total repair is 1.8years. The 43 patients were operated as primary total correction. The 53 patients were operated using transannular patch for right ventricular outflow reconstruction. And 12 patients were operated as right ventricular outflow recontruction only. Six patients were died postoperatively among 67 patients and with mortality rate of 8.7%. In patients group less than 0.7 of PRV/LV, there was no expired case but in patient group over than this level 3 patients were died among 14 patients. There were 6 death among the transanular patch group and no death in right ventricular outflow recontruction performed group. Postoperative complications were found in 9 cases including bleeding; 3 cases, residual VSD; 2 cases, wound infection: 2 cases, chylothorax 1 case and Lt. phrenic nerve palsy 1 case.

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Organizing Thrombus Mimicking a Cardiac Tumor Located at the Mitral-Aortic Intervalvular Fibrosa

  • Lee, Ji Seong;Kim, Wan Seop;Ko, Seong Min;Shin, Je Kyoun
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.42-45
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    • 2016
  • Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intraoperative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.

Properties of Muscarinic Receptor in Bovine Adrenal Medulla (소 부신수질 Muscarine 수용체의 성질)

  • 이신웅;이해태
    • Biomolecules & Therapeutics
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    • v.2 no.4
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    • pp.361-368
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    • 1994
  • The nature of the muscarinic receptors in bovine adrenal medulla was investigated in this study. [$^3$H]Quinuclidinyl benzilate(QNB) specifically bound to a single class of muscarinic receptor with a $K_{D}$ value of about 70 pM in bovine adrenal medullary, cardiac ventricular and ileal homogenates. Pirenzepine inhibition curves of [$^3$H]QNB binding to cardiac ventricular and ileal homogenates were steep, indicating the presence of a single class of binding site for pirenzepine with a Ki value of 990 nM and 508 nM, respectively. However, pirenzepine/[$^3$H]QNB competition binding curves in adrenal medulla suggested the presence of two binding sites (Hill coefficient=0.59) with a high( $M_1$) and a low( $M_2$) affinity. Respective Ki values for pirenfepine were 16 nM and 633 nM, with 44% of total sites having a high affinity( $M_1$). Gallamine, which is selective to cardiac $M_2$-receptor, inhibited [$^3$H]QNB binding to adrenal medullary, cardiac ventricular and ileal homogenates with Ki values of 12 $\mu$M, 6 $\mu$M and 13 $\mu$M, respectively. Thus, the binding affinities of pirenzepine and gallamine for $M_2$-receptor in adrenal medulla were similar to those in ileum, which contains the $M_3$-receptor. These results indicate that the $M_1$- and $M_3$- muscarinic receptor subtypes coexist in the bovine adrenal medulla.a.

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Sphingomonas Paucimobilis : A Rare Infectious Agent Found in Cerebrospinal Fluid

  • Goker, Tuncer;Asik, Rahile Zulal;Yilmaz, Muhammet Bahadir;Celik, Ilhami;Tekiner, Ayhan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.481-483
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    • 2017
  • Sphingomonas paucimobilis (S. paucimobilis) is a gram negative bacillus. It has existed in soil, drinking water and plants. It has been isolated from distilled water tanks, respirators, and hemodialysis devices at the hospital setting. Patients with chronic disorders or immune suppression may be susceptible to infections with it. This microorganism has also been reported to infect healthy persons. Both nosocomial and community-acquired infections have been reported. So far, a variety of infections have been reported, including sepsis, septic pulmonary embolism, septic arthritis, peritonitis, and endophthalmitis. Only 2 cases of meningitis have been reported so far in the literature. So far, no previous reports of culture proliferation have been reported in patients with external ventricular drains, as was the case in our patient. Therefore, our case is the first to have S. paucimobilis proliferation in cerebrospinal fluid culture during intensive care unit stay for an external ventricular drain.

Clinical Study of Spontaneous Closure in Simple Ventricular Septal Defects (완전 자연폐쇄된 단순 심실중격결손에 관한 임상적 고찰)

  • Lee, Young-Hwan;Park, Yong-Hoon
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.105-112
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    • 1995
  • During the period of 9.5 years from September, 1985 to March, 1995, 32 cases with spontaneous closure in simple ventricular septal defect(VSD) were observed and evaluated at Yeungnam University Hospital, and those were confirmed by 2D-echocardiogram. The results were as follows: 1. Among these 32 cases, there were 23 cases(71.9%) of perimembranous VSD, 8 cases(25.0%) of muscular VSD and 1 case(3.1%) of subarterial VSD. Septal aneurysms appears to be main mechanism of spontaneous closure of VSD because of the presence of septal aneurysm in all cases with spontaneous closure of a perimembranous VSD. 2. The size of the defect was variable in diameter, but 27 cases(81.2%) were less than 5 mm. 3. The mean age was 12.1 months at spontaneous closure with the range from 1 month old to 72 months. 4. The mean weight was 9.0 kg at spontaneous closure. 5. Among these 32 cases, 3 cases had the clinical evidence of cardimegaly or congestive hert failure during infancy. 6. Male to female sex ratio was 1.5:1.

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Multi-scale modelling of the blood chamber of a left ventricular assist device

  • Kopernik, Magdalena;Milenin, Andrzej
    • Advances in biomechanics and applications
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    • v.1 no.1
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    • pp.23-40
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    • 2014
  • This paper examines the blood chamber of a left ventricular assist device (LVAD) under static loading conditions and standard operating temperatures. The LVAD's walls are made of a temperature-sensitive polymer (ChronoFlex C 55D) and are covered with a titanium nitride (TiN) nano-coating (deposited by laser ablation) to improve their haemocompatibility. A loss of cohesion may be observed near the coating-substrate boundary. Therefore, a micro-scale stress-strain analysis of the multilayered blood chamber was conducted with FE (finite element) code. The multi-scale model included a macro-model of the LVAD's blood chamber and a micro-model of the TiN coating. The theories of non-linear elasticity and elasto-plasticity were applied. The formulated problems were solved with a finite element method. The micro-scale problem was solved for a representative volume element (RVE). This micro-model accounted for the residual stress, a material model of the TiN coating, the stress results under loading pressures, the thickness of the TiN coating and the wave parameters of the TiN surface. The numerical results (displacements and strains) were experimentally validated using digital image correlation (DIC) during static blood pressure deformations. The maximum strain and stress were determined at static pressure steps in a macro-scale FE simulation. The strain and stress were also computed at the same loading conditions in a micro-scale FE simulation.

Effect of Korea Red Ginseng on the Symptoms and Hemodynamics in Healthy Elders

  • Jin En-Yuan;Li Ya-Jun;Yang Lian-Xing;Jin Ming;Wei Yu-Lin;Nam Ki Yeul
    • Proceedings of the Ginseng society Conference
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    • 2002.10a
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    • pp.27-34
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    • 2002
  • Clinical study on hemodynamics of healthy elders before and after tread mill. Using doubleblind, placebo-controlled study design. Seventy-five 50-70 years old volunteers without organic disease were divided into two groups, Ginseng group and control group. Each subject was received 3 g Korea Red Ginseng (KRG) capsules or placebo per day for 4 weeks. Before and after administration 4 weeks, the symptoms were asked and hemodynamics parameter such as pump function, systolic function, preload and afterload were recorded before and after tread mill 1,5, 10 minutes by the method of thoracic impedance cardiograph. The result showed that Ginseng could improve quality of life, had obvious effect of increasing PEP (pre-ejection period), PEP/LVET (pre-ejection period/left ventricular ejection period), PCWP (wedged pressure pulmonary capillary). The change rate of HR (heart rate), SV (stroke volume) in KRG group were much lowered, while EF (ejection fraction), LVET (left ventricular ejection period), LVEDP (left ventricular end diastolic pressure) was recovered much quickly. The circulation showed Ginseng could improve the quality of life though its promoting circulation function which are increasing both the systolic function and the preload.

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