• Korean Journal of Veterinary Research
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• v.55 no.3
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• pp.209-211
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• 2015

An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.252-256
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• 2000

There have been few reports documenting the outcome of arterial swich operations(ASO) in selected patients with transposition of great arteries(TGA) and with left ventricular outflow tract obstruction(LVOTO). In the case of TGA with LVOTO, if the atrial septal defect(ASD) is large and the ventricular septal defect(VSD) is restricive, this deprives the left ventricle(LV) of approporiate preload and could lead to underdevelopment of the ventircular mass and lead poor LV performance after the arterial switch operation, dspite a high pressure in the LV preoperatively. Because an increase in the systolic ventricular pressure is not necessarily paralleled by an increase in ventricular mass, which is also essential for optimal ventricular performance after the operation. We report here a case of rapid LV training after ASO in TGA with unprepared LV (because of large ASD and restrictive VSD) despite a high pressure in the LV(due to LVOTO) preoperatively.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.157-160
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• 1994

Primary tumors of the heart are extremely rare, and about 25 per cent of primary cardiac tumors are malignant. Recently, We experienced a case of primary cardiac liposarcoma occurred on the right ventricular outflow tract and extended into the main pulmonary artery. The patient was 57 year-old man and the chief complaints was severe exertional dyspnea. Emergency operation to relieve the right ventricular outflow tract obstruction was performed under cardiopulmonary bypass. The tumor was 5$\times$4$\times$3 cm in size and infiltrated into the right ventricle and ventricular septum. The tumor in the main pulmonary artery was removed without any difficulty but the on the right ventricular outflow tract was difficult to remove completely. The patient was recovered without any specific problems. After successful surgical resection and postoperative radiotherapy the patient discharged with good condition. Herein, the clinical characteristics of cardiac liposarcoma, the problems in differential diagnosis, the prognosis and current therapy are reviewed.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.725-728
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• 2010

Rhabdomyoma is the most common benign cardiac neoplasm in neonates. Most patients with rhabdomyoma experienced spontaneous regression. Yet some of them need surgical therapy because of hemodynamic problems of the heart such as arrhythmia, outflow tract obstruction and valvular dysfunction. We found multiple masses in both ventricles on the patient's fetal echocardiogram. Heart failure caused by severe left ventricular outflow tract obstruction quickly presented after birth. The mass interfering with the outflow tract was resected via the transaortic approach at the first day of birth. Postoperative echocardiography showed complete release of the outflow tract obstruction. He was discharged on the postoperative day 8. During the 3 years of follow up, we found that the sizes of the remnant masses had gradually decreased.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.830-833
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• 2000

Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.739-744
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• 1992

Discrete membranous subaortic stenosis[DMSS] is one of the subtype of congenital left ventricular outflow obstruction and can be associated with aortic regurgitation, infective endocarditis, ventricular obstruction. DMSS should be removed early, when diagnosed, and completely before secondary myocardial changes occur. Recently we experienced a case of DMSS with aortic regurgitation, and its left ventricular outflow tract obstruction[LVOTO] peak systolic gradient was 10lmmHg. Resection of membrane and aortic valve replacement is adequet for LVOTO and postoperative pressure gradient was 26mmHg. Postoperative echocardiogram shows no obstuctive membrane and well functioning aortic valve.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.363-365
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• 2008

Accessory mitral valve tissue is a very rare congenital cardiac malformation and it is an uncommon cause of left Ventricular outflow tract obstruction(LVOTO). The pathogenetic mechanism of subaortic obstruction is thought to be systolic ballooning of the abnormal valve tissue into LVOT. We are reporting a case of an accessory mitral valve tissue that was associated with LVOTO, and this was completely relieved after trans-aortic surgical excision of the accessory tissue.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.576-580
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• 1994

For 26 months since August 1991, 10 consecutive patients with congenital left ventricular outflow tract obstruction underwent corrective surgery in Pusan Paik Hospital. Their ages ranged from 2 to 18 years. There were 6 male and 4 female patients. According to stenotic site, obstruction were classified into supravalvular [n = 5], subvalvular [n = 4], valvular stenosis [n = 1]. We have performed patch enlargement of ascending aorta [n = 2], supravalvular membrane resection and patch enlargement of ascending aorta [n = 3], subvalvular membrane resection [n = 2], subvalvular membrane resection and left ventricular myectomy [n = 2] and aortic annuloplasty with Dacron patch and aortic valve replacement [n = 1]. Preoperative mean value of systolic pressure gradient were 85.0 $\pm$29.2mmHg[supravalvular], 70.0mmHg[valvular], 72.5 $\pm$ 22.5mmHg[subvalvular], and 78.5 $\pm$ 24.3mmHg[total]. Postoperative mean value of systolic pressure gradient were 31.0 $\pm$ 8.9mmHg[supravalvular], 0mmHg[valvular], 15.0 $\pm$ 10.8mmHg[subvalvular], and 21.5 $\pm$ 13.9mmHg[total]. Postoperative systolic pressure gradient was decreased significantly[p = 0.001]. Postoperative course and short-term follow up results were good except one case of transient heart failure.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.637-639
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• 2006

Cardiac myxoma is the most common primary tumor of the heart, but right ventricular myxoma causing outflow obstruction is relatively rare. A 15 years old girl developed dyspnea on exertion and intermittent syncope caused by a right ventricular mass obstructing the right ventricle outflow tract. Transthoracic echocardiography revealed $3.6{\times}3.0\;cm$ sized pedunculated subpumonic mass originating from the right ventricular anterior free wall. The patient underwent an emergency operation, consisting of the removal of the mass by wide excision of the tumor base and PTFE (polytetrafluoroethylene) patching of the right ventricular anterior free wall defect. Pathological findings of the mass were compatible with myxoma, and the patient was discharged uneventfully 7 days after the operation.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.65-68
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• 1978

The unusual congenital anomaly, double chambered right ventricle due to aberrant muscle band with intact ventricular septum in 10 years old female patient is presented. The pressure gradient is 70mmHg between inflow tract and outflow tract of right ventricle and the aberrant muscle band is 2X4.5cm arising below the infundibulum and traverses the right ventricular cavity, extending from its anterior wall to the crista supraventricularis forming broad triangular base in parietal anterior wall. By resecting out this muscle band clearly, the outflow tract obstruction is completely relieved.