Clinical features, laboratory and operative findings were reviewed in 10 cases of Ebstein's anomaly admitted to Dong San Hospital, Keimyung University during a 7(1/2)-year period from January 1982 to June 1989. The following results obtained : 1) Exertional dyspnea(90%) and palpitation(30%) were the predominant symptoms, and cyanosis was documented in 2 cases among 10 patients. 2) Chest X-ray showed cardiomegaly in all cases, but cardio-thoracic ratio was above 0.6 in 4 cases. 3) Electrocardiograms showed RBBB in 4 cases, RVH in 2 cases, 1st degree AV block in 4 cases. 4) Echocardiograms and angiograms showed displacement of tricuspid valve in all cases. 5) Interatrial communication via atrial septal defect (5) and patent foramen ovale (5) was present in 10 cases(100%). 6) Operative findings of 5 cases showed abnormalities of septal leaflet in 5(100%), posterior leaflet in 5(100%), and anterior leaflet in 1 case (20%).
Atrioventricular Block ; Cardiomegaly ; Cyanosis ; Ebstein Anomaly* ; Electrocardiography ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Humans ; Thorax ; Tricuspid Valve

PURPOSE: Transcatheter closure of patent foramen ovale (PFO), atrial septal defect (ASD) and patent ductus arteriosus (PDA) is a new and less traumatic technique than open heart surgery. One of the more popular occluding devices is the Amplatzer(R) septal occluder which is made of nitinol. The present study was undertaken to evaluate the safety and release of nickel after implantation of Amplatzer(R) occluder in patients with PFO, ASD and PDA. METHODS: Random blood samples were obtained from 25 patients with Amplatzer(R) PFO, ASD, PDA occluder during 4-year and 7-month post closure period. The nickel content in the specimens was determined using atomic absorption spectrometer. RESULTS: All patients showed satisfactory clinical improvements and there was no echocardiographic evidence of complications. During the post closure, concentrations of nickel in serum were within normal range with values 0.2 ug/dL. CONCLUSION: Nickel seems to be released from Amplatzer(R) occluder. The dissolusion of nickel from Amplatzer(R) occluder is minimal and systemic rise in serum levels of nickel are within normal range. However, further studies are needed to evaluate biological effects in patients with nickel hypersensitivity.
Absorption ; Ductus Arteriosus, Patent ; Echocardiography ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Humans ; Hypersensitivity ; Nickel* ; Reference Values ; Septal Occluder Device ; Thoracic Surgery

Isolated right ventricular hypoplasia, unassociated with severe pulmonary or tricuspid valvar malformations, is a rare primary congenital cardiac anomaly in which of the trabecular portion of right ventricle fails to develop. An atrial septal defect or a patent foramen ovale serves as an escape valve. We observed a 2-day-old neonate with this disorder who suffered from cyanosis. The diagnosis was made by Doppler-echocardiography which revealed marked reduction in right ventricular size and right-to-left shunt through the atrial septal defect. There was no other cardiac malformation such as pulmonary atresia or tricuspid atresia.
Cyanosis ; Diagnosis ; Foramen Ovale, Patent ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Ventricles ; Humans ; Infant, Newborn ; Pulmonary Atresia* ; Tricuspid Atresia* ; United Nations

PURPOSE: Transcatheter closure of atrial septal defects (ASD) is currently established therapy as an alternative to surgery. But rarely, complications are reported in some studies. We report early and intermediate term complications associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder (ASO). METHODS: From June 2003 to May 2006, 64 patients underwent transcatheter closure of secundum ASD or patent foramen ovale using the ASO. The ratio of male to female was 1:2.4, the median age was 17 years (range: 2.6-64 years) and their median weight was 47.5 kg (range: 2.6-64 kg). RESULTS: The median diameter of ASD measured with transthoracic or transesophageal echocardiography was 15 mm (range: 6-28 mm), the median balloon stretched diameter was 18 mm (range: 6.5-34 mm), and the median size of device was 19.5 mm (range: 6-36 mm), was little difference with balloon stretched diameter. There were 10 cases of complications: arrhythmia (2), device malformation (2), aorta to right atrial fistula (1), hemolytic anemia (1), mitral valve encroachment (1), malposition (1), residual shunt (1), and inferior vena cava perforation (1). CONCLUSION: Transcatheter closure of ASD using ASO is effective and safe therapy. However, significant complications such as aorta to atrial fistula, atrial erosion, or device embolization can happen, so an appropriate selection of patient and device in relevance to size and anatomy of ASD is important for successful closure.
Anemia, Hemolytic ; Aorta ; Arrhythmias, Cardiac ; Echocardiography, Transesophageal ; Female ; Fistula ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Humans ; Male ; Mitral Valve ; Septal Occluder Device ; Vena Cava, Inferior

Infrequently, patent foramen ovale or atrial septal defect act as a passage for the venous thrombi to reach the arterial circulation. These arterial thrombi can evoke tragic paradoxical embolisms. We report a case of impending paradoxical embolism due to a huge thrombus trapped through a patent foramen ovale in a 66-year-old man who presented with sudden dyspnea and chest discomfort in ten days after colon cancer surgery. The transthoracic echocardiogram demonstrated signs of acute right ventricular pressure overload and a huge linear mass wedged in a patent foramen ovale. On the intraoperative transesophageal echocardiography, the huge linear mass was freely floating in both right and left cardiac chambers passing through atrial septum. To prevent paradoxical embolism from this thrombus, he underwent emergent embolectomy and about 25 cm sized linear thrombus entrapped PFO was successfully removed.
Aged ; Atrial Septum ; Colonic Neoplasms ; Dyspnea ; Echocardiography, Transesophageal ; Embolectomy ; Embolism, Paradoxical* ; Foramen Ovale, Patent* ; Heart Septal Defects, Atrial ; Humans ; Pulmonary Embolism ; Thorax ; Thrombosis ; Ventricular Pressure

Background: Atrial Septal Defect (ASD) is a common congenital cardiac disease, accounting for 10% of congenital heart diseases and 1/3 congenital heart defect in adults. Closure of ASD is often used as a treatment method. However, there is controversial opinions about ASD closure in adult >=40. Objective: To study the outcomes of ASD closure of in adults >= 40 years. Subject and Method: 40 patients (27 female and 13 male) of ASD ostium secundum with an age average of 48.85 +/-5.91 (40 \u2013 62 years) and the mean ASD sizeof 27.53 +/-8.37 mm, mean Qp/Qs of 2.97 +/-1.59 had indications for ASD closure (clinically symptomatic and/or right ventricular [RV] enlargement by echocardiography). Follow-up at 1 week, 1 month, 3 months, 6 months after ASD closure. Results: Left ventricular systolic function was unaffected by ASD closure and the majority of the patients reported improvement in their symptoms. The right ventricle end-diastolic dimension and pulmonary artery diameter decreased significantly (p<0,0001). No trivial shunts. Conclusion: ASD closure is safe and effective in patient over 40 years of age with minimal complications. The procedure resulted in a decrease in the RV size that was accompanied by improvement in clinical symptoms.
Atrial septal defect ; Closure of ASD

Background: Atrial Septal Defect (ASD) is among most common congenital heart diseases. Doppler echocardiography could be a useful method to monitor the outcomes of ASD in children. Objectives: To evaluate the role of echocardiography in monitoring the outcomes of ASD closure in children. Subjects and methods: 31 patients (20 girls, 11 boys) with ASD ostinum secundum. The mean age of patients was 9.19+/-4.58 (2-15 years old). The patients had a mean ASD size of 20.71+/-7.81mm, mean Qp/Qs of 3.04+/-1.37. All of them underwent the ASD closure (slow physical development and/or Right Ventricular [RV] enlargement by echo cardiography). They were followed up at 1 week, 1 month, 3 months and 6 months after the closure procedure. Results: All of the patients had improvement in weight. The right ventricular end-diastolic dimension and pulmonary artery diameter decreased significantly (p<0.0001) and normalised at 6 months after ASD closure. There were no trivial shunts. Conclusions: Echocardiography is a helpful noninvasive method to assess the outcomes of ASD closure in children less than 15 years old. ASD closure should be done as soon as possible in children. The procedure resulted in normalization of RV size that was associated with improvement in physical development of children.
Echocardiography ; atrial septal defect ; ECG

Interrupted aortic arch is a extreme type of coarctation of aorta and mostly associated with other cardiac anomalies. Unless there were no proper management, about 90% of babies would be dead in their neonatal period. A 28-year-old nulliparous woman was refered to our hospital for fetal echocardiography at 23 weeks' gestation with an abnormal prenatal ultrasonographic findings. We found interrupted aortic arch(type A), which was located in distal portion of the left subclavian artery, and ventricular septal defect. After 5 months follow up, the baby was vaginally delivered at 40 weeks' gestation. This baby was delivered at 40 weeks' gestation of a male infant with APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Neonatal echocardiography and electron beam tomography revealed interrupted aortic arch(type A), ventricular septal defect(subaortic type), patent ductus arteriosus, and atrial septal defect(ostium secondum defect). At the 10th day of birth, the infant was performed the operation of end to end anastomosis of desending aorta, patch repair of atrial septal defect, ligation of patent ductus arteriosus, and direct closure of patent foramen ovale.
Adult ; Aorta ; Aorta, Thoracic* ; Aortic Coarctation ; Ductus Arteriosus, Patent ; Echocardiography* ; Female ; Follow-Up Studies ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Ligation ; Male ; Parturition ; Pregnancy ; Subclavian Artery ; Tomography, X-Ray Computed

STUDY DESIGN: Retrospective study. PURPOSE: To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. OVERVIEW OF LITERATURE: Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. METHODS: Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. RESULTS: We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). CONCLUSIONS: We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups.
Aneurysm ; Aortic Valve ; Aortic Valve Stenosis ; Bicuspid ; Cardiomyopathies ; Dextrocardia ; Echocardiography ; Female ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Medical Records ; Mitral Valve Prolapse ; Retrospective Studies* ; Scoliosis*

STUDY DESIGN: Retrospective study. PURPOSE: To identify the incidence of congenital cardiac abnormalities in patients who had scoliosis and underwent surgical treatment for scoliosis. OVERVIEW OF LITERATURE: Congenital and idiopathic scoliosis (IS) are associated with cardiac abnormalities. We sought to establish and compare the incidence of congenital cardiac abnormalities in patients with idiopathic and congenital scoliosis (CS) who underwent surgical treatment for scoliosis. METHODS: Ninety consecutive scoliosis patients, who underwent surgical correction of scoliosis, were classified as CS (55 patients, 28 female [51%]) and IS (35 patients, 21 female [60%]). The complete data of the patients, including medical records, plain radiograph and transthoracic echocardiography were retrospectively assessed. RESULTS: We found that mitral valve prolapse was the most common cardiac abnormality in both patients with IS (nine patients, 26%) and CS (13 patients, 24%). Other congenital cardiac abnormalities were atrial septal aneurysm (23% of IS patients, 18% of CS patients), pulmonary insufficiency (20% of IS patients, 4% of CS patients), aortic insufficiency (17% of IS patients), atrial septal defect (11% of IS patients, 13% of CS patients), patent foramen ovale (15% of CS patients), dextrocardia (4% of CS patients), bicuspid aortic valve (3% of IS patients), aortic stenosis (2% of CS patients), ventricular septal defect (2% of CS patients), and cardiomyopathy (2% of CS patients). CONCLUSIONS: We determined the increased incidence of congenital cardiac abnormalities among patients with congenital and IS. Mitral valve prolapse appeared to be the most prevalent congenital cardiac abnormality in both groups.
Aneurysm ; Aortic Valve ; Aortic Valve Stenosis ; Bicuspid ; Cardiomyopathies ; Dextrocardia ; Echocardiography ; Female ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Medical Records ; Mitral Valve Prolapse ; Retrospective Studies* ; Scoliosis*