Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect;1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective method to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.
Follow-Up Studies ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Mortality ; Sternotomy ; Thoracic Surgery* ; Thoracotomy*

During 1986, 111 cases of open heart surgery were performed at Yeungnam University Hospital consisting 88 cases of congenital heart disease and 23 cases of acquired heart disease. Among 88 congenital heart disease, 72 were acyanotic group and 16 were cyanotic. Common congenital heart diseases were ventricular septal defect (51%), atrial septal defect (18%) and Tetralogy of Fallot (16%). Among 23 acquired heart disease, 22 cases were valvular heart disease and one was dissecting aortic aneurysm. Three cases of the postoperative death were present resulting 2.7% of surgical mortality rate.
Aortic Aneurysm ; Heart Defects, Congenital ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart Valve Diseases ; Heart* ; Mortality ; Tetralogy of Fallot ; Thoracic Surgery*

BACKGROUND: There is limited data on comparisons between the effect of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegic (CBC) solution in pediatric cardiac surgery. The purpose of this study was to compare the myocardial protective effect of HTK solution and CBC solution in patients undergoing pediatric cardiac surgery. MATERILAS AND METHODS: We selected 49 patients with ventricular septal defect and atrial septal defect. HTK solution was used in 21 patients and CBC solution was used in 28 patents. HTK solution was given as a single dose, whereas CBC solution was used in the usual multi-dose method. The incidence of EKG change and concentration of Troponin T and CK-MB were compared for the evaluation of myocardial damage. RESULTS: There were no significant differences in the incidence of ST, T segment change by EKG and serial cardiac enzyme levels between two groups. CONCLUSION: These results suggested that the myocardial protective effect of HTK solution was similar to CBC solution in simple pediatric cardiac surgery.
Cardioplegic Solutions* ; Electrocardiography ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Thoracic Surgery* ; Troponin T

Female ; Heart Defects, Congenital ; surgery ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Male ; Pulmonary Artery ; abnormalities ; Pulmonary Atresia ; surgery

Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.
Academies and Institutes ; Balloon Valvuloplasty ; Catheterization ; Embolization, Therapeutic ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypoplastic Left Heart Syndrome ; Stents ; Thoracic Surgery

We experienced a case of open heart surgery for correction of ventricular septal defect and patent ductus arteriosus in five years old boy with hemophilia A. Factor VIII activity in this patient was 0.7% of normal activity. He received 2,000 unit of factor VIII intravenously for loading dose and has been infused 6 unit/kg/hour for 12 hours before the operation. And his factor VIII activity was 68% in the morning of the operation day. During the operation, he received 6 unit/kg/hour of factor VIII. After intracardiac anomaly was repaired and protamine was injected, we administrated 1000 unit of factor VIII. At that time, his factor VIII was 57%. After operation was done, he received 6 unit/kg/hour of factor VIII during stay in ICU and postoperative 14 days. His factor VIII activity was maintained at 36~104% during stay in hospital. So we report a successful case of perioperative management for the open heart surgery in patient with hemophilia A.
Ductus Arteriosus, Patent ; Factor VIII ; Heart Septal Defects, Ventricular ; Heart* ; Hemophilia A* ; Humans ; Male ; Thoracic Surgery*

We experienced a case of open heart surgery for correction of ventricular septal defect and patent ductus arteriosus in five years old boy with hemophilia A. Factor VIII activity in this patient was 0.7% of normal activity. He received 2,000 unit of factor VIII intravenously for loading dose and has been infused 6 unit/kg/hour for 12 hours before the operation. And his factor VIII activity was 68% in the morning of the operation day. During the operation, he received 6 unit/kg/hour of factor VIII. After intracardiac anomaly was repaired and protamine was injected, we administrated 1000 unit of factor VIII. At that time, his factor VIII was 57%. After operation was done, he received 6 unit/kg/hour of factor VIII during stay in ICU and postoperative 14 days. His factor VIII activity was maintained at 36~104% during stay in hospital. So we report a successful case of perioperative management for the open heart surgery in patient with hemophilia A.
Ductus Arteriosus, Patent ; Factor VIII ; Heart Septal Defects, Ventricular ; Heart* ; Hemophilia A* ; Humans ; Male ; Thoracic Surgery*

Subaortic stenosis usually occurs without a previous heart operation, however, it can occur after heart surgery as well, with a condition known as a secondary subaortic stenosis (SSS). SSS has been reported after surgical repair of several congenital heart defects. There are only a few recorded cases of SSS after repair of ventricular septal defect (VSD). Here we report a rare case of SSS that occurred 3 years after surgical repair of subarterial VSD. A follow-up echocardiogram is essential for detecting SSS caused by the newly developed subaortic membrane in patients who had cardiac surgery.
Constriction, Pathologic ; Discrete Subaortic Stenosis ; Echocardiography ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Membranes ; Thoracic Surgery

This study was performed to assess the accuracy of pulsed Doppler echocardiographic(PDE) diagnosis of ventricular septal defect(VSD). 119 children with congenital heart disease, aged 9 months to 17 years, admitted to our hospital for cardiac surgery, were studied. These children had VSD(56), ASD(18), PDA(43), PS(1) and Cortriatrium(1). A specific PDE diagnosis of VSD can be made by following the turbulent VSD jet(TVJ) through the septum, and a PDE diagnosis of VSD was made in 53 out of 56 patients(95%) proven by catheterization and operation. There were two false positive PDE diagnosis of VSD by PDE, were proven to be perimembranous VSD at operation, and 3 children who were classified into subarterial infundibular VSD by PDE, were proven to be perimembranous VSD at operation. PDE seems to be a very useful tool in preoperative evaluation of VSD.
Catheterization ; Catheters ; Child ; Diagnosis* ; Echocardiography, Doppler, Pulsed* ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Humans ; Thoracic Surgery

Percutaneous cardiopulmonary support (PCPS) is accepted as a very helpful mechanical support available for patients with cardiogenic shock unresponsive to medical treatment and intra-aortic balloon pump (IABP). Although the indication criteria or guidelines for the application of PCPS have not been established, several reports demonstrate that the early initiation of PCPS allows for good clinical outcomes in patients suffering cardiogenic shock. We experienced two patients that required PCPS before and after emergent cardiotomy to correct ventricular septal defect and left ventricular rupture due to myocardial ischemia, respectively. Herein, we report these cases to emphasize that the early application of PCPS is essential to improve the clinical outcomes in patients with severe cardiogenic shock.
Heart Septal Defects, Ventricular ; Humans ; Myocardial Ischemia ; Rupture ; Shock, Cardiogenic ; Stress, Psychological ; Thoracic Surgery