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*

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

A clinical study is done on 234 adult patients with congenital heart disease who visited Dong San Hospital, Keimyung University during the period of January 1982 to May 1987. Among those the number of men is 109 and the female is 125. There are female preponderance in atrial septal defect and patent ductus arteriosus while male in tetralogy of Fallot and pulmonary stenosis. Most of patients are found below 30 years of age and the incidence decrease with age; below 30 years of age, ninty percent of ventricular septal defect, eight-eight percent of tetralogy of Fallot, eighty-four percent of patent ductus arteriosus and seventy-seven percent of atrial septal defect are found. The incidence of congenital heart diseases in adult are as follow; ventricular septal defect 30.8%, atrial septal defect 30.3%, tetralogy of Fallot 17.1%, patent ductus arteriosus 12.8%, pulmonary stenosis 3.4% and miscellaneous congenital diseases 4%. Associated anomalies of major congenital heart diseases are as follows; the most commonly associated anomaly in ventricular septal defect is pulmonary stenosis, and Sinus Valsalva aneurysm with/without rupture or aortic regrugitation is frequently associated in ventricular septal defect. Mitral regurgitation or pulmonary stenosis are frequently as sociated with atrial septal defect. Patent foramen ovale or atrial septal defect and persistent left superior vena cave are associated with tetralogy of Fallot. The lesion of aortic valve is frequent in patient ductus arteriosus.
Adult ; Aneurysm ; Aortic Valve ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Female ; Foramen Ovale, Patent ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Incidence ; Male ; Mitral Valve Insufficiency ; Multiple Endocrine Neoplasia Type 1 ; Pulmonary Valve Stenosis ; Rupture ; Tetralogy of Fallot

BACKGROUND: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery (OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. MATERIAL AND METHOD: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease (CHD) and 468 cases were acquired heart disease (AHD). The age distribution was 9 days (4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. RESULT: The CHD cases consisted of 940 ventricular septal defects (61.4%), 324 atrial septal defects (21.1%), 112 tetralogy of Fallot (7.3%), 46 pulmonary stenosis (3%), 38 endocardial cushion defects (2.5%), 15 valsalva sinus ruptures (1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles (0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements (36 aortic valve replacements (AVR), 188 mitral valve replacements (MVR), and 2 tricuspid valve replacements (TVR), among these were 71 cases of double valve replacements (AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty (TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery (CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. CONCLUSION: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6% (72/2,000).
Age Distribution ; Aortic Aneurysm ; Aortic Valve ; Busan ; Coronary Artery Bypass ; Dilatation, Pathologic ; Endocardial Cushion Defects ; Heart Defects, Congenital ; Heart Diseases ; Heart Neoplasms ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart Valve Diseases ; Heart Ventricles ; Heart* ; Hospital Mortality ; Humans ; Mitral Valve ; Mortality ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Rupture ; Sinus of Valsalva ; Tetralogy of Fallot ; Thoracic Surgery* ; Transplants ; Transposition of Great Vessels ; Tricuspid Valve

BACKGROUND: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. MATERIAL AND METHOD: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was 157.8+/-245.3 (15.0~994.0) days and mean weight was 4.8+/-2.5 (1.7~10.7) kg. Patent ductus arteriosus (8), atrial septal defect (7), interrupted aortic arch (5), ventricular septal defect (4), patent foramen ovale (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. RESULT: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was 6.8+/-5.6 (57.0 days~16.7 years)years and all patients belonged to NYHA class I. CONCLUSION: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.
Aorta ; Aorta, Thoracic ; Aortic Coarctation ; Aortic Valve ; Bronchi ; Constriction, Pathologic ; Dextrocardia ; Diagnosis ; Ductus Arteriosus, Patent ; Follow-Up Studies ; Foramen Ovale, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Intensive Care Units ; Length of Stay ; Mitral Valve Insufficiency ; Pulmonary Artery ; Reoperation ; Tracheal Stenosis ; Tricuspid Valve Insufficiency ; Vena Cava, Superior

The right pulmonary artery(RPA0 of the patients with intracardiac left to right shunt was examined by suprasternal M-mode echocardiography, the subjects were 6 atrial septal defects, 8 ventricular septal defects and 6 patient ductus arteriosus. The enddiastolic and the widest systolic dimension of the RPA were measured from the echogram, and the systolic widening rate was calculated. The systolic widening rate of the RPA in the patients with left to right shunt was significantly larger than that of the 56 apparently healthy control subjects. The systolic widening rate of the RPA was well correlated with the ratio of the pulmonary to systemic blood flow(Qp/Qs) in the patients with left to right shunt thru atrial septal defects(n=6, correlation coefficient=0.918, p<0.01). In 14 patients with either atrial(6 cases) r ventricular septal defects(8 cases) with left to right shunt, the widening rate of the RPA and Qp/Qs ratio were positively correlated with correlation coefficient of 0.787(p<0.001). In conclusion the noninvasive examination of the RPA by suprasternal echocardiography is thought to be very helpful in estimating the Qp/Qs ratio in the patients with left to rifht shunt thru artial or ventricular septal defect.
Ductus Arteriosus ; Echocardiography* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Pulmonary Artery*

No abstract available.
Aorta, Thoracic* ; Heart Septal Defects, Atrial* ; Heart Septal Defects, Ventricular* ; Pulmonary Artery*

A clinical obsevation was made on 8 patients with Corrected Transposition of the Great Arteries who visited seoul National University Hospital during the period of Feb., 1979-Sep., 1982. 1. Sex distribution was 5 male and 3 female patients. 2. Age distribution was from 16 to 39 years and the mean age was 24 years. 3. Symptoms were exertional dyspnea in all cases, cyanosis in 3 cases. Other symptoms were palpitation, chest pain, growth retardation and chest deformity. Duration of illness was from 6 to 16 years and N.Y.H.A. functional class was between II and III. 4. On physical examination, cardiac mumurs were heard in all cases. Cyanosis on the lips and nail beds were noticed in 3 cases and clubbing of fingers was seen in 1 case. 5. Situs inversus was noticed in 1 case, mesocardia in 3 cases, dextrocardia in 1 cases and right sided aortic arch in 1 case by simple Chest PA. 6. Electrocardiographic findings were Biventricular hypertrophy in 3 cases, Left ventricular hypertrophy in 2 cases, Right ventricular hypertrophy in 2 cases and Incomplete right bundle branch block in 1 case. No arrhythmias were observed. Septal Qwave was not observed on the left precordial leads in all cases. 7. CTGA were suspected or diagnosed by Echocardiography in 7 cases. 8. The diagnosis of CTGA and its associated anomalies were confirmed in all cases by cardiac catheterization and angiocardiography. There were one case of I.D.D. type CTGA and seven cases of S.L.L. type CTGA's. Associated anomalies were ventricular septal defect in 5 cases, pulmonary stenosis in 5 cases, patent foramen ovale in 3 cases, atrial septal defect in 2 cases, patent ductus arteriosus in 1 case, dextrocardia in 1 case, left sided A.V. valve regurtation in 2 cases, and right sided aortic arch in 1 case. 9. Operation was done in the case associated with patent ductus arteriosus, and corrective surgery was done in the another case associated with ASD, VSD, PS and TR with C-TGA.
Age Distribution ; Angiocardiography ; Aorta, Thoracic ; Arrhythmias, Cardiac ; Arteries ; Bundle-Branch Block ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Congenital Abnormalities ; Cyanosis ; Dextrocardia ; Diagnosis ; Ductus Arteriosus, Patent ; Dyspnea ; Echocardiography ; Electrocardiography ; Female ; Fingers ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Lip ; Male ; Physical Examination ; Pulmonary Valve Stenosis ; Seoul ; Sex Distribution ; Situs Inversus ; Thorax