No abstract available.
Aneurysm, False* ; Myocardial Infarction*

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

No abstract available.
Aortic Rupture*

A total 139 patients with Tetralogy of Fallot underwent total correction in the Department of Thoracic Surgery, Seoul university Hospital during 5 year-period from January 1974 to December 1978, with overall mortality of 16.5 percent. Operative mortality varied according to severity of the lesion, age of the patients, nature of the previous surgical treatment and presence or absence of an outflow tract across the pulmonic valve ring. Twenty-two patients died in the early postoperative period, one in the postoperative 15 th day and 116 patients were discharged from the hospital alive. There were 90 male patients and 49 female patients with male preponderance. And the age of the patients varied from 2.8 years to 31 years with average of 11.1 years. A patch of the right ventricular outflow tract and pulmonic annulus was required to relieve pulmonic stenosis in 104 patients. There were 20 deaths in group(19.2%) as compared to 3 deaths in the group of 35 patients who were treated without a patch. The electrocardiogram showed right ventricular hypertrophy in 101 cyanotic patients. The interventricular conduction was normal in 112 patients preoperatively. It was normal postoperatively in 22 among 112 patients in these group who were survived. Complete RBBB appeared at operation in 70 patients and 20 patients developed incomplete RBBB. Major causes of death were complete A-V block, Congestive Heart Failure and Bleeding in order.
Cause of Death ; Electrocardiography ; Female ; Heart Failure ; Hemorrhage ; Humans ; Hypertrophy, Right Ventricular ; Male ; Mortality ; Postoperative Period ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot* ; Thoracic Surgery

A total 139 patients with Tetralogy of Fallot underwent total correction in the Department of Thoracic Surgery, Seoul university Hospital during 5 year-period from January 1974 to December 1978, with overall mortality of 16.5 percent. Operative mortality varied according to severity of the lesion, age of the patients, nature of the previous surgical treatment and presence or absence of an outflow tract across the pulmonic valve ring. Twenty-two patients died in the early postoperative period, one in the postoperative 15 th day and 116 patients were discharged from the hospital alive. There were 90 male patients and 49 female patients with male preponderance. And the age of the patients varied from 2.8 years to 31 years with average of 11.1 years. A patch of the right ventricular outflow tract and pulmonic annulus was required to relieve pulmonic stenosis in 104 patients. There were 20 deaths in group(19.2%) as compared to 3 deaths in the group of 35 patients who were treated without a patch. The electrocardiogram showed right ventricular hypertrophy in 101 cyanotic patients. The interventricular conduction was normal in 112 patients preoperatively. It was normal postoperatively in 22 among 112 patients in these group who were survived. Complete RBBB appeared at operation in 70 patients and 20 patients developed incomplete RBBB. Major causes of death were complete A-V block, Congestive Heart Failure and Bleeding in order.
Cause of Death ; Electrocardiography ; Female ; Heart Failure ; Hemorrhage ; Humans ; Hypertrophy, Right Ventricular ; Male ; Mortality ; Postoperative Period ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot* ; Thoracic Surgery

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Mass Screening*

This study was designed to determine if topical cardiac hypothermia is a necessary adjunct to intraoperative myocardial protection. In this study, 105 patients ranging in age from 22 to 74 years were included. Myocardial temperature was measured at the ventricular septum. All patients received cold blood cardioplegia without topical cooling. In most of the patients(90%) the myocardial temperature was dropped to 10-15degrees C without topical cooling. In Group A, myocardial temperature was dropped rapidly to 10-15degrees C with, 1,000ml or less cardioplegic solution. In Group B, the amount of cardioplegic solution required for lowering myocardial temperature to 10-15degrees C was 1,000-2,000ml. In Group C, myocardial temperature was not dropped below 18degrees C or cardioplegic solution over 2,000ml was required for lowering myocardial temperatur. Eight patients(8/61, 8%) in group A, 12 patients(12/35, 34%) in group B and 8 patients(8/9. 89%) in group C had Complete obstructive lesions in at least one of major branches of coronary artery(p=0.001). Myocardial perfusion score was different among the groups(8.27+/-2.27 in group A, 9.98+/-2.21 in group B, 10.30+/-2.49 in group C, p<0.002). These data suggest that routine topical hypothermia may be unnecessary if myocardial temperature of less than 15degrees C could be attained with cold blood cardioplegia, especially in case of myocardial perfusion score below 10.
Cardioplegic Solutions* ; Heart Arrest, Induced ; Humans ; Hypothermia ; Perfusion ; Ventricular Septum

From July 1988, open heart surgery was performed on fifty adults utilizing the pulmonary artery vent instead of conventional venting methods. The open heart procedures included were twenty coronary artery bypass grafitings(CABG), ten mitral valve replacements(MVR), ten aortic aneurysms(DA), and three ventricular septal defects(VSD). To determine the effectiveness of the pulmonary artery venting, non-cardiotomy procedures(CABGs') were classified into satisfactory, ordinary and poor group in terms of the degree of chamber dilatation throughtout the entire period of the operation. Again, cardiotomy procedures were categorized as degree 0, I, II, III and IV according to the clearness of the operative fields. Out of the twenty non-cardiotomy procedures, 17 cases(85%) were fallen into the satisfactory group, while the remained three cases into ordinary group. The degree of satisfaction, in cardiotomy procedures, was III or IV in patients having mitral valve replacement, aortic valve replacement, double valve replacement or dissecting aneurysm repair, and it was I or II in patients having ventricular septal defect repair, on the other hand. There was neither bleeding complication nor stenosis on the vent site. There was only one suspicious perfusion defect on routine postoperative perfusion lung scan. The study demonstrated that venting the pulmonary artery was very helpful in most of the procedures, because it was easy to reach, removal of the vent cannula was safe and simple and complications were trivial.
Adult ; Aneurysm, Dissecting ; Aortic Valve ; Catheters ; Constriction, Pathologic ; Coronary Artery Bypass ; Dilatation ; Hand ; Heart ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Lung ; Mitral Valve ; Perfusion ; Pulmonary Artery* ; Thoracic Surgery

No abstract available.
Heart* ; Hyperbilirubinemia* ; Thoracic Surgery*

A total of 3,119 cardiac valves were replaced in 2,471 patients with acquired valvular heart diseases at Seoul National University Hospital during a period of 26 years from 1968 to 1994. Mechanical valves including St. Jude, Carbomedics, Bjork-Shiley and Duromedics were used in 1,609 cases(52%) and bioprosthetic valves including Lonescu-Shiley, Hancock and Angell Shiley were implanted for the rest of the patients(1,510 cases, 48%). A total of 308(12.5%) redo valve replacement was performed during the same period, and 10 of 308 patients underwent second redo valve replacements. The single valve replacement was done in 1,846 cases, double valve replacement in 602 cases and triple valve replacement in 23 cases. Among the single valve replacement, the mitral valve replacement was performed most frequently(1,377 cases). The male to female ratio was almost equal(1.223 : 1,248) and the mean age was 37.9+/-10.5 years old. But the mean age has been increasing year by year and it reached to 44.8 years old in the 1990's. The overall hospital mortality was 5.3%, and 6.8% in redo valve replacement. However, the hospital mortality for the recent 10 years dropped to 1 to 4%. The number of redo valve surgery has been increasing since the mid-1980's because of structural deterioration of bioprostheses that were replaced during the late-1970's and early 1980's. Redo valve surgery comprised 34% for all valve replacement in 1994. The causes of the redo valve operation were structural deterioration(81.5%), prosthetic valve endocarditis(11.7%), paravalvular leakage(5.6%), and valve thrombosis(0.9%). The actuarial freedom from overall valve failure in Ionescu-Shiley were 81.0+/-7.1%(5 year) in mitral position, 89.1+/-1.8%(7 year) in aortic position and 88.9+/-7.6% in double valve replacement. The 5 year actuarial freedom from all complications in Carbomedics were 90.1+/-3.1% in mitral position, 84.9+/-4.2% in aortic position and 81.7+/-5.1% in double valve replacement. The 10 year actuarial freedom from all complications in St. Jude were 80.9+/-3.8%, 81.4+/-6.1%, 72.4+/-10.7% in each positions. In conclusion, the mean age of patients was younger than that of western countries, but it showed increasing tendency year by year. Bioprosthetic valves were used during the initial period until mid-1980's when mechanical valves were used instead of bioprosthetic valves, mainly because of the structural deterioration of the bioprostheses. In terms of thromboembolism, both bioprostheses and mechanical valves seems to be almost comparable although the comparison of both valves was impossible because of the different period of operation, various surgeon and level of the prothrombin time and so on. Recently the number of valve replacement has been decreased since the 1990's and the number of redo valve surgery and valve repair has been increased.
Bioprosthesis ; Female ; Freedom ; Heart Valve Diseases ; Heart Valves* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Prothrombin Time ; Seoul* ; Thromboembolism