1.Extracorporeal Membrane Oxygenation for 67 Days as a Bridge to Heart Transplantation in a Postcardiotomy Patient with Failing Heart and Mediastinitis.
Hyoung Woo CHANG ; Yang Hyun CHO ; Suhyun CHO ; Kiick SUNG ; Pyo Won PARK
Korean Journal of Critical Care Medicine 2015;30(4):295-298
We report a case of successful heart transplantation after 67 days of support with venoarterial extracorporeal membrane oxygenation (ECMO) in a patient who underwent surgery for type A aortic dissection and myocardial infarction complicated by irreversible myocardial damage and a deep sternal wound infection. During ECMO support, left heart vent and distal limb perfusion were performed. Mediastinitis was treated with mediastinal washout and irrigation. Multiple complications from peripheral ECMO were successfully managed.
Cardiomyopathies
;
Extracorporeal Membrane Oxygenation*
;
Extremities
;
Heart Transplantation*
;
Heart*
;
Humans
;
Mediastinitis*
;
Myocardial Infarction
;
Perfusion
;
Shock
;
Transplantation
;
Wound Infection
2.Refractory Ventricular Arrhythmia Induced by Aconite Intoxication and Its Treatment with Extracorporeal Cardiopulmonary Resuscitation.
Mi Kyoung HONG ; Jeong Hoon YANG ; Chi Ryang CHUNG ; Jinkyeong PARK ; Gee Young SUH ; Kiick SUNG ; Yang Hyun CHO
Korean Journal of Critical Care Medicine 2017;32(2):228-230
No abstract available.
Aconitum*
;
Arrhythmias, Cardiac*
;
Cardiopulmonary Resuscitation*
3.Mitral Valve Repair.
Hanyang Medical Reviews 2007;27(2):36-43
Mitral valve repair is the preferred treatment, especially for mitral regurgitation and could be performed successfully in the majority of the patients. To decrease the time for learning curve and achieve successful results, an overall knowledge of the anatomic, functional, and pathology of the mitral valve and familiarization with many useful repair techniques is necessary. With such point of view, we reviewed mitral valve anatomy, physiology, pathology, and many mitral valve repair techniques.
Humans
;
Learning Curve
;
Mitral Valve Insufficiency
;
Mitral Valve*
;
Pathology
;
Physiology
4.Mitral Valve Repair.
Hanyang Medical Reviews 2007;27(2):36-43
Mitral valve repair is the preferred treatment, especially for mitral regurgitation and could be performed successfully in the majority of the patients. To decrease the time for learning curve and achieve successful results, an overall knowledge of the anatomic, functional, and pathology of the mitral valve and familiarization with many useful repair techniques is necessary. With such point of view, we reviewed mitral valve anatomy, physiology, pathology, and many mitral valve repair techniques.
Humans
;
Learning Curve
;
Mitral Valve Insufficiency
;
Mitral Valve*
;
Pathology
;
Physiology
5.Histologic Changes of the Immunologically Untreated Xenogenic Valved Conduit.
Kiick SUNG ; Jeong Wook SEO ; Won Gon KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2007;40(1):1-7
BACKGROUND: It has been shown that the endothelium of cardiac valves and adjacent great vessels have a reduced immune reaction compared to other vessels. We investigated the clinical feasibility of using immunologically untreated xenogenic valves, in a pig-to-goat pulmonary valve conduit implantation model. MATERIAL AND METHOD: Porcine pulmonary valve conduits were prepared without specific immunologic treatment and implanted into the right ventricular outflow tract of goats while undergoing cardiopulmonary bypass. Two goats each were assigned to the following observation time intervals: one day, one week, three months, six months and twelve months. Echocardiographic examinations were performed prior to sacrifice of the goat to evaluate pulmonary valve function. After the xenograft specimens were retrieved, histological changes were evaluated microscopically. RESULT: Ten of the twelve animals survived the predetermined observation time intervals. Aneurysmal dilatations, of the anterior wall of the implanted pulmonary artery, were observed at each of three and twelve month-survival animals. A variable degree of pulmonary valve regurgitation was observed on echocardiography. However, valve stenosis, thrombotic occlusion and vegetation were not seen. Microscopically, the nuclei of the donor tissue disappeared as a result of pyknosis and karyolysis; however the three components of the implanted xenografts (the pulmonary artery, the valve and the infundibulum) were gradually replaced by host cells over time, while maintaining their structural integrity. CONCLUSION: Immunologically untreated xenogenic pulmonary valve conduits were replaced by host cells with few observed clinical problems in a pig to goat pulmonary valve implantation model. Therefore, they might be an alternative bioprosthesis option.
Aneurysm
;
Animals
;
Bioprosthesis
;
Cardiopulmonary Bypass
;
Constriction, Pathologic
;
Dilatation
;
Echocardiography
;
Endothelium
;
Goats
;
Heart Valves
;
Heterografts
;
Humans
;
Models, Animal
;
Pulmonary Artery
;
Pulmonary Valve
;
Pulmonary Valve Insufficiency
;
Tissue Donors
;
Tissue Engineering
6.Histological Comparison of Vascular Grafts in a Pig to Goat Xenotransplantation Model.
Ji Hyuk YANG ; Kiick SUNG ; Won Gon KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2006;39(6):427-433
BACKGROUND: Current vascular prostheses are considered still inadequate for reconstruction of small-diameter vessels. To evaluate the potential use of xenograft vessels as small diameter arterial grafts, we implanted porcine vessels in goats. The grafts were treated with two different processes, freezing and acellularization, before implantation, and gross inspection as well as microscopic examination followed after a predetermined period. MATERIAL AND METHOD: Bilateral porcine carotid arteries were harvested and immediately stored at -70 degrees C within tissue preservation solution. One of them was designated as frozen xenograft vessel. The other one was put on acellularization process using NaCl-SDS solution and stored frozen until further use. Grafts were implanted in the place of carotid arteries of the same goat. The grafts have remained implanted for 1, 3, and 6 months in three animals, respectively. Periodic ultrasonographic examinations were performed during the observation period. After explantation, the grafts were analyzed grossly and histologically under light microscope. RESULT: All animals survived the experimental procedure without problems. Ultrasonographic examinations showed excellent patency of all the grafts during the observation period. Gross examination revealed nonthrombotic, patent lumens with smooth surfaces. Microscopic examinations of the explanted grafts showed cellular reconstruction at the 6-month stage in both grafts. Although more inflammatory responses were observed in the early phase of frozen xenografts, there was no evidence of significant rejection. CONCLUSION: These findings suggest that porcine xenograft vessels, regardless of pre-implantation processes of acelluarization or freezing, can be acceptably implanted in goats, although short duration of observation in a small number of animals may limit this study.
Animals
;
Bioprosthesis
;
Blood Vessel Prosthesis
;
Carotid Arteries
;
Freezing
;
Goats*
;
Heterografts
;
Tissue Preservation
;
Transplantation, Heterologous*
;
Transplants*
7.Transfromation of Percutaneous Extracorporeal Life Support to Paracorporeal Ventricular Assist Device: A Case Report.
Chilsung KIM ; Yang Hyun CHO ; Kiick SUNG ; Ji Hyuk YANG
The Korean Journal of Thoracic and Cardiovascular Surgery 2014;47(4):409-412
Percutaneous extracorporeal life support (P-ECLS) is a useful modality for the management of refractory cardiac or pulmonary failure. However, venoarterial P-ECLS may result in a complication of left ventricular distension. In this case report, we discuss a patient with drug-induced dilated cardiomyopathy managed with venoarterial P-ECLS and a left atrial vent catheter. The venoarterial P-ECLS was modified to a paracorporeal left ventricular assist device (LVAD) by removing the femoral venous cannula. After 28 days of hospitalization, the patient was successfully weaned from the paracorporeal LVAD and discharged home from the hospital.
Cardiomyopathy, Dilated
;
Catheters
;
Extracorporeal Membrane Oxygenation
;
Heart Failure
;
Heart-Assist Devices*
;
Hospitalization
;
Humans
8.A Rapidly Expanding Ascending Aortic Aneurysm in a Patient with Relapsing Polychondritis.
Haseong CHANG ; Dongwuk KIM ; Juwon KIM ; Daegeun LEE ; Kiick SUNG ; Duk Kyung KIM
Korean Journal of Medicine 2016;91(3):292-295
Here we describe a case of rapidly expanding ascending aortic aneurysm in a patient with relapsing polychondritis. To prevent aneurysm rupture, the patient underwent emergent surgical repair. Silent inflammation can progress in the aorta wall, even in asymptomatic patients with mild disease activity under immunosuppressive treatment, leading to the rapid growth of aortic aneurysms. Close monitoring with routine imaging is needed once a patient with relapsing polychondritis is diagnosed with an aortic aneurysm.
Aneurysm
;
Aorta
;
Aortic Aneurysm*
;
Aortitis
;
Humans
;
Inflammation
;
Polychondritis, Relapsing*
;
Rupture
9.Successful Management of Atrio-Esophageal Fistula after Cardiac Radiofrequency Catheter Ablation.
Hun Bo SHIM ; Chilsung KIM ; Hong Kwan KIM ; Kiick SUNG
The Korean Journal of Thoracic and Cardiovascular Surgery 2013;46(2):142-145
An increase in cardiac radiofrequency catheter ablation for treating refractory atrial fibrillation has resulted in an increased prevalence of complications. Among numerous complications of radiofrequency catheter ablation, atrio-esophageal fistula, although rare, is known to have fatal results. We report a case of successful management of an atrio-esophageal fistula as a complication of cardiac radiofrequency catheter ablation.
Atrial Fibrillation
;
Catheter Ablation
;
Fistula
;
Prevalence
10.Clinical Pearls of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock
Min Suk CHOI ; Kiick SUNG ; Yang Hyun CHO
Korean Circulation Journal 2019;49(8):657-677
Extracorporeal membrane oxygenation (ECMO) is a technique that uses a pump to drain blood from a body, circulate blood through a membrane lung, and return the oxygenated blood back into the body. Venoarterial (VA) ECMO is a simplified version of the heart-lung machine that assists native pulmonary and/or cardiac function. VA ECMO is composed of a drainage cannula in the venous system and a return cannula in the arterial system. Because VA ECMO can increase tissue perfusion by increasing the arterial blood flow, it is used to treat medically refractory cardiogenic shock or cardiac arrest. VA ECMO has a distinct physiology that is referred to as differential flows. It can cause several complications such as left ventricular distension with pulmonary edema, distal limb ischemia, bleeding, and thromboembolism. Physicians who are using this technology should be knowledgeable on the prevention and management of these complications. We review the basic physiology of VA ECMO, the mechanism of complications, and the simple management of VA ECMO.
Catheters
;
Drainage
;
Extracorporeal Membrane Oxygenation
;
Extremities
;
Heart Arrest
;
Heart-Lung Machine
;
Hemorrhage
;
Ischemia
;
Lung
;
Membranes
;
Oxygen
;
Perfusion
;
Physiology
;
Postoperative Complications
;
Pulmonary Edema
;
Shock
;
Shock, Cardiogenic
;
Thromboembolism