No abstract available.
Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

This is a report of 13 cases of surgically corrected ruptured aneurysm of the aortic sinus of Valsaha. The simultaneous trans-venous and trans-arterial catheterization and cineangiogram are the best diagnostic procedures. In 12 cases, the aneurysm originated from the right coronary sinus and only one from the noncoronary sinus. Eleven aneurysms ruptured into the right ventricle and 2 into the right atrium. Eight cases were associated with ventricular septa1 defect and 5 with aortic regurgitation. In three cases the Hancock porcine valve replacement was done. There was no surgical mortality.
Adolescent ; Adult ; Aortic Aneurysm/surgery* ; Aortic Rupture/diagnosis ; Aortic Rupture/surgery* ; Child ; Female ; Heart Catheterization ; Human ; Male ; Sinus of Valsalva/surgery*

Pulmonary artery aneurysms are extremely rare. Even though their etiology or mechanism remain uncertain, congetial anenrysms follow the congenital heart defects which elevate the pulmonary artery pressure or increase the pulmonary blood flow and acquired aneurysms are developed by syphilis, mycotic change and atherosclerosis. Pulmonary artery aneurysms involve the artery trunk rupture and exanguination if untreated, there has been an emphasis in the need for surgical intervention whenever the diagnosis is made regardless of the presence or absence of symptoms. Here we report a case of patient ductus arterious associated with main pulmonary artery aneurysm in 39 year old female patient with review of literatures.
Adult ; Aneurysm* ; Arteries ; Atherosclerosis ; Diagnosis ; Ductus Arteriosus, Patent* ; Female ; Heart Defects, Congenital ; Humans ; Pulmonary Artery* ; Rupture ; Syphilis

Surgical revascularization is very effective for the relief of chest pain, improvement of exercise tolerance and ventricular performance in certain ischemic heart diseases. Bypass graft angiography and native coronary angiography after coronary artery bypass graft(CABG) were required for the evaluation of graft patency, progression of the native coronary artery disease and to predict the prognosis of the patients after CABG. The cases included in this study involved 15 patients who underwent selective bypass graft angiography among 102 CABG cases. Thirty eight sites were bypassed by saphenous vein and two sites by internal mammary artery. The results were as follows: 1) The overall patency rate of the saphenous vein bypass graft was 76.3% and the two sites of the internal mammary artery bypass graft were both patent. 2) The patency rate of direct anastomosis was 86.2% and of sequential anastomosis, 44.4%. 3) In eight patients who underwent native coronary angiography, five patients showed progression of grafted coronary artery disease. Among them, two patients had accompanying progression of coronary artery disease in non-grafted vessels. 4) Follow up treadmill test performed in six patients showed improvement of exercise tolerance in all patients. 5) There was some increase in the ejection fraction of the left ventricle after CABG in six patients who received follow up left ventriculography.
Angiography* ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mammary Arteries ; Myocardial Ischemia ; Prognosis ; Saphenous Vein ; Transplants*

Twenty-one patients undergoing aortic valve replacement for pure aoritic regurgitation were studied retrospectively to evaluate the left ventricular function and internal dimension change before, 1-6 weeks(early postoperative) and 2-36 months after(late postoperative) aortic valve replacement by serial echocardiography. Postoperatively, NYHA function class improved remarkably (from 3.3+/-0.6 to 1.4+/-0.7). Early postoperatively, left ventricular end-diastolic dimension (EDD), left ventricular end-systolic dimension(ESD), left ventricular fractional shortenting(FS) significantly decreased in all patients(7.6+/-1.2cm vs 5.8+/-1.5cm P<0.001, 5.5+/-1.3cm vs 4.7+/-1.3cm P<0.001, 39+/-12% vs20+/-8% P<0.001 respectively). Interventricular septum thickness(IVS) and posterior wall thickness (PW) were slightly thickened before(1.4+/-0.3cm, 1.3+/-0.3cm respectively) and in the early postoperative period (1.3+/-0.4cm, 1.3+/-0.3cm respectively) without significant interval change. Late postoperatively, EDD and ESD decreased significantly (7.8+/-1.2cm vs 5.1+/-0.8cm P<0.01, 5.1+/-1.1cm vs 3.4+/-0.8cm P<0.001. respectively), and FS increased significantly (25+/-9% vs 34+/-9%, P<0.05). Among 3 patients of so called high risk group mentioned by Henry(22,33), ESD and FS improved to normal range in 2 patients, and ESD decreased to 4.4cm and FS increased to 33% in the other one. EDD and ESD decreased significantly in both group I(preoperative ESD<5.5cm) and group II(preoperative ESD<5.5cm), without no decrement difference between two groups, and there was a significant difference of FS decrement between group I and group II at early postoperative period. Preoperative ESD correlated highly with the early postoperative EDD(r=0.89) and ESD(r=0.87) with statistical significance, and moderately high with late postoperative EDD(r=0.45), ESD(r=0.50) and FS(r=0.42) without statistical signiticance. We concluded that there was significant improvement in left ventricular function in pure aortic regurgitation patients postoperatively. Preoperative left ventricular and systolic dimension above 5.5cm and fractional shortenting below 25% are not so reliabel index of poor postoperative prognosis.
Aortic Valve Insufficiency* ; Aortic Valve* ; Echocardiography* ; Humans ; Postoperative Period ; Prognosis ; Reference Values ; Retrospective Studies ; Ventricular Function, Left

No abstract available.
Neuroblastoma*

Patent Ductus Arteriosus is one of the most common congenital heart diseases. The symptoms and clinical findings in patients with typical patnet ductus arteriosus are well recognized. That not all patient with ductus arteriosus have the typical clinical findings is well documented. Since the poor prognosis of untreated patent ductus arteriosus and good results of surgical intervention are fairly well established fact, it is important that all altered in according to hemodynamic changes depending on the pulmonary pressure, amount of shunt, degree of resistance of pulmonary circulation. This series comprises 165 patients of patent ductus arteriosus who had been admitted to Severance Hospital from Apr. 1964 to Aug. 1979. An attempt was made to correlate the hemodynamic data with age. The results of this study may be summarized briefly as follows : 1.Of the 165 patients, 67 were male and 98 were female. Their age range from 1 day to 48 years. About 50% of all patients was below 10 years. 2.Major symptoms on admission were frequent URI, exertional dyspnea, palpitation and evaluation of known congenital heart disease etc. 3.Of 165 patients, continuous murmur was audible in 128 patients and systolic murmur in 28 patients. 4.The children (below 15 years of age) had the variable distribution of pulmonary to systemic flow ratio (Qp/Qs) Most of adult had the Qp/Qs of below 3. 5.Severe pulmonary hypertension was noted in 13% of right heart catheterized patients. 6.There was no obvious correlation between aging and pulmonary wascular resistance or pulmonary hypertension. 7.There was linear correlation between the diameter of ductus and pulmonary blood flow. 8.The left atrium to aortic root dimension ratio in echocardiogram showed correlation with the pulmonary to systemic flow ratio measured at catherization (r=0.45) 9.Operative mortality was 2.5% in 165 cases of isolated patent ductus arteriosus.
Adult ; Aging ; Cardiac Catheters ; Child ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Dyspnea ; Female ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Male ; Mortality ; Prognosis ; Pulmonary Circulation ; Systolic Murmurs

The patency of graft vessels and their effects on the native coronary circulation were studied by evaluation of 78 graft sites in 35 patients who underwent selective bypass graft angiography among 152 CABG cases at a mean follow-up 12.6 month. The result were as follows ; 1) The overall graft patency rate was 70.5% : 73.8% for left anterior descending artery, 68.4% for left circumflex arterty, 64.7% for right coronary artery. 2) The patency rate of internal mammary artery was 77.8%. 3) In twenty eight patients who underwent native coronary angiography, twelve pateints showed progression of coronary artery disease in grafted vessel and two patients showed progression of coronary artery disease in non-grafted vessel. 4) The treadmill test was performed before and after coronary artery bypass graft in thirteen patients. Among 13 patients, nine patinets showed improved exercise tolerance. 5) The percutaneous transluminal coronary angioplasty were successfully performed for dilating three cases of stenotic vein graft and two cases of left main lesions after CABG and one case of stenotic left internal mammary artery graft.
Angiography ; Angioplasty, Balloon, Coronary ; Arteries ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Circulation ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Humans ; Mammary Arteries ; Transplants ; Veins