BACKGROUND AND PURPOSE: We performed this study to explore the various diagnostic roles of video-EEG monitoring (VEM) and to assess the outcome after VEM. METHODS: 1749 patients who underwent VEM in the adult epilepsy section were included. We classified purposes of VEM and assessed outcome after VEM or epilepsy surgery guided by VEM. The outcome was assessed according to seizure frequency during the previous 12 months from the day of follow-up evaluation. RESULTS: The purposes of VEM were presurgical evaluation (68.5%), confirmation of epilepsy (15%), classification of seizures (9.4%), diagnosis of pseudoseizures (5.5%), and detection of nonconvulsive status epilepticus (1.7%). The efficiency of VEM was 89.2%, highest for presurgical evaluation (97.1%) and lowest for confirmation of seizures (66.0%). The number of events detected and the number of days needed differed according to the purposes of VEM. Epilepsy surgery was performed in 629 patients. The outcome of patients with epilepsy surgery was significantly better compared with patients without surgery despite presurgical evaluation (p<0.0001). Various other illnesses with transient symptoms as well as various epileptic syndromes were diagnosed by VEM. Better outcomes were observed in patients in whom VEM was used for classification and confirmation of seizures compared with patients in whom VEM was used for presurgical evaluation. CONCLUSIONS: VEM is a useful tool for various purposes. The efficiency, number of events and days of VEM differed according to the purposes. Patient outcome was also dependent on the purpose of the VEM as well as on treatment modalities.
Adult ; Epilepsy ; Follow-Up Studies ; Humans ; Seizures ; Status Epilepticus

BACKGROUND: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. MATERIAL AND METHOD: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were 92.1+/-25.9 min, 39.1+/-10.6 min, and 30.2+/-10.7 min, respectively. Mean follow-up duration was 41.4+/-29.1 months and follow-up was possible in all patients. RESULT: The median age and body weight at operation were 28.5 days (0~478 days) and 3.4 kg (1.4~9 kg). Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were 94.5+/-2.7% and 97.2+/-2.0%, respectively. CONCLUSION: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.
Body Weight ; Cause of Death ; Constriction, Pathologic* ; Coronary Sinus ; Death, Sudden ; Follow-Up Studies ; Freedom ; Humans ; Mortality ; Perioperative Care ; Pulmonary Veins* ; Retrospective Studies ; Scimitar Syndrome* ; Sepsis ; Survival Rate

Left ventricular inflow obstruction can be caused by a persistent left superior vena cava (SVC) and a dilated coronary sinus. A 31-day-old male infant with secondum atrial septal defect (ASD) and bilateral SVC underwent an operation for treating his uncontrollable congestive heart failure. The preoperative 2-dimensional echocardiography showed a normally sized mitral valve shrouded by a dilated coronary sinus. The operation consisted of pericardial patch closure of the ASD, coronary sinus unroofing and left SVC transfer to the right atrial auricle. The postoperative course was complicated by persistent chylothorax, which was controlled by thoracic duct ligation. He was discharged to home at the postoperative day 39. He has been followed up for 9 months and has displayed normal development.
Chylothorax ; Coronary Sinus* ; Echocardiography ; Heart Failure ; Heart Septal Defects, Atrial ; Humans ; Infant ; Ligation ; Male ; Mitral Valve ; Thoracic Duct ; Vena Cava, Superior*

BACKGROUND: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. MATERIAL AND METHOD: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years. The mean age was 5.3+/-5.3 years and the mean body weight was 20.0+/-16.3 kg. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). RESULT: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were 93.3+/-4.6% and 76.1+/-8.2%, respectively. The 5-year freedom from mitral valve replacement rate was 83.6+/-6.7%. There was no significant risk factor for reoperation. CONCLUSION: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.
Adult ; Body Weight ; Child ; Freedom ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Prolapse ; Reoperation ; Retrospective Studies ; Risk Factors ; Survival Rate

No abstract available.
Cardiopulmonary Resuscitation*

No abstract available.
Cardiopulmonary Resuscitation*