Showing papers in "The Korean Journal of Thoracic and Cardiovascular Surgery in 1984"

Polytetrafluoroethylene인조혈관을 이용한 동맥재건술

Abstract: THE outstanding stability of fluorinated hydrocarbons has been fully exploited in the field of high polymers. The preparation and polymerization of tetrafluoroethylene was described some two years ago (Ind. Eng. Chem., 870; 1946). The polymer (P.T.F.E.) is an excellent dielectric (power factor = 0·0002 over a wide frequency-range) and it is resistant to all common solvents up to 300° C. Molten alkali metals alone have any appreciable attack. In its strength, however, lies its greatest weakness. Form stability is retained up to 250° C., and even at higher temperatures there is no true softening ; thus moulding and fabrication present major obstacles. Progress in overcoming this difficulty has, however, been made by Messrs. British Mechanical Productions, Ltd., 21 Bruton Street, London, W.I, who recently exhibited in London examples of moulded valve -holders and other components in polytetrafluoroethylene.

단심실증의 수술치험 2례

Abstract: 【A modified Fontan procedure was performed on two patients with Univentricular heart. The first patient had UVH of right ventricular type with trabecular pouch and had various associated anomalies, such as common atrium, common atrioventricular valve and combined pulmonary stenosis. The second patient had UVH of left ventricular type with outlet chamber and the associated anomalies were atrial septal defect, tricuspid stenosis and combined pulmonary stenosis. Postoperative hemodynamic insufficiency, fluid retention and renal insufficiency were occurred in the first patient, but relieved with the aid of inotropics and vasodilators. We thought that the good postoperative course and surgical result were gained from the widely patent atriopulmonary anastomosis.】

Ionescu-Shiley 인조판막을 이용한 판막대치술의 혈류역학적 성적

Abstract: 【Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.】

급성 화농성 심낭염

Abstract: 【Acute purulent pericarditis, though not common in incidence after introduction of antibiotics, is still potentially life treating isease. Since 1971, we have experienced 14 cases of acute purulent pericarditis with successful treatment. Among these 14 cases, 9 cases were male and they had high occurrence on their third to fifth decades in age distribution. Isolation of causative organisms were obtained in 11 cases through the bacterial culture of infectious source which was mainly pericardial effusion or blood, and the most frequently recovered organism was the staphylococcus aureus. Pre-existing inflammatory disease preceding to pericarditis, named as antecedent disease, were proved in 12 cases, and among which contiguous extension from the intrathoracic infection such as pneumonia or empyema accounted for the majority of antecedent disease. Pericardiocentesis with administration of antibiotics were tried in all cases, but result in recovery in 1 patient only. Remaining 13 cases had persistent picture of pericarditis and necessitated surgical drainage procedure. Ten of these 13 cases were underwent the open pericardial window using a mode of anterior approach in 4 and subxiphoid approach in 6 cases respectively. Two cases of subxiphoid group were reoperated by the anterior interphrenic pericardiectomy, due to insufficient drain of too thick effusion. In remaining 3 cases, anterior interphrenic pericardiectomy was performed initially because of purulent effusion already changed into fibrinopurulent peel with thickened pericardium. Through the experience of this series, we recommended that pericardiectomy should not be reluctant in purulent pericarditis as a initial surgical procedure for advantage of complete removal of infected space and avoidance of late constrictive pericarditis.】