LPA Occulusion Due to the Erroneous Ligature of Patent Ductus Arteriosus: a report of 3 cases / 대한흉부외과학회지

Confusion of a patent ductus arteriosus (PDA) for the descending thoracic aorta is a fatal error occurring occasionally in infants or neonates. As a result, the left pulmonary artery (LPA) may be misconceived as the PDA, and ligated. This surgical mishap of other hospital leads to serious congestive heart failure and loss of left lung function due to the underdevelopment in the peripheral vascular and alveolar structures in neonates and premature infants. In this report, 3 cases of LPA ligation and subsequent treatment are presented.

A Comparison on the Operative Results of Benign Esophageal Disease by Video-Assisted Thoracic Surgery and Thoracotomy / 대한흉부외과학회지

BACKGROUND: Video-assisted thoracic surgery (VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. MATERIAL AND METHOD: Group I (n=18) underwent video-assisted thoracic surgery, and group II (n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. RESULT: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I (155.6+/-77.8cc) than in group II (572.8+/-280.1cc) (p<0.05). CONCLUSION: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.

Valvuloplasy in Mitral Regurgitation: available option in Young rheumatic mitral regurgitation patients / 대한흉부외과학회지

BACKGROUND: The present study was undertaken to assess the effectiveness of surgical repair as a method of treatment for rheumatic mitral regurgitation by comparing the results of mitral valvuloplasty(MVP) in rheumatic mitral regurgitation and degenerative mitral regurgitation. MATERIAL AND METHOD: Among the 184 MVP patients between January 1995 to December 1998, 49 Rheumatic mirtal regurgiation patients(Group I) and 72 degenerative mirtal regurgitation(Group II) patients were studied. The mean age in group I was 36.3+/-14.6(16-74) and in group II, 52.5+/-13.4(14-77) years. The total follow up duration was 72.2patient years for group I and 77.2 patient years for group II. The Echocardiography was performed preoperatively, at 6months and 1 year postoperatively, and then yearly thereafter in both groups. RESULT: Preoperatively, there were no hemodynamic differences between the two groups. The preoperative mitral regurgitation was 3.9+/-0.4 in group I and 3.9+/-0.3 in group II, but on follow up, both groups showed decrease of grade of regurgitation to 0.9+/-0.9 in group I and 0.8+/-0.7 in group II. The mitral valve area or the mean transmitral pressure gradient was not significantly different between the two groups. There was neither early nor late mortality in either group and the reoperation rate in group I was 1.4% per patient year and 2.6% per patient year in group II. The rate of thromboembolism in group I was 2.8% per patient year and 1.3% per patient year in group II. There was one bacterial endocarditis in group I. Statistical analysis of the data between the two groups failed to reveal any significant differences. CONCLUSION: Although the results of a long term follow up will be required, the current intermedite term study showed that repair was a viable option in the treatment of rheumatic mitral regurgitation.

A Modification of Maze III Procedure to Improve Left Atrial Function / 대한흉부외과학회지

BACKGROUND: The current study was undertaken to investigate the results of a modification in the conventional Maze III Procedure devised by the authors. The aim of the technical modification was in improving the left atrial contractility. MATERIAL AND METHOD: Between July 1997 and December 1998, 34 patients with chronic atrial fibrillation for more than 1 year duration underwent a modified Maze III procedure. The assessment of the left atrial function was made by various echocardiographic measurements and SA nodal recovery was evaluated by HRV Holter monitoring. RESULT: All 34 patients were in sinus rhythm. On echocardiography, right atrial contraction was detected in 32 patients(94.1%) and left atrial contraction in 33 patients(97.1%). The echocardiographic A wave at 1, 6, and 12 months or more were 50.5+/-31.5, 62.1+/-25.1, 66+/-20.6 cm/sec, respectively, and the E wave measurements at the same time points were 152+/-31.1, 134.4+/-35.2, 133+/-27.5 cm/sec. The corresponding A/E ratios were 0.32+/-0.13, 0.48+/-0.18, 0.5+/-0.15, showing a rising trend. Treadmill evaluation at 6 months showed a mean 82% increase in heart rate after excising, and the SDNN and SDANN upon HRV Holter at 1 and 3 months postoperatively were 65.3+/-28.1/87.8+/-27.2 ms, and 60.0+/-24.1/83.4+/-25.7 ms, respectively, showing a predoinant autonomic recovery in the parasympathetic system(PSDNN = 0.01, PSDANN =0.015). CONCLUSION: The results of our data suggest that the current modification in the conventional Maze III Procedure was efective in enhancing the postoperative left atrial contractility.

One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation / 대한흉부외과학회지

After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

Primary Neurofibroma of Trachea: A Case Report / 대한흉부외과학회지

Benign tumors of the trachea are rare and are usually misdiagnosed as bronchial asthma because of the similarity of the symptoms and signs. Although the prognosis of neurofibroma which originats from Schwann cells is good, it may recur or undergo malignant change, so segmental resection of the trachea is recommended. Recently, we experienced a case of primary neurofibroma of the trachea treated successfully by segmental resection of the trachea and end-to-end anastomosis. We report it with a brief review of literatures.