Late Results of Total Correction for Tetralogy of Fallot / 대한흉부외과학회지

Tetralogy of Fallot is the most common cyanotic congenital cardiac malformation. Between April 1984 and December 1993, we experinced with 39 cases of total correction for the tetralogy of Fallot at the department of Thoracic and Cardiovascular Surgery, Masan Samsung General Hospital. The results were as follows; There were 14 males and 25 females, and their ages ranged from 2 to 36 years, with an average age of 13.33+/-7.40 years. There was type I VSD in 10 cases(25.6%), type II VSD in 19 cases(48.8%) and type I+II VSD in 10 cases(25.6%). Types of right ventricular outflow tract obstruction were valvar + infundibular stenosis in 19 cases(48.7%), valvar + infundibular + annular stenosis in 10 cases(25.6%), infundibular stenosis in 9 cases(23.1%)and pure valvar stenosis in 1 case(2.6%). Right ventricular outflow tract patch widening was necessary in 33 cases(84.6%) and a transannular patch including 2 cases of Monocusp-bearing outflow patch was used in 10 cases. In 36 hospital survivors, 23 patients were evaluated by 2 dimensional and doppler echocardiography. The most common complication was arrthymia, especially complete right bundle branch block, in 30 cases (76.9%). The operative mortality was 7.7%, and the cause of death was low cardiac output syndrome.

Comparative Study of Tracheal Anastomotic Techniques / 대한흉부외과학회지

Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was performed to evaluate the effect of telescoping anastomotic technique upon the healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. METHOD: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n=15). RESULT: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< 5days) and remarkable band-like fibrous union compared to the simple interrupted group.

Clinical Evaluation of Open Thoracotomy Cases in Spontaneous Pneumothorax / 대한흉부외과학회지

Spontaneous pneumothorax is the sudden collapse of a lung usually caused by air leakage from a subvisceral pleural bleb. Responses to closed thoracostomy,thoracentesis and simple observation are usually prompt and effective. But in some cases, these are unsucceful and open thoracotomy is indicated. A clinical evaluation was performed on 242 cases(236 patients) of open thoracotomy in spontaneous pneumothorax who were admitted and treated at department of Thoracic and Cardiovascular Surgery. Masan Samsung General Hospital during the past 9 years from January 1988 to December 1996. The results were as follows 1. The sex ratio was male predominance(M:F=11.7:1). 2. The most common age group were 2nd, 3rd decades(2nd=29.3%, 3rd=30.2%). 3. The most common chief complaints were chest pain and dyspnea(chest pain=41.7%, dyspnea=36.8). 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax(86.4%), tuberculosis(9.1%), COPD(3.7%) and pleuritis(0.8%). 5. The site of spontaneous pneumothorax was 52.1% in right, 45.4% in left and 2.5% in both. 6. The common indications of open thoracotomy were recurrence(44.2%), persistent air leakage(31.8%) and inadequate expansion(15.7%). 7. The operative procedures were bullectomy or mechanical pleurodesis through posterolateral thoracotomy or median sternotomy. 8. The most frequent location of bulla or bleb were apical segment of RUL(35.1%) and apicoposterior segment of LUL(41.3%). 9. The number of bulla or bleb were mainly 1 to 5(88%), and there were no significant differences among operation indications. 10. The size of bulla or bleb were mainly below 5cm(81%)and small bulla(5cm)were predominant in persistent air leakage and inadequate expansion group. 11. The pleural adhesion was seen in 54.5%.(Recurrence group 64.1%, Persistent air leakage group 51.9%,Inadequate expansion group 47.4%).