Extraction of an Infected Permanent Pacemaker Lead UsingCardiopulmonary Bypass: 2 case reports / 대한흉부외과학회지

Implanting a pacemaker is the most often used intervention for treating bradycardia. The most commonly used pacemaker is the intracardiac pacemaker, yet it can have many complications. An infected pacemaker can spread to systemic infection and the condition of the patient can quickly get worse, so if an infected pacemaker is suspected, then the pacemaker must be removed. Apart from the use of interventional methods such as a loop or a weight, we can take a more aggressive approach by using extracorporeal circulation for removal of the pacemaker. We report here on two cases in which extracorporeal circulation was used to remove the infected pacemakers.

The Early Results of Open Heart Surgery in Neonates / 대한흉부외과학회지

BACKGROUND: Remarkable progress has recently been made in achieving successful early repair of congenital heart disease with using cardiopulmonary bypass in the neonatal period. The aim of this study is to evaluate our short-term outcomes for performing neonatal cardiac surgery under extracorporeal circulation. MATERIAL AND METHOD: Fifty five neonates underwent open heart surgery from February 2002 to December 2007. The mean ages and body weight was 13.5 days and 3.2 kg, respectively. The diagnoses of the patients were transposition of the great arteries (14), total anomalous pulmonary venous connection (7), large ventricular septal defect (VSD) (7), coarctation of the aorta with VSD (6), interrupted aortic arch (5) and others (16). RESULT: Six patients had difficulties being weaned from extracorporeal circulation. Four patients left the operating room with an open sternum. Low cardiac output syndrome and acute renal insufficiency were observed in 3 patients each, respectively. Post-operative complications were observed in 27 patients (49.1%). The postoperative mortality was 12.7% (7 patients); 5 patients experienced early hospital death and 2 experienced late death (2). CONCLUSION: In our hospital, early surgical repair with extracorporeal circulation in neonates was feasible with tolerable mortality. Further follow-up is required to establish the long-term survival and complications.

The Early Results of Tricuspid Valvuloplasty with Using the Edwards MC3 Annuloplasty System / 대한흉부외과학회지

BACKGROUND: Functional tricuspid regurgitation (TR) greater than or equal to a mild grade requires tricuspid valvuloplasty, and tricuspid valvuloplasty with ring annuloplasty has shown good outcomes. We report here on our early experience with the Edwards MC3 annuloplasty system (Edwards LifeSciences, Irvine, CA). MATERIAL AND METHOD: From November 2004 to July 2006, 72 patients with tricuspid annular dilatation and TR underwent tricuspid valvuloplasty with using the Edwards MC3 annuloplasty ring. Sixty-eight patients were operated on via median sternotomy and four patients were operated on using robotic assisted minimal invasive thoracotomy. The patient population included 21 males and 51 females and their mean age was 53.9+/-12.3. The mean grade of TR, as assessed by the preoperative echocardiography, was 2.2+/-1.0. The mean NYHA functional class was 3.1+/-0.8. The mean left ventricular ejection fraction was 57.0+/-9.9%. RESULT: The TR and NYHA functional class, as assessed by postoperative echocardiography, was significantly reduced (mean=0.4+/-0.6 and 2.0+/-0.7, respectively p<0.001). There was one case of hospital mortality. One patient required permanent pacemaker insertion for third degree atrioventricular block. CONCLUSION: Our study shows that the Edwards MC3 remodeling ring is easy to implant and it effectively corrects functional TR with excellent clinical and echocardiographic outcomes. Further follow-up and a larger clinical series are required to establish the long-term stability of this repair technique.