Aortic Root Replacement Using Aortic Homograft in Acute Bacterial Endocarditis: one case report / 대한흉부외과학회지

Aortic valve replacement with aortic allograft has been considered a treatment of choice for aortic valve disease secondary to bacterial endocarditis because of its good hemodynamic performance and higher resistance to infection. The aortic root replacement technique might be superior to the subcoronary allograft implantation technique with regard to aortic regurgitation. A 46 years old male patient had acute aortic regurgitation with progressing heart failure secondary to acute bacterial endocarditis. The patient underwent emergent aortic root replacement using 20 mm aortic allograft. At operation, right coronary cusp perforation and heavy calcification of commissure between right and left coronary cusp were observed. The patient recovered well and postoperative echocardiography demonstrated no aortic regurgitation. Inflammatory signs were subsided after 8 weeks of antibiotics therapy. Medically uncontrolled acute bacterial endocarditis was treated successfully by aortic root replacement using aortic homograft.

A Case Report of Left Ventricular Remodeling Surgery on End-Stage Dilated Cardiomyopathy / 대한흉부외과학회지

We present a case of 58-year-old female with dilated cardiomyopathy(DCMP) in whom we performed left ventricular(LV) remodeling surgery(Batista operation) to reduce the left ventricle diameter and improve left ventricular function. The patient was admitted September 1996 with heart failure NYHA class IV. There was severe orthopnea and peripheral edema. 2-D echocardiography(Echo) showed DCMP with the ejection fraction(EF) 15%, LV end diastolic dimension(LVEDD) 80mm, mitral regurgitation(MR) grade IV, tricuspid regurgitation (TR) grade II. Preoperative cardiac output(CO) was 1.5L/min and cardiac index(CI) was 1.0 L/min/m2. We proceeded with LV remodeling surgery by resection a part of LV lateral wall between both papillary muscle, from the mitral annulus to the LV apex. Size of resected LV wall was 90 x 100 x 15 mm. At the mean time, mitral valve and tricuspid valve were repaired. Postoperative 2-D Echo showed the EF 37%, LVEDD 50 mm, trivial MR, no TR. CO was 3.5L/min and CI was 2.3 L/min/m2. Her fuctional NYHA class was I.

Coronary Artery Bypass Grafting without Extracorporeal Circulation: one case report / 대한흉부외과학회지

Coronary artery bypass grafting(CABG) without cardiopulmonary bypass(CPB) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. The lesion was total(100%) occlusion of proximal right coronary artery (RCA) without any evidence of disease in the rest of coronary arteries. Percutaneous transluminal angioplasty(PTCA) was tried but unsuccessful. We herein report a case of successful CABG to right coronary artery without CPB on a patient with complete occlusion of RCA and symptomatic with minimal activity.