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체정맥 이상환류를 동반한 성인 활로씨 4증후군의 치험 1례
유환국 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.11
Anomalous systemic venous return to the right atrium is clinically innocuous and cause no functional disturbances or physiologic abnormalities by themselves and consequently require no treatment but may be surgical importance. We experienced a case of adult TOF combined with anomalous systemic venous drainage. Rudimentary right SVC with draining left sided vertical vein and IVC with separately drained left vein was revealed at operation time. With the bicaval cannulation, large sucker was used for drainage of blood from the left hepatic vein. Postoperative angiocardiogram showed above findings and combined double inferior vena cava at lumbar level.
승모판막 치환술후 합병한 좌심실 파열의 외과적 고찰 - 3례 보고 -
유환국 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.5
An unusual but often lethal complication of mitral valve replacement is rupture of the left ventricle. From March 1977 through June 1990, 424 mitral valve replacements were performed as isolated or combined procedures. Rupture of the posterior wall of the left ventricle was observed in 3 patients. Their was one type I and two type II rupture. Once the diagnosis was made, all of the patient were connected to the heart-lung machine again and total cardiopulmonary bypass is re-established. Repair was attempted in all of them from the outside of the heart. One of them was successively repaired but two were failed due to myocardial ischemia by circumflex coronary artery injury and failure of adequate closure of the ruptured site. From this results, we concluded that prevention is the best solution. But if we encountered this condition, early diagnosis and rapid treatment may improve the patient`s chances for survival.
유환국 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.6
We experienced one case of the left ventricular aneurysm. The patient was 44 years old male, who complained of dysarthria and dysphagia due to right cerebellar infarction EKG revealed antero-lateral myocardial infarction, so checked 2-D echo-cardiogram showed the left ventricular aneurysm with the mural thrombus. Aneurysmectomy with removal of thrombi was made for preventing further propagation of the systemic embolization. But CABG was impossible due to fine coronary artery at the portion of myocardial infarction. Mild LCOS was noted but postop course was smooth. During 12 months follow-up period, he lives in good physical activity [MYHA F.C. II /IV] and absence of chest pain.
허용,유환국,안욱수,김병열,이정호,유회성,Hur, Y.,Yu, H.K.,Ahn, W.S.,Kim, B.Y.,Lee, J.H.,Yu, H.S. 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1
A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].
유재현,유환국,이원용,나찬영,정윤섭,김응수,백완기,한재진,이영탁 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.2
Supravalvular aortic stenosis is an uncommon, congenital narrowing of ascending aorta just above aortic valve. Eleven patients underwent an aortoplasty to relieve supravalvular aortic stenosis at Sejong General Hospital from July 1985 to December 1991. Age ranged from 5 to 14 years(median 9 years). There were 7 male and 4 female patients. Seven patients had characteristics of Williams' syndrome including elfin face and mental retardation. All patients had localized, hourglass type but 4 patients had atypical findings. Preoperative left ventricula-aortic pressure gradient ranged from 40 to 190 mmHg(mean 88 mmHg). To relieve severe supravalvular aortic stenosis, extended aortoplasty was used in 7 patients and standard aortoplasty in 4 patients. Postoperative pressure gradient ranged from 0 to 40 mmHg (mean 16.6 mmHg). Follow-up pressure gradient with Doppler ranged from 0 to 88mmHg(mean 32.5mmHg).
최병철,유환국,안욱수,허용,김병열,이정호,유회성,Choi, B.C.,Yoo, H.K.,Ahn, W.S.,Hur, Y.,Kim, B.Y.,Yoo, H.S. 대한심장혈관흉부외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.7
To evaluate risks, complications and mortality of reoperations on heart valve prosthesis, we reviewed clinical records of 53 patients who underwent reoperation because of prosthetic valve failure[PVF], from Jan 1959 through Jun. 1991. They had undergone 48 mitral, 10 aortic valve rereplacement Primary tissue failure was the main cause of reoperation : it occurred in 51 valves at a mean postoperative interval of 58 months. Calcification and collagen disruption of prosthesis were main causes of primary tissue failure in macro and micropathology, In 3 failing mechanical prostheses, paravalvular leak was in 2 cases, another one case had the thrombi at the hinge portion. If conditions such as emergency operation with or without endocarditis, thromboembolism and advanced NYHA functional class are prevented, we think that reoperative valve replacement has similar morbidity and mortality to initial valve replacement surgery. But our sturdy represents higher mortality [22.6%] because of late surgical intervention failing the prevention of conditions leading to myocardial damage. In conclusion if the tearing, calcification, and a new murmur were detected the early reoperation should be considered to increase late survival.
식도 재건술후 발생한 식도-위 문합부 협착의 식도스텐트를 이용한 치험 -3례-
정성철,배윤숙,유환국,정승혁,이정호,김병열,이명준 대한흉부외과학회 2003 Journal of Chest Surgery (J Chest Surg) Vol.36 No.1
Esophageal Stent Insertion at the Esophagogastrostomy Site Stenosis- Report of 3 cases - 식도 재건술을 시행한 뒤에 발생하는 문합부의 협착은 비교적 드물지만 환자와 의료진에게 반갑지 않은 이다. 이에 대한 해결책으로 풍선확장술, 협착부에 대한 재수술 또는 심한 경우 식이용 장루술이 고려된다. 그러나 풍선확장술의 경우 단기간내 재발의 확률이 높고, 썩 효과적이지 않으며, 협착부에 대한 재수술은 수술적 접근이 쉽지 않고 재협착의 가능성 배제가 어려우며, 식이용 장루술의 경우 경구식이가 불가능하다는 어려운 점들이 있다. 이에 2001년 1월부터 2001년 12월까지 식도스텐트를 이용하여 문합부 협착의 완화를 시도하였다. 1예는 양성협착의 수술이었고 2예는 악성종양이었다. 약 1년이상의 추적관찰을 하였고 연하곤란은 개선되었다. 이에 식도 스텐트를 이용한 술후 문합부 협착의 임상적 호전에 대하여 증례를 보고하고자 한다.