• Journal of Chest Surgery
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• v.15 no.1
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• pp.61-66
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• 1982

The present study was performed to evaluate hemodynamic effects on the pericardial patch graft for stenosis of right ventricle outflow tract in 19 patients of tetralogy of Fallot. The stenosis of right ventricle outflow tract was associated with or without pulmonary annular nar-rowing, pulmonary valvular stenosis, and hypoplastic narrowing of pulmonary artery. Total correction of tetralogy of Fallot was performed under cardiopulmonary bypass with moderate hypothermia and cardioplegic cardiac arrest. Ventricular septal defects were closed with Teflon patch graft. The chamber pressures in the heart were measured before and after a total correction of tetralogy of Fallot. The data of pressure measurement and the results of postoperative observation of pericardial patch were as followings: 1. Systolic and diastolic pressure of right ventricle was decreased after operation from $96.0{\pm}14.7/10.0{\pm}14.4mmHg$ to $61.0{\pm}13.1/8.0{\pm}9.3mmHg$. 2. Systolic and diastolic pressure of pulmonary artery was increased after operation from $18.0{\pm}5.6/10.0{\pm}5.5mmHg$ to $31.0{\pm}10.7/14.0{\pm}4.9mmHg$. 3. Preoperative pressure gradient between right ventricle and pulmonary artery was decreased immediately after operation from 78.0mmHg to 30.0mmHg. 4. It was observed that excellent widening effects of right ventricle outflow tract was resulted from pericardial patch graft. 5. No postoperative bleeding from pericardial patch graft was observed. 6. Aneurysm formation of pericardial patch was not be observed during 1 to 6 years postoperative periods.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.602-605
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• 2003

A patch design using bovine pericardial patch for aortic enlargement in the Nowood procedure has been introduced to avoid problems related to homograft availability. We report 2 successful cases of Norwood procedure with home-made bovine pericardial patch. The first case was a 23-day-old (2.2 kg) patient with multi-level left ven-tricular outflow tract obstruction with ductal-dependent systemic circulation. The other case was a 9-day-old (3 kg) patient with hypoplastic lefi heart syndrome. This technique was relatively easy to perform, reproducible and quite effective like homograft patch.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.574-582
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• 1988

Endocardial cushion defects is a rare congenital heart disease. We experienced two complete endocardial cushion defects[ECD] and three partial ones, which were successfully repaired between 1986 and 1987. In a patient of complete ECD, associated with secundum ASD, Pulmonary stenosis and Down`s syndrome, the atrial and ventricular septal defects were closed separately with bovine pericardium and Dacron patches respectively, and then pulmonary stenosis was relieved by transannular patch widening in addition to valvotomy and infundibulectomy. In another patient with complete ECD, small interventricular communication was closed with simple suture with pledget and primum ASD was closed with pericardial patch. In first patient of partial ECD, primum atrial septal defect was closed with pericardial patch. In second patient of partial ECD, associated with secundum ASD, direct closure of secundum ASD and patch closure of primum ASD were performed. In third patient of partial ECD, associated with patent foramen ovale[PFO], primum ASD was closed with bovine pericardial patch and PFO was closed directly. In all patient except third patient of partial ECD, mitral clefts were closed with three or four 5-0 prolene interrupted sutures. Transient A-V dissociation developed postoperatively in two patients and transient nodal rhythm developed postoperatively in other two patients. Heart failure in complete ECD with Down`s syndrome was overcome with medical treatment.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.460-462
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• 2002

We experienced primary repair of complete atrioventricular septal defect with Teralogy of Fallot. The diagnosis was established preoperatively by echocardiography, cardiac catheterization and cardioangiography. Repair was accomplished using cardiopulmonary bypass. Two patch techinque were performed using Dacron patch for ventricular septal defect and pericardial patch for atrial septal defect. Infundibullectomy and right ventricular outflow tract reconstruction with the transannular pericardial patch were performed. The postoperative echocardiography showed mild mitral and tricuspid regurgitation, but there were no hemodynamic abnormalities.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.177-181
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• 1987

For the treatment of bronchial stenosis due to trauma, inflammatory and neoplastic lesion, bronchoplastic procedure in the interest of preservation of lung tissue are relatively new developments in the field of thoracic surgery. We reported on case of bronchoplasty using to pericardial patch for the treatment of bronchial stenosis due to chronic inflammation. The patient was 26 years old female and chief complaint was respiratory difficulty. Bronchogram revealed diffuse stenosis of left main bronchus about 4cm and especially, at just below the carina marked narrowing of lumen and fine serration in the wall. At the time of operation, longitudinal incision was made at left main bronchus about 5cm and reconstructed bronchus using to pericadial patch at membranous compartment of bronchus. The postoperative course was uneventful and post-operative follow up bronchography showed that improvement of bronchoplastic segmented region.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.337-341
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• 1983

The experience with operative treatment for total correction of Tetralogy of Fallot at the department of Thoracic and Cardiovascular Surgery, Korea University Hospital from January, 1977, through April, 1983 was reviewed. Of the 29 patients reviewed, male to female occurrence ratio was 22:7 Type of V.S.D. was type II in 26 cases[90%] and total conus defect in 3 cases[10%]. Average size of V.S.D. was 19 mm. Type of Right ventricular outflow tract stenosis was highest frequency with pulmonary valvular and infundibular stenosis combined type in 21 cases[72%], and there were 8 deaths In this group. Type of R.V.O.T. reconstruction contains 2 cases of infundibulectomy only, 1 case of infundibulectomy with valvular commissurotomy, 2 cases of pericardial patch, 23 Cases of pericardial patch with Teflon or Dacron felt reinforced and 1 case of pulmonary valved conduit reconstruction. Operative mortality was higher in outflow patch through pulmonary valve ring. Overall mortality was 31%. Major causes of death and postoperative complications were low output syndrome, complete A-V block acute renal failure, ventricular fibrillation, bleeding brain abscess, and sudden cardiac arrest.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.448-455
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• 1989

Till June 1988, We experienced 3 cases of single atrium at Dept. of Thoracic k Cardiovascular Surgery of National Medical Center. Case 1 was 26 years old female, and had single atrium associated with partial cleft in mitral anterior leaflet and PAPVC. Atrial septation with Dacron patch and MVR [I-S, 31 mm] were done, followed by TAP, De Vega. Postoperative course was good, OPD follow-up for about 4 years with normal physical activity and ordinary working. Case 2 was 4 years old female with single atrium alone. Atrial septation with pericardial patch. Good postoperative course and OPD follow-up for about 2 years with appropriate physical growth. Case 3 was 22 years old female, single atrium with complete cleft in the anterior and posterior mitral leaflet, and septal tricuspid cleft were identified. Atrial septation with polystan bovine pericardial patch and repair of mitral anterior cleft. Postoperatively, residual regurgitation of mitral and tricuspid valve, but tolerable in some limitation of physical activity.

• Journal of Chest Surgery
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• v.34 no.5
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• pp.386-392
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• 2001

배경: 기관지에 광범위한 협착을 가지고 있는 환자들에게서 협착된 기관지 이하 부위에 있는 폐를 절제하지 않고 기관지 협착 부위를 교정하여 폐환기를 원할하게 하고자 하는 다양한 술식의 기관지 성형술이 고안시도되어 왔지만 만족할만한 술기는 아직 정립되어 있지 않다. 저자들은 이러한 기관지 협착을 교정하기 위한 술식의 하나로서 기관지 대치물을 이용한 기관 성형술의 효과를 조사하기 위하여 본 실험을 시행하였다. 대상 및 방법: 기관지 대치물로 사용한 두 종류의 첨포에 따라 성숙견을 실험 동물로 하여 두 군으로 분류하였으며 A군(5예)에서는 좌측 주기관지 전측방 부위를 0.5$\times$0.5cm 크기의 직사각형으로 절제한 후 늑연골에 자가 심낭편을 댄 동일한 크기의 첨포를 절제 부위에 부착하였고 B군(5예)에서는 동일한 크기의 기관지 절제 부위에 glutaraldehyde로 처리된 우심낭편을 부착하였다. 첨포를 이용한 기관지 성형술 12주후에 실험견을 도살하고 육안적 및 현미경적으로 관찰하였다. 결과: A군이 기관지 성형술 부위에서는 첨포의 외면은 주위의 결합조직과 막상유착을 이루고 있었으며 첨포의 가장자리는 자가 기관지에 잘 부착되어 있었다. 기관지 내면은 내경의 협착이 없이 윤기 있는 점막으로 잘 유지되어 있었고 자가 기관지와 첨호와의 경계면은 신생육아조직이 일부 차지하고 있었으며 새로운 이행 상피가 가교를 이루고 있는 현미경적 소견을 보았다. B군의 기관지 성형술 부위에서는 첨포의 와부는 암갈색으로 변화된 부분적 괴사의 양상을 보였다. 기관지 내면은 첨포와 가자기관지 경계부위에서 염증성 육아조직과 부분적 출현 양상을 보고 기관지 내경의 일부가 수축되었으며 자가 기관지로부터 첨포내로의 새로운 상피 형성은 되어 있지 않았다. 결론: 늑연골에 자가 심낭편을 댄 첨포는는 자가 기관지와 상피 가교를 형성하고 기관지 내강의 협착이 없이 구조를 유지하므로 기관지 협착 및 결손의 치료를 위한 기관지 성형술시에 기관지 대치물로 사용될수 있는 것으로 사료된다.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.363-366
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• 2003

Background: Left ventricular rupture after acute myocardial infarction is a serious complication with high mortality. Emergency operation is usually the only available treatment. A 76-year-old female with persistent chest pain and syncopal attacks was admitted. Transthoracic echocardiography showed the pericardial effusion and generalized hypokinesia of the inferolateral wall of left ventricle. Coronary angiography revealed a total occlusion of the first diagonal branch. After percutaneous transluminal coronary angioplasty with coronary stent and insertion of intraaortic balloon pump, emergency operation was performed. Under cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia, coronary artery bypass graft with saphenous vein, pericardial patch covering on the rupture area with 6-0 polypropylene running sutures, and fibrin glue compression under the patch were performed. We present a case of left ventricular (free wall) rupture after acute myocardial infarction.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.560-569
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• 1991

The surgical management of symptomatic tetralogy of Fallot in infants is debatable. From November 1986 to August 1990, 21 infants under 10 kg of the body weight with tetralogy of Fallot underwent primary repair. Mean body weight was 8.6$\pm$1.40kg. All the patient were clubbing and there were cyanotic except for 1 patient. Transannular patch was laid down in 8 patients. Right ventricular outflow patch was used with Goretex but pericardial patch was utilized in 3 patients at the initial period of operation. Incidence of the complications following total correction of tetralogy of Fallot was more frequent in the patients placed with transannular patch compared to the patients with right ventricular outflow tract patch. Two deaths occurred in the 21 patients, Hospital mortality was 9.4%, but there were no operative deaths in the patients who transannular patch was laid down. Causes of deaths were low cardiac output.