Hyun Chul Joo

Purpose: We retrospectively analyzed 28 years of experience with the Bentall procedure in patients with aortic valve, aortic root, and ascending aortic disease. Materials and Methods: Between March 1982 and December 2010, a total of 218 patients underwent the Bentall procedure using a composite valved conduit. The “inclusion technique” was used in 30 patients (13.8%), the “open-button technique”in 181 patients (83.0%), and the Cabrol technique in 7 patients (3.2%). Results:The early mortality ra

Purpose: To compare the outcomes of thoracic endovascular aortic repair (TEVAR) with those of open repair for descending thoracic aortic aneurysms (DTAA). Materialsand Methods: We compared the outcomes of 114 patients with DTAA and proximal landing zones 3 or 4 after TEVAR to those of 53 patients after conventionalopen repairs. Thirty-day and late mortality were the primary endpoints, and early morbidities, aneurysm-related death, and re-intervention were the secondary endpoints. Results: The TE

Necrotizing aortitis is a rare and life-threatening complication of local or generalized bacterial infections and most commonly affects the abdominal aorta. We described a case of a 79-year-old man with an acupuncture-induced bacterial aortitis associated with pseudoaneurysm formation causing near rupture. The patient underwent emergent explolapartomy, resection of the infected aorta, wide debridement of surrounding infected tissues, and extra-anatomic axillary to bifemoral graft bypass. The mic

Leaflet escape of prosthetic valve is rare but potentially life threatening. It is essential to make timely diagnosis in order to avoid mortality. Transesophageal echocardiography and cinefluoroscopy is usually diagnostic and the location of the missing leaflet can be identified by computed tomography (CT). Emergent surgical correction is mandatory. We report a case of fractured escape of Edward-Duromedics mitral valve 27 years after the surgery. The patient presented with symptoms of acute deco

Purpose: Acute aortic diseases, such as aortic dissection and aortic aneurysm, can be life-threatening vascular conditions. In this study, we compared outcomes before and after the implementation of a critical pathway (CP) for patients with acute aortic diseaseat the emergency department (ED). Materials and Methods: This was a retrospective observational cohort study. The CP was composed of two phases: PRE-AORTA for early diagnosis and AORTA for prompt treatment. We compared patients who were di

da VinciTM 수술로봇(da VinciTM Surgical System)은 삼차원영상시스템과 사람의 손동작을 재현할 수 있는 로봇팔을 갖추고 있어, 최소절개를 통한 제한된 공간에서도 입체시야에서 다양한 수술을 시행할 수 있도록 해줌으로써, 최소침습적수술의 장점을 극대화할 수 있도록 해준다. 저자들은 심방중격결손에 대하여 da VinciTM 수술로봇을 이용한 개심수술을 성공적으로 시행하였기에 보고하는 바이다.

배경: 완전절제는 pT1/2N1 비소세포폐암의 가장 효과적인 치료 방법이지만 수술 후 5년 생존율은 40% 정도이며 많은 환자가 암의 재발로 사망하게 된다. 완전 절제된 pT1/2N1 비소세포폐암에서 재발에 영향을 주는 인자를 규명하고자 하였다. 대상 및 방법: 1990년 1월부터 2003년 7월까지 연세대학교 의과대학 세브란스병원 흉부외과에서 pT1/2N1 비소세포폐암으로 수술받은 환자 117명을 대상으로 환자의 특성, 조직병리학적 소견, 수술방법, 림프절 전이 양상, 술 후 보조요법등과 재발과의 관계를 후향적으로 연구하였다. 결과: 전체 환자의 평균 연령은 59.3 9.1세였으며 T1N1이 14명, T2N1이 103명이었다. 추적관찰기간은 27.5개월이었으며 5년 생존율은 41.3%였다. 수술 후 재발은 44명(37.6%)에서 관찰되었으며 원격전이가 40명이었다. 재발한 환자의 5년 생존율은 3.3%로 재발이 없는 환자(61.3%)에 비해 유의하게 낮았으며(p=0.000), 전체

Background and Objectives: There are pathophysiologic similarities between calcification and atherosclerosis because both are the product of an active inflammatory process. The aim of this study was to examine the effects of statin treatment on calcification in bovine pericardial tissue valves. Materials and Methods: Forty Sprague-Dawley rats were randomly divided into 4 groups according to hypercholesterolemia induction and statin intake (Group 1, n=10: normal diet without statin treatment, Gro

Background: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve replacement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of conventional AVR vs. TAVI in high risk severe AS patients. Methods: From January 2008 to July 2012, 44 high risk severe aortic stenosis patients underwent conventional AVR, and 15 patients underwent TAVI. We compared echocardiographic data, periprocedural complication, and surviv

Purpose: Significant late-onset tricuspid regurgitation (TR) is unfortunately common after double valve replacement (DVR); however, its underlying factors remain undefined. We evaluated the effect of aortic patient-prosthesis mismatch (PPM) on late-onset TR and clinical outcomes after DVR. Materials and Methods: Of the 2392 consecutive patients who underwent aortic valve replacement between January 1990 and May 2014 at our institution, we retrospectively studied 462 patients who underwent DVR (e

A foreign body in heart is rare, but it is more frequently encountered than the past as iatrogenic causes are increasing. Clinicians should be aware that foreign body could be mistaken for normal structure of heart. In order for accurate diagnosis, multi-imaging modalities should be used for information of exact location, mobilityand hemodynamic effects. A decision to intervene should be made based on potentialharms harbored by foreign bodies. Endovascular retrieval should be consideredas an opt

심막에 발생한 중피종은 매우 드문 종양으로서 중피종 가운데에서도 그 발생빈도가 매우 낮고, 초기 발견 및 진단이 어려우며 치료 방법 역시 정립되어 있지 않고 예후가 좋지 않은 종양으로 알려져 있다. 저자들은 최근 심막에 발생한 악성 중피종 1예를 경험하였기에 문헌 고찰과 함께 보고하고자 한다. 환자는 55세 여자로 지속되는 호흡 곤란과 기침으로 타 병원을 방문하여 검사를 받던 중에 심낭삼출액이 발견되어 심낭 개창술을 받았고 이때 시행한 조직 검사에서는 만성 심낭염의 진단만을 받았다. 그 후 계속된 호흡 곤란 및 우측 어깨의 통증과 흉통으로 본원에서 흉부 전산화단층촬영을 시행한 결과 심장 주변에 네 개의 종괴가 발견되었고 진단 및 치료의 목적으로 개흉 수술을 통하여 우측 심낭에 위치한 두개의 종괴를 절제하여 조직검사를 시행하여 악성 심막 중피종으로 확인되었다. 심막의 중피종은 드물기는 하지만 원인을 알 수 없는 호흡 곤란 및 협착성 심막염의 증상이 계속되는 환자에서 반드시 감별해야 할

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established