Korean Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Mid-Term Results of Totally Thoracoscopic Ablation in Patients with Recurrent Atrial Fibrillation after Catheter Ablation.","authors":"Suk Kyung Lim,&nbsp;Joo Yeon Kim,&nbsp;Young Keun On,&nbsp;Dong Seop Jeong","doi":"10.5090/kjtcs.19.059","DOIUrl":"https://doi.org/10.5090/kjtcs.19.059","url":null,"abstract":"<p><strong>Background: </strong>We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF).</p><p><strong>Methods: </strong>Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history.</p><p><strong>Results: </strong>All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant.</p><p><strong>Conclusion: </strong>Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"270-276"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c9/41/KJTCV-53-270.PMC7553833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Experience with Epicardial Ultrasound Scanning in Coronary Artery Bypass Grafting.","authors":"Dae Hyeon Kim, Suk Ho Sohn, Ho Young Hwang","doi":"10.5090/kjtcs.20.005","DOIUrl":"10.5090/kjtcs.20.005","url":null,"abstract":"<p><strong>Background: </strong>The benefits of epicardial ultrasound scanning (EUS) in coronary artery bypass grafting (CABG) have not yet been established. The aim of this study was to evaluate the usefulness of EUS in CABG, including in the assessment of the quality of distal anastomoses, the identification of epicardial target vessels, and the evaluation of any graft issues other than the distal anastomoses.</p><p><strong>Methods: </strong>Fifty-three patients undergoing CABG were enrolled between March 2018 and February 2019. Intraoperative EUS was performed along with transit-time flow measurement (TTFM). Graft evaluations were performed early (shortly after surgery) and 1 year after surgery for 53 (100%) and 47 (88.7%) patients, respectively.</p><p><strong>Results: </strong>EUS was applied to assess the quality of all distal anastomoses, 32 target vessels, and 2 conduit trunks. Insufficient TTFM findings were obtained for 18 grafts. However, graft revision was performed for only 3 distal anastomoses; based on the EUS findings, the remaining 15 sites were not revised. The early and 1-year overall graft patency rates were 100% (141 anastomoses) and 96.1% (122 of 127 anastomoses), respectively. All 15 of the distal anastomoses that were not revised despite insufficient TTFM results were patent at the 1-year mark.</p><p><strong>Conclusion: </strong>The routine application of EUS in CABG could be beneficial by confirming the quality of surgery and reducing unnecessary procedures.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"263-269"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/ef/KJTCV-53-263.PMC7553820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38371225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cone Repair in Adult Patients with Ebstein Anomaly.","authors":"Chang-Ha Lee,&nbsp;Jae Hong Lim,&nbsp;Eung Rae Kim,&nbsp;Yong Jin Kim","doi":"10.5090/kjtcs.20.113","DOIUrl":"https://doi.org/10.5090/kjtcs.20.113","url":null,"abstract":"<p><p>Ebstein anomaly is a rare congenital heart malformation typically involving the tricuspid valve and the right ventricle that has a wide range of anatomical and pathophysiological presentations. Various surgical repair techniques for Ebstein anomaly have been reported because of its near-infinite anatomical variability. Cone repair for Ebstein anomaly can achieve nearly anatomical reconstruction of the tricuspid valve with promising outcomes. In this article, the surgical techniques for cone repair in adult patients with Ebstein anomaly are described in detail, and clinical experiences and technically challenging cases are presented.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"243-249"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/7a/KJTCV-53-243.PMC7553823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38457407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and Prognosis of Extracorporeal Life Support in Patients Who Develop Cardiac Arrest during or after Office-Based Cosmetic Surgery.","authors":"Seong Soon Kwon,&nbsp;Byoung-Won Park,&nbsp;Min-Ho Lee,&nbsp;Duk Won Bang,&nbsp;Min-Su Hyon,&nbsp;Won-Ho Chang,&nbsp;Hong Chul Oh,&nbsp;Young Woo Park","doi":"10.5090/kjtcs.19.077","DOIUrl":"https://doi.org/10.5090/kjtcs.19.077","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest during or after office-based cosmetic surgery is rare, and little is known about its prognosis. We assessed the clinical outcomes of patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics.</p><p><strong>Methods: </strong>Between May 2009 and May 2016, 32 patients who developed cardiac arrest during or after treatment at cosmetic surgery clinics were consecutively enrolled. We compared clinical outcomes, including complications, between survivors (n=19) and non-survivors (n=13) and attempted to determine the prognostic factors of mortality.</p><p><strong>Results: </strong>All 32 of the patients were female, with a mean age of 30.40±11.87 years. Of the 32 patients, 13 (41%) died. Extracorporeal life support (ECLS) was applied in a greater percentage of non-survivors than survivors (92.3% vs. 47.4%, respectively; p=0.009). The mean duration of in-hospital cardiopulmonary resuscitation (CPR) was longer for the non-survivors than the survivors (31.55±33 minutes vs. 7.59±9.07 minutes, respectively; p=0.01). The mean Acute Physiology and Chronic Health Evaluation score was also higher among non-survivors than survivors (23.85±6.68 vs. 16.79±7.44, respectively; p=0.01). No predictor of death was identified in the patients for whom ECLS was applied. Of the 19 survivors, 10 (52.6%) had hypoxic brain damage, and 1 (5.3%) had permanent lower leg ischemia. Logistic regression analyses revealed that the estimated glomerular filtration rate was a predictor of mortality.</p><p><strong>Conclusion: </strong>Patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics experienced poor prognoses, even though ECLS was applied in most cases. The survivors suffered serious complications. Careful monitoring of subjects and active CPR (when necessary) in cosmetic surgery clinics may be essential.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"277-284"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/6a/KJTCV-53-277.PMC7553826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature.","authors":"Tullio Valente,&nbsp;Giorgio Bocchini,&nbsp;Maurizio Cappelli Bigazzi,&nbsp;Massimo Muto,&nbsp;Paolo Golino,&nbsp;Giacomo Sica","doi":"10.5090/kjtcs.19.085","DOIUrl":"https://doi.org/10.5090/kjtcs.19.085","url":null,"abstract":"<p><p>Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"310-312"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/30/KJTCV-53-310.PMC7553824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38457411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of 3-Dimensional Body Surface Scanning in the Evaluation of Patients with Pectus Carinatum.","authors":"Seung Hwan Song,&nbsp;Chong Hoon Kim,&nbsp;Duk Hwan Moon,&nbsp;Sungsoo Lee","doi":"10.5090/kjtcs.20.042","DOIUrl":"https://doi.org/10.5090/kjtcs.20.042","url":null,"abstract":"<p><strong>Background: </strong>Radiographic modalities have been commonly used to evaluate pectus carinatum (PC), and compressive orthotic bracing is the most widely accepted treatment method. The aim of this study was to determine the efficacy of 3-dimensional (3D) body surface scanning as an alternative modality for the evaluation of PC.</p><p><strong>Methods: </strong>The medical records of 63 patients with PC who were treated with compressive orthotic bracing therapy between July 2017 and February 2019 were retrospectively analyzed. Using both 2-view chest radiography (posteroanterior and lateral view) and 3D body scanning, the height of maximal protrusion of the chest wall was measured both before and after 2 weeks of bracing therapy. The difference between the pre- and post-treatment measurements was calculated for both modalities, and these differences were compared and analyzed.</p><p><strong>Results: </strong>Based on the comparison between the pre- and post-treatment radiographs, bracing therapy produced favorable outcomes in all patients (p<0.001). The measurements obtained via 3D scanning were strongly correlated with those obtained via chest radiography (r=0.60).</p><p><strong>Conclusion: </strong>Based on the findings of this study, 3D body surface scanning appears to be an effective, radiation-free, and simple method for the post-treatment follow-up evaluation of PC, and thus can be considered an alternative to radiography.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"301-305"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/9c/KJTCV-53-301.PMC7553828.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Assist Device Implantation via Dual Left Thoracotomy in an Adult Patient with Congenitally Corrected Transposition of the Great Arteries.","authors":"Shin Kim,&nbsp;Yang-Hyun Cho,&nbsp;Pyo Won Park,&nbsp;Young Tak Lee,&nbsp;Tae-Gook Jun,&nbsp;Wook Sung Kim,&nbsp;Kiick Sung,&nbsp;Ji-Hyuk Yang,&nbsp;Suryeun Chung","doi":"10.5090/kjtcs.19.053","DOIUrl":"https://doi.org/10.5090/kjtcs.19.053","url":null,"abstract":"<p><p>A 59-year-old man presented for possible durable ventricular assist device (VAD) implantation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardiac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic regurgitation, we performed VAD implantation and aortic valve closure via a dual left thoracotomy and partial sternotomy.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"306-309"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/da/KJTCV-53-306.PMC7553819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38457412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Associated with Difficult Reversal of Heparin by Protamine Sulfate in Cardiopulmonary Bypass: An Ignored Issue.","authors":"Min Jung Ku,&nbsp;Su Wan Kim,&nbsp;Seogjae Lee,&nbsp;Jee Won Chang,&nbsp;Jonggeun Lee","doi":"10.5090/kjtcs.19.055","DOIUrl":"https://doi.org/10.5090/kjtcs.19.055","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate risk factors associated with difficult heparin reversal by protamine after cardiopulmonary bypass.</p><p><strong>Methods: </strong>Data from 120 consecutive patients who underwent open heart surgery from 2009 to 2017 were retrospectively reviewed. Patients were divided into 2 groups: (1) those in whom complete heparin reversal was achieved after a single infusion of protamine (group A, n=89); and (2) those who required more protamine for heparin reversal (group B, n=31).</p><p><strong>Results: </strong>Female sex, prolonged bypass time (>200 min), long aortic cross-clamping time (>120 min), and a lowest rectal temperature <26°C were significant predictors of difficult heparin reversal. Larger amounts of fresh frozen plasma and platelet concentrate were transfused in group B than in group A.</p><p><strong>Conclusion: </strong>Surgeons' efforts to reduce operative time and avoid deep hypothermia may be helpful for increasing the likelihood of easy heparin reversal, especially in female patients.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"258-262"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/ea/KJTCV-53-258.PMC7553821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38468569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transit Time Flowmetry and Vein Size Are Predictive of Arteriovenous Fistula Maturation.","authors":"Yelee Kwon,&nbsp;Young Jong Cho,&nbsp;Pil Je Kang,&nbsp;Won Chul Cho","doi":"10.5090/kjtcs.20.008","DOIUrl":"https://doi.org/10.5090/kjtcs.20.008","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the effect of vessel size and flow characteristics on the maturation of autogenous radiocephalic arteriovenous fistulae (RCAVFs).</p><p><strong>Methods: </strong>We retrospectively reviewed records of patients undergoing RCAVF creation at a single medical center from January 2013 to December 2019. Operative variables were compared between patients whose fistulae matured and those whose fistulae failed to mature.</p><p><strong>Results: </strong>Overall, 152 patients (33 of whom were women) with a mean age of 62.6±13.6 years underwent RCAVF creation; functional maturation was achieved in 123. No statistically significant differences were observed between patients in whom maturation was or was not achieved in terms of the following variables: female sex (20.3% vs. 25.0%), radial artery size (2.5 vs. 2.4 mm), and pulsatility index (0.69 vs. 0.62). Low intraoperative transit time flowmetry (TTF; 150.4 vs. 98.1 mL/min) and small vein size (2.4 vs. 2.0 mm) were associated with failure of maturation. The best cutoff diameter for RCAVF TTF and cephalic vein size were 105 mL/min and 2.45 mm, respectively.</p><p><strong>Conclusion: </strong>In patients who undergo RCAVF creation, vein diameter on preoperative ultrasonography and intraoperative TTF are predictors of functional maturation. We identified an intraoperative TTF cutoff value that can be used for intraoperative decision-making.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 5","pages":"297-300"},"PeriodicalIF":0.0,"publicationDate":"2020-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/bf/KJTCV-53-297.PMC7553831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38371226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Multi-Detector Computed Tomography Evidence of Transcatheter Pacing System Migration and Embolization into the Pulmonary Vasculature.","authors":"Tullio Valente, Giorgio Bocchini, Maurizio Cappelli Bigazzi, Massimo Muto, Paolo Golino, Giacomo Sica","doi":"10.5090/kjtcs.19.185","DOIUrl":"10.5090/kjtcs.19.185","url":null,"abstract":"<p><p>Transcatheter leadless pacemaker dislodgment is a rare and potentially fatal complication of leadless device implantation. We present the first case of multidetector computed tomography images of leadless pacemaker migration and embolization in the pulmonary middle lobe artery. The patient was managed by percutaneous retrieval of the dislodged device and re-implantation in the appropriate position.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38371227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}