Korean Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Functional Intracardiac Paraganglioma.","authors":"Yongwoo Chung,&nbsp;Jae Woong Choi,&nbsp;Kyung-Hwan Kim","doi":"10.5090/kjtcs.2020.53.2.86","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.2.86","url":null,"abstract":"<p><p>A 39-year-old man presented to the department of emergency medicine in Seoul National University Hospital complaining of chest pain, heart palpitation, and headache. Upon arrival, a computed tomography scan showed a 7.0 cm×6.2 cm lesion with the typical features of a paraganglioma. The patient was treated with an alpha-blocker and a beta-blocker prior to surgical intervention. We removed the tumor successfully, and histopathologic findings indicated that the tumor was indeed a paraganglioma. Since intracardiac paraganglioma is a rare disease, we present this case together with a literature review.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 2","pages":"86-88"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/19/kjtcv-53-086.PMC7155182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37850204","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":"Corrigendum: Lymphangiographic Interventions to Manage Postoperative Chylothorax.","authors":"Hyuncheol Jeong,&nbsp;Hyo Yeong Ahn,&nbsp;Hoon Kwon,&nbsp;Yeong Dae Kim,&nbsp;Jeong Su Cho,&nbsp;Jungseop Eom","doi":"10.5090/kjtcs.2020.53.2.92","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.2.92","url":null,"abstract":"<p><p>[This corrects the article on p. 409 in vol. 52, PMID: 31832377.].</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 2","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/ea/kjtcv-53-092.PMC7155183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37850206","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":"Outcomes and Patency of Complex Configurations of Composite Grafts Using Bilateral Internal Thoracic Arteries.","authors":"Beatrice Chia-Hui Shih,&nbsp;Suryeun Chung,&nbsp;Hakju Kim,&nbsp;Hyoung Woo Chang,&nbsp;Dong Jung Kim,&nbsp;Cheong Lim,&nbsp;Kay-Hyun Park,&nbsp;Jun Sung Kim","doi":"10.5090/kjtcs.2020.53.2.64","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.2.64","url":null,"abstract":"<p><strong>Background: </strong>It is generally agreed that using a bilateral internal thoracic artery (BITA) composite graft improves long-term survival after coronary artery bypass grafting (CABG). Although the left internal thoracic artery (LITA)-based Y-composite graft is widely adopted, technical or anatomical difficulties necessitate complex configurations. We aimed to investigate whether BITA configuration impacts survival or patency in patients undergoing coronary revascularization.</p><p><strong>Methods: </strong>Between January 2006 and June 2017, 1,161 patients underwent CABG at Seoul National University Bundang Hospital, where the standard technique is a LITA-based Y-composite graft with the right internal thoracic artery (RITA) sequentially anastomosed to non-left anterior descending (LAD) targets. Total of 160 patients underwent CABG using BITA with modifications. Their medical records and imaging data were reviewed retrospectively to investigate technical details, clinical outcomes, and graft patency.</p><p><strong>Results: </strong>Modifications of the typical Y-graft (group 1, n=90), LITA-based I-graft (group 2, n=39), and RITA-based composite graft (group 3, n=31) were used due to insufficient RITA length (47%), problems using LITA (28%), and target vessel anatomy (25%). The overall 30-day mortality rate was 1.9%. Among 116 patients who underwent computed tomography or conventional angiography at a mean interval of 29.9±33.1 months postoperatively, the graft patency rates were 98.7%, 95.3%, and 83.6% for the LAD, left circumflex artery, and right coronary artery territories, respectively. Patency rates for the inflow, secondary, and tertiary grafts were 98.2%, 90.5%, and 80.4%, respectively. The RITA-based graft (group 3) had the lowest patency rate of the various configurations (p<0.011).</p><p><strong>Conclusion: </strong>LITA-based Y composite graft, showed satisfactory clinical outcomes and patency whereas modifications of RITA-based composite graft had the lowest patency and 5-year survival rates. Therefore, when using RITA-based composite graft, other options should be considered before proceeding atypical configurations.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 2","pages":"64-72"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/cc/kjtcv-53-064.PMC7155177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37851765","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":"A Case Report of Rare Complications after Epicardial Permanent Pacemaker Implantation in an Infant: Airway Compression, Skin Necrosis, and Bowel Perforation.","authors":"Woojung Kim,&nbsp;Jae Gun Kwak,&nbsp;Jooncheol Min,&nbsp;Woong-Han Kim","doi":"10.5090/kjtcs.2020.53.2.82","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.2.82","url":null,"abstract":"<p><p>Insertion of an epicardial pacemaker is a useful treatment for pediatric patients with an abnormal heart rhythm. However, there are limitations and concerns when implanting epicardial pacemakers in infants and neonates due to their small body size. We report a patient who experienced rare complications after implantation of a permanent pacemaker.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 2","pages":"82-85"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/f4/kjtcv-53-082.PMC7155185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37851768","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":"Clinical Outcomes of Arteriovenous Graft in End-Stage Renal Disease Patients with an Unsuitable Cephalic Vein for Hemodialysis Access.","authors":"Joung Woo Son,&nbsp;Jae-Wook Ryu,&nbsp;Pil Won Seo,&nbsp;Kyoung Min Ryu,&nbsp;Sung Wook Chang","doi":"10.5090/kjtcs.2020.53.2.73","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.2.73","url":null,"abstract":"<p><strong>Background: </strong>As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited. In this study, we examined the surgical outcomes of upper-limb AVG creation.</p><p><strong>Methods: </strong>Among the arteriovenous fistula formation procedures performed between January 2014 and March 2019 at Dankook University Hospital, 42 cases involved AVG creation. We compared patients in whom the axillary vein was used (group A; brachioaxillary AVG [B-Ax AVG]; n=20) with those in whom upper limb veins were used (group B; brachiobasilic AVG or brachioantecubital AVG; n=22).</p><p><strong>Results: </strong>The 1-year primary patency rate was higher in group A than in group B (57.9% vs. 41.7%; p=0.262). The incidence of postoperative complications was not significantly different between groups.</p><p><strong>Conclusion: </strong>AVG using the axillary vein showed no major differences in safety or functionality compared to AVG using other veins. Therefore, accounting for age, underlying disease, and expected patient lifespan, B-Ax AVG can be considered an acceptable surgical method.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 2","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2020-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/e1/kjtcv-53-073.PMC7155179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37851766","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":"Surgical Treatment of Bronchobiliary Fistula with Pulmonary Resection and Omentopexy.","authors":"Hyon Keun Joh,&nbsp;Seong Yong Park","doi":"10.5090/kjtcs.2020.53.1.38","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.1.38","url":null,"abstract":"<p><p>Bronchobiliary fistula is a rare disease defined as an abnormal connection between the biliary tract and the bronchial tree. We report the successful surgical repair of bronchobiliary fistula. A 78-year-old man underwent surgery and several rounds of transcatheter arterial chemoembolization and radiofrequency ablation as treatment for hepatocellular carcinoma. He presented with greenish sputum and chronic cough for several months, and his symptoms did not resolve after endoscopic treatment. We performed lobectomy of the right lower lobe and omentopexy for bronchobiliary fistula under laparotomy and thoracotomy. The bronchobiliary fistula was successfully closed, and the bilious sputum disappeared after surgery.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 1","pages":"38-40"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/bb/kjtcv-53-038.PMC7006612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37669537","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":"Does Early Drain Removal Affect Postoperative Pericardial Effusion after Congenital Cardiac Surgery?","authors":"Young Eun Kim,&nbsp;Hanna Jung,&nbsp;Joon Yong Cho,&nbsp;Yeo Hyang Kim,&nbsp;Myung Chul Hyun,&nbsp;Youngok Lee","doi":"10.5090/kjtcs.2020.53.1.16","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.1.16","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery.</p><p><strong>Methods: </strong>The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled.</p><p><strong>Results: </strong>Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%.</p><p><strong>Conclusion: </strong>Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/3f/kjtcv-53-016.PMC7006611.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37669533","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":"Videoscopic Surgery for Arteriovenous Hemodialysis Access.","authors":"Hyuncheol Jeong,&nbsp;Miju Bae,&nbsp;Sung Woon Chung,&nbsp;Chung Won Lee,&nbsp;Up Huh,&nbsp;Min Su Kim","doi":"10.5090/kjtcs.2020.53.1.28","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.1.28","url":null,"abstract":"<p><strong>Background: </strong>When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions.</p><p><strong>Methods: </strong>Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed.</p><p><strong>Results: </strong>Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days).</p><p><strong>Conclusion: </strong>Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 1","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/d4/kjtcv-53-028.PMC7006609.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37669535","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":"Relationship between Cancer Stem Cell Marker CD133 and Cancer Germline Antigen Genes in NCI-H292 Lung Cancer Cells.","authors":"Taek Yong Ko,&nbsp;Jong In Kim,&nbsp;Sang Ho Lee","doi":"10.5090/kjtcs.2020.53.1.22","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.1.22","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that lung cancer stem cells express CD133 and that certain cancer stem cells express cancer germline antigens (CGAs). The transcriptional regulation of CD133 is complicated and poorly understood. We investigated CD133 and CGA expression in a non-small cell lung cancer cell line.</p><p><strong>Methods: </strong>The expression levels of CD133 and CGAs (MAGE-6, GAGE, SSX, and TRAG-3) were measured in an NCI-H292 lung cancer cell line. The methylation status of the CD133 gene promoter region was analyzed. The expression levels and promoter methylation statuses of CD133 and CGAs were confirmed by treatment with the demethylating agent 5-aza-2'-deoxycytidine (ADC).</p><p><strong>Results: </strong>After treatment with ADC, CD133 expression was no longer detected. MAGE-6 and TRAG-3 were detected before ADC treatment, while GAGE and SSX were not detected. ADC treatment upregulated MAGE-6 and TRAG-3 expression, while GAGE expression was still undetected after treatment, and only weak SSX expression was observed. GAGE expression was not correlated with expression of CD133, while the levels of expression of MAGE-6, TRAG-3, and SSX were inversely correlated with CD133 expression.</p><p><strong>Conclusion: </strong>These results showed that CD133 expression can be regulated by methylation. Thus, the demethylation of the CD133 promoter may compromise the treatment of lung cancer by inactivating cancer stem cells and/or activating CGAs.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 1","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/38/kjtcv-53-022.PMC7006610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37669534","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":"The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting.","authors":"Dong Jung Kim,&nbsp;Bongyeon Sohn,&nbsp;Hakju Kim,&nbsp;Hyoung Woo Chang,&nbsp;Jae Hang Lee,&nbsp;Jun Sung Kim,&nbsp;Cheong Lim,&nbsp;Kay-Hyun Park","doi":"10.5090/kjtcs.2020.53.1.8","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.1.8","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the associations of critical care provided in a cardiac surgical intensive care unit (CSICU) staffed by an attending intensivist with improvements in intensive care unit (ICU) quality and reductions in postoperative complications.</p><p><strong>Methods: </strong>Patients who underwent elective isolated coronary artery bypass grafting (CABG) between January 2007 and December 2012 (the control group) were propensity-matched (1:1) to CABG patients between January 2013 and June 2018 (the intensivist group).</p><p><strong>Results: </strong>Using propensity score matching, 302 patients were extracted from each group. The proportion of patients with at least 1 postoperative complication was significantly lower in the intensivist group than in the control group (17.2% vs. 28.5%, p=0.001). In the intensivist group, the duration of mechanical ventilation (6.4±13.7 hours vs. 13.7±49.3 hours, p=0.013) and length of ICU stay (28.7±33.9 hours vs. 41.7±90.4 hours, p=0.018) were significantly shorter than in the control group. The proportions of patients with prolonged mechanical ventilation (2.3% vs. 7.6%, p=0.006), delirium (1.3% vs. 6.3%, p=0.003) and acute kidney injury (1.3% vs. 5.3%, p=0.012) were significantly lower in the intensivist group than in the control group.</p><p><strong>Conclusion: </strong>A transition from an open ICU model with trainee coverage to a closed ICU model with attending intensivist coverage can be expected to yield improvements in CSICU quality and reductions in postoperative complications.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 1","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/e8/kjtcv-53-008.PMC7006613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37670602","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}