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Korean Journal of Thoracic and Cardiovascular Surgery

Heeyoung Lee, Kun Sei Lee, Sung Bo Sim, Hyo Seon Jeong, Hye Mi Ahn, Hyun Keun Chee
BACKGROUND: Coronary angioplasty has been replacing coronary artery bypass grafting (CABG) because of the relative advantage in terms of recovery time and noninvasiveness of the procedure. Compared to other Organization for Economic Cooperation and Development (OECD) countries, Korea has experienced a rapid increase in coronary angioplasty volumes. METHODS: We analyzed changes in procedure volumes of CABG and of percutaneous coronary intervention (PCI) from three sources: the OECD Health Data, the National Health Insurance Service (NHIS) surgery statistics, and the National Health Insurance claims data...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Hyo Seon Jeong, Kun Sei Lee, Hyun Keun Chee, Hye Mi Ahn, Sung Bo Sim
BACKGROUND: The purpose of this study is to evaluate the concentration of cardiovascular surgical procedures in a metropolitan area and investigate the perception of specialists regarding governmental policies to resolve this imbalance. METHODS: From March to May 2015, surveys were distributed to members of the Thoracic and Cardiovascular Surgery Association. The final pool of research subjects consisted of 75 respondents. Subjects were queried regarding the concentration of cardiovascular operations in metropolitan areas, alternatives to the imbalance, and governmental policies to resolve the inequalities...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Young-Hoon Lee, Kun Sei Lee, Hyo Seon Jeong, Hye Mi Ahn, Gyung-Jae Oh
BACKGROUND: This study investigates the perception of the general public regarding the concentration to metropolitan, hospitals of cardiac and cerebrovascular surgeries, and the perceived public need for government policies to resolve this issue. METHODS: A total of 800 participants were recruited for our telephone interview survey. Quota sampling was performed, adjusting for age and sex, to select by various geographic regions. Sampling with random digit dialing was performed; we called the randomly generated telephone numbers and made three attempts for non-responders before moving on to a different telephone number...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Jung Jeung Lee, Nam Hee Park, Kun Sei Lee, Hyun Keun Chee, Sung Bo Sim, Myo Jeong Kim, Ji Suk Choi, Myunghwa Kim, Choon Seon Park
BACKGROUND: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. METHODS: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Choon Seon Park, Nam Hee Park, Sung Bo Sim, Sang Cheol Yun, Hye Mi Ahn, Myunghwa Kim, Ji Suk Choi, Myo Jeong Kim, Hyunsu Kim, Hyun Keun Chee, Sanggi Oh, Shinkwang Kang, Sok-Goo Lee, Jun Ho Shin, Keonyeop Kim, Kun Sei Lee
BACKGROUND: This study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions. METHODS: To develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Ji Suk Choi, Choon Seon Park, Myunghwa Kim, Myo Jeong Kim, Kun Sei Lee, Sung Bo Sim, Hyun Keun Chee, Nam Hee Park, Sung Min Park
BACKGROUND: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. METHODS: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Myunghwa Kim, Seok-Jun Yoon, Ji Suk Choi, Myo Jeong Kim, Sung Bo Sim, Kun Sei Lee, Hyun Keun Chee, Nam Hee Park, Choon Seon Park
BACKGROUND: This study uses the relevance index to understand the condition of regional medical service use for cardiovascular surgery and to identify the medical service use imbalance between regions. METHODS: This study calculated the relevance index of 16 metropolitan cities and provinces using resident registration address data from the Ministry of Government Administration and Home Affairs and the 2010-2014 health insurance, medical care assistance, and medical benefits claims data from the Health Insurance Review and Assessment Service...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Kyeong Soo Lee, Chang Suk Kim, Jong Heon Park, Tae Yoon Hwang, Sang Won Kim, Sung Bo Sim, Kun Sei Lee
BACKGROUND: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. METHODS: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Sang-Ho Cho, Dae Hyun Kim, Young Tae Kwak
The original valve-sparing procedures for aortic root aneurysms were remodeling and reimplantation of the aortic root. The remodeling technique provides more physiologic movement of the cusps within 3 reconstructed neo-sinuses, thus preserving root expansibility through the interleaflet triangles. However, the durability of remodeling has been a matter of concern due to the high rate of aortic insufficiency when annular dilation is not addressed. Therefore, a modified approach was developed, combining a physiologic remodeling of the root with a subvalvular annuloplasty...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Mi Kyung Lee, Joon Young Song, Tae Youn Kim, Jong Hun Kim, Jong Bum Choi, Ja Hong Kuh
Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Ki Tae Kim, Pil Won Seo
A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Young Woo Do, Chang Young Lee, Sungsoo Lee, Ha Eun Kim, Bong Jun Kim, Jin Gu Lee
Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Bub-Se Na, Sungjoon Park, Sukki Cho
Elevated carbohydrate antigen (CA) 19-9 can indicate malignancies of the gastrointestinal, pancreatic, and biliary tracts, and be found in a pulmonary sequestration. A 30-year-old man visited Seoul National University Bundang Hospital due to elevated CA 19-9 levels, representing pulmonary sequestration of the bilateral lower lobes, which were connected with each other. We performed left lower lobectomy and division of the systemic arteries. After operation, CA 19-9 levels decreased to normal range, even though a small amount of sequestrated lung remained in the right lower lobe...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Jae-Bum Kim, Jae Hyun Kim, Kyung Sub Song
Fatal anaphylactic reactions to protamine sulfate during cardiac surgery are very rare. We report a case of catastrophic bronchial spasm due to an anaphylactic reaction to protamine. The patient was managed successfully using a bronchodilator, steroid treatment, and extracorporeal membrane oxygenation.
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Hae Young Lee, Seong Ho Cho, Hyun Su Kim, Jeong Min Moon, Sangho Lee, Jong In Kim
An 81-year-old male patient presented with complaint of a pulsating neck mass. The patient had a previous history of cervical lymphadenopathy by non-tuberculous mycobacterium infection. Rapid growth of the mass on admission and contrast enhanced computed tomography of the neck resulted in a diagnosis of non-tuberculous mycobacterium induced pseudoaneurysm. The patient underwent emergency open repair of the pseudoaneurysm. Pseudoaneurysm of the common carotid artery is regularly reported, but here we report a rare case of non-tuberculous mycobacterium induced pseudoaneurysm of the common carotid artery...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Youngok Lee, Gun-Jik Kim, Young Eun Kim, Seong Wook Hong, Jong Tae Lee
The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Young Woo Do, Hee Suk Jung, Chang Young Lee, Jin Gu Lee, Young-Nam Youn, Hyo Chae Paik
Coronary artery disease has historically been a contraindication to lung transplantation. We report a successful combined bilateral lung transplantation and off-pump coronary artery bypass in a 62-year-old man. The patient had a progressive decline in lung function due to idiopathic pulmonary fibrosis and a history of severe occlusive coronary artery disease.
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Hyo Yeong Ahn, Yeong Dae Kim, I Hoseok, Jeong Su Cho, Jonggeun Lee, Joohyung Son
BACKGROUND: Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide (CO2) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy. METHODS: Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Kanghoon Lee, Moon Chul Kang, Hae Won Lee, Jong Ho Park, Hee Jong Baek, Sung Joon Cho, Dae-Geun Jeon
BACKGROUND: This study assessed the efficacy of pulmonary metastasectomy for synovial sarcoma in adult patients. METHODS: Fifty patients, diagnosed with pulmonary metastasis from June 1990 to August 2010, were reviewed retrospectively. Twenty-eight patients underwent complete pulmonary metastasectomy, and their survival was evaluated. Age, sex, time to metastatic progression, laterality, number of tumors, size of largest nodule, and number of metastasectomies were analyzed as potential prognostic factors...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Yong Han Kim, Ji Seong Kim, Jae-Woong Choi, Hyoung Woo Chang, Kwon Joong Na, Jun Sung Kim, Kyung-Hwan Kim
BACKGROUND: Although unique aortic pathology related to bicuspid aortic valve (BAV) has been previously reported, clinical implications of BAV to aortopathy risk have yet to be investigated. We looked for potential differences in matrix protein expressions in the aortic wall in BAV patients. METHODS: Aorta specimens were obtained from 31 patients: BAV group (n=27), tricuspid aortic valve (TAV) group (n=4). The BAV group was categorized into three subgroups: left coronary sinus-right coronary sinus (R+L group; n=13, 42%), right coronary sinus-non-coronary sinus (R+N group; n=8, 26%), and anteroposterior (AP group; n=6, 19%)...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
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