The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Woong-han Kim - One of the best experts on this subject based on the ideXlab platform.
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Changes of Brain Magnetic Resonance Imaging Findings After Congenital Aortic Arch Anomaly Repair Using Regional Cerebral Perfusion in Neonates and Young Infants
The Annals of thoracic surgery, 2010Co-Authors: Jae Gun Kwak, Woong-han Kim, Jin-tae Kim, In One Kim, Jong Hee ChaeAbstract:Background The objective of this prospective study is to compare magnetic resonance imaging (MRI) findings before and after surgery for repairing congenital Aortic Arch anomalies using regional cerebral perfusion. Methods Neurologic examinations that included brain MRI, brain sonography, and electroencephalograms were performed before and after surgery for congenital Aortic Arch anomalies and the accompanying intracardiac anomalies using regional cerebral perfusion in 11 neonates and young infants. Results The median age at operation was 11 days (range, 5 to 46). The diagnoses included coarctation of the aorta with accompanying intracardiac anomalies (n = 10) and interruption of the Aortic Arch (n = 1). Aortic Arch repair was performed using regional cerebral perfusion through the right innominate artery (regional perfusion time: 25.6 ± 6.0 minutes) without cardiac arrest. Two patients had new postoperative lesions on postoperative brain MRI, and these were acute focal subdural hemorrhage (n = 1) and acute focal infarction (n = 1). However, they were without clinical significance. Periventricular leukomalacia was not observed on brain MRI. There was no significant change between the preoperative and postoperative findings on brain sonography and electroencephalograms. All the patients showed normal neurologic growth for a mean follow-up duration of 175.3 days (range: 25 to 497 days). Conclusions There were newly developed lesions on the postoperative brain MRI in 2 of 11 patients, even though these patients showed normal brain sonography and electroencephalogram findings and normal neurologic development. Our regional cerebral perfusion protocol for Aortic Arch repair showed tolerable neurologic outcomes, and it did not induce periventricular leukomalacia.
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Usefulness of Regional Cerebral Perfusion Combined With Coronary Perfusion During One-Stage Total Repair of Aortic Arch Anomaly
The Annals of thoracic surgery, 2010Co-Authors: Hong-gook Lim, Woong-han Kim, Chang-ha Lee, C. Park, Eui Suk Chung, Jeong Ryul Lee, Yong Jin KimAbstract:Background We assessed whether regional cerebral perfusion is neurologically safe during long-term follow up, and evaluated the effect of our current combined coronary perfusion strategy by comparing outcomes of nonworking beating hearts and arrested hearts under regional cerebral perfusion. Methods From MArch 2000 to October 2008, 159 neonates or infants with an Aortic Arch Anomaly underwent one-stage biventricular repair with continuous cerebral perfusion. Patients (group A, n=111) under continuous cerebral perfusion with a nonworking beating heart using the dual-perfusion technique through the innominate artery and Aortic root were compared with patients (group B, n=48) under continuous cerebral perfusion with an arrested heart. Results There were three hospital mortalities. A transient neurologic complication occurred in 3 patients, who recovered completely. During a mean (±standard deviation) of 37.9 ± 26.3 months (range, 0.5 to 95.4 months) of follow-up, 2 late deaths occurred without abnormal neurologic development. Group A had less myocardial ischemic time, which resulted in less total inotropic and vasopressin requirements, and also less delayed sternal closure, duration of ventilator care and chest tube drainage, amount of pleural effusion, and lengths of intensive care unit and hospital stay than group B, particularly in neonates and patients with complex anomalies. Conclusions One-stage total Arch repair under regional cerebral perfusion provides an excellent means of minimizing neurologic complications during long-term follow up. Our perfusion strategy for Arch Anomaly under continuous cerebral perfusion with a nonworking beating heart using the dual-perfusion technique may also minimize myocardial complications and morbidities, and should be recommended, particularly in neonates and patients with complex anomalies.
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One-stage total repair of Aortic Arch Anomaly using regional perfusion.
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2006Co-Authors: Hong-gook Lim, Woong-han Kim, Woo-sung Jang, Cheong Lim, Jae Gun Kwak, Cheul Lee, Seong Wook Hwang, Chang-ha LeeAbstract:Objective: Primary repair of Aortic Arch obstructions and associated cardiac anomalies is a surgical challenge in neonates and infants. Deep hypothermic circulatory arrest prolongs myocardial ischemia and might induce cerebral and myocardial dysfunction. Methods: From MArch 2000 to December 2005, 69 neonates or infants with Aortic Arch Anomaly underwent one-stage biventricular repair with continuous cerebral perfusion in the presence of a nonworking beating heart using the dual perfusion technique on the innominate artery and Aortic root. Preoperative diagnoses of Arch Anomaly comprised Aortic coarctation (n = 54) or an interrupted Aortic Arch (n = 15). Combined anomalies were ventricular septal defect (n = 52), anomalous origin of the right pulmonary artery from ascending aorta (n = 3), hypoplastic left heart syndrome (n = 2), truncus arteriosus (n = 2), atrioventricular septal defect (n = 2), double outlet right ventricle (n =1 ), total anomalous pulmonary venous return (n = 1), partial anomalous pulmonary venous return (n = 1), and Aortic stenosis (n =1 ).Results: The mean regional perfusion time was 27.8 9.8 min. There was no operative mortality. Postoperative low cardiac output was present in four patients (5.8%). A neurologic complication was noted in one patient (1.5%) who developed transient chorea, but recovered completely. During 32.8 17.5 months of follow-up, one late death (1.5%) occurred. There was neither reoperation associated with Arch Anomaly nor recoarctation except in one patient. One patient developed left main bronchial compression necessitating aortopexy. Conclusions: Onestage total Arch repair using our regional perfusion technique is an excellent method that may minimize neurologic and myocardial complications without mortality. Our surgical strategy for Arch Anomaly has a low rate of residual and recurrent coarctation when performed in neonates and infants. # 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Yong Jin Kim - One of the best experts on this subject based on the ideXlab platform.
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Usefulness of Regional Cerebral Perfusion Combined With Coronary Perfusion During One-Stage Total Repair of Aortic Arch Anomaly
The Annals of thoracic surgery, 2010Co-Authors: Hong-gook Lim, Woong-han Kim, Chang-ha Lee, C. Park, Eui Suk Chung, Jeong Ryul Lee, Yong Jin KimAbstract:Background We assessed whether regional cerebral perfusion is neurologically safe during long-term follow up, and evaluated the effect of our current combined coronary perfusion strategy by comparing outcomes of nonworking beating hearts and arrested hearts under regional cerebral perfusion. Methods From MArch 2000 to October 2008, 159 neonates or infants with an Aortic Arch Anomaly underwent one-stage biventricular repair with continuous cerebral perfusion. Patients (group A, n=111) under continuous cerebral perfusion with a nonworking beating heart using the dual-perfusion technique through the innominate artery and Aortic root were compared with patients (group B, n=48) under continuous cerebral perfusion with an arrested heart. Results There were three hospital mortalities. A transient neurologic complication occurred in 3 patients, who recovered completely. During a mean (±standard deviation) of 37.9 ± 26.3 months (range, 0.5 to 95.4 months) of follow-up, 2 late deaths occurred without abnormal neurologic development. Group A had less myocardial ischemic time, which resulted in less total inotropic and vasopressin requirements, and also less delayed sternal closure, duration of ventilator care and chest tube drainage, amount of pleural effusion, and lengths of intensive care unit and hospital stay than group B, particularly in neonates and patients with complex anomalies. Conclusions One-stage total Arch repair under regional cerebral perfusion provides an excellent means of minimizing neurologic complications during long-term follow up. Our perfusion strategy for Arch Anomaly under continuous cerebral perfusion with a nonworking beating heart using the dual-perfusion technique may also minimize myocardial complications and morbidities, and should be recommended, particularly in neonates and patients with complex anomalies.
Ufuk Yetkin - One of the best experts on this subject based on the ideXlab platform.
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Pentalogy of Fallot and Down’s syndrome with right Aortic Arch Anomaly
The Internet Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Ali Gürbüz, Banu Lafci, Berkan Ozpak, Ovunc Aslan, Ismail Yurekli, Ufuk YetkinAbstract:Down syndrome is a disease caused by trisomy of chromosome 21. Tetralogy of Fallot is often associated with chromosomal aberration.In this study we describe a case of pentalogy of Fallot and Down’s syndrome with right Aortic Arch Anomaly.
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pentalogy of fallot and down s syndrome with right Aortic Arch Anomaly
The Internet Journal of Thoracic and Cardiovascular Surgery, 2008Co-Authors: Ali Gürbüz, Banu Lafci, Berkan Ozpak, Ovunc Aslan, Ismail Yurekli, Ufuk YetkinAbstract:Down syndrome is a disease caused by trisomy of chromosome 21. Tetralogy of Fallot is often associated with chromosomal aberration.In this study we describe a case of pentalogy of Fallot and Down’s syndrome with right Aortic Arch Anomaly.
Jong Hee Chae - One of the best experts on this subject based on the ideXlab platform.
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Changes of Brain Magnetic Resonance Imaging Findings After Congenital Aortic Arch Anomaly Repair Using Regional Cerebral Perfusion in Neonates and Young Infants
The Annals of thoracic surgery, 2010Co-Authors: Jae Gun Kwak, Woong-han Kim, Jin-tae Kim, In One Kim, Jong Hee ChaeAbstract:Background The objective of this prospective study is to compare magnetic resonance imaging (MRI) findings before and after surgery for repairing congenital Aortic Arch anomalies using regional cerebral perfusion. Methods Neurologic examinations that included brain MRI, brain sonography, and electroencephalograms were performed before and after surgery for congenital Aortic Arch anomalies and the accompanying intracardiac anomalies using regional cerebral perfusion in 11 neonates and young infants. Results The median age at operation was 11 days (range, 5 to 46). The diagnoses included coarctation of the aorta with accompanying intracardiac anomalies (n = 10) and interruption of the Aortic Arch (n = 1). Aortic Arch repair was performed using regional cerebral perfusion through the right innominate artery (regional perfusion time: 25.6 ± 6.0 minutes) without cardiac arrest. Two patients had new postoperative lesions on postoperative brain MRI, and these were acute focal subdural hemorrhage (n = 1) and acute focal infarction (n = 1). However, they were without clinical significance. Periventricular leukomalacia was not observed on brain MRI. There was no significant change between the preoperative and postoperative findings on brain sonography and electroencephalograms. All the patients showed normal neurologic growth for a mean follow-up duration of 175.3 days (range: 25 to 497 days). Conclusions There were newly developed lesions on the postoperative brain MRI in 2 of 11 patients, even though these patients showed normal brain sonography and electroencephalogram findings and normal neurologic development. Our regional cerebral perfusion protocol for Aortic Arch repair showed tolerable neurologic outcomes, and it did not induce periventricular leukomalacia.
Ronald G Grifka - One of the best experts on this subject based on the ideXlab platform.
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right Aortic Arch with isolation of the left subclavian artery moderate patent ductus arteriosus and subclavian steal syndrome a rare Aortic Arch Anomaly treated with the gianturco grifka vascular occlusion device
Catheterization and Cardiovascular Interventions, 1999Co-Authors: Thomas K Jones, Hrair Garabedian, Ronald G GrifkaAbstract:We present the first described use of the Gianturco-Grifka Vascular Occlusion Device to close a moderate patent ductus arteriosus associated with the rare congenital condition of right Aortic Arch with isolation of the left subclavian artery. Left vertebral artery "steal" through the moderate patent ductus arteriosus was eliminated by this transcatheter technique. Cathet. Cardiovasc. Intervent. 47:320-322, 1999.