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KMID : 0364019760090020220
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Korean Journal of Thoracic and Cardiovascular Surgery
1976 Volume.9 No. 2 p.220 ~ p.238
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Open Heart Surgery for Six Cases of the Congenital Heart Disease.
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李聖行/Lee, Sung Haing
李成久/韓承世/李吉魯/金松明/李光淑/李鍾國/Lee, Sung Koo/Han, Sung Sae/Lee, Kihl Rho/Kim, Song Myung/Lee, Kwang Sook/Lee, Chong Kook
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Abstract
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Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976.
Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic atenosis with patent ductus arteriosus were operated.
Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer´s lactate solution, 5% dextrose in water, mannitol, and ACD blood.
Flow rate ranged from 2.0 to 2.4 L/M^(2)/min. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into super for and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia (30℃) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal defects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by direct closure with Dacron patch reinforcement.
Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma.
Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of O_(2), electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.
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