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KMID : 0371319690110010017
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Journal of the Korean Surgical Society
1969 Volume.11 No. 1 p.17 ~ p.25
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Repair of Atrial Septal Defects by Open Hert Surgery
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洪弼勳/Hong, Pill Whoon
李世淳/洪承祿/徐相賢/金義烈/Lee, Sae Soon/Hong, Sung Nok/Suh, Sang Hyon/Kim, Eui Yul
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Abstract
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Atrial septal defect is one of the most frequently encountered congenital cardiac anomalies. Since the first description of atrial septal defect by Rokitansky in 1857, this anomaly has been studied by many workers in past one century, but it was not until 1952 when open heart surgery became available with the aid of artifical heart-lung bypass that complete correction of this intracardiac defect was achieved under direct vision.
In past 5 years since authors begun open heart surgery in Yonsei University Severance Hospital in November 1963, 68 patients have been undergone open heart surgery, among whom 15 cases had simple atrial septal dects and 3 cases had atrial septal defects combined with pulmonary stenosis. There were 3 more which was found concomitantly during repair of tetralogy of Fallot, ruptured aneurysm of sinus Valsalva and myxoma of the heart respectively. These 3 complicated cases were not included in this study.
Among 18 cases of atrialseptal defects, 10 cases were female and remainders male. Their ages ranged between 6 and 54 years. In all patients preperative cardiac catheterization was performed and ascertained that they had left to right shunt except a case of reversed shunt with pulmonary stenosis.
Their intracardiac defects were repaired under direct vision utilizing DeWall´s helical reservoir bubble type pump oxygenator which was modified by Zuhdi, by hemodilution technic combined with moderate hypothermia. All 18 case had ostium secundum defects and 14 cases were repaired by direct sutures while 4 cases needed Teflon patches. The average entire perfusion time to repair the defect was 38 minutes; the shortest 18 and the longest 74 minutes.
Blood gas study was perfomed pre and postoperatively and during bypass, and confirmed that oxygen saturation of the arterial blood supplied by heart lung machine was satisfactory. But acisosis developed in the end of the perfusion, however, these changes returned to normal usually by 24 hours postoperatively.
There has been no surgical mortality encountered and follow-up study of these cases found to be excellent.
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KEYWORD
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