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We evaluated the surgical results of postinfarction ventricular septal perforation by endocardial patch with infarction exclusion.We reviewed 8 patients complicating AMI who underwent surgical treatment at our institution from July 1997 to August 2000 (6 males, 2 females, mean age 73.9 +/- 9, range 57-87). The localization of AMI and VSP was anterior in 6 patients, inferior in 2. All patients had coronary angiography preoperatively. And 7 patients had the percutaneous transluminal coronary angioplasty of the infarct artery.There were 2 hospital deaths due to cerebral infarction and pulmonary hemorrhage. All deaths occurred in patients with cardiogenic shock.Good results were obtained by infarction exclusion technique. Better operative results may be expected with the preoperative coronary angioplasty of the infarct artery.

From March 1989 to July 2000, 82 patients have received the aortic-mitral replacement in our hospital. Among these patients, 11 patients had left ventricular ejection fraction less than 40%. We evaluated the mortality, the cause of death, postoperative complications and mid-term results of these patients. Five-years' survival rate was determined by means of the Kaplan-Meire method. Follow-up was complete for 100% of the patients.One patient (9%) died on 7 days after operation, due to multiorgan failure. Postoperativery, all patients had anticoagurant therapy with warfarin sodium and showed improvement in functional class. Mean follow-up was 3.4 years (0-5.9 years). The late death rate was 20% (2 patients). But there were no valve-related deaths during the follow-up periods. Overall survivals rate at 5 years was 70%.Despite the poor left ventricular function, we obtained satisfactory mid-term results of mitral-aortic valve operations.

From January 1995 to August 2000, 34 patients received the triple valve operation in our hospital. We evaluated the mortality, the cause of death, postoperative complications and mid-term results in these patients. Five-years'survival rate was determined by means of the Kaplan-Meire method.Two patient died after operation due to cardiac failure and cerebral infarction. Postoperativery, all patients had anticoagurant therapy with warfarin sodium. Mean follow-up was 3.2 years (0-5.6 years). There was one late sudden death among 32 perioerative survivors. There were 3 episodes of cerebral infarction. The rate of freedom from cardiac event at 5 years was 79%. Overall survival rate at 5 years was 94%.We obtained good mid-term results of triple valve operation. We recommend aggressive treatment for functional tricuspid valve regurgitation.

A case of simultaneous, bilateral squamous cell carcinoma of the lung was presented. One located in right basal bronchus had mediastinal lymph node metastasis even though primary lesion was localized within the bronchial wall. So right lower lobectomy with R 2 lymph node dissection was carried out. The left one located in the left basal bronchus was treated using laser preoperatively, which revealed its location and extension. Sequentially S6 segmental sleeve resection was carried out and preserved his residual lung function. Six months later, the third primary lung cancer was found in left B3. We discussed about diagnosis and treatment of the multiple lung cancer and emphasize that bronchoplastic procedures in segmental level is available for treatment of multiple lung cancer.