25 results on '"Jooncheol Min"'
Search Results
2. Outcomes of the Warden Procedure for Anomalous Pulmonary Venous Return to the Superior Vena Cava: A 17-Year Experience
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Su Chan Lim, Jae Gun Kwak, Sungkyu Cho, Jooncheol Min, Sangjun Lee, Hye Won Kwon, and Woong-Han Kim
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congenital heart disease ,pulmonary veins ,atrial heart septal defects ,Medicine (General) ,R5-920 - Abstract
Background: Surgical repair of partial anomalous pulmonary venous return (PAPVR) to the superior vena cava (SVC) using the Warden procedure has favorable outcomes. However, there remain some concerns after the Warden procedure, such as sinoatrial nodal dysfunction and systemic or pulmonary venous stenosis. We investigated the outcomes of the Warden procedure for repair of PAPVR to the SVC. Methods: This retrospective study included 22 consecutive patients who underwent the Warden procedure for PAPVR between 2002 and 2018. The median age and body weight at operation were 27.5 months (interquartile range [IQR], 5.0–56.8 months) and 13.2 kg (IQR, 6.5–16.0 kg), respectively. The median follow-up duration was 6.2 years (IQR, 3.5–11.6 years). Results: There were no cases of early or late mortality. No patients had postoperative heart rhythm problems, except 1 patient who showed transient sinoatrial nodal dysfunction in the immediate postoperative period. Procedure-related complications requiring reintervention occurred in 5 patients, including 3 of 4 SVC stenosis cases and 2 pulmonary venous stenosis cases during follow-up. The rate of freedom from reintervention related to the Warden procedure was 75.9% at 10 years. Conclusion: In cases requiring extension or creation of an atrial septal defect to achieve a sufficient venous pathway, or interposition of an entire circumferential conduit between the SVC and right atrium due to the shortness of the SVC in the Warden procedure, stenotic complications of the venous pathway occurred. Careful observation of changes in the pressure gradient or anatomical stenosis is required in such patients.
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- 2022
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3. Postcardiotomy Extracorporeal Membrane Oxygenation Support in Patients with Congenital Heart Disease
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Seohee Joo, Sungkyu Cho, Jae Hong Lee, Jooncheol Min, Hye Won Kwon, Jae Gun Kwak, and Woong-Han Kim
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extracorporeal membrane oxygenation ,congenital heart disease ,thoracic surgery ,postcardiotomy ,Medicine (General) ,R5-920 - Abstract
Background: This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD). Methods: CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed. Results: Fifty patients required postoperative ECMO support. Patients’ median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23– 14.5 months) and 3.84 kg (IQR, 3.08–7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3–12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death. Conclusion: Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.
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- 2022
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4. Percutaneous bicaval dual lumen cannula for extracorporeal life support
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Woojung Kim, Hye Won Kwon, Jooncheol Min, Sungkyu Cho, Jae Gun Kwak, June Dong Park, and Woong-Han Kim
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extracorporeal membrane oxygenation ,pediatrics ,respiratory insufficiency ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Veno-venous extracorporeal membrane oxygenation (ECMO) is a useful mechanical device for pediatric patients with severe respiratory failure. Conventional veno-venous ECMO using double cannulation, however, is not feasible due to size limitations in pediatric patients who have small femoral vessels. Recently, percutaneous bicaval dual-lumen cannula can be inserted using single cannulation via the right internal jugular vein. Herein, we report the case of a pediatric patient with severe respiratory failure who was weaned off the ECMO successfully after treatment with bicaval dual-lumen cannulation for 5 days despite the small body size and immunocompromised condition due to chemotherapy for hemophagocytic lymphohistiocytosis.
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- 2020
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5. Extracorporeal Membrane Oxygenation in Pediatric Patients with Respiratory Failure: Early Experience with the Double-Lumen Cannula Over 2 Years
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Woojung Kim, Hye Won Kwon, Jooncheol Min, Sungkyu Cho, Jae Gun Kwak, and Woong Han Kim
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extracorporeal membrane oxygenation ,respiratory insufficiency ,pediatrics ,Surgery ,RD1-811 - Abstract
Background: The double-lumen cannula (DLC) has begun to be used worldwide for venovenous (VV) extracorporeal membrane oxygenation (ECMO). We aimed to examine whether the DLC could be an effective tool in the treatment of pediatric respiratory failure in Korea.Methods: We reviewed the records of patients weighing under 15 kg who underwent ECMO due to respiratory failure between January 2017 and December 2018. Outcomes of ECMO using a DLC and conventional ECMO using central method or 2 peripheral cannulas were compared.Results: Twelve patients were treated with ECMO for respiratory failure. Among them, a DLC was used in 5 patients, the median age of whom was 3.8 months (interquartile range, 0.1–49.7 months). In these patients, the median values of pH, partial pressure of carbon dioxide, and partial pressure of oxygen were 7.09, 74 mm Hg, and 37 mm Hg before ECMO and corrected to 7.31, 44 mm Hg, and 85 mm Hg, respectively, after ECMO cannulation. Median blood flow rate in the patients treated with ECMO using a DLC was slightly higher than that in the conventional ECMO group, but this difference was not statistically signif-icant (86.1 mL/kg/min and 74.3 mL/kg/min, respectively; p=1.00). One patient from the DLC group and 3 patients from the conventional group were weaned off ECMO.Conclusion: VV ECMO using a DLC provided adequate oxygenation, ventilation, and blood flow rate in Korean pediatric patients with respiratory failure. Further prospective and randomized studies are warranted.
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- 2020
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6. A Case Report of Rare Complications after Epicardial Permanent Pacemaker Implantation in an Infant: Airway Compression, Skin Necrosis, and Bowel Perforation
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Woojung Kim, Jae Gun Kwak, Jooncheol Min, and Woong-Han Kim
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artificial cardiac pacemaker ,infant ,postoperative complications ,Surgery ,RD1-811 - Abstract
Insertion of an epicardial pacemaker is a useful treatment for pediatric patients with an abnormal heart rhythm. However, there are limitations and concerns when implanting epicardial pacemakers in infants and neonates due to their small body size. We report a pa-tient who experienced rare complications after implantation of a permanent pacemaker.
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- 2020
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7. Incomplete Form of Shone Complex in an Adult Congenital Heart Disease Patient
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Beatrice Chia-Hui Shih, Jae Hong Lim, Jooncheol Min, Eung Re Kim, Jae Gun Kwak, and Woong-Han Kim
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Shone’s complex ,Bicuspid aortic valve ,Parachute mitral valve ,Extraanatomic bypass ,Aortic coarctation ,Surgery ,RD1-811 - Abstract
Shone complex is a rare congenital disorder that involves 4 obstructive lesions of the left heart, as follows: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta. Incomplete forms with 2 or 3 of these lesions in adult patients have been rarely reported in the literature, meaning that insufficient general data exist concerning the surgical strategy and clinical follow-up. Herein, we report the case of a 31-year-old woman with a diagnosis of incomplete form of Shone complex with parachute mitral valve and coarctation of the aorta who underwent successful single-stage surgical repair.
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- 2019
- Full Text
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8. Long-Term Outcomes of Atrioventricular Valve Surgery in Patients with Functional Single Ventricle: Should We Avoid Valve Replacement?
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Sungkyu Cho, Jooncheol Min, Jae Gun Kwak, Jae Hong Lim, and Woong Han Kim
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medicine.medical_specialty ,Atrioventricular valve ,business.industry ,medicine.medical_treatment ,Regurgitation (circulation) ,Vascular surgery ,Cardiac surgery ,Surgery ,medicine.anatomical_structure ,Valve replacement ,Ventricle ,Statistical significance ,Pediatrics, Perinatology and Child Health ,medicine ,Risk factor ,Cardiology and Cardiovascular Medicine ,business - Abstract
Atrioventricular valve regurgitation (AVVR) is associated with increased morbidity and mortality in patients with single ventricle physiology. The purpose of this study was to evaluate the long-term results of the surgical management of AVVR and to analyze the effects of AV valve replacement. The medical records of 38 single ventricle patients who underwent atrioventricular valve surgery more than once between January 2001 and March 2018 were retrospectively reviewed. We analyzed and compared clinical data of patients who underwent valve replacement as an initial treatment (n = 8) for AVVR with patients who initially underwent valve repair (n = 30). The median follow-up duration was 98.1 months (range, 0.9–209.6 months). There was one early mortality and seven late mortalities. Freedom from reoperation between the two groups at 15 years of follow-up was significantly different: 18.3% in the repair group and 100% in the replacement group (p = 0.013). The replacement group showed a better overall survival rate (100%) at 15 years than the repair group (68.5%) without statistical significance (p = 0.097). All mortalities occurred in the repair group. Nine patients in the repair group (30%) and one patient in the replacement group (12.5%) showed preoperative ventricular dysfunction. RV-type single ventricle with atrioventricular (AV) valve annular dilatation was found out as a risk factor of AVV replacement both in univariate (p = 0.04) and multivariate (p = 0.004) analysis. AV valve replacement might be considered as a primary treatment option for patients who have an annular dilation with an RV-type single ventricle rather than repeated valvuloplasty.
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- 2021
9. Tricuspid valve detachment for ventricular septal defect closure in infants <5 kg: should we be hesitant?
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Jeong Ryul Lee, Jooncheol Min, Jae Gun Kwak, Jae Hong Lee, Sungkyu Cho, Yujin Kwak, Woong Han Kim, and Hye Won Kwon
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Heart Septal Defects, Ventricular ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,Body weight ,Intracardiac injection ,03 medical and health sciences ,Defect closure ,0302 clinical medicine ,Tricuspid Valve Insufficiency ,Interquartile range ,Internal medicine ,medicine ,Humans ,Cardiac Surgical Procedures ,Retrospective Studies ,Tricuspid valve ,business.industry ,Infant ,General Medicine ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Cardiology ,Surgery ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,Follow-Up Studies - Abstract
OBJECTIVES We compared the clinical outcomes between tricuspid valve detachment (TVD) and non-TVD for ventricular septal defect (VSD) closure in infants METHODS From January 2004 to April 2020, 462 infants RESULTS The median age and body weight at operation were 1.9 months [interquartile range(IQR), 1.4–2.5] and 4.2 kg (IQR, 3.7–4.6). The median follow-up duration was 83.4 months (IQR, 43.5–130.4). After matching, 44 pairs were extracted from each group. There were no significant differences in all-cause mortality (P = 0.176), reoperation (P = 0.172), postoperative morbidities, including residual VSD, aortic regurgitation, atrioventricular block and significant tricuspid regurgitation (TR) (P = 0.346) between group D and group N. However, group D showed significantly less TR progression during follow-up (P = 0.019). CONCLUSIONS In infants
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- 2021
10. Twenty-Year Experience with Truncus Arteriosus Repair: Changes in Risk Factors in the Current Era
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Woong-Han Kim, Jae Gun Kwak, Yoonjin Kang, Jae Hong Lim, and Jooncheol Min
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Male ,Reoperation ,medicine.medical_specialty ,Time Factors ,Persistent truncus arteriosus ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Modified ultrafiltration ,Humans ,Cardiac Surgical Procedures ,Risk factor ,Proportional Hazards Models ,business.industry ,Hazard ratio ,Infant, Newborn ,Infant ,Perioperative ,Vascular surgery ,medicine.disease ,Truncus Arteriosus, Persistent ,Rev operation ,Surgery ,Cardiac surgery ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Although the clinical outcomes of truncus arteriosus (TA) repair have been improving, few data are available on long-term outcomes after truncus arteriosus repair in the current era. This study evaluated long-term outcome after repair of TA. Fifty-one patients underwent total correction from April 1982 to June 2018. Since 2003, perioperative strategy has changed to minimal priming volume, modified ultrafiltration, and early total repair (n = 26). Mortality and reoperation rates were analyzed before and after 2003. There were 8 hospital deaths after initial operation, all before 1997. During the mean follow-up of 9.8 years, there were 2 deaths. The Kaplan-Meier estimate of survival among all hospital survivors was 94.7% at 5 years and 88.0% at 20 years. A significant independent risk factor for early mortality was operation before 2003 (Hazard ratio (HR) 9.710, p = 0.041) and REV operation (HR 8.000, p = 0.028). Freedom from reoperation for conduit change and TV repair were 88.3% and 41% at 1 and 5 years, and 96.2% and 85.4% at 1 and 5 years, respectively. After 2003, younger age and conduit choice were risk factors for conduit-related reoperation. Initial preoperative TV regurgitation was independent risk factor for sequential TV repair. Patients with TA can undergo total repair of TA with excellent results, especially in current era. Most of the patients require conduit-related reoperations. Younger age and the methods of RVOT reconstruction were risk factors for conduit-related reoperations. TV repair is necessary in limited patients, and initial regurgitation was a risk factor.
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- 2020
11. Experience with Temporary Centrifugal Pump Bi-ventricular Assist Device for Pediatric Acute Heart Failure: Comparison with ECMO
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Gi Beom Kim, Jooncheol Min, Hye Won Kwon, Jeong Ryul Lee, Jae Gun Kwak, Jae Hong Lim, Eun Jung Bae, Woong Han Kim, and Mi Kyung Song
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Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,Myocarditis ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Extracorporeal Membrane Oxygenation ,parasitic diseases ,medicine ,Humans ,Respiratory function ,cardiovascular diseases ,Child ,Retrospective Studies ,Heart transplantation ,Pediatric ,Heart Failure ,business.industry ,Infant ,Dilated cardiomyopathy ,medicine.disease ,Cardiac surgery ,Surgery ,Transplantation ,surgical procedures, operative ,Treatment Outcome ,030228 respiratory system ,Ventricular assist device ,Heart failure ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Heart Transplantation ,Original Article ,Female ,Heart-Assist Devices ,biological phenomena, cell phenomena, and immunity ,Cardiology and Cardiovascular Medicine ,business - Abstract
Though ventricular assist devices (VADs) are an important treatment option for acute heart failure, an extracorporeal membrane oxygenator (ECMO) is usually used in pediatric patients for several reasons. However, a temporary centrifugal pump-based Bi-VAD might have clinical advantages versus ECMO or implantable VADs. From January 2000 to July 2018, we retrospectively reviewed 36 pediatric patients who required mechanical circulatory support (MCS) for acute heart failure. Cases with postoperative MCS were excluded. Since 2016, we have tried to immediately add a right VAD rather than ECMO, when the patients begin to present features of right heart failure after left VAD support started in cases that the patients’ respiratory function did not require an oxygenator. Original diagnoses included dilated cardiomyopathy (n = 18), myocarditis (n = 11), and others (n = 7). Eleven patients were supported by Bi-VAD, and 25 patients were supported by ECMO; of these. Four patients were successfully weaned from VAD, and 10 patients were weaned from ECMO. Eleven patients underwent heart transplantation. Overall, we have 15 (41.7%) early mortalities. There were no significant differences in early mortality, morbidity, and weaning rate between the Bi-VAD group and the ECMO group. During the support, patients with Bi-VADs significantly required fewer platelets and showed less hemolysis than ECMO patients. Patients with myocarditis were successfully weaned from Bi-VAD support and bridged to transplantation thereafter. A temporary centrifugal pump-based Bi-VAD was clinically comparable to ECMO for pediatric patients with acceptable pulmonary function.
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- 2020
12. Postcardiotomy Extracorporeal Membrane Oxygenation Support in Patients with Congenital Heart Disease
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Seohee Joo, Sungkyu Cho, Jae Hong Lee, Jooncheol Min, Hye Won Kwon, Jae Gun Kwak, and Woong-Han Kim
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Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Abstract
This study investigated mortality and morbidity in patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) support after operations for congenital heart disease (CHD).CHD patients requiring postoperative ECMO support between May 2011 and May 2021 were retrospectively reviewed. Patients were divided into non-survivors and survivors to hospital discharge. Survival outcomes and associations of various factors with in-hospital death were analyzed.Fifty patients required postoperative ECMO support. Patients' median age and weight at the time of ECMO insertion were 1.85 months (interquartile range [IQR], 0.23-14.5 months) and 3.84 kg (IQR, 3.08-7.88 kg), respectively. Twenty-nine patients (58%) were male. The median duration of ECMO support was 6 days (IQR, 3-12 days). Twenty-nine patients (58%) died on ECMO support or after ECMO weaning, and 21 (42%) survived to hospital discharge. Postoperative complications included renal failure (n=33, 66%), bleeding (n=11, 22%), and sepsis (n=15, 30%). Prolonged ECMO support (p=0.017), renal failure (p=0.005), continuous renal replacement therapy (CRRT) application (p=0.001), sepsis (p=0.012), bleeding (p=0.032), and high serum lactate (p=0.002) and total bilirubin (p=0.017) levels during ECMO support were associated with higher mortality risk in a univariate analysis. A multivariable analysis identified CRRT application (p=0.013) and a high serum total bilirubin level (p=0.001) as independent risk factors for death.Postcardiotomy ECMO should be considered as an important therapeutic modality for patients unresponsive to conventional management. ECMO implementation strategies and management in appropriate patients without severe complications, particularly renal failure and/or liver failure, are crucial for achieving positive outcomes.
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- 2021
13. Aortic Valve Repair in Young Patients: A Single Patch Design for Leaflet Extension
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Jooncheol Min, Jae Hong Lee, Sungkyu Cho, Hye Won Kwon, Yu Jin Kwak, Woong Han Kim, Jae Gun Kwak, and Hong Ju Shin
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Reoperation ,medicine.medical_specialty ,Leaflet (botany) ,business.industry ,Aortic Valve Insufficiency ,Regurgitation (circulation) ,Aortic Valve Stenosis ,Vascular surgery ,medicine.disease ,Surgery ,Cardiac surgery ,Stenosis ,Aortic valve repair ,Treatment Outcome ,Concomitant ,Aortic Valve ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,cardiovascular system ,medicine ,Humans ,Cardiac Surgical Procedures ,Cardiology and Cardiovascular Medicine ,business ,New York Heart Association Class I - Abstract
The surgical treatment for young patients with aortic valve diseases has not been standardized because of differences in the patients’ growth. We aimed to investigate short-term results of aortic valve repair with leaflet extension techniques. From October 2017 to June 2020, we performed aortic valve repair with leaflet extension technique in 15 consecutive patients with a median age of 13 years (range, 33 months–27 years). Among them, all had moderate or severe aortic regurgitation (AR), eight had concomitant aortic stenosis, and 12 underwent prior cardiac operations. The leaflet patch design has been modified from separate patch design to single patch design. No early and late deaths were reported, no re-operations were performed, and temporary ectopic atrial arrhythmia was the only early complication noted. The patients were discharged with less than moderate AR after a median postoperative period of 5 (range, 3–7) days. All the patients were New York Heart Association class I after a median follow-up period of 17.3 (range, 4.4–34.6) months. However, two patients progressed to moderate AR postoperatively at 6 and 30 months, respectively, after which one was treated with single patch technique. Among the remaining patients, six had trace, six had mild, and one had mild-to-moderate AR. Aortic valve repair with leaflet extension is acceptable in young patients. Our single patch design was easy to manipulate and showed good short-term results. Long-term follow-up is required to further confirm the efficacy of this technique.
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- 2021
14. Surgery on a dilated aorta associated with a connective tissue disease or inflammatory vasculitis in children and adolescents
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Jooncheol Min, Yong Jin Kim, Yoon Jin Kang, Jae Gun Kwak, Eung Re Kim, Jae Hong Lim, and Woong Han Kim
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Male ,Reoperation ,Vasculitis ,Marfan syndrome ,medicine.medical_specialty ,Adolescent ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Tuberous sclerosis ,0302 clinical medicine ,030225 pediatrics ,medicine.artery ,Republic of Korea ,Ascending aorta ,medicine ,Humans ,Child ,Connective Tissue Diseases ,Retrospective Studies ,Aorta ,Vascular disease ,business.industry ,General Medicine ,medicine.disease ,Connective tissue disease ,Surgery ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Kawasaki disease ,Cardiology and Cardiovascular Medicine ,business ,Dilatation, Pathologic - Abstract
Introduction:This research investigated patients who underwent surgery for a dilated aorta associated with a connective tissue disease or inflammatory vasculitis in children and adolescents.Materials and Methods:The medical records of 11 patients who underwent aortic surgery for dilatation resulting from a connective tissue disease or inflammatory vasculitis between 2000 and 2017 were retrospectively reviewed.Results:The median age and body weight of the patients were 9.6 years (range 5.4 months–15.5 years) and 25.8 kg (range 6.8–81.5), respectively. The associated diseases were Marfan syndrome (n = 3), Loeys-Dietz syndrome (n = 3), Kawasaki disease (n = 1), Takayasu arteritis (n = 1), PHACE syndrome (n = 1), tuberous sclerosis (n = 1), and unknown (n = 1). The most common initially affected area was the ascending aorta. During the 66.4 ± 35.9 months of follow-up, two Marfan syndrome patients died, and four patients (one Marfan syndrome and three Loeys-Dietz syndrome) had repeated aortic operation. Except for one patient, the functional class was well maintained in all patients who were followed up.Conclusion:Cases of surgical treatment for a dilated aorta associated with a connective tissue disease and inflammatory vasculitis are rare in children and adolescents at our institution. Most of the patients in this study showed a tolerable postoperative course. However, the aorta showed progressive dilation over time even after surgical treatment, especially in patients with Loeys-Dietz syndrome. In these patients, close and more frequent regular follow-up is required.
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- 2019
15. Incomplete Form of Shone Complex in an Adult Congenital Heart Disease Patient
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Jooncheol Min, Jae Gun Kwak, Jae Hong Lim, Beatrice Chia Hui Shih, Woong Han Kim, and Eung Re Kim
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart disease ,Bicuspid aortic valve ,Coarctation of the aorta ,lcsh:Surgery ,Case Report ,030204 cardiovascular system & hematology ,Shone complex ,Aortic coarctation ,03 medical and health sciences ,0302 clinical medicine ,Mitral valve ,Shone’s complex ,medicine ,Parachute mitral valve ,Subaortic stenosis ,Surgical repair ,business.industry ,lcsh:RD1-811 ,medicine.disease ,Extraanatomic bypass ,Surgery ,medicine.anatomical_structure ,030228 respiratory system ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business ,Congenital disorder - Abstract
Shone complex is a rare congenital disorder that involves 4 obstructive lesions of the left heart, as follows: parachute mitral valve, supravalvular mitral ring, subaortic stenosis, and coarctation of the aorta. Incomplete forms with 2 or 3 of these lesions in adult patients have been rarely reported in the literature, meaning that insufficient general data exist concerning the surgical strategy and clinical follow-up. Herein, we report the case of a 31-year-old woman with a diagnosis of incomplete form of Shone complex with parachute mitral valve and coarctation of the aorta who underwent successful single-stage surgical repair.
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- 2019
16. Tricuspid Valve Repair at Pulmonary Valve Replacement in Repaired Tetralogy of Fallot
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Sungkyu Cho, Woong Han Kim, Jooncheol Min, Jae Hong Lim, Eung Re Kim, Chang-Ha Lee, and Jae Gun Kwak
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medicine.medical_specialty ,Pulmonary Valve Replacement ,Internal medicine ,medicine ,Humans ,Tetralogy of Fallot ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,Pulmonary Valve ,business.industry ,Vascular surgery ,medicine.disease ,eye diseases ,Pulmonary Valve Insufficiency ,Cardiac surgery ,medicine.anatomical_structure ,Treatment Outcome ,Ventricle ,Pulmonary valve ,Concomitant ,Pediatrics, Perinatology and Child Health ,Cardiology ,Tricuspid Valve ,Tricuspid Valve Regurgitation ,Cardiology and Cardiovascular Medicine ,business - Abstract
Pulmonary valve replacement (PVR) is often performed in patients with repaired tetralogy of Fallot (TOF). Concomitant tricuspid valvuloplasty (TVP) in those with tricuspid regurgitation (TR) at the time of PVR is still controversial. We retrospectively reviewed clinical records of patients who underwent PVR between 2001 and 2012. We analyzed the impact of concomitant TVP on the tricuspid valve function and right ventricle function and size in mid-term. 119 patients with mild to moderate TR at the time of PVR were enrolled. 33 patients underwent concomitant TVP (TVP group) and 86 patients underwent PVR alone (no-TVP group). There was a significant reduction of TR (p
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- 2021
17. Long-Term Outcomes of Atrioventricular Valve Surgery in Patients with Functional Single Ventricle: Should We Avoid Valve Replacement?
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Jae Hong, Lim, Jae Gun, Kwak, Jooncheol, Min, Sungkyu, Cho, and Woong-Han, Kim
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Reoperation ,Time Factors ,Treatment Outcome ,Humans ,Infant ,Heart Valves ,Univentricular Heart ,Retrospective Studies - Abstract
Atrioventricular valve regurgitation (AVVR) is associated with increased morbidity and mortality in patients with single ventricle physiology. The purpose of this study was to evaluate the long-term results of the surgical management of AVVR and to analyze the effects of AV valve replacement. The medical records of 38 single ventricle patients who underwent atrioventricular valve surgery more than once between January 2001 and March 2018 were retrospectively reviewed. We analyzed and compared clinical data of patients who underwent valve replacement as an initial treatment (n = 8) for AVVR with patients who initially underwent valve repair (n = 30). The median follow-up duration was 98.1 months (range, 0.9-209.6 months). There was one early mortality and seven late mortalities. Freedom from reoperation between the two groups at 15 years of follow-up was significantly different: 18.3% in the repair group and 100% in the replacement group (p = 0.013). The replacement group showed a better overall survival rate (100%) at 15 years than the repair group (68.5%) without statistical significance (p = 0.097). All mortalities occurred in the repair group. Nine patients in the repair group (30%) and one patient in the replacement group (12.5%) showed preoperative ventricular dysfunction. RV-type single ventricle with atrioventricular (AV) valve annular dilatation was found out as a risk factor of AVV replacement both in univariate (p = 0.04) and multivariate (p = 0.004) analysis. AV valve replacement might be considered as a primary treatment option for patients who have an annular dilation with an RV-type single ventricle rather than repeated valvuloplasty.
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- 2021
18. Pulmonary valve replacement may not restore ventricular volume and functional status in patients with pulmonary regurgitation after late tetralogy of Fallot repair
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Jae Gun Kwak, Woong-Han Kim, Jooncheol Min, Woojung Kim, Hye Won Kwon, Jeong Ryul Lee, and Sungkyu Cho
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Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,Cardiac output ,Adolescent ,medicine.medical_treatment ,Oxygen pulse ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,Internal medicine ,Pulmonary Valve Replacement ,medicine ,Humans ,Child ,Cardiac catheterization ,Tetralogy of Fallot ,Retrospective Studies ,Pulmonary Valve ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,General Medicine ,Stroke volume ,medicine.disease ,Pulmonary Valve Insufficiency ,medicine.anatomical_structure ,Functional Status ,Treatment Outcome ,Ventricle ,Child, Preschool ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES Clinically, tetralogy of Fallot (TOF) patients who underwent repair late (older than 2 years) appears to have worse outcomes after pulmonary valve replacement than patients who underwent repair early. We proceeded to review the clinical features of late-repaired TOF patients who required pulmonary valve replacement. METHODS Fifty patients who underwent pulmonary valve replacement after TOF repair over the age of 2 years from 2000 to 2018 were retrospectively reviewed. Pre- and postoperative cardiac magnetic resonance imaging, cardiopulmonary exercise tests, and cardiac catheterization were analysed. RESULTS The median age of patients at the time of TOF repair and pulmonary valve replacement was 3.6 and 23.4 years, respectively. The median interval from TOF repair to pulmonary valve replacement was 20.5 years. Cardiac magnetic resonance imaging and cardiopulmonary exercise tests were performed at a median of 5.9 and 3.7 years after pulmonary valve replacement, respectively. Cardiac magnetic resonance revealed that there were significant changes in the indexed values of the right ventricle end-diastolic volume (164.7–106.9 ml/m2, P CONCLUSIONS Although pulmonary valve replacement after late TOF correction improves right ventricular volume status, only a minority of patients achieve normalization of right ventricular end systolic volume and a normal functional status.
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- 2020
19. Reoperation for coronary artery stenosis after arterial switch operation
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Jooncheol Min, Jae Gun Kwak, Eung Re Kim, Joon Chul Jung, Woong Han Kim, Jae Hong Lim, and Ji Hyun Bang
- Subjects
Heart Defects, Congenital ,Male ,Reoperation ,Pulmonary and Respiratory Medicine ,Coronary angiography ,medicine.medical_specialty ,Computed Tomography Angiography ,Transposition of Great Vessels ,medicine.medical_treatment ,Coronary stenosis ,030204 cardiovascular system & hematology ,Coronary Angiography ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Angioplasty ,medicine ,Humans ,Survival rate ,Computed tomography angiography ,medicine.diagnostic_test ,business.industry ,Coronary Stenosis ,Infant, Newborn ,Infant ,Coronary Vessels ,Surgery ,Arterial Switch Operation ,Survival Rate ,medicine.anatomical_structure ,030228 respiratory system ,Great arteries ,Angiography ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Objectives Coronary artery stenosis after an arterial switch operation (ASO) leads to subsequent reoperation. Therefore, we investigated the indications for reoperation and the results of reoperation to suggest methods to improve our management protocol for coronary artery stenosis after an ASO. Methods Between September 2003 and December 2016, 86 consecutive patients who underwent an ASO were included in the study. The indications for reoperation, reoperation techniques and postoperative results were investigated. Results There were 4 in-hospital deaths (4.7%). One late death occurred during the median follow-up period of 59.6 months. The 5-year overall survival rate was 94.2%. Seven reoperations were performed in 5 patients due to coronary artery stenosis. The indications for reoperation were severe coronary artery stenosis confirmed by computed tomography (CT) angiography or coronary angiography with or without symptoms. Patients with a coronary artery between the great arteries or a high take-off coronary artery frequently required reoperation due to coronary artery stenosis. None of the patients who underwent unroofing or cut-back angioplasty experienced complications during the median follow-up period of 52.0 months. However, 2 patients who underwent ostioplasty required an additional reoperation due to coronary artery restenosis. Conclusions A standardized follow-up protocol including CT angiography or coronary angiography after the ASO is required to address coronary artery stenosis. Good reoperation results were observed using the unroofing and cut-back angioplasty techniques.
- Published
- 2018
20. One-Year Follow-up After Tetralogy of Fallot Total Repair Preserving Pulmonary Valve and Avoiding Right Ventriculotomy
- Author
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Jooncheol Min, Woong-Han Kim, Jae Hong Lim, Eung Re Kim, and Jae Gun Kwak
- Subjects
Male ,medicine.medical_specialty ,Surgical strategy ,One year follow up ,030204 cardiovascular system & hematology ,Ventriculotomy ,03 medical and health sciences ,0302 clinical medicine ,Patient age ,medicine ,Humans ,Tetralogy of Fallot ,Pulmonary Valve ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,medicine.disease ,Pulmonary Valve Insufficiency ,Surgery ,Pulmonary Valve Stenosis ,Stenosis ,medicine.anatomical_structure ,030228 respiratory system ,Echocardiography ,Pulmonary valve ,Child, Preschool ,Female ,Cardiology and Cardiovascular Medicine ,business ,Commissurotomy ,Follow-Up Studies - Abstract
Background We reviewed our revised surgical strategy for tetralogy of Fallot (TOF) total correction to minimize early exposure to significant pulmonary regurgitation (PR) and to avoid right ventriculotomy (RV-tomy). Methods and Results: Since February 2016, we have tried to preserve, first, pulmonary valve (PV) function to minimize PR by extensive commissurotomy with annulus saving; and second, RV infundibular function by avoiding RV-tomy. With this strategy, we performed total correction for 50 consecutive patients with TOF until May 2018. We reviewed the early outcomes of 27 of 50 patients who received follow-up for ≥3 months. Mean patient age at operation was 10.2±5.0 months, and mean body weight was 8.8±1.2 kg. The preoperative pressure gradient at the RV outflow tract and the PV z-score were improved at most recent echocardiography from 82.0±7.1 to 26.8±6.4 mmHg, and from -2.35±0.49 to -0.55±0.54, respectively, during 11.1±1.6 months of follow-up after operation. One patient required re-intervention for residual pulmonary stenosis. Twenty-two patients had less than moderate PR (none, 1; trivial, 8; mild, 13), and 5 patients had moderate PR. There was no free or severe PR. Conclusions At 1-year follow-up, the patients who underwent total TOF correction with our revised surgical strategy had acceptable results in terms of PV function. The preserved PV had a tendency to grow on short-term follow-up.
- Published
- 2018
21. Successful Repair of Critical Tricuspid Regurgitation Secondary to a Ruptured Papillary Muscle in a Neonate
- Author
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Woong Han Kim, Eung Re Kim, Jooncheol Min, Woo Sung Jang, Chan Kyu Yang, and Sungkyu Cho
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Neonatal cyanosis ,medicine.medical_treatment ,Case Report ,Regurgitation (circulation) ,Tricuspid valve surgery ,Neonate ,Tricuspid Valve Insufficiency ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Tricuspid valve insufficiency ,cardiovascular diseases ,Papillary muscle ,Anterior leaflet ,Tricuspid valve ,business.industry ,Surgery ,medicine.anatomical_structure ,Papillary muscles ,Cardiothoracic surgery ,Cardiology ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business - Abstract
Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report a neonate with profound cyanosis and severe tricuspid regurgitation caused by a rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. The repair of the tricuspid valve was performed after initial stabilization by using extracorporeal membrane oxygenation.
- Published
- 2014
22. Postoperative Life-Threatening Recurrent Ventricular Arrhythmia Triggered by the Swan-Ganz Catheter in a Patient Undergoing Off-Pump Coronary Artery Bypass Surgery
- Author
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Se Jin Oh, Yong Won Seong, Jae Sung Choi, Hyeon Jong Moon, Jooncheol Min, and Jeongsang Lee
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Pulmonary artery catheter ,Case Report ,Swan Ganz Catheter ,Surgery ,Hemodynamic compromise ,Catheter ,Intensive care ,cardiovascular system ,Medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Arrhythmia ,Swan-Ganz catheter ,Off-pump coronary artery bypass - Abstract
Recurrent ventricular arrhythmia can be fatal and cause serious complications, particularly when it is caused immediately after an operation. Incorrect placement of a Swan-Ganz catheter can trigger life-threatening ventricular arrhythmia, but even intensive care specialists tend to miss this fact. Here, we report a case of recurrent ventricular arrhythmia causing a severe hemodynamic compromise; the arrhythmia was induced by a severely angulated Swan-Ganz catheter. The recurrent ventricular arrhythmia was not controlled by any measures including repositioning of the catheter, until the complete removal of the Swan-Ganz catheter. It is necessary to keep in mind that the position of the pulmonary artery catheter should be promptly checked if there is intractable recurrent ventricular arrhythmia.
- Published
- 2014
23. Successful Surgical Treatment of Cardiac Complication of Graves Disease
- Author
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Eun Seok Choi, Kwangho Choi, Woo Sung Jang, Sungkyu Cho, Jooncheol Min, and Woong-Han Kim
- Subjects
Pulmonary and Respiratory Medicine ,endocrine system ,medicine.medical_specialty ,endocrine system diseases ,Medical treatment ,business.industry ,Graves' disease ,Early detection ,Case Report ,2. Arrhythmia ,medicine.disease ,Surgery ,Heart failure ,Cardiac complication ,cardiovascular system ,medicine ,Proper treatment ,3. Graves disease ,Thyroid function ,Cardiology and Cardiovascular Medicine ,Surgical treatment ,business ,1. Heart valve disease - Abstract
Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.
- Published
- 2014
24. Iatrogenic Mitral Regurgitation After Muscular Ventricular Septal Defect Repair Detected by Transesophageal Echocardiography in a Pediatric Patient
- Author
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Jae Gun Kwak, Ji Hyun Lee, Young Eun Jang, Hee-Soo Kim, Eun Hee Kim, Jooncheol Min, and Jin-Tae Kim
- Subjects
Heart Septal Defects, Ventricular ,Male ,medicine.medical_specialty ,Iatrogenic Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Text mining ,030202 anesthesiology ,Internal medicine ,MUSCULAR VENTRICULAR SEPTAL DEFECT ,medicine ,Iatrogenic disease ,Humans ,Mitral regurgitation ,Heart septal defect ,business.industry ,Infant ,Mitral Valve Insufficiency ,General Medicine ,medicine.disease ,Pediatric patient ,Cardiology ,business ,Echocardiography, Transesophageal - Published
- 2018
25. Efficacy of Cox Maze IV Procedure Using Argon-Based Cryoablation: A Comparative Study with N2O-Based Cryoablation
- Author
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Ho Young Hwang, Jun Sung Kim, Kyung Hwan Kim, Jooncheol Min, and Kyung Hak Lee
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Arrhythmia surgery ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,Cryoablation ,Odds ratio ,Ablation ,medicine.disease ,Cryosurgery ,Surgery ,Clinical Research ,Anesthesia ,medicine ,Sinus rhythm ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Energy source ,Arrhythmia - Abstract
Background: We compared the mid-term results of the Cox maze IV procedure using argon-based cryoablation with a procedure using N 2 O-based cryoablation. Methods: From May 2006 to June 2012, 138 patients (mean age, 58.2±11.0 years) underwent the Cox maze IV procedure. Eighty-five patients underwent the maze procedure using an N 2 O-based cryoprobe (group N), and 53 patients underwent the maze procedure using an argon-based cryoprobe (group A). Bipolar radiofrequency ablation was concomitantly used in 131 patients. The presence of atrial fibrillation immediately, 6 months, 1 year, and 2 years after surgery was compared. Results: Early mortality occurred in 6 patients (4.3%). There were no differences in early mortality or postoperative complications between the two groups. Nineteen of 115 patients (16.5%) remained in atrial fibrillation at postoperative 12 months (14 of 80 patients (17.5%) in group N and 5 of 35 patients (14.3%) in group A, p=0.669). There were no differences in the number of patients who remained in atrial fibrillation at any of the time periods except in the immediate postoperative period. A multivariable analysis revealed that the energy source of cryoablation was not associated with the presence of atrial fibrillation at 1 year (p=0.862) and that a fine F wave (<0.1 mV) was the only risk factor predicting the presence of atrial fibrillation at 1 year (p<0.001, odds ratio=20.287). Conclusion: The Cox maze IV procedure using an argon-based cryoprobe was safe and effective compared with the maze procedure using an N 2 O-based cryoprobe in terms of operative outcomes and the restoration of sinus rhythm for up to 2 years after surgery.
- Published
- 2013
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