Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Surgical Treatment of Occluded Aberrant Left Subclavian Artery with Right-sided Aortic Arch -A case report-

우측 대동맥궁을 가진 환자에서 이상 기시된 좌쇄골하 동맥 폐색의 수술적 치료 - 1예 보고

  • Cho Yang Hyun (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Ryu Se Min (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Kim Hyun Koo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Cho Jong Ho (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Sohn Young-sang (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Choi Young Ho (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University) ;
  • Kim Hark Jei (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University)
  • 조양현 (고려대학교 의과대학 흉부외과학교실) ;
  • 류세민 (고려대학교 의과대학 흉부외과학교실) ;
  • 김현구 (고려대학교 의과대학 흉부외과학교실) ;
  • 조종호 (고려대학교 의과대학 흉부외과학교실) ;
  • 손영상 (고려대학교 의과대학 흉부외과학교실) ;
  • 최영호 (고려대학교 의과대학 흉부외과학교실) ;
  • 김학제 (고려대학교 의과대학 흉부외과학교실)
  • Published : 2005.03.01
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Abstract

A 57-year-old man with numbness and paresthesia of left arm is presented. There was no pulse in the left arm was absent and his chest radiograph suggested right-sided aortic arch. The aortogram showed right-sided aortic arch with Kommerell's diverticulum. The proximal portion of left subclavian artery was totally occluded and blood was being supplied through vertebral arteries to distal subclavian artery. He underwent bypass grafting between both subclavian arteries by an expanded polytetrafluoroethylene graft. Because the size of Kommerell's diverticulum was small, it need to be observed closely.

57세 남자가 3년 전부터 발생한 좌측 팔의 통증과 감각이상을 주소로 내원하였다. 환자는 경미한 연하곤란을 호소하는 것 이외에 다른 증상은 얼었다. 좌측 팔의 동맥압은 촉지되지 않았으며, 흉부방사선 사진상 우측 대동맥궁이 의심되었다. 대동맥 조영술 상에서 우측 대동맥궁과 Kommerell 게실이 관찰되었고 좌쇄골하 동맥은 기시부의 완전 폐색을 보였으며 혈류는 척추 혈관을 통해 우회하여 쇄골하동맥에 공급되고 있었다. 전신마취 하에 우측 쇄골하 동맥으로부터 8 m 인조혈관을 이용하여 좌쇄골하 동맥에 연결하였다. Kommerell 게실은 크기가 작아 추적 관찰하기로 하였다.

Keywords

References

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