• Journal of Chest Surgery
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• v.43 no.6
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• pp.778-780
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• 2010

A 48-year-old female complained of edema and pain in her left neck. She underwent acupuncture therapy for 1 month in a local oriental medicine clinic because of her arm pain. Computer tomography showed left internal jugular vein thrombosis. The patient's condition improved after antibiotic medication and anticoagulation. The patient is currently in outpatient department follow-up and doing well. To the best of our knowledge, this is the first report of an internal jugular vein thrombosis secondary to acupuncture.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.70-74
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• 1999

Thrombosis in valve or left atrium after mechanical mitral valve replacement causes prosthetic valve dysfunction or thromboembolism. Early and adequate therapy is very important but clinically not easy. Thrombolysis can avoid reoperation-related risks and act as an optimal therapy for prosthetic valve thrombosis. This report describes three patients who were treated by using low molecular weight heparin (LMWH) and wafarin. Two patients, including one pregnant woman, had prosthetic valve thrombosis and immobility of valve leaflets, and one patient with recent cerebral infarction due to thromboembolism had thrombus in left atrium. Fraxiparine 0.3 cc (7,500 ICU AXa) was administrated subcutaneously twice or triple daily. At discharge, thrombosis in valve and left atrium were completely or near totally lysed and valve leaflets were normally mobile. During the period of thrombolysis and follow up, there were no complications in all patients.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.132-135
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• 2007

A right atrial thrombus in structurally normal heart is very rare. A 66-year-old woman was admitted with chest discomfort and dyspnea. She was diagnosed of right atrial myxoma on echocardiography and chest computed tomography, We peformed an excision of the mass attached to atrial septum, which was found to be an organized mural thrombus by pathologic examination. We report this rare case with a review of literature.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.600-604
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• 2010

A ten-year-old female mongrel dog was presented to Veterinary Medical Center, Chungbuk National University with the signs of anorexia, weakness, and hemoglobinuria. Patient had been diagnosed as dirofilariasis based on heartworm antigen test and treated with adulticide (melarsomine) at local hospital one day before admission. On laboratory examinations, there were hypochromic and microcytic regenerative anemia, thrombocytopenia, moderate neutrophilia, and increase ALT, AST, and ALP. Radiographic exam showed main pulmonary artery bulging, pulmonary infiltration and hypervascularity, reduced abdominal serosal detail and mild hepatomegaly. Abdominal ultrasonographic exam showed mild peritoneal effusion and large hyperechoic thrombi at trifurcation of the porta hepatica and the splenic vein. In addition, intraluminal low density area and intravascular filling defect were confirmed on contrast enhanced CT scanning at the same anatomic locations. Patient was treated with anticoagulant and thrombolytic therapy. On day 42 after treatment, complete resolution of thrombi was confirmed via ultrasonography and improvement of clinical signs was observed.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.202-205
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• 2003

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.911-917
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• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.448-451
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• 2004

Report of right atrial thrombus complicating pulmonary embolism after cardiac surgery is rare. A 54-year-old woman operated on the atrial septal defect 10 months ago was admitted for left pleuritic pain and dyspnea. Multiple segmental perfusion defects were detected in lung perfusion scan. Transesophageal echocardiography showed a large mobile right atrial mass attached to the free wall of the right atrium with a stalk. Despite the intravenous heparinization for 13 days, follow-up echocardiography revealed the right atrial mass had not diminished in size. The mass which was confirmed as an organizing thrombus was excised under cardiopulmonary bypass. The patient recovered uneventfully and was discharged on warfarin therapy.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.475-478
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• 2002

A 45 year old man was admitted for aggravated dyspnea, abdominal distension and poor oral intake. On Echocardiogram, mitral stenosis(severe), tricuspid regurgitaion(IV), and LA thrombus were diagnosed. We used heparin with continuous infusion for prevention of systemic thrombo embolism. On the 11th day of admission, the patient showed thrombocytopenia and we suspected Heparin-induced thrombocytopenia. Hirudin was used in this case as alternative anticoagulant during cardiopulmonary bypass to prevent serious complication of heparin. The patient was recovered without any complication as postoperative bleeding or systemic thromboembolism.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.677-683
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• 2009

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1010-1014
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• 2004

Though acute pulmonary thromboembolism is usually managed medically with the use of thrombolytics or anticoagulants, an emergent life-saving surgery would be required. In a case of acute pulmonary thromboembolism with acute severe right heart failure and deferment of it could result in fatal outcomes in a short time. In addition, the mortality is raised considerably if it is combined with right heart thrombi. Despite paradoxical thromboembolism via patent foramen ovale was reported, few report might be presented, in which showed the thrombus in right atrium has traversed atrial septal defect into left atrium and left ventricle like this case as the evidence of paradoxical thromboembolism. We report a case of acute pulmonary thromboembolism with acute right heart failure arising from deep vein thrombosis, developed immediately after low anterior resection for colon cancer in a 63-year-old male, who was managed successfully by emergent thromboembolectomy with cardiopulmonary bypass.