• Journal of Chest Surgery
• /
• v.30 no.3
• /
• pp.330-335
• /
• 1997

Aspergillus Infection is a major.cause of mortality in individuals with depressed cell-mediated immunity. Despite therapy with intravenous amphotericin B and oral antifungal agents, high mortality has been reported among heart transplant recipients. We experienced two cases of pulmonary aspergillosis among 15 heart transplantation cases. Both cases were similiar in terms of age, time of diagnosis, and medication. Percutaneous needle aspiration biopsy revealed Aspergillus fumigatus in both cases. The thirst case showed multiple aspergilloma on both lung fields and were treated by IV Amphotericin B and oral itraconazole. After completion of treatment, the lesion completely disappeared and he has been followed up for more than one year in his good condition. The second case showed a single nodule on his right lower lung field and were treated by both medication and surgery. The patient recovered well and had been doing well until 4th postoperative month when he developed humoral rejection and expired.

• Journal of Chest Surgery
• /
• v.38 no.1 s.246
• /
• pp.67-71
• /
• 2005

The major etiology of superior vena cava (SVC) syndrome is malignancy. Radiologic endovascular intervention is the treatment of choice for patients with SVC syndrome due to malignant disease, which is unresponsive to radiation therapy and chemotherapy. However, it is not clear whether endovascular intervention can replace open surgery as the primary method of management of benign SVC syndrome. We report two cases of benign SVC syndrome resulting from dialysis catheters placed in the central veins. One patient underwent bypass surgery between innominate vein and right atrium by expanded polytetrafluoroethylene. Another patient had large thrombi in SVC and other central veins. We removed them under cardiopulmonary bypass to prevent pulmonary embolism, and SVC was repaired and augmented by autologous pericardium. Prompt symptomatic relief and angiographic improvements of collateral flow were achieved in both patients.

• Journal of Chest Surgery
• /
• v.43 no.3
• /
• pp.273-279
• /
• 2010

Background: The benefit of superior vena cava (SVC) resection in thoracic malignancies remains controversial. We analyzed the results of extended resection in patients with thoracic malignancy involving the SVC. Material and Method: From March 2000 to March 2009, we performed surgical resection and reconstruction in 18 thoracic malignancies involving the SVC. Ten male and 8 female enrolled and their mean age was 56 years. Result: SVC reconstruction was performed in 9 patients with polytetrafluoroethylene (PTFE) graft. Primary closure was possible in 6 patients by partially clamping the SVC. Patch angioplasty was performed in 3 patients with PTFE or autologous pericardial patch. Three-year survival was 58.0% and median survival time was 24.5 months. Disease specific survival and recurrence free survival were not significantly different between lung cancer and mediastinal malignancy. Obstruction of graft was detected in 4 patients during follow-up; SVC graft obstruction in 1 patient, and accessory graft between the innominate vein and right atrium in 3 patients. Conclusion: Extended resection of thoracic malignancies involving the SVC was a feasible method in selected patients. Although the morbidity rate was relatively high, mid-term survival was acceptable when complete resection was possible.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.739-742
• /
• 2010

Two stents were placed across the right subclavian vein due to stenosis of the right subclavian vein in a 40-year-old patient with chronic renal failure on hemodialysis. During the follow up period, one of stents migrated into the right ventricle inducing tricuspid valve insufficiency. Percutaneous stent removal had failed and the stent was removed by open heart surgery with Tricuspid valve repair with a good result, and then we report the case.

• Journal of Chest Surgery
• /
• v.29 no.4
• /
• pp.454-457
• /
• 1996

The Incidence of synovial sarcoma Is very low but sarcoma Is a well-defined entity, which occurs primarily around large Joints and usually in association with tendon sheaths, bursae or the capsule. Recently we experienced a case of synovial sarcoma which invaded the right femoral vein of 433 5-year-old man. The tumor was widely excised incl ding the invaded femoral vein, and vein reconstruction was done using saphenous vein graft. The postoperative course was uneventful without intractable edema nor disability.

• Journal of Chest Surgery
• /
• v.39 no.12 s.269
• /
• pp.946-948
• /
• 2006

The patient was a 42-year-old female with breast cancer who had an implantable central venous catheter inserted percutaneously into left subclavian vein for chemotherapy. The postinsertion chest x ray revealed that there was no compressive sigh of catheter. Three months after insertion of the catheter, the patient was admitted to the hospital for 4th chemotherapy. The port was accessed but blood could not be aspirated and the catheter could not be flushed. A chest x ray revealed that the catheter was completely transected at the point where the catheter passed under the clavicle. Percutaneous removal of the distal fragment of the catheter was accomplished. The patient was discharged after successful removal of fragment of catheter.

• Journal of Chest Surgery
• /
• v.31 no.1
• /
• pp.69-72
• /
• 1998

Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4$\times$5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

• Journal of Chest Surgery
• /
• v.43 no.2
• /
• pp.150-155
• /
• 2010

Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.

• Journal of Chest Surgery
• /
• v.35 no.8
• /
• pp.626-629
• /
• 2002

Cavernous hemangioma in mediastinum is a rare tumor. A 13 year old girl was referred becaused of abnormal mediastinal shadow in simple chest X-ray. Chest CT scan revealed a somewhat inhomogenous cystic legion arround the whole length of SVC. Surgical excision was done through the right posterolateral thorachotomy. The pathology was confirmed as cavernous hemangioma.

• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.985-990
• /
• 2003

Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.