• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.782-785
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• 2006

Chronic pulmonary obstructive disease is known to be a significant risk factor for mortality in patients who under-went operation for abdominal aortic aneurysm. To decrease perioperative respiratory complication in these patients, maintenance of self respiration as possible is one of the better method. A seventy-seven year old male patient complained of abdominal pain and he was diagnosed for 9 cm sized abdominal aortic aneurysm. But he had severe chronic obstructive pulmonary disease which was expected to increase surgical mortality. So we introduced epidural anesthesia with maintenance of self respiration and performed surgical resection and graft replacement of abdominal aorta, and he recovered without any complication.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.261-266
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• 2003

Background: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years' experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. Material and Method: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center Mean age was $62.8{\pm}12.7$ and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was $8.8{\pm}2.4$cm. Result: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p<0.05), preoperative BUN level (p<0.05), and DM (p<0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was $3.6{\pm}0.2$ years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed $81.7{\pm}7.6$% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. Conclusion: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.648-650
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• 2001

Bleeding from anastomotic site in operation for aorta has been troublesome, because it has influence on postoperative morbidity and mortality. Therefore, hemostasis is very important. We describe a simple and effective method for achieving hemostasis of the anastomotic site in aortic surgery. By wrapping around anastomotic site with remnant artificial vascular graft, we have acquired good results.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.520-523
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• 2009

Aortic arch aneurysm generally requires an urgent treatment due to the risk of catastrophic aortic rupture. However conventional surgery for aortic arch repair still carries significant risks of postoperative morbidity and mortality, especially in patients with old age. In an effort to correct the aortic pathology while minimizing the risks of complication, we performed a hybrid technique which comprises the off pump arch aortic stent grafting in an 86-old male patient with an aortic arch aneurysm.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.564-568
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• 1996

Pseudoaneurysm of the ascending aorta following cardiac surgery is very unusual and it is poten- tially fatal. We report here a fourteen year-old female patient with pseudoaneurysm of the ascending aorta following a repair of a congenital ventricular septal defect at other hospital 50 months ago. Although she had a mild superficial wound infection postoperatively, she enjoyed uneventful. life until she visited our hospital for a generalized weakness and exertional dyspnea which developed a month ago. Chest CT and echocardiogram showed partially calcified pseudoaneurysm of the ascending aorta. Two aortic defects were located on the anterolateral ascending aortic wall wkere it was suspected as a previous sites of aortic and cardioplegic cannulation. The internal wall of the pseudoaneurysm was covered with neoendothelium and intervened by septal tissue. Two defects on he aortic wall were oval in shape and about 1.5cm in the greatest diameter The defects were trimmed to make a one large de- fect and it was reconstructed with patch designed from 22mm collagen impregnated double velour Dacron graft. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.427-430
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• 2003

The surgical managements for the complicated aortic disease is still one of most challenging fields for the cardiac surgeons. The endovascular stent graft procedure has been tried recently to avoid serious complications caused by traditional graft replacement technique. However, indications for the procedures or management methods for the complications have not been clearly elucidated so far. We report a case of successful management for the newly-onset aneurysmal dilation of the distal aorta after an endovascular stent graft procedure in a patient with acute aortic dissection type IIIB.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.178-181
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• 1998

Among the late postoperative complications of the acute dissection of aorta, the fistula between dilated distal aorta and pulmonary parenchym is so rare that only few case have been reported sporadically. Although the aortopulmonary fistula is one of a fatal condition that needs prompt surgical intervention, with an appropriate management it is well controllable condition. Early diagnosis and urgent surgical intervention is the only way to prevent catastrophic hemorrhage. We experienced a surgical management of aortoplumonary fistula which occurred between upper lobe of the left lung and distal aortic dilatation of previous aortic bypass graft which was performed for Debakey type I acute aortic dissection.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.336-339
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• 1997

The surgical treatment of diseases of thoracic aorta has had much better success rate in recent years compaired to the past. Aortic aneurysms or dissections that extend along the entire thoracic aorta are usually approached in two or three stages. Recently we successfully perfofm d one-stage aortic replacement from the aortic root to the abdominal aorta in chronic DeBakey type I dissection. A 25 year-old man who had dyspnea on exertion (NYHA Fc II) and a Marfanoid feature was operated under the diagnosis of chronic type I dissection with severe aortic regurgitation. ' At operation, a huge ascending aorta with two intimal tearings was seen and the blood supply of intercostal arteries and right renal artery was done from the false lumen. Modified Bentall operation with total aortic replacement was done successfully, and the patient is being followed-up without major complications.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.159-168
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• 2012

The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.758-763
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• 2010

In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.