• Title/Summary/Keyword: 흉부 대동맥 혈관내 치료

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Retrograde Aortic Dissection after Thoracic Endovascular Aortic Repair for Descending Aorta - 2 case reports- (하행 대동맥 내 스텐트-도관 삽입 후 발생한 역행성 대동맥 박리 - 2예 보고 -)

  • Hong, Soon-Chang;Kim, Jung-Hwan;Lee, Hee-Jeong;Youn, Young-Nam
    • 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.

Aorta-esophageal Fistula That Developed after Endovascular Stent-grafting of a Mycotic Aneurysm - A case report- (감염성 대동맥류에 혈관 내 스텐트 삽입 시행 후 발생한 대동맥-식도루 - 1예 보고 -)

  • Nam, Jin-Hae;Park, Kay-Hyun;Yoo, Jae-Suk;Lee, Jae-Hang;Lim, Cheong;Jheon, Sang-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.781-784
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    • 2010
  • A 74-year-old woman presented at our hospital with hemoptysis. Three months ago, she had endovascular stent-grafting done by a general surgeon for a saccular thoracic aneurysm that was found accidentally following an episode of fever and chills. Despite a lasting fever after the procedure, she was discharged without further treatment and follow-up. She was subsequently admitted to the hospital for evaluation and several exams were performed. Chest CT scans and an esophagoscopy identified an aorto-esophageal fistula at the level of the aorta that was covered by a previous stent-graft. After extensive administration of antibiotics, surgery was done - esophagectomy, cervical esophago-gastrostomy and replacement of the thoracic aorta. She was later discharged uneventfully.

Treating a Ruptured Ascending Aorta with an Endovascular Stent Graft (상행 대동맥 파열에서 혈관내 스텐트 그라프트를 이용한 치료)

  • Kim, Gwan-Sic;Lee, Taek-Yeon;Kim, Joon-Bum;Lee, Seung-Hyun;Kim, Hee-Jung;Cho, Won-Chul
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.92-95
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    • 2010
  • Endovascular stent grafting is regarded as a promising alternative approach to open surgical repair for treating various aortic diseases in high risk patients. We report here on a case of a 79-year-old female who underwent endovascular stent-graft insertion in the ascending aorta for treating a complicated ascending aortic rupture that occurred secondary to radiation necrosis during the treatment of recurrent breast cancer.

Aortic Arch Debranching and Antegrade Stent Graft Placement in an Expanding Distal Dissecting Aneurysm after Repair of an Acute Type I Aortic Dissection (Type I 급성 대동맥 박리 수술 후 진행하는 원위부 박리성 동맥류에 대한 대동맥궁 탈분지술과 전향적 대동맥궁 스텐트 그라프트의 설치)

  • Baek, Wan-Ki;Kim, Young-Sam;Lim, Hyun-Kyoung;Yoon, Yang-Han;Kim, Joung-Taek;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.729-733
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    • 2010
  • Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.

Primary Aortoesophageal Fistula - A case report - (원발성 대동맥-식도 누공 - 1예 보고 -)

  • Kim, Dae-Hyun;Kim, Bum-Shik
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.520-522
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    • 2008
  • Aortoesophageal fistula that causes massive bleeding from the esophagus is a rare and fatal disease. The most common cause of aortoesophageal fistula is an aortic aneurysm, and the other causes are inflammatory disease and neoplasm. The treatment of choice for aortoesophageal fistula is surgery, and this surgery carries a high rate of mortality and morbidity. Stent-graft treatment is now being applied for this malady. Herein we report on a case of primary aortoesophageal fistula that was treated with primary repair of the fistula openings, and we include a review of the relevant literature.

Use of Percutaneous Endovascular Stent Graft in Patients with Thoracic Aortic Aneurysm (흉부대동맥류 환자에서 경피적 인조혈관 스텐트의 사용)

  • Geon Yong Sun;Baek Wan Ki;Yoon Yong Han;Kim Young Sam;Kim Kwang Ho;Kim Joung Taek
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.157-161
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    • 2006
  • Use of endovascular stent-graft in aortic aneurysm disease is now accepted as an alternative treatment to surgery. We successfully treated two patients with high risk of thoracic aortic aneurysm with percutaneous endovascular stent-graft. Three and ten months follow up chest CT showed obliteration of aneurysm and there was no complication after stent grafting.

Aorto-Esophageal Fistula Complicated by Esophageal Metalic Stent -A case report- (식도 내 금속 스텐트 삽입 후 발생한 대동맥 식도 누공 -치험 1례-)

  • 윤영철;조광현;김기봉;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.479-482
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    • 2002
  • Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

Management for the Newly-Onset Aneurysmal Dilation of the Distal Aorta after an Endovascular Stent Graft Procedure for the Patient with Acute Aortic Dissection Type IIIb (급성 하행대동맥 박리증에서 스텐트-그라프트 삽입 후 새로이 발생한 원위부 대동맥류에 대한 인조혈관 대치술 치험 1예)

  • 이길수;방정희;조광조;성시찬;우종수
    • 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.

Surgical Therapy of Stanford Type A Acute Aortic Dissection -Dose intimal tear within replaced aortic segment make any difference in its clinical characteristics- (Stanford A형 급성 대동맥박리증의 외과적 치료 -내막 파열점 위치에 따른 임상경과의 차이-)

  • 조광조;우종수;성시찬
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.125-132
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    • 2001
  • 배경 및 목적: Stand A형 급성대동맥박리증의 박리 시발점이 수술치환부위 내에 있는 경우와 그렇지 않은 경우의 임상적 차이점을 분석하여 치료에 도움을 주고자 하였다. 방법: 1991년 3월부터 1999년 7월까지 본원에서 급성상행대동맥박리증으로 진단되어 상행대동맥치환술을 받은 40명의 환자를 대상으로 병력기록을 근거로 수술 소견 상 찢어진 부위를 발견한 환자 27명을 1군, 발견 못한 나머지 13명을 2군으로 나누고 환자의 술 전 상태와 수술소견 및 술후 경과의 임상적 차이점을 분석하였다. 결과: 1군에서 술전에 저혈압, 대동맥판막부전, 심허혈, 신부전 등이 더 많이 발생되었다. 수술 소견 상 대동맥근부 이상은 1군에서 많았다. 가성 내강 내 혈종은 2군에서 더 많이 관찰되었지만 통계적으로 유의하지는 않았다. 술후에 2군에서는 신부전이 더 많이 발생하였고 술후 출혈로 인한 재수술은 1군에서 더 많았다. 조기 수술사망은 1군에 6명으로 사망률은 22.2%이었고 2군에는 사망 례는 없었다. 결론: 본 연구를 통하여 상행대동맥에서 내막 파열이 발견된 1군에서는 2군에 비해 술전 상태가 불량하였고 대동맥판막 병변으로 수술이 복잡해져 사망률이 높다고 생각된다. 반면 원위부 하행대동맥에서 박리가 진행되어 상행대동맥으로 이어진 2군에서는 1군에 비해 순환 장애로 인해 술후에 신부전이 더 많이 발생되었다. 결론적으로 상행대동맥내막에 파열점이 없었던 군에서 수술 예후는 상행대동맥내막에 파열점이 있는 군보다 더 좋았다.

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