• Journal of Chest Surgery
• /
• 제21권3호
• /
• pp.488-496
• /
• 1988

Thirty-seven patients of aortic aneurysm underwent operations during January 1984 December 1987 at our hospital. Twenty-six patients had aneurysms involving ascending aorta, three patients had aneurysms involving both ascending aorta and abdominal aorta. and eleven patients had aneurysms involving descending thoracic or abdominal aorta. Among the patients who had aneurysms involving ascending aorta, annuloaortic ectasia with aortic regurgitation were thirteen and all of these underwent ascending aorta graft replacement + AVR with composite graft. The patients who had aortic regurgitation due to ascending aortic dissection were three and all of these underwent intraluminal ringed graft insertion at ascending aorta + aortic valve resuspension. Intraluminal ringed graft insertion was safe, simple, and fast method in the operation for aortic aneurysm. Eleven patients were underwent this operation and the results were good. Major causes of death of the patients who underwent aortic aneurysm operation are underlying cardiovascular diseases or delayed rupture of the aneurysm or complications related newly appeared aneurysm. Among our patients, dissection progressions were appeared in two but neither severe nor complicated. And no patient died from delayed rupture of aneurysm or complications related newly appeared aneurysm. All patients were followed up via OPD and were controlled hypertension or heart failure if present. Operative mortality is 18.9\ulcornera in all, 23% in patients who had aneurysms involving ascending aorta and 7.6` who had aneurysms involving descending thoracic or abdominal aorta. Comparing with other reports, our operative mortality is still high but improved steadily. So we recommend aggressive surgical management of the aortic aneurysm.

• Journal of Chest Surgery
• /
• 제23권4호
• /
• pp.782-784
• /
• 1990

We present a case of ruptured abdominal aortic aneurysm caused by blunt injury. The patient was 23-year-old soldier injured by a motor vehicle accident. Injuries sustained a contused abdominal aorta. At the time of aortic repair, the involved segment formed huge pseudoaneurysm, and which had intimal tear. Aorto-iliac graft replacement was carried out with a woven-dacron Y-graft prosthesis, which restored satisfactory circulation to both lower limbs. The postoperative course was uneventful.

• Journal of Chest Surgery
• /
• 제44권2호
• /
• pp.142-147
• /
• 2011

Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.

• Journal of Chest Surgery
• /
• 제16권3호
• /
• pp.301-309
• /
• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Chest Surgery
• /
• 제42권5호
• /
• pp.645-648
• /
• 2009

저자들은 우리나라에서는 처음으로 복강경을 이용한 수기보조 방법으로 복부 대동맥류 치환술을 시행하였다. 환자는 67세 남자였으며, 복부 대동맥류의 직경은 약 5.8 cm였다. 첫 단계로 상복부에 6 cm 절개선을 내고, 복강경하에서 집도의의 왼손을 이용하여 대동맥류 주위를 박리하였다. 근위부 문합은 절개창을 통하여 직접 하였으며, 인조혈관의 양쪽 다리를 후복막을 통하여 양족 서혜부에서 총대퇴동맥과 단측문합하였다. 환자는 술 후 6시간 후 경구 식이를 시작하였으며, 술 후 4일째 퇴원하였다.

• Journal of Chest Surgery
• /
• 제50권4호
• /
• pp.263-269
• /
• 2017

Background: Endovascular aneurysm repair (EVAR) has dramatically changed the management of abdominal aortic aneurysms (AAAs) as the number of open aneurysm repairs have declined over time. This report compares AAA-related demographics, operative data, complications, and mortality after treatment by open aneurysm repair or EVAR. Methods: We retrospectively reviewed 136 patients with AAAs who were treated over an 8-year time period with open aneurysm repair or EVAR. Results: The mean age of the EVAR group was higher than that of the open repair group (p=0.001), and hospital mortality did not differ significantly between groups (p=0.360). However, overall survival was significantly lower in the EVAR group (p=0.033). Conclusion: Although EVAR is the primary treatment modality for elderly patients, it would be ideal to set slightly more stringent criteria within the anatomical guidelines contained in the instructions for use of the EVAR device when treating younger patients.

• Journal of Chest Surgery
• /
• 제17권3호
• /
• pp.432-437
• /
• 1984

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.976-986
• /
• 1990

We experienced 12 patients with the abdominal aortic aneurysm during last 31 years [Dec. 1958 \ulcornerSep. 1989]. Among them, 10 patients were reviewed. They were all male. The age ranged from 34 to 80 years with the mean age of 59.4 years. The etiology of the aneurysm was atherosclerotic in 8, mycotic in 1, and aortitis in 1. The location of the aneurysm was infrarenal in 8, and suprarenal in 2 cases. Aneurysmectomy and Dacron Y-graft interposition in 8 cases, and lease with Teflon Y-graft were made. In another 1 case, long thoracoabdominal bypass surgery was made. The operative mortality was 30%[3cases]. The postoperative complications were respiratory complications[3cases], acute renal failure[2cases], bleeding[lease], mechanical ileus[ lease], and peritonitis[lease].

• Journal of Chest Surgery
• /
• 제41권3호
• /
• pp.377-380
• /
• 2008

복부 대동맥류는 수술적 치료가 일반적으로 행해져 왔으나, 최근 스텐트 그라프트가 새로운 치료법으로 소개되고 있다. 본 병원에서 고혈압, 뇌졸중으로 및 신기능의 저하 등으로 거동이 불가능한 고위험 군의 복부대동맥류 환자에서, 흉부외과의사가 스탠트 그라프트를 시행한 경험을 하였기에 보고하는 바이다.

• 대한기계학회:학술대회논문집
• /
• 대한기계학회 2001년도 춘계학술대회논문집E
• /
• pp.560-565
• /
• 2001

The objective of the present study is to investigate the characteristics for flow and wall shear stress in the aneurysm which is a local dilatation of the blood vessel. The numerical simulation using the commercial software for the laminar and steady flow were carried out over the diameter ratios(ratio of maximum diameter of aneurysm to the diameter of blood vessel) ranging from 1.5 to 2.5 and Reynolds number ranging from 900 to 1800. It was shown that a recirculating vortex occupied the entire bulge with its core located closer to the distal end of the bulge and the strength of vortex increased with increase of the Reynolds number and diameter ratio. Especially, for the Reynolds number of 1800 and diameter ratio of 2.5, the very weak secondary recirculating flow was produced at the left upper of the aneurysm. The position of a maximum wall shear stress was the distal end of the aneurysm(z=18mm) regardless of the Reynolds number and diameter ratios. But the maximum values of the wall shear stress increased in proportion to the increase of Reynolds number and diameter ratio.