• Journal of Chest Surgery
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• 제16권3호
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• pp.301-309
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• 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
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• 제46권6호
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• pp.467-470
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• 2013

The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.

• Journal of Chest Surgery
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• 제48권1호
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• pp.1-6
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• 2015

Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

• Journal of Chest Surgery
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• 제47권4호
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• pp.413-415
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• 2014

The superficial femoral artery (SFA) is a relatively rare location for lower limb aneurysmatic disease. In the literature, this disease is described an association between a relatively high growth rate and/or the rupture of aneurysms and chemotherapeutic agents. We report a case of the rupture of a giant SFA aneurysm in a patient during chemotherapy for acute lymphatic leukemia.

• Journal of Chest Surgery
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• 제48권3호
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• pp.202-205
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• 2015

Formation of an aneurysm in the sinus of Valsalva of the aortic root is usually due to an area of congenital weakness in its wall. This aneurysm may progressively dilate and rupture into any of the cardiac chambers or into the pericardial cavity. Though this is conventionally treated by surgery, interventional therapy using various closure devices is becoming more common. Embolization of these closure devices may occur. We report a case of embolization of such a device into the left pulmonary artery which during surgical retrieval, unmasked the hidden ventricular septal defect (VSD). Therefore one has to be cautious while making a diagnosis of rupture of the sinus of Valsalva of right coronary sinus without VSD.

• 한국전산유체공학회:학술대회논문집
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• 한국전산유체공학회 2008년도 춘계학술대회논문집
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• pp.10-12
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• 2008

Hemodynamic features of blood flow in the abdominal aorta aneurysm (AAA) are very important, because they are closely related with the rupture of aneurysm to death. It has been considered that the wall shear stress of blood flows influences the formation, growth, and rupture of AAA. On this account, it is important to understand the flow structure of blood in the aneurysm. In this study, the whole velocity field information inside a typical AAA was measured using an in vitro AAA model under the pulsatile flow condition. The vessel geometry was reconstructed based on the computerized tomography (CT) data of a patient. The AAA model was made by using a rapid prototyping (RP) method, based on the reconstructed vessel geometry. Velocity fields in the AAA model were measured at different pulsatile phases using a PIV (particle image velocimetry) system. As experimental results, a large-scale vortex is formed inside the AAA model and the vortices located near the AAA wall are supposed to increase the local pressure and wall shear stress. In this study, the AAA wall stress found to be was one of the most important governing parameters giving rise to the ruptured aneurysm.

• Journal of Chest Surgery
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• 제38권10호
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• pp.693-698
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• 2005

배경: 발살바동류(Sinus Valsalva Aneurysm, SVA)는 드문 질환으로, 심실중격결손증과 대동맥판막 궤쇄부전 등이 흔하게 동반되는 것으로 알려져 있다 이에 대한 치료로는 여러 가지 접근 방법을 통한 수술 기법이 시도되고 있지만 국내에서의 수술 치료 후 장기적인 결과는 보고된 바가 없다. 저자들은 지난 30년간 발살바동류 및 발살바동 파열로 수술 받은 환자들의 임상 기록을 고찰하여, 발살바동류 및 발살바동 파열의 수술 후 장기 성적을 살펴보았다. 대상 및 방법: 1974년 3월부터 2002년 2월까지 연세대학교 심장혈관병원에서 SVA 및 파열로 수술을 시행한 81명을 대상으로 후향적인 조사를 시행하였는데, 환자들의 평균 나이는 $29.2\pm1l.5$세였고 남자가 49명이었다. SVA에 동반된 심장 기형으로는 VSD가 50예, 동맥관 개존증과 Bechet's병이 각각 2예, 활로 4증후군, 우심실유출로 협착 그리고 대동맥륜 확장이 각각 1예에서 있었다. 77명$(95\%)$의 환자들에서 SVA의 파열이 있었으며, 14명의 환자들에서 아급성 세균성 심내막염이 동반되어 있었다. 대동맥판막 폐쇄부전은 grade I: 8명, II: 10명, III: 9명, IV: 4명에서 발견되었다. 발살바동류는 우관상동 부위에서 66예$(81\%)$로 가장 많이 발견되었으며, 발살바동류의 파열은 우심실과의 교통이 가장 많았다(53/77). 수술은 첨포를 사용한 경우가 37예, 직접 봉합을 한 경우가 38예, 기타의 방법이 1예 있었다. 결과: 수술 사망이 1명 있었다(수술 사망률=$1.2\%$). 환자들의 추적관찰은 2명을 제외한 78명에서 가능하였는데(추적률=$97.5\%$), 평균 추적기간은 $123.3\pm80.9 (3\~330)$개월이었다. 추적 기간 중에 3명의 환자가 사망하였으며(사망률=$3.8\%$), 1명의 환자는 심부전으로, 1명의 환자는 부정맥으로 사망하였으며, 1명의 환자는 원인을 알 수 없이 사망하였다. SVA수술 후 2명의 환자에서 추적 기간 중에 완전 방실차단이 발생하였으며, SVA수술과 관련하여 재발한 경우는 없었다. Kaplan-Meier 방법에 의한 생존율은 15년과 27년에 각각 $92.5\pm3.5\%$로 매우 양호한 결과를 나타내었다. 결론: 발상바동류 및 파열의 수술 결과는 매우 양호하였으며, 장기간의 생존율도 만족할 만하였다.

• 한국전산구조공학회논문집
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• 제33권3호
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• pp.179-186
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• 2020

본 연구에서는 복부대동맥류가 발생한 환자들에서의 연령과 복부대동맥류 형상에 따른 벽 응력과 파열 위험성을 평가하였다. 복부대동맥류의 형상은 의료영상 데이터로부터 추출되어 모사되었으며, 재료 물성치 단계에서는 동맥 조직의 이방성 초탄성 성질을 모사하기 위해 Gasser-Ogden-Holzapfel 모델을 적용하였다. 또한, 모델에서 필요한 각 재료 정수들은 환자들의 연령과 정상 조직 및 동맥류 조직의 특성들을 고려하기 위하여 각기 다른 값들로 산정되었다. 게다가 복부대동맥류에서의 대동맥 직경과 목의 각도에 관한 상관관계를 분석하고, 이에 대한 시리즈 시뮬레이션 역시 수행되었다. 그 결과, 복부대동맥류 환자의 연령과 대동맥 직경, 그리고 대동맥 목의 각도에 따른 복부대동맥류의 파열 위험성이 평가되었다.

• 대한한방내과학회지
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• 제44권5호
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• pp.1050-1061
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• 2023

This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

• Journal of Chest Surgery
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• 제14권1호
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• pp.63-66
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• 1981

True aneurysm of the carotid artery is relatively rare in comparison with the total number of aneurysms of the arterial system. The threat of rupture and embolization from mural thrombi are indications for treatment even though no symptoms may be present. Resection of the aneurysm and restoration of arterial continuity is the treatment of choice. A case of aneurysm of the Lt. common carotid artery of a 21 year-old male patient is presented. The confirmatory diagnosis was made by left carotid angiogram, and the aneurysmectomy & reconstruction with woven dacron vascular prosthesis was done, while cerebral circulation was maintained by internal shunt.