• Journal of Chest Surgery
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• v.43 no.5
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• pp.546-549
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• 2010

A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.304-307
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• 1998

Aneurysm of the sinus of Valsalva on mostly congenital disease that develops more frequently in Orientals, is very low in incidence. In most cases, aneurysm of the sinus of Valsalva extends to intracardiac and results in ruptures into the right ventricle or atrium. The likelihood of extracardiac aneurysm of the sinus of Valsalva is very low. Cases of extracardiac aneurysm are usually accompanied by aortic regurgitation and can cause right ventricle outflow tract obstruction, myocardial ischemia, and myocardial infarction due to compression by aneurysm. Since the aneurysm can rupture in the intrapericardium and cause cardiogenic shock or sudden death, definite diagnosis and management are important. If confirmed, it is preferable operform a surgical correction. We report here, with a literature review, a case where myocardial ischemia and aortic egurgitation caused by aneurysm developed in the left coronary and noncoronary sinus, and were surgically corrected with satisfactory esults.

• Journal of Korean Neurosurgical Society
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• v.43 no.2
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• pp.117-118
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• 2008

Aortic abdominal aneurysm rarely has been reported as causing osteolytic lesions of the spine. It may produce back and radiating pain patterns similar to those of several commonly encountered neurosurgical processes. We report a uncommon complication of huge pulsating aortic aneurysm causing severe vertebral erosion with incapacitating back and radiating pain.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.167-170
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• 2014

Herein, we present a case of a successful treatment of persistent type 2 endoleaks associated with aneurysmal sac enlargement after endovascular aneurysm repair in an elderly patient. We confirmed the diagnosis by abdominal computed tomography and selective angiography revealing an 11.0-cm aneurysm sac with type 2 endoleaks. An attempt for the endovascular embolization of collateral arteries was unsuccessful due to anatomic variations and their multiple complex communications. Instead, transperitoneal sacotomy and direct suturing on the feeding target vessels was successfully performed without any endograft damage. In conclusion, sacotomy appears to be a feasible therapeutic substitute where endovascular or other techniques have a high risk of failure and lead to unsuccessful 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.32 no.9
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• pp.831-834
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• 1999

The Kawasaki disease has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The Kawasaki disease rarely affects adults and accordingly, there have been only a few cases reported in literatures. The present case describes a successful surgical treatment of a 43-year-old female patient with coronary artery aneurysm and stenosis, which resulted from an episode of the Kawasaki disease that occurred 20 years earlier. The patient was well at 5 months followup.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.918-922
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• 2000

Objective : The authors analyzed the results of management outcomes for basilar bifurcation aneurysms treated with transcranial surgery and endovascular surgery. Methods : At the authors' institution between May 1989 and December 1998, 47 aneurysms with 45 patients were treated with transcranial surgery including surgical clipping/wrapping and endovascular surgery for basilar bifurcation aneurysms. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : Of the 45 patients, 87 percent of the aneurysms were ruptured and 13% unruptured. Forty six percent of the patients had multiple aneurysms including basilar bifurcation aneurysm. Of the 39 patients with subarachnoid hemorrahge, 77% were in good neurological status(Hunt Hess grade I-III), 23% were in poor grade(H-H grade IV-V). Thirty two patients were treated with transcranial surgery and 15 patients were treated with endovascular surgery. Two patients who had treated with wrapping surgery later bled during follow-up period and treated with endovascular surgery. The management outcome of the transcranial surgery was : Glasgow outcome scale(GOS) I 66%, GOS II 12.5%, GOS III 6.3%, GOS IV 6.3% and GOS V(death) 9.4%. The major causes of morbidity related to transcranial surgery were perforator occlusion, vasospasm and retraction injury. The management outcome of the endovascular surgery was : GOS I 66.7%, GOS II 6.7%, and GOS V 26.7%. The major causes of mortality related to endovascular surgery were related to intraoperative aneurysmal bleeding. Conclusion : This report documents that more than 75% of patients undergoing treatment either transcranial or endovascular surgery can expect good clinical outcomes. Treatment modality in management of basilar bifurcation aneurysm must be carefully selected based on various considering factors.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.432-437
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• 1984

• Journal of Chest Surgery
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• v.28 no.11
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• pp.989-993
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• 1995

Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.491-499
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• 2000

Objective : In the cerebral aneurysm surgery, the goal is complete circulatory exclusion of the aneurysm without compromise of normal vessels. In an operating room, an operator should confirm the completeness and precision of the surgical result, before closing the wound. Object of this study was to determine which cases require intraoperative angiography. Methods : We reported our experience with 48 intraoperative angiographic studies performed during the surgical treatment of cerebral aneurysm of these 48 cases. There were 5 giant(10.4%), 15 globular(1.5-2.5cm)(31.25%) and 28 saccular(58.3%) aneurysm. We recorded the incidence of unexpected findings, such as residual aneurysms, major vessel occlusions. Using Fischer's exact test, we assessed whether unexpected angiographic findings showed any correlation with aneurysm site, size and clinical findings. Results : In 5 cases(10.4%), we detected unexpected angiographic findings which resulted in clip adjustment. By means of clip adjustment, an operator could restore the flow of two major arterial occlusion(4.2%) and also obliterate three persistent filling aneurysms(6.3%). Globular aneurysm was the only factor to predict unexpected angiographic findings(p<0.05). The subgroup of globular and giant aneurysm has a high risk of occlusion of the parent artery and its branches and/or residual aneurysm. There were two minor complications related to this procedure. Conclusion : Intraoperative assessment makes it possible to recognize and correct the technical defect. Particularly in globular aneurysm, we were able to prevent both the chance for another operation and the risk of postoperative complications.