• Journal of Chest Surgery
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• v.46 no.3
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• pp.212-215
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• 2013

A 79-year-old man was admitted to Samsung Changwon Hospital due to chest pain and dyspnea. The ejection fraction was 31% and mean pressure gradient between the left ventricle and aorta was 69.4 mmHg on echocardiography. Chest computed tomography showed severe calcification of the ascending aorta. Aortic valve replacement was successfully performed using a thoracic endovascular aortic repair balloon catheter without classic aortic cross clamping. The patient was discharged on the eleventh postoperative day.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.186-188
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• 2019

We report an unusual case of delayed bleeding after open surgical repair of a thoracoabdominal aortic aneurysm. A 79-year-old man developed a massive retroperitoneal hematoma 49 days after Crawford type III thoracoabdominal aorta replacement. During emergency surgery, a tear was found in the prosthetic vascular graft caused by a sharp bony spur arising from the second lumbar vertebral body. This rare, but potentially lethal, complication indicates that attention should be paid to sharp bony structures during open repair of the descending aorta.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.308-311
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• 2010

Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.174-177
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• 1990

Aortic dissection is a challenging disease and the causes of that are well-known. Blunt chest trauma is one of the causes of aortic dissection. In such cases, nearly all cases involves the isthmic portion of descending aorta, but ascending aorta is involved in about 10. We experienced a patient who had ascending aortic dissection due to automobile accident and who showed spontaneous rupture of the aorta during operation. In this case, after installation of aortic line via left femoral artery, ascending aorta ruptured and a large amount of blood gushed out, which was suckered by cardiotomy sucker. A little delay of cardiopulmonary bypass may cause the fatal outcome in such a case because the bleeding from aorta is too much to be controlled. Fortunately, we controlled the bleeding with cardiopulmonary bypass and got the good outcome of this patient by interpositioning the vascular graft. One should suspect the possibility of aortic dissection in blunt chest trauma, and prepare all the facilities against bleeding due to rupture.

• Journal of Chest Surgery
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• v.45 no.6
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• pp.408-411
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• 2012

A 51-year-old male with sustained fever was diagnosed with military tuberculosis and tuberculous aortitis complicated with pseudoaneurysm formation at the proximal descending aorta. A follow-up computed tomography evaluation showed an increased size of the pseudoaneurysm in this area, suggestive of a contained rupture. Consequently, the patient underwent emergency excision and replacement of the aorta using a left heart bypass. The patient was discharged without postoperative complications on post-operative day 12. During the one-year follow-up period, the patient was free of any complications or recurrence of tuberculosis. We report a case of pseudoaneurysm of the descending aorta that was successfully surgically repaired.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.270-274
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• 2017

Background: We evaluated the operative outcomes of an extra-anatomic bypass from the ascending aorta to the abdominal aorta in patients with type II or III Takayasu arteritis (TA) with mid-aortic syndrome. Methods: From 1988 to 2014, 8 patients with type II (n=2) or III (n=6) TA underwent an ascending aorta to abdominal aorta bypass. The mean patient age was $43.5{\pm}12.2years$ and the mean peak pressure gradient between the upper and lower extremities was $54.8{\pm}39.0mm\;Hg$. The median follow-up duration was 54.4 months (range, 17.8 to 177.4 months). Results: There were no cases of operative mortality. The mean peak pressure gradient significantly decreased to $-2.4{\pm}32.3mm\;Hg$ (p=0.017 compared to the preoperative value). Late death occurred in 2 patients. The symptoms of upper extremity hypertension and claudication improved in all patients. The bypass grafts were patent at $47.1{\pm}58.9months$ in 7 patients who underwent follow-up imaging studies. Conclusion: An extra-anatomic ascending aorta to abdominal aorta bypass could be an effective treatment option for severe aortic steno-occlusive disease in patients with type II or III TA, with favorable early and long-term outcomes.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.51-56
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• 1973

This is one case report of successful resection of the aneurysm of the thoracic aorta, which det-ected by thoractomy unexpectedly, in the Department of Thoracic Surgery, Hanyang University Hospital. The patient was a 34 years old woman and subjective complaints was not related with the aneurysm. Chest film showed a small round hazy shadow in the left margin of the upper posterior mediastinum. A saccular aneurysm located on the descending thoracic aorta, 7cm distal to the left subclavian artery and arouse from the antero-lateral wall of the aorta. Excision of the saccular aneurysm was performed by cross clamping the descending aorta above and below the aneurysm, and then the defect of the aortic wall was closed by aortorrhaphy with continuous suture. Crossclamping time was required 15 minute. Histopathologically, the wall of the aneurysm consisted of all layers of the arterial wall, that is, intima, media and adventitia. Postoperative course was uneventful and aortogram showed good continuity of the blood flow of the entire aorta.

• Journal of Chest Surgery
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• v.57 no.5
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• pp.419-429
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• 2024

The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient-tailored approach.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.317-319
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• 2006

Under median sternotomy and left thoracotomy, extra-anatomic aorta bypass between ascending aorta and descending thoracic aorta without cardiopulmonary bypass support has been done effectively and easily without complications for a selected case of atypical coarctation associated with hypoplasia of aortic arch. It should be considered as an alternative operative technique for complex aortic arch reconstruction.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.24-28
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• 2018

Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.