• Title/Summary/Keyword: Aorta, aneurysm

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Hybrid Endovascular Repair of Thoracoabdominal Aortic Aneurysm Using Visceral Debranching Technique - 2 case reports- (내장동맥 탈분지술과 혈관내 교정 하이브리드 술식으로 치료한 흉복부대동맥류 치험 - 2예 보고 -)

  • Kim, Jong-Woo;Choi, Jun-Young;Rhie, Sang-Ho;Jang, In-Seok;Sim, Hee-Jae;Shin, Tae-Beom
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.747-752
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    • 2010
  • Surgical repair of thoracoabdominal aortic aneurysm (TAAA) remains a formidable challenge associated with significant rates of mortality and morbidity, especially in patients with high risk. Use of endovascular stent graff in aortic aneurysm disease is now accepted as an alternative treatment to surgery. But the saving of visceral arteries is the chief obstacle to endovascular repair of TAAA. We successfully treated two patients of TAAA with high risk by hybrid procedure including open visceral debranching and concomitant endovascular aneurysm exclusion.

Clinical Experiences of Aortic Arch Replacement (대동맥궁 절제술의 임상적 고찰)

  • Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.907-913
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    • 1994
  • From October 1990 to May 1993, 19 patients underwent replacement of the transverse aortic arch. [10 men, 9 women, mean age 52.5 years] Underlying diseases were acute aortic dissection [10 cases], chronic aortic dissection [4 cases],and aortic arch aneurysm [ 5 cases]. In 19 patients, 10 underwent partial replacement and 9 underwent total arch replacement. The cerebral protection was achieved by profound hypothermia [rectal temperature,16$^{\circ}$ to 2$0^{\circ}C$] associated with total circulatory arrest [mean 35.5 minutes]. In one patient, the aortic arch distal to the left common carotid artery was resected with the distal arch being cross-clamped and in another two patients, the selective cerebral perfusion was also applied during the period of total circulatory arrest via innominate artery and left common carotid artery because of longer total circulatory arrest time. Among 14 patients of aortic dissecton, 10 presented hypertension, 1 presented Marfan syndrome, 1 presented pregnancy-induced hypertension and 2 revealed no evidence of hypertension. All of the above 14 patients complained chest pain. Among 5 patients of aortic arch aneurysm, Be het disease was suspected in only one patient and atherosclerotic aneurysm was proved in another 4 patients. The overall hospital mortality was 32% [6/19]. In aortic dissection, the mortality was 43% [Acute aortic dissection 30%, chronic aortic dissection 75%] and in aortic arch aneurysm, the mortality was 0%. Follow-up was done in all survivors for from 7 months to 36 months[mean,17.3%].

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A Case of Dissection in Marfan Syndrome with Ascending Aortic Aneurysm (상행 대동맥 동맥류를 동반한 Marfan씨증후군 환자에서 생긴 대동맥 박리(Aortic Dissection) 1례)

  • Yoon, Bong-Young;Yang, Chang-Heon;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo;Ryu, Han-Young;Jung, Tae-Eun;Park, Yee-Tae;Han, Sung-Sae
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.179-184
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    • 1989
  • The Marfans syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aoritc aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.

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A Chylous Cyst in the Mediastinum: Report of A Case (종격동에 발생한 유미성 낭종 1예)

  • Park, Kang-Sik;Park, Yeong-Gwan;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.102-107
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    • 1978
  • This is a report of a chylous cyst in the mediastinum found in a 61 year old Korean female patient who suffered from mild swallowing difficulty and right chest discomfort. These symptoms had developed 5 years previously when chest P-A view showed thumb-tip sized mass shadow in right mediastinum, just right to ascending aorta. Esophagogram revealed an indentation of midesophagus. Follow up checks showed growing mass shadow which suggested aneurysm of ascending aorta. On admission chest X-ray revealed a well circumscribed infant head sized mass density along the right heart border and middle mediastinal border, and extended near to the middle clavicular line in right chest cavity. Aortogram revealed no relationship between the mass and aorta. Right thoracotomy was performed under impression of mediastinal tumor. There was a large cyst containing 700 cc of milky fluid. There was no connection to the thoracic duct nor adjacent organs. The fluid was analyzed chemically and identified the fluid as chyle. The origin of the isolated chylous cyst was uncertain postoperative course was uneventful.

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One-Stage Management of Ascending Aorta Replacement and Percutaneous Endovascular Repair for Ascending and Descending Aortic Aneurysms - A case report - (상행 및 하향대동맥류에 대한 상행대동맥 치환술 및 경피적 Stent Graft 삽입의 단일 단계 치료 - 1예 보고 -)

  • Kim, Chang-Young;Chang, Woo-Ik;Kim, Yeon-Soo;Park, Kyung-Taek;Ryoo, Ji-Yoon
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.524-527
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    • 2009
  • A stent graft has been accepted as an alternative method for treating aortic diseases or to reduce the extent of surgery. We report here on a one-stage Management of Ascending Aorta Replacement and Percutaneous Endovascular Repair for the seperate aneurysmal lesions on the ascending and descending aorta.

Surgical Treatment of Annuloaortic Ectasia - Review of 4 cases - (Annuloaortic ectasia의 외과적 치험)

  • Lee, S.;Ahn, W.S.;Kim, B.Y.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.36-40
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    • 1991
  • Between November, 1981 and July, 1989, 4 patients, 3 male and 1 female patients ranging in age from 36 to 45 years, were operated on for aortic insufficiency associated with uncomplicated annuloaortic ectasia. All patients were in New York Heart Association class III. Two patients had clinical stigmata of the Marfan syndrome. The surgical treatment consisted of. supracoronary replacement of ascending aorta with vascular graft and replacement of the aortic valve in our first case. and composite graft replacement of the ascending aorta and aortic valve with reimplantation of the coronary arteries in subsequent 3 cases. Our first patient developed aneurysm of proximal aorta and pseudoaneurysm of distal aortic anastomosis 5 years postoperatively. One patient among the three patients with Ben-tall operation, died of ventricular fibrillation and myocardial failure during immediate postoperative period. Remaining 2 patients were in NYHA class I with follow-up of 16 months and 20 months respectively.

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Comparison of Correlation Coefficients and Intraclass Correlation Coefficients Between Two-way FSI Flow Velocity of Simulated Abdominal Aorta and Human 4D Flow MRI Flow Velocity (시뮬레이션 복부 대동맥의 양방향 FSI 유속과 인체 4D flow MRI 유속의 상관계수, 급내상관계수 비교)

  • Ahn, Hae Nam;Kim, Jung Hun;Park, Ji eun;Choi, Hyeun Woo;Lee, Jong Min
    • Journal of Biomedical Engineering Research
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    • v.42 no.4
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    • pp.143-149
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    • 2021
  • In order to predict and prevent the disease of the abdominal aorta, which is the largest artery in the human body and the most common aneurysm, the normal arterial blood flow operation should be considered. To this end, we are trying to solve problems that may arise in the future by executing FSI based on the data obtained from 4D flow MRI. However, to match the similarity between the 4D flow MRI flow and the FSI flow, correlation was used in previous papers, but the correlation did not show the degree of agreement. Therefore, in this paper, we analyzed the correlation between the 4D flow MRI flow velocity of the human abdominal aorta and the two-way FSI flow velocity in which the three physical properties used for the aortic FSI were added to the CT abdominal aorta 3D model and the interclass correlation coefficient. As a result, the physical property M2 showed the highest similarity in correlation and intraclass correlation coefficient, and this property is intended to be helpful in the future study of the abdominal aortic two-way FSI flow rate.

Surgical Treatment of Annuloaortic Ectasia - Experience in Two Patients - (Bentall 씨 술식에 의한 annuloaortic ectasia 의 치험 2례 보고)

  • 방종경
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.803-808
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    • 1987
  • Two young male patients were operated on for the Marfan syndrome complicating ascending aortic aneurysm and a moderate degree of aortic regurgitation. We replaced the ascending aorta and aortic valve with Bjork-Shiley aortic valve composite graft and implanted the coronary ostia in the sides of the graft directly. Postoperatively, the atrial fibrillation occurred in one case and the other had uneventful course. They showed improvement in activity at follow-up.

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Surgical Treatment of the Aortic Aneurysm (대동맥류의 외과적 치료)

  • 김학제;조원민;김태식;이송암;김욱진;손영상;최영호
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.13-19
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    • 1998
  • Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

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Surgical Treatment of the Descending Thoracic Aorta ; An analysis of 22 cases (하행 흉부 대동맥류의 외과적 치료; 22예의 분석)

  • 이홍섭;이선훈;윤영철;구본일;김창호
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.532-535
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    • 1999
  • Background: The purpose of this study was to evaluate and analyze the surgical techniques and postoperative complications in patients undergoing operations for descending thoracic aortic aneurysms. Material and Method: The data of 22 major operations between March 1987 and August 1997 were retrospectively reviewed. Result: There were 18 men and 4 women with a mean age of 49 years (range 33 years to 82 years). The cause of the aneurysm was aortic dissection in 13 patients, atherosclerosis in 3, mycotic in 3, trauma in 2 and uncertain in 1. The operative techniques were resection and graft replacement in 16, axillofemoral bypass graft in 2, femorofemoral bypass graft in 2, exclusion, aneurysmorrhaphy in 1 and transfemoral stent insertion in 1. During the operation, 16 cases were performed under total aortic clamp. Among the 16 patients, femorofemoral bypass was used in 14 cases and previously made shunt in 2 cases. The mean total aortic clamp time was 91 minutes and the mean extracorporeal circulation time was 116 minutes. One death occurred in an excluded patient on the 52 postoperative day due to a rupture of the aneurysm. Postoperative complications were paraplegia in 1 case, acute renal failure in 1 case and acute respiratory failure in 1 case. Conclusion: Although surgical treatment of the descending thoracic aneurysm has many postoperative complications, good surgical results can be achieved with a proper patient selection and fine surgical techniques.

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