• 제목/요약/키워드: Aorta, aneurysm

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복부 대동맥류의 외과적 치료 (Surgical Treatment of Abdominal Aortic Aneurysm)

  • 김동원
    • Journal of Chest Surgery
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    • 제28권1호
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    • pp.31-36
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    • 1995
  • Between January 1984 to June 1994, fourteen patients from 37 to 80 years of age [mean 66.42 11.71 years of age have undergone surgical treatment of abdominal aortic aneurysm in Kyung Hee Univ. Hospital. There were 11 males and 3 female patients. All but one were infra-renal type. The etiology of the aneurysm consisted of twelve atherosclerotic, one inflammatory and one traumatic abdominal aortic aneurysm.Two patients were operated on for ruptured abdominal aortic aneurysm. We performed dacron graft interposition in all patients and one patient was also performed aorto-renal end to side anastomosis. Two patients died of postoperative complications which was a pulmonary insufficiency in one, acute renal failure in another patient.Remaining twelve patients were discharged with good condition and followed up from 2 months to 87 months.[mean $34.58{\pm}29.79$ months.

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식도파열 후 발생한 식도 흉막루와 대동맥루의 수술적 치료: 식도 및 대동맥 이중 우회술 (Double Bypass of Esophagus and Descending Thoracic Aorta for the Treatment of Esophagapleural and Aortopleural Fistula)

  • 박성준;강창현;김경환;유병수;김영태;김주현
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.753-757
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    • 2010
  • 식도 파열 후 발생한 식도 흉막루 및 대동맥 흉막루를 식도와 대동맥 이중 우회술로 치험하여 보고하고자 한다. 48세 남자가 폭발 사고로 인한 손상으로 하부 식도 파열을 진단받았다. 외부 병원에서 1차례 식도 봉합술을 시행받았으나 식도 누출이 지속되었고, 이로 인해 좌측 흉강의 농흉이 동반되어 있었고, 이차적인 대동맥 손상으로 흉부 하행 대동맥에 스텐트를 삽입한 상태로 본원으로 전원되었다. 반복적인 수술 및 농흉으로 인한 유착 및 대동맥 손상을 고려하여 흉골 하행 경로를 통해 식도-위 우회술을 시행하였다. 남아있는 농흉은 감염 징후 없이 만성화 단계를 거치던 중 흉관 삽입 부위로 출혈이 관찰되었다. 검사 결과 흉부 하행 대동맥의 감염성 동맥류로 대동맥 벽이 약해진 상태가 확인되어 대동맥 우회술을 시행하였다. 우측 흉강을 통해 상행 대동맥과 복부 대동맥에 인조혈관으로 우회술을 시행하였고, 흉부 대동액 부위는 결찰하였다. 이후 원위부 결찰 부위에 남아 있는 개통 부위에 대해 혈관 플러그(vascular plug)를 이용하여 색전술을 시행하였다. 환자는 더 이상 출혈 없이 4개월째 외래 관찰 중이다.

복부 대동맥류의 외과적 치료 (Surgical Treatment of the Abdominal Aortic Aneurysm)

  • 황석하
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.355-359
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    • 1993
  • Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

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Intra-luminal Thrombus Reduces Stress in the Aneurysm Wall: Fluid-Structure Interaction in Pulsatile Flow

  • Kim S. Y.;Kim Y. H.
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2003년도 The Fifth Asian Computational Fluid Dynamics Conference
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    • pp.147-149
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    • 2003
  • Using computational fluid dynamics with the fluid-structure interaction, structural effects of intra-luminal thrombus were determined in thrombosed axisymmetric abdominal aorta aneurysm (AAA) models under pulsatile flow. Four different models, varying dilatations of the aneurysm and Young's moduli of intra-luminal thrombus, were defmed. Compared with unthrombosed AAA models, both von Mises stress and radial displacements in the aneurysm wall significantly decreased. Stiffer intra-luminal thrombus reduced von Mises stress in the aneUtysm wall. The present study supported that intra-luminal thrombus might reduce wall stress in the aneurysm.

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흉부 대동맥류 (Thoracic Aortic Aneurysm)

  • 김수현;이정철;한승세
    • Journal of Chest Surgery
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    • 제25권8호
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    • pp.877-884
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    • 1992
  • From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

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Ruptured Abdominal Aortic Aneurysm after Endovascular Aortic Aneurysm Repair

  • Lee, Chung-Won;Chung, Sung-Woon;Kim, Jong-Won;Kim, Sang-Pil;Bae, Mi-Ju;Kim, Chang-Won
    • Journal of Chest Surgery
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    • 제44권1호
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    • pp.68-71
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    • 2011
  • In treating uncomplicated abdominal aortic aenurysm, endovascular aortic aneurysm repair (EVAR) has been employed as a good alternative to open repair with low perioperative morbidity and mortality. However, the aneurysm can enlarge or rupture even after EVAR as a result of device failure, endoleak, or graft migration. We experienced two cases of aneurismal rupture after EVAR, which were successfully treated by surgical extra-anatomic bypass.

Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Comprehensive Review

  • Hyoung Ook Kim;Nam Yeol Yim;Jae Kyu Kim;Yang Jun Kang;Byung Chan Lee
    • Korean Journal of Radiology
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    • 제20권8호
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    • pp.1247-1265
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    • 2019
  • Abdominal aortic aneurysm (AAA) can be defined as an abnormal, progressive dilatation of the abdominal aorta, carrying a substantial risk for fatal aneurysmal rupture. Endovascular aneurysmal repair (EVAR) for AAA is a minimally invasive endovascular procedure that involves the placement of a bifurcated or tubular stent-graft over the AAA to exclude the aneurysm from arterial circulation. In contrast to open surgical repair, EVAR only requires a stab incision, shorter procedure time, and early recovery. Although EVAR seems to be an attractive solution with many advantages for AAA repair, there are detailed requirements and many important aspects should be understood before the procedure. In this comprehensive review, fundamental information regarding AAA and EVAR is presented.

Annuloaortic Ectasia 수술치험 (Surgical Treatment of Annuloaortic Ectasia Report of One Case)

  • 김광택
    • Journal of Chest Surgery
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    • 제18권3호
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    • pp.456-460
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    • 1985
  • A case of Annuloaortic Ectasia associated with Marfan syndrome was treated by replacement of aorta and aortic valve with a valved conduit. A 26 years old man had suffered from palpitation and precordial pain. He had stigmata of Marfan`s syndrome. Aortogram and 2-D echocardiogram confirmed aneurysm of the ascending aorta with aortic insufficiency. Surgery was performed under the moderate hypothermia to 28oC. There was marked dilatation of the aortic annulus as well as sinus of Valsalva, with displacement of the coronary ostia. Aortic valve and aneurysm was replacement with 25mm, woven Dacron tubular graft, to which a 25mm, S.T. Jude Medical valve had been previously sutured. Right & left coronary ostia were anastomosed to the graft with the use of 3O Nylon pledget suture. The patient had a satisfactory post operation period with out specific complication.

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Delayed Type III Endoleak Caused by Fabric Erosion after Endovascular Repair of an Abdominal Aortic Aneurysm

  • Lee, Jae Hang;Kim, Eung-joong;Choi, Jin-Ho
    • Journal of Chest Surgery
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    • 제50권4호
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    • pp.291-294
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    • 2017
  • A 74-year-old patient presented with recurrent aneurysms in the infrarenal abdominal aorta and right common iliac artery 6 years after endovascular aortic repair using endografts in the same location. The patient underwent an aorto-bi-iliac replacement with removal of the stent graft. Two holes measuring 2 mm each were found in the removed graft, and they appeared to have been caused by wear from continuous friction between the endograft and the aortic wall.

Wrapping of an Ascending Aortic Aneurysm with the Multiple Boot-Straps Technique in a Patient Undergoing Off-Pump Coronary Artery Bypass Grafting

  • Na, Kwon Joong;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.206-209
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    • 2015
  • Ascending aortic aneurysms are usually treated with graft replacement under cardiopulmonary bypass. However, if a candidate for off-pump coronary artery bypass grafting has an enlarged ascending aorta, surgeons may consider wrapping it without cardiopulmonary bypass. Here, we report a 78-year-old female who underwent successful wrapping of the ascending aorta concomitant with off-pump coronary artery bypass grafting, using a new wrapping technique that involves multiple bootstraps.