• Title/Summary/Keyword: Aorta, descending

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Aorto-Esophageal Fistula Complicated by Esophageal Metalic Stent -A case report- (식도 내 금속 스텐트 삽입 후 발생한 대동맥 식도 누공 -치험 1례-)

  • 윤영철;조광현;김기봉;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.479-482
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    • 2002
  • Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

HeartMate 3 Implantation via Only Left Thoracotomy: A Case Report

  • Mi Young Jang;Jun Ho Lee;Su Ryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.224-227
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    • 2023
  • Median sternotomy is a standard surgical technique used for left ventricular assist device (LVAD) implantation. However, if sternotomy has a prohibitive surgical risk, LVAD implantation can be performed through only left thoracotomy. We managed a patient with end-stage heart failure who had recently undergone coronary artery bypass grafting (CABG) elsewhere. The patient also had a deep sternal wound infection and bacteremia. Because of refractory cardiogenic shock, we performed extracorporeal membrane oxygenation (ECMO). After multiple mediastinal washouts and omental flap placement, ECMO was converted to extracorporeal LVAD (from the left ventricular apex to the descending aorta) through a left thoracotomy. The extracorporeal LVAD was maintained for 18 days and replaced by the HeartMate 3 LVAD. The patient was discharged in good condition 115 days after CABG.

Clamp and Sew Technique without Distal Perfusion for the Management of Traumatic Descending Thoracic Aortic Rupture (외상성 흉부 하행 대동맥 파열에서 원위부 관류 없이 시행한 겸자 봉합술)

  • Seok, Yang-Ki;Lee, Jong-Tae;Kim, Gun-Jik;Park, Il;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.558-563
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    • 2007
  • Background: Traumatic aortic rupture is a highly fatal condition in which a patient's outcome is strongly affected by other associated injuries. Selection of the appropriate surgical timing and the management plan is important. Material and Method: The medical records of the 15 traumatic descending thoracic aortic rupture patients who underwent the clamp & sew technique were retrospectively reviewed and checked for the presence of associated injuries and the postoperative course. Result: The hospital mortality was 6.07% (one patient). This patient died intra-operatively and the cause of the death was delayed hemoperitoneum. The mean operative time and aortic clamp time were $231{\pm}53.1$ and $13.1{\pm}5.3$ minutes, respectively. One patient complained the bowel obstructive symptoms at postoperative 10 days. We found the mechanical bowel obstruction on computed tomography of the abdomen, and segmental bowel resection was done. Conclusion: Although several surgical strategies may be appropriate for managing traumatic aortic rupture, the clamp & sew technique is a safe and effective method for the treatment of traumatic aortic injury.

Redo CABG through a Left Posterolateral Thoracotomy - A case report- (좌측 후측방개흉술을 이용한 관상동맥 우회 재수술 치험 1예)

  • Song, Chang-Min;Kim, Mi-Jung;Jeong, Seong-Cheol;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.366-368
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    • 2008
  • We report there on a 46-year-old male patient whose angina recurred after a coronary bypass graft (CABG). Occlusion of the first diagonal branch was found on performing a coronary angiogram (CAG), and this occlusion had not previously been present. So, a redo-off pump CABG was performed via a left posterolateral thoracotomy. The anastomosis was made between the descending thoracic aorta and the diagonal branch by using the right radial artery. On the Multi-detector computerized tomography (MDCT) coronary angiogram conducted after the operation, it was confirmed that there was no abnormality in the anastomosis site. A Redo-CABG was successfully performed via left posterolateral thoracotomy in the patient whose disease was only at the diagonal branch.

Retrograde Aortic Dissection after Thoracic Endovascular Aortic Repair for Descending Aorta - 2 case reports- (하행 대동맥 내 스텐트-도관 삽입 후 발생한 역행성 대동맥 박리 - 2예 보고 -)

  • Hong, Soon-Chang;Kim, Jung-Hwan;Lee, Hee-Jeong;Youn, Young-Nam
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.758-763
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    • 2010
  • In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.

Significance of the Preoperative Examinations in Predicting the Defect Size of Ventricular Septal Defect (심실중격결손의 크기 측정에 있어서 술전 검사의 의의)

  • Kim, Keun;Chang, Bong-Hyun;Lee, Jong-Tae;Kim, Kyu-Tae;Lee, Sang-Bum
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.289-295
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    • 1992
  • We evaluated the correlationship between the predicted defect size at preoperative examination and the actual defect size at operation room, by examining 69 cases of ventricular septal defect operated at the deparment of Thoracic and Cardiovascular surgery, Kyungpook University Hospital from January 1988 to December 1990. We excluded cases associated with other cardiac anomalies. Of the 69 cases, 39 are male and 30 female, forming 1.3:1 sex ratio in males favor. Their age range from 6 months to 16 year, and 4.3 on the average Their body weights are from 6 to 45kg and 15 on the average. According to Soto`s classification, perimembranous type costitutes 42 cases[61%], doubly committed subarterial type 23 cases[33%], and muscular type 4 cases[6%]. The average diameter of defect size is 8.0$\pm$3.5mm measured in 2D-echocardiogram, 5.6$\pm$3.4mm in angiogram, and 7.4$\pm$4.4mm in operative field. There is statistically significant correlation between the size from 2D-echocardiogram and actual defect size[p=0.001], and no significant difference between the two. Especially in the cases without anurysmal formation, they are nearly the same. Cardiothoracic ratio, pulmonary to systemic flow ratio, pressure ratio and resistance ratio also have statistically significant correlation. Main pumonary artery to descending aorta diameter ratio is correlated with the actual defect size. There is statistically significant correlation between the size from angiogram and actual defect size with some difference.

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Development and Animal Tests of Pneumatic Ventricular Assist Device (공압식 심실보조장치의 개발 및 동물실험)

  • 박영환;김상현
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.247-252
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    • 1997
  • Ten acute and chronic in vivo studies were utilized to develop a pneumatic ventricular assist device (VAD) as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial funct on after cardiac surgery. Two sizes of blood pump of 70cc for adult patients and 34cc for pediatric patients were implanted in the animals. Ventricle of the blood pump was made from the polyurethaae to enhance antithrombogenecity. The VAD was implanted between the left atrium and the descending aorta. Average flow rate was 2.38 L/min for adult and 0.41 L/min for pediatric VAD at the rate of 60 bum. The duration of support ranged from 1 to 26 hours. The most frequent complication was bleeding. Main causes of death were heart failure and respiratory failure. The device function was good for short term use. Studies to date suggest that, with further refinement, a reliable long term VAD that will have clinical application can be developed.

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Anomalous Systemic Arterial Supply to Normal Basal Segments of Left Lower Lobe : A Report of Two Cases (폐격리 없이 좌하엽이 체순환 동맥으로부터 공급되는 기형적인 혈관 2예)

  • Lee, Ki-Man;Ahn, Jong-Joon;Kim, Byung-Chul;Jeong, In-Du;Shin, Je-Kyoun;Jung, Jong-Pil;Hwang, Jae-Cheol;Suh, Jae-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.710-717
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    • 2001
  • Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary sequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiography, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segments of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complications. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.

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Endobronchial Leiomyoma Combined with Pulmonary Sequestration -A case report - (폐격리증을 동반한 기관지 내 평활근종 -1예 보고-)

  • Lee Seock-Yeol;Oh Jae-Yoon;Lee Seung-Jin;Lee Cheol-Sae;Lee Kihl-Rho;Cho Hyun-Deuk
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.556-560
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    • 2006
  • A 42-year-old female was admitted to our hospital complaining of a dyspnea. Chest X-ray showed left atelectasis. A mass was detected in left main bronchus by computed tomography and bronchoscopy. The mass was diagnosed as a endobronchial leiomyoma by biopsy exam. After open thoracotomy and bronchotomy, mass removal was done and middle lobe was ventilated normally. Aberrant arterial supply from descending aorta to left lower lobe of the lung was detected and left lower lobectomy was done. The lower lobe of the left lung was pathologically diagnosed as intralobar pulmonary sequestration. Herein we report a rare coexistent case of endobronchial leiomyoma and intralobar pulmonary sequestration.

Anomalous Systemic Arterial Supply to the Left Basal Segments without Sequestration from Descending Thoracic Aorta - A case report - (폐분획증이 없이 하행 흉부 대동맥에서 분지된 좌측 바닥 구역의 이상 기시 체혈관 - 1예 보고 -)

  • Kim, Hyuck;Chung, Won-Sang;Jang, Hyo-Jun;Kang, Jeong-Ho;Kim, Young-Hak;Kim, Ji-Hoon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.512-515
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    • 2008
  • An anomalous systemic arterial supply to the left basal segments without sequestration is a rare congenital abnormality within the spectrum of pulmonary sequestration. But this is rather different from the definition of pulmonary sequestration in that it has normal bronchial connections. We describe here our experience with surgical treatments for an anomalous systemic arterial supply to the left basal segments without sequestration, and this condition was confirmed preoperatively.