• Journal of Chest Surgery
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• 제51권6호
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• pp.399-402
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• 2018

A 61-year-old woman who presented with claudication and dyspnea on exertion was found to have severe calcified narrowing of the descending aorta and severe insufficiency of the aortic valve. These findings were compatible with Takayasu arteritis. To treat these hemodynamic abnormalities, extra-aortic bypass surgery combined with replacement of the aortic valve and ascending aorta-to-hemiarch replacement was performed through a separated upper hemi-sternotomy and limited median laparotomy. We present our successful surgical experience with this case.

• Journal of Chest Surgery
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• 제21권1호
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• pp.10-16
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• 1988

Ten patients with tetralogy of Fallot were studied angiocardiographically before a modified Blalock-Taussig shunt and again 25*3.2 months after the previous shunt. All of ten patients had patent previous shunt at the time of follow up examination. Pre-and postoperative diameters of left and right pulmonary artery and descending aorta were measured and pulmonary artery index [the sum of the crossectional areas of the right and left pulmonary arteries standardized by the body surface area] was calculated. The ratio of mean diameter of left and right pulmonary arteries to the diameter of the descending aorta [LPA+RPA/2xDA] was increased postoperatively by 0.20*0.068 [p=0.020]. Mean PAI [pulmonary artery index] increased from 283.8*178.4 mm/m2 BSA to 345.8~144.5 mm/m2 BSA after shunt operation [p=0.019]. This results suggested that the modified Blalock-Taussig shunt was effective to help growth of the pulmonary arteries in most cases of the study populations but the ones with the PAI>233mm*/m* BSA appeared less benefited by Blalock Taussig shunt. Calculation of PAI could be an aid to making a decision whether to perform a one stage corrective surgical procedure or a palliative shunt procedure in the patient with small pulmonary arteries.

• 대한방사선기술학회지:방사선기술과학
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• 제44권2호
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• pp.91-100
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• 2021

High-Resolution thoracic CT (HRCT) is a scanning protocol in which thin slice thickness and sharpness algorithm are utilized to enhance image resolution for diagnosis and assessment of interstitial lung disease (ILD). This examination is sometimes performed in both supine and prone position to improve sensitivity to early changes of these conditions. Anatomical structures (the size of lung field and heart and descending aorta) of 150 patients who underwent HRCT were retrospectively compared. HRCT had been conducted in two positions (supine and prone). Data were divided into five groups according to patient body weights (from 40 to more than 80kg, 10kg intervals, 60 patients/each group). Quantitative analysis was utilized in Image J program. In the supine position defined as the control group, the average values of lung fields and heart size and aorta were compared with the prone position defined as the experimental group. The size of the lungs was found to be higher in the supine position, and it was confirmed that there was a statistically significant difference in patients over 70 kg (p<0.05). In addition, both sizes of the heart and descending aorta were larger in prone position, but in the case of the heart, there was no correlation with the presence or absence of ILD disease (p>0.05). Also, the area of prone in the descending aorta was higher than supine position, but there was no statistically significant difference between supine and prone position (p>0.05). In conclusion, when the severity of ILD disease was severe, there was no statistically significant difference in the area difference between supine and prone position, so it is considered that it will be helpful in diagnostic decision.

• Journal of Chest Surgery
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• 제47권4호
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• pp.389-393
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• 2014

Retroesophageal aortic arch, in which the aortic arch crosses the midline behind the esophagus to the contralateral side, is a rare form of vascular anomaly. The complete form may cause symptoms by compressing the esophagus or the trachea and need a surgical intervention. We report a rare case of a hypoplastic left heart syndrome variant with the left retroesophageal circumflex aortic arch in which the left aortic arch, retroesophageal circumflex aorta, and the right descending aorta with the aberrant right subclavian artery encircle the esophagus completely, thus causing central bronchial compression. Bilateral pulmonary artery banding and subsequent modified Norwood procedure with extensive mobilization and creation of the neo-aorta were performed. As a result of the successful translocation of the aorta, the airway compression was relieved. The patient underwent the second-stage operation and is doing well currently.

• Journal of Chest Surgery
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• 제51권4호
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• pp.286-289
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• 2018

We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol.

• Journal of Chest Surgery
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• 제31권2호
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• pp.173-177
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• 1998

28세 여자환자가 임신중 발생한 급성 A 형 대동맥 박리증으로 응급제왕 절개술을 시행하여 아이를 분만하고 곧바로 응급 상행 및 전대동맥궁 치환술을 시행받아 별 문제없이 퇴원하였다가 수술후 1년 6개월 뒤에 만성 대동맥 박리증에 의한 하행 대동맥 및 복부 대동맥류가 재발하여 하행 대동맥으로부터 복부 대동맥을 거쳐 양쪽 총장골동맥까지 치환하는 수술을 시행하여 결국 대동맥 전장을 치환하여 이를 문헌 고찰과 함께 보고한다.

• Journal of Chest Surgery
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• 제46권5호
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• pp.365-368
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• 2013

We report a case of concurrent saccular aneurysms caused by a penetrating atherosclerotic ulcer of the thoracic and abdominal aorta that were successfully treated by staged endovascular repair. Even though surgical open repair or endovascular repair is the treatment option, use of endovascular repair is now accepted as an alternative treatment to surgery in selected patients. To prevent contrast medium-induced nephropathy and spinal cord ischemia caused by a simultaneous endovascular procedure, a saccular aneurysm of the descending thoracic aorta was excluded by stent graft, followed by the placement of a bifurcated stent graft in the infrarenal abdominal aorta one month later.

• Journal of Chest Surgery
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• 제34권12호
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• pp.968-971
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• 2001

유경 대망이식술은 흉부 수술시에 효과적으로 사용되지만 수술 후 몇 가지 합병증을 일으킬 수 있다. 본 교실에서는 65세 남자 환자에서 유경 대망이식술 후 합병증으로 발생한 횡격막탈장 1례를 경험하여 보고한다. 환자는 진균성 하행흉부대동맥류의 대동맥 이식편성형술 시행 3개월 후 발생한 대동맥식도누공으로 흉부동맥류는 절제하고 상행흉부대동맥과 복부대동맥간에 우회술을 시행받고 식도누공을 봉합한 후 유경 대망판을 식도의 봉합부와 대동맥 단락부에 이식하였다. 수술 3년 뒤에 위가 횡격막으로 탈장된 것이 발견되었고 개흉술 실시하에 유경 대망판을 결찰하고 분리한 뒤 횡격막의 결손부위를 봉합하였다.

• Journal of Chest Surgery
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• 제49권1호
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• pp.54-58
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• 2016

A 49-year-old male presented with chills and a fever. Five years previously, he underwent ascending aorta and aortic arch replacement using the elephant trunk technique for DeBakey type 1 aortic dissection. The preoperative evaluation found an esophago-paraprosthetic fistula between the prosthetic graft and the esophagus. Multiple-stage surgery was performed with appropriate antibiotic and antifungal management. First, we performed esophageal exclusion and drainage of the perigraft abscess. Second, we removed the previous graft, debrided the abscess, and performed an in situ re-replacement of the ascending aorta, aortic arch, and proximal descending thoracic aorta, with separate replacement of the innominate artery, left common carotid artery, and extra-anatomical bypass of the left subclavian artery. Finally, staged esophageal reconstruction was performed via transthoracic anastomosis. The patient's postoperative course was unremarkable and the patient has done well without dietary problems or recurrent infections over one and a half years of follow-up.

• Journal of Chest Surgery
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• 제54권6호
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• pp.513-516
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• 2021

An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV⁶ Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.