• Journal of Chest Surgery
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• 제38권3호
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• pp.221-228
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• 2005

대동맥 축소성형술은 대동맥판막 질환과 동반된 상행대동맥 확장을 가진 고령 혹은 고위험군의 환자들에서 수술치료의 한 방법이라고 주장되어 왔다. 저자들은 대동맥판막치환술과 동반 시행한 상행대동맥의 변형 축소성형술에 대한 결과에 대해 알아보았다. 대상 및 방법: 2001년 7월부터 2002년 12월까지 상행대동맥벽의 절제 없이 봉합봉축법에 의한 변형 대동맥 축소성형술을 받은 14명의환자들을 대상으로 하였다. 평균 연령은 63.7$\pm$6.7세(50$\~$75세)였다. 10명의 환자에서 이엽성 대동맥판막이 동반되었다. 10명에서 심한 대동맥판막 협착을 보였으며 6명에서는 III-lV도의 대동맥판막폐쇄부전이 동반되었다. 상행대동맥의 직경은 수술 전과 후 그리고 6개월과 12개월 후에 심장초음파 및 컴퓨터 단층촬영으로 측정하였다. 술 후 평균 추적기간은 14.7$\pm$5.4개월(7$\~$24개월)이었으며 모든 7환자에서 추적이 가능하였다. 결과: 술 후 조기 사망이나 출혈과 같은 합병증은 없었다. 봉합봉축법에 의한 대동맥 축소성형술 후 상행대동맥의 직경은 술 전 49.4$\pm$3.5 mm에서 술 후 33.2$\pm$3.4 mm (P<0.001)로 감소하였다. 추적기간동안 만기 사망이나 상행대동맥의 재확장은 없었다. 결론: 대동맥벽의 절제없이 봉합봉축법에 의한 변형 대동맥축소성형술은 대동맥판막 질환과 동반된 상행대동맥 확장을 가진 고령 혹은 고위험군의 환자들에서 양호한 조기 및 중기성적을 보였다. 하지만 본 방법들 사용한 환자들에 대한 장기 추적결과에 추가적인 연구가 필요하리라 생각한다.

• Journal of Chest Surgery
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• 제39권10호
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• pp.782-785
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• 2006

복부 대동맥류의 수술에 있어서 만성 폐쇄성 폐질환은 수술 사망에 유의한 영향을 미치는 위험 인자로 알려져 있다. 따라서 수술 후 호흡기 합병증을 줄이기 위해서는 강제적 기계 호흡을 줄이고 가능한 환자의 자발 호흡을 유지하는 것이 수술 결과를 향상시킬 수 있다. 본 증례에서는 복부 통증을 주소로 내원한 77세의 남자 환자로 수술 전 검사에서 약 9 cm크기의 복부 대동맥류가 발견되었으나, 심한 만성 폐쇄성 폐질환이 동반되어 수술 후 사망률이 높을 것으로 예상된 경우에서 경막외 마취등을 통해 환자의 자발 호흡을 유지한 상태로 복부 대동맥류 절제 및 인조혈관 삽입술을 시행하여 좋은 결과를 얻을 수 있었다.

• 대한영상의학회지
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• 제82권4호
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• pp.826-837
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• 2021

면역글로불린G4 연관 질환(immunoglobulin G4-related disease; 이하 IgG4-RD)는 IgG4를 생산하는 면역세포에 의한 만성 염증성질환으로, 주로 타액선, 누액선, 안와, 췌장, 담도, 간, 신장, 후복막, 대동맥, 폐, 림프절 등 다양한 장기를 침범하고, 조직학적으로 IgG4 양성 형질세포와 림프구의 침윤 및 나선형의 섬유화(storiform fibrosis), 폐색정맥염(obliterative phlebitis)을 특징으로 한다. IgG4-RD의 흉부 침범에서 가장 흔한 소견은 종격동 림프절 비대와 폐의 림프관주위 간질 비후이다. 폐의 기관지혈관주위 간질 비후와 우측 척추곁 밴드형 연부조직은 IgG4-RD의 특징적 소견이고, 그 외에도 폐결절 혹은 종괴, 간유리음영, 폐포 간질비후, 흉막삼출 및 비후, 흉벽이나 종격동 종괴, 대동맥과 관상동맥의 혈관염이 발생할 수 있다. 영상의학적으로는 악성 종양이나 감염 및 다양한 염증성질환과의 감별진단이 필요하다. 본 연구에서는 흉부에서 발생하는 IgG4-RD의 영상 소견과 감별진단에 대해 기술하였다.

• Journal of Chest Surgery
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• 제23권2호
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• pp.357-361
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• 1990

The pulmonary sequestration is rare congenital pulmonary disease with nonfunctioning lung tissue supplied by aberrant arteries arising from systemic arteries-thoracic aorta, subclavian artery, innominate artery, internal mammary artery, etc. In our country, only 23 cases were reported previously and the majority was intralobar pulmonary sequestration except 2 cases. The patient was 17 year-old man and admitted due to intermittent cough, productive sputum and fever for 8 years. On simple chest P \ulcornerA view, multiple cysts with air-fluid levels were located at left lower lobe area. Aortogram revealed two aberrant arteries arising from thoracic aorta just above the diaphragm. On the operative field, the arteries were 0.7 and 0.3 cm in diameter. Left lower lobectomy was done with ligation of aberrant arteries. The patient was recovered and discharged uneventfully.

• Journal of Chest Surgery
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• 제10권1호
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• pp.106-112
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• 1977

Transposition of the great arteries is one of the commonest forms of severe congenital heart disease and produces severe cyanosis threatening survival from the day of birth. Anatomical anomalies which the aorta arises from the infundibulum of the right ventricle and the pulmonary artery arises from the outflow tract of the left ventricle make the deranged circulation. Survival is possible only if additional anomalies are present which allow mixing of the pulmonary and systemic circulations. Preoperative diagnosis as TGA was taken on the 15 day old female via the preoperative examination and the right cordioangiography. As palliative treatment for cyanosis, Blalock-Hanlon operation was performed in this patient. The results were good as 54 mmHg changed from 27 mmHg of $PO_2$ in aorta, but sudden cardiac arrest was developed in postoperative 12 hours. In order to confirm the cause of death and the cardiac anomalies, autopsy was performed on the date of death. The diagnosis of the autopsy showed; [1] Transposition of the Great Arteries. [2] Patent Ductus Arteriosus. [3] Patent Foramen Ovale. [4] Ventricular Septal Defect, 2 Muscular Type. [5] Double Ureter, Right. [6] Artificial Atrial Septal Defect. [7] Total Collapse of the left lung and Intraparenchymal hemorrhage of right lung.

• Journal of Chest Surgery
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• 제50권1호
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• pp.44-46
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• 2017

We report the case of a newborn with a rare anatomic variation: a right aortic arch with a retroesophageal left subclavian artery and an anomalous origin of the pulmonary artery from the aorta. This variation was diagnosed using echocardiography and computed tomography, and we treated the condition surgically.

• 대한후두음성언어의학회지
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• 제8권2호
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• pp.232-234
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• 1997

After the first report of mitral stenosis as a cause of recurrent laryngeal nerve palsy by Ortner in 1897, many authors have described that some kinds of cardiovascular disease might contribute to the development of recurrent laryngeal nerve palsy. The estimated rate of aortic aneurysm related with recurrent laryngeal nerve palsy is about 5%. Aortic aneurysm is classified into 3 types according to the involving segment of aorta in which aneurysms develop, and the first class-aneurysm in ascending aorta and aortic arch-is known to be the only type related to recurrent laryngeal nerve palsy. Recently we experienced two cases of recurrent laryngeal nerve palsy each of which had aneurysm on aortic arch as a major contributing factor. We report these cases with brief review of the literature.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.380-384
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• 2015

Systemic arterial supply from the descending thoracic aorta to the basal segment of the left lower lobe without a pulmonary arterial supply is a rare congenital anomaly within the spectrum of sequestration lung disease. The most common pattern of anomalous systemic artery to the lung arises from the descending thoracic aorta and feeds the basal segments of the left lower lobe. We report an extremely rare case of a 29-year-old woman who underwent a successful left upper lobectomy for the treatment of recurrent massive hemoptysis from anomalous bronchial arterial supply to the lingular segment of left upper lobe.

• 대한수의학회지
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• 제60권2호
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• pp.89-92
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• 2020

A 5-year-old dog was evaluated for a lethargy and respiratory distress. Radiograph revealed cardiomegaly with pleural effusion, and the dog died during a thoracocentesis. At necropsy, the descending aorta and pulmonary trunk were dilated and in close contact, but there was no external evidence of a patent ductus arteriosus (PDA). When the descending aorta was opened however, an ostium opening into the pulmonary trunk was evident. Histopathological investigation revealed that the intramural PDA resembled vascular tissue with a structure and architecture. The diagnosis was an intramural PDA, an extremely rarely reported type of PDA in the dog.

• Journal of Chest Surgery
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• 제52권3호
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• pp.182-185
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• 2019

Aortoesophageal fistula (AEF) is a rare and potentially fatal disease that causes massive gastrointestinal bleeding. Therefore, early diagnosis and treatment are essential to prevent mortality. Controlling the massive bleeding is the most important aspect of treating AEF. The traditional surgical treatment was emergent thoracotomy, but intraoperative or perioperative mortality was high. We report a case of a patient presenting with hematemesis who was successfully treated by a staged treatment, in which bridging thoracic endovascular aortic repair was followed by delayed surgical repair of the esophagus and aorta.