• Journal of Chest Surgery
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• v.43 no.6
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• pp.729-733
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• 2010

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.260-263
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• 2008

We performed three cases of extraanatomic bypass graft for treating adult coarctation. Two cases of left subclavian artery to descending aorta bypass graft were done via left thoracotomy for treating 2 patients who had extensive aortic occlusive disease. One case of ascending aorta to descending aorta bypass graft and aortic valve replacement was done via median sternotomy for a patient who had combined arch hypoplasia and aortic valve regurgitation. One patient was reoperated on for aneurysm rupture of an anastomosis site four months after the first operation and two patients have had no specific problems during and after their operations.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.870-874
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• 2001

Takayasu arteritis is a chronic non-specific inflammatory arteriopathy that involves primarily the first branches of aortic arch but may also affect the aorta and any of its primary branches. A characteristic trait of the disease is that most of the patients are young females of mainly Asian and South American origin. Recently, we experienced a rare case of Takayasu arteritis which showed a cord-like atresia of abdominal aorta just below renal arteries in 52-year-old woman. We performed a side to side bypass graft from descending thoracic aorta to abdominal aorta just above the aortic bifurcation with a 18mm PTFE(polytetrafluoroethylene) vascular graft. The postoperative course was uneventful. .

• Journal of Chest Surgery
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• v.30 no.3
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• pp.340-343
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• 1997

We experienced a female patient with intramural hematoma of the aorta. This patient had a severe anterior chest pain radiating to interscapular area with choking sensation. CT revealed a intramural hematoma of the thoracic aorta and a part of the abdominal aorta but there was no evidence of intimal tearing. We did the eme gency operation under hypothermic circulatory arrest and retrograde cerebral perfusion. Ascending aorta was replaced and coronary artery bypass graft was done because of intimal tearing of the ostium of right coronary artery. She was discharged without any significant complication. We reported this case with consideration about necessity of emergency operation for intramural hematoma of the thoracic aorta.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.93-100
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• 1974

This is a case report of successful surgical correction of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart anomaly was suspected at the sixth month after birth. Afterward there has been no embarrassing symptoms until the day of operation except slight dyspnea on exertion, The diagnosis of coarctation of the aorta and the patent ductus arteriesus detected by physical signs and X-ray studies including aortography. In the first place, coarctation of the aorta was corrected with following procedure: partial resections of the aortic wall just above and below the coarctating line of the aorta and removal of diaphragmatic structure of coarctation performed by. cross clamping aorta above and below coarctation, and then the defect of the aortic wall was closed by lateral aortorrhapic suture with atraumatic needle 3-0 silk continuously [Fig. 6]. In the second place, the patent ductus arteriosus was closed with double ligation method. The persistent left superior vena cava left as it has been, because there has been no evidence of hemodynamic abnormal shunt. After operation, excellent result was obtained; blood pressure in the upper and lower extremities was normalized and subjective complains of hypertension in the upper extremity was disappeared.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.506-514
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• 1986

Coarctation of aorta is rather common congenital cardiovascular defect in the western countries, but it is known to be rare in Korea. And no coarctation of Aorta has been reported and operated upon during early infancy in Korea. During 4 months period from May 1984 to September 1984, four small infants of coarctation of aorta were seen and treated surgically by subclavian flap aortoplasty in Guro Hospital, Korea University. All infants were male, ranging from 7 days to 54 days old [mean 29 days], weighing between 3.2 Kg and 5.0 Kg [mean 4.1 Kg], and all were in congestive heart failure. Examination of the femoral artery pulse gave in all cases clues to the diagnosis. By Two dimensional echocardiogram, detail anatomical features as well as the diagnosis were revealed and associated anomalies, for example, ventricular septal defect could be seen. Besides one case of isolated coarctation of aorta, other three infants had associated VSD. The 3 patients with VSD were treated by pulmonary artery banding in addition to aortoplasty. The postoperative course were smooth in all patients. In conclusion, coarctation of aorta may not be so rare in Korea as we thought previously. The importance of femoral pulse examination can not be overemphasized for the diagnosis. As we experienced, two-dimensional echocardiography in most cases can substitute those invasive examinations such as angiography and catheterization which carry difficulty and risk in infants.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.554-557
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• 2021

Surgeons are increasingly using the right mini-thoracotomy approach to perform aortic valve surgery. This approach has shown better results in terms of blood loss and length of hospital stay than the sternotomy approach. For selected patients requiring aortic root and ascending aorta surgery, a right mini-thoracotomy approach may prove beneficial. In our technique, we placed a 5-cm horizontal skin incision in the right second intercostal space. Femoro-femoral cardiopulmonary bypass was established. A valved aortic conduit was used for aortic root replacement. The patient's postoperative course was uneventful, with a short hospital stay. This technique offers a minimally invasive approach to aortic root and ascending aorta surgery with easy adaptability and reduced costs.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.6-12
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• 2014

Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.852-855
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• 2005

A 85-day-old infant was successfully operated on for truncus arteriosus (type I) with interrupted aortic arch (type A) using one-stage anterior approach without circulatory arrest. Aortic arch was reconstructed by direct anastomosis of ascending aorta and descending aorta with regional perfusion and continuity of right ventricle to pulmonary artery was established with $Shelhigh^{circledR}$ pulmonic conduit. The patient experienced left bronchus compression by descending aorta immediately postoperatively, which was improved with positional change and physiotherapy. The patient had reoperation due to stenosis of valved conduit at 13 months later. The patient is currently well under follow-up of 14 months from initial repair.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.150-153
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• 2006

Percutaneous transcatheter closure of atrial septal defects as a therapeutic alternative in appropriate patients provides superior cosmetic results, is less invasive, and allows for shorter hospital stays. Unfortunately, however, such percutaneous procedures can be associated with catastrophic procedure complications that may require immediate surgical intervention. We report a case of aorta-to-right atrial fistula two months after transcatheter occlusion of an atrial septal defect by an Amplatzer septal occluder. Revealed by dyspnea, palpitation and hemolysis, this complication needed an emergency surgical operation. The fistula between the noncoronary Valsalva sinus of the aorta and the right atrium was repaired. The atrial septal defect was closed by patch. The cause of this serious complication appears to be erosion into the aorta by the right atrial disk.