• Journal of Chest Surgery
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• v.27 no.1
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• pp.31-35
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• 1994

Dissecting aortic aneurysm is a life threatening condition which necessitates prompt diagnosis and management. Between January 1987 and September 1993,58 patients was admitted to our department. Mean age at admission was 53 years.[range 25-82]. Clinical findings included chest pain in 48 cases[83%],renal failure in 12[20%],aortic insufficiency in 11[19%] and stroke in 9[15%]. Predisposing factors were hypertension in 50 cases[86%],Marfan`s syndrome in 6[10%] and diabetes melitus in 1 [2%]. 23 patients[ type A 13,type B 10 ] underwent surgical treatment. Surgical technique for type A included graft replacement of ascending aorta in 7 cases,graft replacement and aortic valve resuspension in 3,and Bentall`s operation in 3 cases. Type B patients were operated when specific indications applied. There were three [Two in type A and 1 in type B] deaths in the operation group and nine [ 5 in type A and 4 in type B] deaths in the medical group. These results support our current policy in the treatment of dissecting aortic aneurysm.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.300-307
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• 1997

We have experienced 25 cases of aortic aneurysm from October 1987 to January 1996. Patients ranged in age from 26yrs to 73yrs(mean age 52. Syrs). There were 13 males and 12 females. Eighteen cases were thoracic aneurysm and seven were abdom nal aneurysm. The cause of aneurysm were dissecting in 16cases aneurysms and non-dissecting in 9 cases. Risk factors of aortic aneurysm were hypertension, hypercholesterolemia, Marfan's syndrome. In thoracic aneurysm patients, 1'S cases of dissecting aneurysm underwent aneurysmectomy and replacement of vessel interposition graft with or without coronary artery implantation on the graft. 6 cases of non-dissecting aneurysm underwent operation with same policy as dissecting aneurysm. In 7 case of abdominal aneurysm,all patients underwent aneurysmectomy and graft interposition with straight i)r Y graft. Thcre were 5 postoperative death(mortality 20%). Several cases of complications were improved with proper managements. All survivors showed improvement in clinical symptom and sign and discharged without specific complications.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.184-190
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• 1988

The treatment of aortic aneurysm of ascending aorta has been fraught with difficult surgical problems. For the most part, these were resolved in 1968 with the introduction of a technique of total replacement of ascending aorta and reimplantation of the coronary arteries by Bentall and De Bono. This technique however, with all of its advantages, caries a certain problems. In chronic dissecting aneurysms, there is frequently a marked disparity in circumference between the true and false lumen distally. Distal perfusion is directed into both the true and false lumens by removing segment of the septum between the two lumens and constructing the distal graft anastomosis is to the outer layer of aortic adventitia. The distal false lumen, aortic branches and fenestrations have matured and healed in most cases. And importantly, major aortic tributaries may be solely dependent on the false lumen for perfusion. We are presenting two cases of chronic dissecting aneurysm of ascending aorta with aortic regurgitation, who have good result by surgical correction of so-called Bentall procedure with maintenance of blood flow directed into both true and false lumen.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.305-313
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• 1985

Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with an intraluminal graft that requires no end-to-end anastomosis has been developed. Of the four patients with dissecting aneurysm of the aorta treated by inserting sutureless ringed intraluminal graft at the Department of Thoracic and Cardiovascular Surgery, S.N.U.H., three were DeBakey type I [one with associated aortic insufficiency] and the other was DeBakey type III. Suspected etiology of the dissection was Marfan`s syndrome in one and hypertension in the others. Total cardiopulmonary bypass was utilized in repairing dissecting aneurysms of the ascending aorta [type A] and simple aortic crossclamping was used for the patient with dissecting aneurysm of the descending aorta. The basic technique consists of inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. The proximal ring of the graft effectively stabilized the flail aortic valve in patient with aortic insufficiency associated with dissection of the ascending aorta. There were no hospital deaths and one patient with type III dissecting aneurysm developed postoperative paraparesis and renal insufficiency which was resolved. Follow-up has been from 1 month to 16 months with no evidence of prosthetic problems, such as erosion, migration, or thrombosis.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.367-373
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• 1987

Dissecting aneurysm has long been recognized as an ominous and highly lethal form of aortic disease. Aortic dissection are characterized by longitudinal separation of aortic media and extension proximally, distally or both from the site of intimal tear. DeBakey and associates defined three types based on where the process originates and how far extends. In type I, intimal tear is located in the ascending aorta and extend beyond the descending aorta. We experienced a case of dissecting aneurysm, Type I of DeBakey`s classification which dissection extend to the left iliac artery. The patient was 61 years old woman and suffered from excruciating pain on admission. Excision of aneurysm and ascending aorta reconstruction using to Dacron Vascular Prosthesis were performed under extracorporeal circulation. The post-operative course was uneventful and follow up is continued.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.291-296
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• 1981

Dissecting aortic aneurysm is a disease which is characterized by hemorrhagic intramural seperation of aortic wall and extension for varlng distances proximally, distally, or both from the site of the intimal tear. Most aortas show some type of medial degeneration most commonly described as cystic medial necrosis. DeBackey classified this disease according to involved aorta and site of intimal tear to 3 basic types, such as type I, II and III. Type III is defined that dissecting process arrises in the descending thoracic aorta just distal to origin of the left subclavian artery and extends distally for a varing distance. We expirienced a case of dissecting aneurysm, type III of DeBackey's classification which dissecting process is limited to the descending thoracic aorta in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. This patient was 40 year old woman and she had suffered from intermittent sharp back pain for 3 years .before admission. Excision of the aneurysm and Dacron graft were placed successfully under the left atrio-femoral bypass with artificial pump. The hospital course was uneventful.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.599-604
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• 2002

Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.687-690
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• 1984

Aortic dissection, a condition characterized by hemorrhage into the media and variable extension along the length of the aorta, has long been recognized as a catastrophic Cardiovascular event. Recent developments in diagnostic and therapeutic skills have improved the prognosis considerably, but there is still controversy as to how cases should be managed. We experienced a case of dissecting aortic aneurysm [DeBakey Type III ], which were managed using intensive medical treatment. The period of follow up was about 11 years. At last, patient was died by progression of dissection into proximal aorta and resulted in aortic insufficiency and congestive heart failure.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.548-551
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• 2014

Type II chronic dissecting thoracoabdominal aortic aneurysms are a surgically challenging disease. The conventional thoracoabdominal aortic aneurysm repair technique using cardiopulmonary bypass is a high-risk procedure. However, a recently developed endovascular technique may be an alternative treatment for the disease, but faces the obstacle of lesional restriction. This new technique uses a hybrid strategy to overcome the limits of endovascular thoracoabdominal aortic aneurysm repair. Herein, we report on a successful outcome after performing the hybrid visceral debranching procedure.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.159-166
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• 1988

Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dessecting aortic aneurysm is occured, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treament(Modified Bentall's operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.