• Journal of Chest Surgery
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• v.26 no.6
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• pp.492-495
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• 1993

We experienced one case of surgical treatment of abdominal aortic aneurysm using retroperitoneal approach. The transperitoneal route has been the standard surgical approach for elective and emergency treatment of aneurysmal or occlusive disease. Among its cited advantages for aortic reconstruction are familarity with the exposure, easy access to the infrarenal aorta and iliac vessels, possibility of simultaneous inspection of the intra-abdominal viscera, and speed of opening and closure.Despite the proved versatility of the transperitoneal approach, it is commonly associated with prolonged ileus, increased third space fluid loss, and significant pulmonary complications. The retroperitoneal approach, on the other hand, has many advantages; excellent exposure for the repair of juxtarenal or suprarenal abdominal aortic aneurysms and visceral vessel occlusive disease, fewer postoperative complications, decreased postoperative third-space fluid losses from intraoperative evaporation and ileus, and improved postoperative pulmonary function. Atherosclerosis was most common cause of abdominal aortic aneurysm. Dacron graft[18mm] was replaced successfully.Postoperative course was uneventful and he was discharged in good condition.

• 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.21 no.2
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• pp.334-339
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• 1988

We have experienced one case of ascending aorta aneurysm with aortic regurgitation due to atherosclerosis. The 45 year old man had been suffered from palpitation and precordial chest pain. 2-D echocardiogram and aortogram confirmed aneurysm of ascending aorta with aortic regurgitation. Atherosclerotic change was noted in the aortic wall and there was marked dilatation of the sinuses of Valsalva as well as the aortic annulus with upward displacement of coronary ostia in the operative field. The patient underwent complete replacement of the aneurysmal ascending aorta and the aortic valve with 27mm Bjork-Shiley aortic valve composite graft. We got preclotting with heparin free blood including thrombin and then autoclave at 132` for 3 minutes. The postoperative course was uneventful and the patient was discharged with good clinical result.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.137-140
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• 2005

Most vascular disorders tend to affect both the brain and heart, and among them, a clinical syndrome constituting cerebral aneurysm and aortic coarctation(AC) has been well recognized. Persistent hypertensive impact to the cerebral vasculature with developmental anomaly of the neural crest, precursor of ectomenchymal, would be closely associated with development of the cerebral aneurysm in AC. Gonadal steroid hormone, a guardian of the cardiovascular system, has been known for its protective effects on the vascular wall. Gonadal steroid hormone (androgen) insensitivity such as 46,XY female syndrome may increase the risk of hypertention and subsequent vascular anomalies. The authors report on a 46-year-old 46,XY female patient with AC who underwent surgical clipping of the ruptured cerebral aneurysm. Clinical implications and proposed pathogenetic mechanisms of aneurysm in this intersex syndrome are presented and discussed.

• 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.

• International Journal of Vascular Biomedical Engineering
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• v.2 no.2
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• pp.10-15
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• 2004

Purpose: In the treatment of aortic aneurysm, endovascular stent-graft application has become an established method of treatment. To observe the outcomes of the procedure as the size change of aneurysm in relation with endoleak, a retrospective analysis was done for the consecutive cases who undertook the procedure. Materials & Method: Stent-graft was applied to the aortic aneurysm in 33 patients. The location of the aneurysm was thoracic in 11 patients and abdominal in 22 patients. CT angiographic was done for the follow-up evaluation to analyze the aneurysm size and the presence of endoleak. Results: Technical success rate was 97% (32/33). The primary success rate without endoleak was 84% (28/33). The secondary success was 90% (30/33). During the follow-up period of 3 months to 7years and 6months in 26 patients, a secondary endoleak developed in 5 cases. Post-implantation syndrome developed in 17 cases (51%). Among the 14 cases with follow-up imaging data for size, endoleak was negative in 10 cases. The aneurysm decreased in 5 cases, stable in size in 4 cases and enlarged in one case (10%).Among the 4 cases with endoleak positive, the aneurysm enlarged in two cases (50%). Conclusion: In the stent-graft application for aortic aneurysm, there is high chance of decrease of aneurysm size in those cases with endoleak negative. However, the aneurysm may increase and eventually rupture in the cases with en do leak positive. Close observation with CT angiography is necessary for the evaluation for the presence of endoleak and size change.

• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.179-184
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• 1989

The Marfans syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aoritc aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.430-435
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• 2017

Background: Mycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy. Methods: From 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue. We recorded the clinical findings, anatomic location of the aneurysm, bacteriology results, antibiotic therapy, morbidity, and mortality for these cases. Results: The median age was $62{\pm}7.2years$ (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was $44.5{\pm}4.9mm$. The mean time from onset of illness to surgery was $14.5{\pm}2.4days$. Aortic continuity was restored in situ with a Dacron prosthesis (79%), homograft (16%), or Gore-Tex graft (5%). Soft-tissue coverage of the prosthesis was performed in 8 patients. The mean follow-up time was $43.2{\pm}11.7months$. The early mortality rate was 10.5%, and the 5-year survival rate was $74.9%{\pm}11.5%$. Conclusion: This study showed acceptable early and midterm outcomes of open repair of mycotic aneurysms. We emphasize that aggressive intraoperative debridement with soft-tissue coverage results in a high rate of success in these high-risk patients.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.292-295
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• 2010

The surgical treatments for aortic arch aneurysm are thought to be very invasive procedures, and high morbidity and mortality rates have been reported after aortic arch aneurysm operations. Many surgeons currently prefer the insertion of a stent-graft rather than an operation for treating an aortic arch aneurysm and if needed, with bypass of the subclavian or carotid arteries, which is called the 'hybrid method'. We managed one patient with an aortic arch aneurysm by using the hybrid method, and so we report on this case with a review of the relevant literature.

• 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.