• Journal of Chest Surgery
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• 제23권3호
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• pp.514-521
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• 1990

Patient with aortic valvular disease have increased left ventricular work and greater myocardial oxygen demand, which may aggravate the effect of concomitant coronary artery disease. Thus in patient who repair aortic valve replacement, concomitant aortocoronary bypass surgery is often performed when angiographically significant coronary artery disease is present. This approach is supported by reports that revascularization does not increase operative risk when associated coronary artery disease is present and significantly reduce the occurrence of late sudden death. Recently we have experienced one case of aortic valve replacement concomitant with aorta-coronary bypass surgery. The patient was 56 year-old male and admitted with complaint of anterior chest pain especially during his exercise. He was diagnosed as aortic valve stenosis and regurgitation [GIII] with proximal right main coronary artery occlusion We performed aortic valve replacement with aorta coronary bypass surgery by use of saphenous vein. Post operative course was uneventful and chest pain was relieved. Post operative coronary angiogram disclosed good patency of grafted vessel.

• Journal of Chest Surgery
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• 제48권1호
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• pp.70-73
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• 2015

Lower limb ischemia caused by multiple stenosis of the thoracoabdominal aorta is one of the rare clinical manifestations of Takayasu arteritis. The optimal management of such mid-aortic syndrome related with Takayasu arteritis has not been established to date. Here we report a case of extra-anatomic aortic bypass through minimally invasive techniques to treat lower limb ischemia caused by Takayasu arteritis.

• Journal of Chest Surgery
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• 제27권4호
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• pp.318-324
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• 1994

Cross-clamping of the descending thoracic aorta results in proximal hypertension,increase in left ventricular afterload,and impairment of distal organ perfusion. Bypass of the descending thoracic aorta is frequently advocated as an adjunct for repair of traumatic tears and degenerative aneurysms. Many methods of bypass have been proposed to provide distal perfusion and reduce left ventricular afterload during cross-clamping of the thoracic aorta. At Seoul National University Hospital, 7 patients were treated for the thoracic or thoracoabdominal aortic aneurysm using left atrium-femoral artery bypass with Bio-medicus centrifugal pump between October,1989, and January,1993. There were atherosclerotic thoracic aneurysm in 3 cases, thoracoabdominal aortic aneurysm due to chronic aortic dissection in 3 cases,aortic rupture due to trauma in 1 case. Total of 7 patients were operated by graft replacement with reimplantation of important branches. None of these cases developed severe complications and hospital death. We believe that the Bio-Medicus centrifugal pump is a simple and safe means of perfusing the lower body, kidneys, and spinal cord without necessitating heparinization.

• Journal of Chest Surgery
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• 제48권3호
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• pp.206-209
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• 2015

Ascending aortic aneurysms are usually treated with graft replacement under cardiopulmonary bypass. However, if a candidate for off-pump coronary artery bypass grafting has an enlarged ascending aorta, surgeons may consider wrapping it without cardiopulmonary bypass. Here, we report a 78-year-old female who underwent successful wrapping of the ascending aorta concomitant with off-pump coronary artery bypass grafting, using a new wrapping technique that involves multiple bootstraps.

• Journal of Chest Surgery
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• 제48권3호
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• pp.187-192
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• 2015

Background: Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. Methods: Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillo-bifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. Results: In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of $21.2{\pm}9.4$ months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up.. Conclusion: To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

• Journal of Chest Surgery
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• 제37권10호
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• pp.865-867
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• 2004

관상 동맥 우회술 중 발생되는 수술 중 대동맥 박리증은 매우 드물며 높은 유병률 및 사망률을 가진 치명적인 질환이다. 이 질환의 예후는 신속한 진단 및 응급 처치에 좌우된다. 72세 여자 환자에서 관상 동맥 우회술 중 발생한 수술 중 급성 대동맥 박리증에 대해 인조 혈관을 이용한 상행 대동맥 치환술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제47권6호
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• pp.552-555
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• 2014

Thoracic endovascular aortic repair has become a widespread alternative treatment option for thoracic aortic aneurysm. The debranching of arch vessels may be required to provide an acceptable landing zone for an endovascular stent graft. We report a case where the bypass graft used in the thoracic endovascular aortic repair procedure compressed the left internal jugular vein, causing acute thrombotic occlusion.

• 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 Trauma and Injury
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• 제31권1호
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• pp.24-28
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• 2018

Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.

• Journal of Chest Surgery
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• 제44권2호
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• pp.131-136
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• 2011

Background: We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods: Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was $59.8{\pm}3.3$ months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results: There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion: The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.