• Journal of Chest Surgery
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• 제45권6호
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• pp.404-407
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• 2012

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

• 대한임상검사과학회지
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• 제52권4호
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• pp.425-429
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• 2020

대동맥박리(aortic dissection)란 대동맥 내막에 미세한 파열이 발생하면 높은 대동맥 압력으로 인해 대동맥의 중막이 장축으로 찢어지면서 대동맥이 진성 내강(true lumen)과 가성 내강(false lumen)으로 분리되는 것을 말하며 사망률이 아주 높은 질환으로 빈도를 보면 남자가 여자보다 2~5배 정도 많이 발생하고, 호발하는 연령대는 50~70세 사이로 알려져 있다. 본 증례에서는 자주 발생되지 않는 젊은 30대 여자에게서 발생된 대동맥 박리증 진단을 직접 경험하였던 바 중증 대동맥판 역류증(severe aortic regurgitation)을 추적하는 과정에서 처음에는 대동맥판 탈출증(aortic valve prolapse)을 의심하였다. 이 의심된 부분을 확인하는 과정에서 상행대동맥의 내막피판 관찰을 통해 대동맥 박리증을 진단할 수 있었기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제54권3호
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• pp.172-178
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• 2021

Background: Complicated acute type B aortic dissection is a life-threatening condition with high morbidity and mortality. The aim of this study was to report a single-center experience with endovascular stent-graft repair of acute type B dissection of the thoracic aorta and to evaluate the mid-term outcomes. Methods: We reviewed 18 patients treated for complicated acute type B aortic dissection by thoracic endovascular aortic repair (TEVAR) from September 2011 to July 2017. The indications for surgery included rupture, impending rupture, limb ischemia, visceral malperfusion, and paraplegia. The median follow-up was 34.50 months (range, 12-80 months). Results: The median interval from aortic dissection to TEVAR was 5.50 days (range, 0-32 days). There was no in-hospital mortality. All cases of malperfusion improved except for 1 patient. The morbidities included endoleak in 2 patients (11.1%), stroke in 3 patients (16.7%), pneumonia in 2 patients (11.1%), transient ischemia of the left arm in 1 patient (5.6%), and temporary visceral ischemia in 1 patient (5.6%). Postoperative computed tomography angiography at 1 year showed complete thrombosis of the false lumen in 15 patients (83.3%). Conclusion: TEVAR of complicated type B aortic dissection with a stent-graft was effective, with a low morbidity and mortality rate.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.128-133
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• 2024

Aortic dissection in pregnant patients results in an inpatient mortality rate of 8.6%. Owing to the pronounced mortality rate and speed at which aortic dissections progress, efficient early detection methods are crucial. Here, we highlight the importance of early chest computed tomography (CT) for differentiating aortic dissection from pulmonary embolism in pregnant patients with dyspnea. We present the unique case of a 38-year-old pregnant woman with elevated D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, initially suspected of having a pulmonary embolism. Initial transthoracic echocardiography did not indicate aortic dissection. Surprisingly, after an emergency cesarean section, a chest CT scan revealed a DeBakey type I aortic dissection, indicating a diagnostic error. Our findings emphasize the need for early chest CT in pregnant patients with dyspnea and elevated D-dimer and NT-proBNP levels. This case report highlights the critical importance of considering both aortic dissection and pulmonary embolism in the differential diagnosis of such cases, which will inform future clinical practice.

• 한국응급구조학회지
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• 제24권3호
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• pp.141-145
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• 2020

The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.

• Journal of Chest Surgery
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• 제23권1호
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• pp.174-177
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• 1990

Aortic dissection is a challenging disease and the causes of that are well-known. Blunt chest trauma is one of the causes of aortic dissection. In such cases, nearly all cases involves the isthmic portion of descending aorta, but ascending aorta is involved in about 10. We experienced a patient who had ascending aortic dissection due to automobile accident and who showed spontaneous rupture of the aorta during operation. In this case, after installation of aortic line via left femoral artery, ascending aorta ruptured and a large amount of blood gushed out, which was suckered by cardiotomy sucker. A little delay of cardiopulmonary bypass may cause the fatal outcome in such a case because the bleeding from aorta is too much to be controlled. Fortunately, we controlled the bleeding with cardiopulmonary bypass and got the good outcome of this patient by interpositioning the vascular graft. One should suspect the possibility of aortic dissection in blunt chest trauma, and prepare all the facilities against bleeding due to rupture.

• The Korean Journal of Legal Medicine
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• 제42권4호
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• pp.172-175
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• 2018

Aortic dissection is an uncommon, life-threatening medical emergency that is associated with a high mortality rate, and death from aortic dissection is mainly related to secondary complications, namely cardiac tamponade, severe aortic regurgitation, acute myocardial infarction, and abdominal organ vessel obstruction. Hence, prompt and accurate diagnosis followed by proper treatment is important for patient survival. Herein, we present a rare case of sudden death after aortic dissection with concomitant acute myocardial infarction and cardiac tamponade.

• Journal of Chest Surgery
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• 제49권2호
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• pp.126-129
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• 2016

We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively.

• Journal of Chest Surgery
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• 제47권1호
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• pp.39-42
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• 2014

It is expected that the stent graft will become an alternative method for treating aortic diseases or reducing the extent of surgery; therefore, thoracic endovascular aortic repair has widened its indications. However, it can have rare but serious complications such as paraplegia and retrograde type A aortic dissection. Here, we report a surgical repair of retrograde type A aortic dissection that was performed after thoracic endovascular aortic repair.

• Journal of Chest Surgery
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• 제43권6호
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• pp.758-763
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• 2010

흉부대동맥 질환에서 대동맥 내에 스텐트-도관(stent-graft)을 삽입하는 흉부 혈관내 대동맥 성형술(Thoracic endovascular aortic repair, TEVAR)은 최근 이의 적용이 점점 늘어나고 있는 추세이다. 하지만, 이 술식은 endoleak으로 인한 치료 실패, 시술 중 안착지점(landing zone)에서 발생하는 혈관벽의 손상으로 인한 역행성 대동맥박리 및 스텐트-도관 감염으로 인한 대동맥 파열 등의 심각한 합병증 발병의 위험성을 내재하고 있다. 저자들은 급성 하행 대동맥 박리 혹은 외상성 하행 대동맥 파열에서 적용된 TEVAR 후 발생한 2예의 역행성 대동맥 박리의 치료 경험을 문헌과 함께 보고하고자 한다.