• Journal of Trauma and Injury
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• 제31권2호
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• pp.66-71
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• 2018

Patients with traumatic aortic rupture rarely reach the hospital alive. Even among those who arrive at the hospital alive, traumatic aortic rupture after high-speed motor vehicle accidents leads to a high in-hospital mortality rate and is associated with other major injuries. Here, we report a rare case of descending midthoracic aortic rupture with blunt diaphragmatic rupture. Successful management with emergency laparotomy after an immediate endovascular procedure resulted in a favorable prognosis in this case.

• Journal of Chest Surgery
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• 제24권7호
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• pp.725-731
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• 1991

Four patients with traumatic rupture of aorta underwent operative repair at Seoul national university hospital. All cases were confirmed by preoperative aortography. Rupture site was aortic isthmus or just distal to it. Operations were somewhat delayed due to the low degree of suspicion and difficulties in diagnosis: ranging from 5 hours to 8 days. Operation was performed as same manners in all cases: resection of the ruptured portion and tubular woven dacron graft interposition in conjunction with shunt or bypass procedures, TDMAC-Heparin shunt between ascending and descending aorta was used in 3 cases, and LA-femoral centrifugal pump was used in one case. There were no intraoperative or postoperative mortality. Hoarseness was developed in all patients but paraplegia or other significant complications were not found in any of patients. We concluded that 1] high degree of suspicion is essential in the early diagnosis and treatment of traumatic aortic rupture and 2] any kind of shunt or bypass procedure is necessary in operative repair of traumatic aortic rupture and use of centrifugal pump without systemic heparinization is easier and safer procedure than others for the maintenance of adequate distal flow.

• Journal of Chest Surgery
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• 제26권11호
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• pp.838-844
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• 1993

Rupture of aortic is for the most part a terminal disorder and requires prompt and aggressive treatment. Most of the patients who develop this condition outside the hospital die before appropriate therapy can be instituted. Thus prompt treatment, sometimes innovative, resulted in a highly significant survival rate. We experionced 21 aortic rupture due to mycotic aneurysm and another 3 due to chest trauma. Operation was done in 11 cases, and mortality was 3 of 11 cases. In another 10 cases, operation was not performed and all of them were expired. We confirmed diagnosis using only non invasive technic as ultrasonogram and computed tomography and invasive technic like aniography was absolutely avoided. Preoperative management was aimed to lower blood pressure for the purpose of preventing srcondary bleeding, and operantions erer porformed promptly if possible.

• Journal of Chest Surgery
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• 제37권9호
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• pp.774-780
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• 2004

외상성 흉부대동맥 파열은 수술적 치료가 요구되는 치명적 손상이며 이외에 다른 부위에 복합손상이 동반되면 심폐 바이패스에 의한 위험도를 크게 증가시킬 수 있다. 여기서 저자들은 심한 동반손상을 먼저 치료한 후 대동맥수술을 하고 그 결과를 관찰하였다. 대상 및 방법: 1997년부터 2003년까지 외상성 흉부 대동맥질환으로 수술을 받은 24명의 환자를 대상으로 의무기록을 후향적으로 검토하여, 동반손상 여부, 수술방법, 수술 후 경과, 합병증 등을 분석하고 국내외 문헌들과 비교하였다. 수술은 초저온 심정지법하에서 심폐 바이패스를 이용한 개흉술로 하였는데 근위부 연결 후 곁가지를 통해 뇌관류를 시행하였고 요추 카테터를 통한 뇌척수액 배액으로 하반신 마비를 예방하였다. 결과： 대상환자 전원에서 83예의 동반손상이 발생하였는데, 흉부손상이 49예, 근골격계 손상 18예, 복부 손상 13예였고, 수상 후 12명의 환자에서 7.6$\pm$12.6일에 16예의 동반손상에 대한 수술이 행해졌다. 수상당시 18예에서만 대동맥 손상이 진단되었다. 중환자실에서 혈압을 약물투여로 조절하면서 안정시키고 수상 후 693 $\pm$ 1350일에 지연수술을 시행하였는데, 관찰기간 중 사망이나 대동맥 파열의 진행은 없었다. 수술 사망은 없었으며, 술 후 큰 합병증은 없었다. 결론： 외상성 흉부대동맥 파열에 있어서 다른 부위 손상이 동반되면 심한 동반손상을 먼저 치료한 후 수술하는 것이 수술 사망률이나 이병률 면에서 좋은 결과를 가져온다.

• 한국전산구조공학회논문집
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• 제33권3호
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• pp.179-186
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• 2020

본 연구에서는 복부대동맥류가 발생한 환자들에서의 연령과 복부대동맥류 형상에 따른 벽 응력과 파열 위험성을 평가하였다. 복부대동맥류의 형상은 의료영상 데이터로부터 추출되어 모사되었으며, 재료 물성치 단계에서는 동맥 조직의 이방성 초탄성 성질을 모사하기 위해 Gasser-Ogden-Holzapfel 모델을 적용하였다. 또한, 모델에서 필요한 각 재료 정수들은 환자들의 연령과 정상 조직 및 동맥류 조직의 특성들을 고려하기 위하여 각기 다른 값들로 산정되었다. 게다가 복부대동맥류에서의 대동맥 직경과 목의 각도에 관한 상관관계를 분석하고, 이에 대한 시리즈 시뮬레이션 역시 수행되었다. 그 결과, 복부대동맥류 환자의 연령과 대동맥 직경, 그리고 대동맥 목의 각도에 따른 복부대동맥류의 파열 위험성이 평가되었다.

• Journal of Chest Surgery
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• 제48권5호
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• pp.364-367
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• 2015

Cardiovascular involvement in cases of Behcet's disease is a rare but life-threatening condition, and prosthetic valve detachment is a frequent and serious complication attributable to Behcet's disease following the surgical repair of aortic regurgitation. We report the case of a patient with Behcet's disease presenting with contained aortic rupture around the aortic root. The patient had previously undergone aortic valve surgery three times due to recurrent prosthetic valve detachment. An emergency operation was performed, consisting of aortic root replacement (ARR) using a composite valved conduit and the replacement of the hemiarch. ARR may be an appropriate surgical option for patients with Behcet's disease in order to prevent recurrence of the disease.

• Journal of Chest Surgery
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• 제44권1호
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• pp.68-71
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• 2011

In treating uncomplicated abdominal aortic aenurysm, endovascular aortic aneurysm repair (EVAR) has been employed as a good alternative to open repair with low perioperative morbidity and mortality. However, the aneurysm can enlarge or rupture even after EVAR as a result of device failure, endoleak, or graft migration. We experienced two cases of aneurismal rupture after EVAR, which were successfully treated by surgical extra-anatomic bypass.

• 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.

• Journal of Chest Surgery
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• 제41권3호
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• pp.373-376
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• 2008

외상성 흉부 대동맥 파열에 의한 가성대동맥류에 대한 일반적인 치료 방법은 수술이다. 그러나 환자의 전신상태가 개흉술을 통한 수술 또는 체외순환보조를 통한 수술을 시행 받기 어려운 경우에는 다른 치료 방법을 선택해야 한다. 저자들은 두부, 복부, 골반의 광범위한 다발성 손상이 동반되어 수술적 치료를 시행하기 어려웠던 대동맥파열에 의한 가성대동맥류 환자에 대하여 중재적 시술을 통해 스텐트-그라프트를 삽입하여 치료한 1예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권3호
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• pp.240-242
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• 2011

We experienced a case of ruptured aneurysm of the sinus of Valsalva, and this resulted in simultaneous aortic and tricuspid valve endocarditis through a shunt. The echocardiography showed a ruptured sinus of Valsalva aneurysm to the right atrium with a shunt. The aortic non-coronary cusp was fibro-thickened with vegetation. Vegetations of the septal leaflet and the anterior leaflet of the tricuspid valve were also found. The blood culture grew Enterococcus garllinarum. We replaced both tricuspid and aortic valve with successful surgical result.