• Journal of Chest Surgery
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• 제18권3호
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• pp.461-465
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• 1985

Rupture of the aorta following blunt trauma of the thorax may occur more frequently than has generally been recognized. Actual complete transection of the aorta usually results in immediate death but varying degrees of lesser disruption permit increased chance of survival. Chronic traumatic aneurysms are so designated following a period of 3 months from the traumatic incident. The exact time required for the acute process and hematoma to convert into an aneurysm is unknown. Because a thoracic surgeon encounters so few of these aneurysms, it is difficult for him to arrive at sound dicta of management from his personal experience. It is not surprising that controversy exists concerning the therapeutic approach to the aneurysm which is asymptomatic and is discovered months or years after the causative injury. In the hope of improving the surgical treatment of patients with this condition, we reported one case with chronic traumatic aneurysm of the descending thoracic aorta.

• Journal of Chest Surgery
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• 제24권2호
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• pp.171-181
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• 1991

Result of St. Jude Medical valve replacement are presented in 106 patients who underwent operation from January 1985 through July 1989. The patient were 52 males and 56 females. Total 136 of St. Jude Medical valves were implanted; 91 in mitral position, 45 in aortic position. The hospital mortality rate was 5.7%o[6 patients] and the late mortality rate was 2.0%[2 patients]. The causes of death were low cardiac output in 5, iatrogenic right ventricular rupture in 1, heart failure in 1, ventricular arrhythmia in l. And, the causes of valve related complication were anticoagulant related hemorrhage in 5 patients[0.03% /patient-year] and thromboembolism[0.01% /patient-year] in 2 patients. In conclusion, the performance of the St. Jude Medical valve compare most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

• Journal of Chest Surgery
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• 제29권3호
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• pp.342-345
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• 1996

세균성 동맥류는 드물지만 전격성 진행으로 말미암아 적절한 치료가 동반되지 않으면 파열이 흔하며 심한경우 사망으로 이어진다. 세균성 동맥류중 비심인성 균형증에 의한 것을 흔히 감염성 동맥류라 한다. 본 교실에서는 후복막강으로 파열된 감염성 복부대동맥류를 1례 치험하였다. 환자는 57세 남자로 배부요통을 주소로 내원하였으며 발열이 있었고 하복부에서 종물이 촉지되었다. 술전검사상 포도상구균에 의한 균형증을 동반한 감염성 복부 대동맥류로 진단되어 동맥류 절제술 및 인조혈관 대치술을 시행하였으면 술후 장기간 항생제를 사용하였다. 환자는 술후 합병증 없이 회복하여 퇴원하였다.

• Parasites, Hosts and Diseases
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• 제47권4호
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• pp.405-407
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• 2009

On July 2009, 5 fly larvae were discovered inside the nose of a 76-year-old female. She was living in Cheonansi, and in a state of coma due to rupture of an aortic aneurysm. Surgery was performed on the day of admission, and the larvae were found 4 days later. By observing their posterior spiracle, the larvae were identified as Lucilia sericata. Considering the rapid development of this species, the infection was likely acquired during hospitalization. Further investigation on the hospital environment should be needed to know the origin of the infection.

• Journal of Chest Surgery
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• 제22권6호
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• pp.970-979
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• 1989

From April 1982 to December, 1988, multiple valve replacement was performed in 49 patients. Mitral and aortic valve replacement were done in 42 patients, 4 underwent mitral and tricuspid valve replacement and 3 patients underwent triple valve replacement. Of the valve implanted, 50 were Duromedics, 21 St. Jude, 13 Bjork-Shiley, 9 Carpentier-Edwards, 6 Ionescu-Shiley, and 2 Medtronic. The hospital mortality rate was 28.5 % [14 patients] and the late mortality rate was 6.1 % [3 patients], the mortality rate was high in early operative period but decreased with time. [20% at 1986, 18.2 % at 1987, 9.5% at 1988] The causes of death were low cardiac output in 8, congestive heart failure in 2, multiple organ failure in 1, LV rupture in 1, intracerebral hemorrhage in 1 and sudden death in l. The actuarial survival rate excluding operative death was 77% at 7 years.

• Journal of Chest Surgery
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• 제21권1호
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• pp.62-69
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• 1988

In the department of chest surgery of WonKwang university hospital, mechanical valve replacement was performed in 51 cases from June 1985 to September 1987. Among these, 32 cases were mitral valve replacement, 4 cases were aortic valve replacement, and 15 cases were double valve replacement. 26 cases were male and 25 cases were female and age distribution ranged from 16 years old to 63 years old. Early death within 30 days after operation was 2 cases [3.9%] and causes of death were right heart failure [1] and right ventricular wall rupture [1]. Among 49 early survivors, 2 cases of late death were developed and the causes of death were cardiomyopathy [1] and ventricular arrhythmia [1] Anticoagulant therapy was done with warfarin sodium to the level of 1.5-2 times of normal prothrombin time [20-40%] in 47 survivors. Symptomatically, 93.6% of preoperative NYHA functional class III or IV were converted to the NYHA functional class I or II during follow up.

• Journal of Chest Surgery
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• 제54권5호
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• pp.429-432
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• 2021

Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control. However, there is limited information on the use of REBOA in non-trauma patients with shock. Herein, we describe a patient with impending cardiac arrest due to isolated ruptured IAA, in whom perioperative bleeding was successfully controlled by REBOA.

• Journal of Chest Surgery
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• 제52권5호
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• pp.372-375
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• 2019

A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.276-280
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• 2023

Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

• Journal of Chest Surgery
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• 제32권6호
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• pp.532-535
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• 1999

배경: 하행 흉부 대동맥류에 대한 외과적 치료에 대하여 수술 방법과 술 후 합병증 등에 대하여 알아보고자 하였다. 대상 및 방법: 인제대학교 의과대학 서울백병원 흉부외과학 교실에서는 1987 년 3 월부터 1997년 8월까지 하행 흉부 대동맥류로 수술을 시행한 22예를 대상으로 후향적 조사를 하였다. 결과: 환자는 남자가 18예 여자 4예로 남자가 많았으며 연령은 33세에서 82 세 이었고 평균은 49 세였다. 대동맥류의 원인은 대동맥 박리증 13, 죽상경화증 3, 진균성 3, 외상성 2, 원인불명 1예였다. 수술은 절제 및 이식편 치환술 16, 액와동맥-양측 대퇴동맥 우회로 이식술 2, 대퇴동맥-대퇴정맥 우회로 이식술 1, 동맥류 공치술(exclusion) 1, 동맥류 봉합술 1, 경대퇴동맥 스텐트 삽입술 1예였다. 수술 시 대동맥을 차단하고 수술한 예는 16예였고, 이 중 14예는 대퇴동맥-대퇴정맥 바이패스를 실시하였고, 2예는 우회로 이식술을 먼저 하였다. 평균 대동맥 차단시간은 91분이었고 체외순환 시간은 116 분이었다. 사망 예는 1예로 공치술 한 환자가 술 후 52일에 갑작스런 출혈로 사망하였고, 대마비 1, 급성 신부전증 2, 급성 호흡부전증 1예가 발생하였다. 결론: 하행 흉부 대동맥류 수술은 많은 술 후 합병증이 예상되나 적절한 환자의 선택과 섬세하고 다양한 수술 기법을 사용하면 비교적 적은 합병율로 수술할 수 있다.