• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.834-840
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• 2020

Objective : Carotid endarterectomy (CEA) is an effective surgical procedure for treating symptomatic or asymptomatic patients with carotid stenosis. Many neurosurgeons use a shunt to reduce perioperative ischemic complications. However, the use of shunting is still controversial, and the shunt procedure can cause several complications. In our institution, we used two types of modified arteriotomy suture techniques instead of using a shunt. Methods : In technique 1, to prevent ischemic complications, we sutured a third of the arteriotomy site from both ends after removing the plaque. Afterward, the unsutured middle third was isolated from the arterial lumen by placing a curved Satinsky clamp. And then, we opened all the clamped carotid arteries before finishing the suture. In technique 2, we sutured the arteriotomy site at the common carotid artery (CCA). We then placed a curved Satinsky clamp crossing from the sutured site to the carotid bifurcation, isolating the unsutured site at the internal carotid artery (ICA). After placing the Satinsky clamp, the CCA and external carotid artery (ECA) were opened to allow blood flow from CCA to ECA. By opening the ECA, ECA collateral flow via ECA-ICA anastomoses could help to reduce cerebral ischemia. Results : The modified suture methods can reduce the cerebral ischemia directly (technique 1) or via using collaterals (technique 2). The modified arteriotomy suture techniques are simple, safe, and applicable to almost all cases of CEA. Conclusion : Two modified arteriotomy suture techniques could reduce perioperative ischemic complications by reducing the cerebral ischemic time.

• Journal of Chest Surgery
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• 제18권2호
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• pp.360-370
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• 1985

A case of complete interruption of aortic arch with aortopulmonary window, patent ductus arteriosus, and aberrantly originated right subclavian artery from proximal descending aorta, in a four year old boy is reported in detail. This is the only reported case in Korea, who has had a successful one-stage total anatomical correction of this combination of defects. Under deep hypothermia and total circulatory arrest, aortic continuity was established using patent ductus arteriosus and anterior wall of pulmonary artery, which was anastomosed obliquely to anteromedial side of ascending aorta. Aortopulmonary window was closed using Impra patch via pulmonary arteriotomy. Then pulmonary arteriotomy was reconstructed primarily except at the junction of right pulmonary artery and main pulmonary artery, where a small piece of pericardium was used to close the defect to prevent kinking and narrowing of right pulmonary artery. Postoperative cardiac catheterization demonstrated a good reconstruction.

• Journal of Chest Surgery
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• 제19권2호
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• pp.232-237
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• 1986

The intraventricular conduction disturbances have been documented after correction of ventricular septal defects by any surgical route but debated its etiology. And so the frequency of conduction disturbances following right ventriculotomy, right atriotomy and pulmonary arteriotomy for closure of ventricular septal defects was compared in various conditions. The present series consists of 218 patients with ventricular septal defects. They had the surgical repair at the Seoul National University Hospital from January 1983 to October 1984. Conduction disturbances were studied with conventional 12 leads electrocardiogram. Of the 218 VSD`s 139 patients were repaired via vertical right ventriculotomy, 45 patients via right atriotomy, 34 patients via pulmonary arteriotomy. 1] Of 218 patients the frequency of RBBB was 26.1% and the frequency of RBBB + LAH was 6.0%. 2] There is no statistical difference between right ventriculotomy group [30.2%] and right atriotomy group [24.4%]. But there is significant difference between right ventriculotomy group and pulmonary arteriotomy group [11.8%] [P<0.05]. 3] In respect to anatomical classification by Kirklin`s method, the frequency of RBBB was higher in type II [32.1%] than in type I [14.9%]. [P<0.05] But in each anatomical type, there is no influence of the various surgical approach on the incidence of postoperative RBBB. 4] The frequency of RBBB was 31.8% in patch closure group and 14.3% in direct closure group. [P<0.05] Although the result suggests that there is no significant difference in various surgical approaches on the incidence of postoperative conduction disturbances, it may be reduced by a new-ventricular approach or a limited incision at right ventricular outflow tract in right ventricular approach.

• Journal of Chest Surgery
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• 제36권11호
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• pp.858-861
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• 2003

대동맥판막질환에 동반된 허혈성 심질환의 원인은 대부분 전신적인 동맥경화의 진행에 따른 것이며, 심한 석회화가 초래된 대동맥판협착증 환자에서 대동맥판막의 일부가 떨어져 나와서 관상동맥 색전증 및 협착을 유발시킨 예는 매우 드물다. 저자들은 흉부압박감을 주소로 내원한 73세 여자 환자에서 심초음파검사와 관상동맥조영술을 시행하여 중증 대동맥판협착증과 우관상동맥의 색전증을 진단하고 대동맥판치환술과 우관상동맥의 색전제거술 및 관상동맥성형술을 시행하였던 예를 치험하였다. 수술 후 우관상동맥 색전의 원인 물질이 대동맥판막으로부터 떨어져 나온 석회성 판막조직으로 판단되었기에 이와 관련된 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제18권4호
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• pp.589-597
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• 1985

Congenitally corrected transposition of great arteries is a rare congenital heart anomaly. We experienced two case of corrected transposition of great arteries, one [S,L,L] and one [I, D,D] associated with patent foramen ovale, ventricular septal defect and pulmonary stenosis. The patent foramen ovales were closed directly under right atriotomy, the ventricular septal defects were closed with Dacron patch under morphological left ventriculotomy and the pulmonary valvular and subvalvular stenosis were corrected under pulmonary arteriotomy. The postoperatively course was uneventful in case I, the permanent pacemaker was implanted in case ll.

• Journal of Chest Surgery
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• 제27권2호
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• pp.166-169
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• 1994

Primary malignant tumors originating in the pulmonary artery are extremely rare. Recently, We experienced a case of primary leiomyosarcoma occurred on the main pulmonary artery and extended into the Rt and Lt pulmonary artery. The patient was 44 year-old woman and the chief complaint was severe exertional dyspnea. Emergency pulmonary arteriotomy to relieve the pulmonary artery obstruction was performed on cardiopulmonary bypass. The tumor was 6 x6 x4 cm in size and infiltrated into the main pulomary artery. The tumor in the pulmonary artery was removed without any difficulties. The patient was recovered without any specific problems. The tumor was confirmed to be leiomyosamoma histopathologically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.312-320
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• 2011

A reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. For a better understanding of oral and maxillofacial reconstructive procedures, basic and advanced microvascular anastomosis techniques must be learned and memorized. The aim of this article was to clarify and define the microvascular anastomosis methods, such as primary closure after an arteriotomy, end to side anastomosis, end to end anastomosis, and side to side anastomosis with an artery and vein. This review article discusses the basic skills regarding microvascular anastomoses with brief schematic diagrams in the Korean language. This article is expected to be helpful, particularly to young doctors in the course of the Korean national board curriculum periods for oral and maxillofacial surgery.

• Journal of Chest Surgery
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• 제19권2호
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• pp.319-324
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• 1986

Congenital coronary arteriovenous fistula is uncommon disease, and was first described by Krause in 1865. About 20% of the cases, it associates additional congenital heart diseases. A 5-year-old female patient was diagnosed as coronary AV fistula with VSD, and was taken surgical correction under cardiopulmonary bypass. VSD was small and subarterial in type, and the fistula was dilated as adult thumb tip size at its distal portion. VSD was closed directly through the pulmonary arteriotomy and the aneurysmal dilation was opened vertically, then it was obliterated using 5-0, 6-0 prolene continuous suture fashioning into a long slender tube. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제36권12호
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• pp.995-998
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• 2003

관상동맥 우회로술 때 보이지 않는 좌전하행지의 노출 방법에는 여러 가지가 있다. 특히 심근 내 위치하는 좌전하행지인 경우 보다 표면에 위치하는 근위 관상동맥을 노출하여 내흉동맥편을 문합함으로써 이식편의 우수한 장기 열림을 기대할 수 있다 육안 상 보이는 원위 좌전하행지의 절개창을 통해 삽입한 더듬자로 심장 외막에 가까운 근위 좌전하행지를 쉽게 노출할 수 있는 방법을 보고하고자 한다.

• Journal of Chest Surgery
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• 제20권4호
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• pp.793-797
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• 1987

Coronary artery fistula is an uncommon congenital heart defect that is readily amenable to surgical treatment. This fistula usually originates from the right coronary artery, but may arise from the left coronary artery, both coronary arteries, or single coronary artery. And the fistulous communication is most often to right ventricle, right atrium or pulmonary artery. Recently we experienced one case of congenital coronary artery fistula which was associated with patent ductus arteriosus. The fistulous communication, forming aneurysmal dilatation, was noted between the left anterior descending coronary artery and the right ventricular outflow tract. Cardiopulmonary bypass was employed in this case. After an arteriotomy was made on the aneurysmal coronary artery, both the proximal opening and the termination site of the fistulous tract were directly closed with partial aneurysmorrhaphy. The right ventricular chamber was also opened to evaluate the fistulous termination site. Postoperative hospital course of the patient was uneventful and she was discharged without problems.