• Title/Summary/Keyword: Chest Wall

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Familial Surpravalvular Aorctic Stenosis in Two Silings (남매에서 발생한 가족성 판상부 대동맥협착증)

  • 강재걸
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1145-1151
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    • 1988
  • Supraventricular tachyarrhythmias are readily characterized and understood, but the surgical procedures for their correction are complex and not easily mastered. Conversely, ventricular tachyarrhythmias are frequently difficult to characterize and localize electrophysiologically and their basic mechanisms are poorly understood. The role of the surgeon in the treatment of cardiac arrhythmia has changed dramatically during the past decade. This report is a case of 26 years old male with supraventricular tachyarrhythmia. The result of endocardial electrophysiologic study demonstrated accessory pathway connecting left atrium to left ventricle which located at left atrial free wall about 4 cm apart from the coronary sinus orifice. The accessory bundle interruption has been successfully accomplished utilizing the internal open heart technique. The operation consisted of dissection of the atrioventricular fat pad and division of all the superficial fibers going from the ventricle to the annulus. Following this, cryoablation made with cryoprobe at - 60` for 90 seconds. The accessory pathway was successfully ablated without specific problems.

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Surgical Angioplasty of Isolated Left Coronary Ostial Stenosis (좌관상동맥 입구협착의 외과적 확장술)

  • 서필원
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.247-252
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    • 1995
  • The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

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Esophageal Duplication Cyst -A Case Report- (식도 중복 낭종 -수술 치험 1례-)

  • 이현석
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.869-871
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    • 1995
  • Esophageal duplication cysts are uncommon, benign lesions of the esophagus. They are rare congenital foregut anomalies. To be considered an esophageal duplication cyst, a lesion must meet the following criteria:1 the cyst in the esophageal wall 2 the cyst is covered with a muscularis propria,generally of two layers and 3 the cyst has an epithelial lining consistent with that of the 4 week embryo, which may be columnar or pseudostratified columnar, and may be ciliated. Herein we report a case of an esophageal cyst located within the thoracic cavity, which is, to the best of our knowledge, the first case reported in Korea. Surgery is generally the treatment of choice for esophageal cyst, and was indicated in this case for the diagnosis and management of symptoms attributable to the cyst.

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Surgical Treatment of Post-Infarction Ventricular Septal Defect with Left Ventricular Rupture -A Case Report- (심근 경색후 발생한 좌심실 파열을 동반한 심실중격 결손의 외과적 치료 -1례 보고-)

  • Kim, Hyun-jo;Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.857-860
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    • 1995
  • In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

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Interrupted Aortic Arch Associated with AP Window, PDA, and Aberrant Origin of the Right Subclavian Artery from Proximal Descending Aorta [A Case Report] (대동맥폐동맥 중격결손증, 개방성 대동맥관 및 우측 쇄골하동맥 이상기시를 동반한 대동맥궁 결손증)

  • Lee, Jeong-Ryeol;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.18 no.2
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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.

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Palliative Treatment with Celestin`s tube in Advanced Esophageal Cancer (진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료)

  • 백광제
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.529-533
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    • 1985
  • Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

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Interrupted Aortic Arch [Type A] associated with ventricular septal defect, patent ductus arteriosus and patent foramen ovale (심실중격결손증, 개방성 대동맥관 및 개방성난원공과 동반한 대동맥궁 결손증: 1례보고)

  • 김한용
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.206-211
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    • 1991
  • Interruption of the aortic arch may be defined as discontinuity of the aortic arch in which either an aortic vessel or a patent ductus arteriosus supplies the descending aorta. This anomaly is a rare congenital malformation that usually occurs with severe associated intracardiac congenital anomalies, such as ventricular septal defect, patent foramen ovale and abnormal arrangement of the brachiocephalic arteries. Rarely, transposition of the great vessel, truncus arteriosus are coexistent. We experienced a case of the interrupted aortic arch [Type A] associated with VSD, PDA and patent foramen ovale in a 16 years old female. One stage total correction was done under profound hypothermia with total circulatory arrest. Aortic continuity was established using patent ductus arteriosus with anterior wall of main pulmonary artery, which was anastomosed obliquely to anteromedial side of the ascending aorta. Ventricular septal defect was closed using Dacron patch and patent foramen ovale was closed directly. Postoperative course was uneventful, except mild hoarseness.

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Coarctation of the Aorta Associated with Thoracic Aortic Aneurysm (대동맥 축착증에 동반된 대동맥류 치험 1례)

  • 유홍석
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.202-205
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    • 1991
  • Development of an aneurysm in the thoracic aorta, intercostal arteries, or cerebral vessels is not an uncommon occurrence in patients with coarctation of the aorta. The mechanism whereby coarctation predisposes to aneurysm formation is incompletely understood and we suggest that in this case, an intrinsic factor in the wall of the aorta underlies the formation of aneurysms. Recently we experienced one case of COA associated with the thoracic aortic aneurysm and operation was done successfully. PDA was simply ligated and the aorta was cross-clamped proximally and distally and the area of constriction or aneurysmal site were excised. Postoperative course was uneventful and the patient was discharged 2 weeks after operation. Hypertension at upper extremities was controlled without any antihypertensive drugs after operation and the degree of regurgitation of mitral valve was improved postoperatively but long-term follow-up should be necessary.

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Intracardiac a Aortic Foreign Body (심장 및 대동맥내 이물 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.932-935
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    • 1997
  • A 50-year-old male patient was admitted due to right ventricular & aortic foreign bodies with ascending aortic pseudoaneurysm. The patient had a history of Kirschner wire fixation of right sternoclavicular joint 3 months ago. Under cardiopulmonary bypass, two K-wires were removed and injured pulmonary valve leaflet and aortic wall were repaired successfully The postoperative course was uneventful and the patient was discharged on the 14th postoperative day.

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Bronchoplasty using to Pericardial Patch (심낭막 절편을 이용한 기관지성형)

  • Lee, Jun-Yeong;Gang, Jeong-Ho;Ji, Haeng-Ok
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.177-181
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    • 1987
  • For the treatment of bronchial stenosis due to trauma, inflammatory and neoplastic lesion, bronchoplastic procedure in the interest of preservation of lung tissue are relatively new developments in the field of thoracic surgery. We reported on case of bronchoplasty using to pericardial patch for the treatment of bronchial stenosis due to chronic inflammation. The patient was 26 years old female and chief complaint was respiratory difficulty. Bronchogram revealed diffuse stenosis of left main bronchus about 4cm and especially, at just below the carina marked narrowing of lumen and fine serration in the wall. At the time of operation, longitudinal incision was made at left main bronchus about 5cm and reconstructed bronchus using to pericadial patch at membranous compartment of bronchus. The postoperative course was uneventful and post-operative follow up bronchography showed that improvement of bronchoplastic segmented region.

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