• Journal of Chest Surgery
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• v.46 no.3
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• pp.165-177
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• 2013

This is the third in a series on coronary artery bypass which reviews three alternative arterial conduits. The radial artery has become the most widely used of the three and accumulating experience demonstrates better patency at 10 years versus saphenous vein. Drawbacks are a long incision on the forearm, the propensity for spasm and persistent sensory disturbance in about 10%. The first is answered by endoscopic harvest which may yield a shorter conduit but reduces sensory nerve injury. Spasm is managed pharmacologically and by less harvest trauma. The gastroepiploic artery is used in situ and free and although the abdominal cavity is entered complications are minimal and patency compares favorably with the radial artery. Use of the inferior epigastric artery remains minimal and its similar length often requires composite use but limited patency data are supportive. Other arteries have had rare use and this is unlikely to change because the three presented here have significant advantages and acceptance.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.213-215
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• 2018

Aneurysm and pseudoaneurysm of the dorsalis pedis artery (DPA) are rare vascular entities. Pseudoaneurysms of the DPA are commonly due to blunt trauma, sharp penetrating injury, fracture, or iatrogenic injury. Herein, we report the case of a patient with a rare iatrogenic pseudoaneurysm that occurred after blood sampling. The diagnosis was suspected based on palpitation of a pulsatile mass on the dorsal foot and confirmed by color Doppler ultrasound and computed tomography angiography. Surgical treatment was successfully performed by reconstruction with an autologous venous graft. The patient recovered well, with no ischemic complications.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.877-884
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• 1992

From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1042-1046
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• 1994

We experienced a case of traumatic aneurysm of descending thoracic aorta by an automobile accident. The patient was 23-year-old-male with a traumatic aortic aneurysm [6x12cm] on the descending thoracic aorta just distal to the origin of the left subclavian artery. Exposure was obtained through a left posterolateral thoracotomy incision in the fourth intercostal space and then partial femoro-femoral cardiopulmonary bypass was established.After aortic cross- clamping, the aneurysmal sac was opened and repaired with interposition of Dacron vascular graft and aortic cross-clamping period lasted for 100 minutes. Postoperative bleeding and vocal cord paralysis were complicated, but bleeding was controlled by reoperation and vocal cord paralysis was improved. Follow up was continued for 14months and postoperative course was uneventful.

• Journal of Chest Surgery
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• v.14 no.2
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• pp.175-178
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• 1981

Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1139-1141
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• 1997

Recently, minimally invasive approach via limited incision becomes one of the rapidly developing strategy in cardiac surgery as it gives less surgical trauma and is more satisfactory to the patients in respect to operative scar although the surgical technique is more demanding. Here, we report two cases of aortic valve replacement via limited transsternal incision. The methodology is described with review of the relevant literature.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.120-123
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• 2008

A 60-year-old man with a history of gunshot vascular injury on the right inguinal area, and this happened in the military service 40 years ago, was admitted to our hospital with claudication and dyspnea on exertion. The patient was diagnosed with a chronic traumatic femoral arteriovenous fistula. The patient underwent a successful operation for arteriovenous fistula closure with bovine pericardium and for femoropopliteal bypass with using a right greater saphenous vein graft. The patient is well at 14 months after the operation.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.293-294
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• 2013

Gastropleural fistula (GPF) is a rare condition that can occur as a consequence of prior pulmonary surgery, trauma, or malignancy. Conservative management usually fails, and gastrectomy and even thoracotomy is often required, especially in debilitated patients. We present a patient with GPF who had a history of Ewing's sarcoma. Diagnosis of GPF was confirmed by upper gastrointestinal system endoscopy and radiographic contrast examination, and the patient underwent a laparoscopic wedge resection of the fistula. To our knowledge, this is the first report of a GPF, in the formation of which recurrence of Ewing's sarcoma had played a role and in the treatment of which wedge resection of the fistula was performed. Laparoscopic treatment of GPF may be associated with less morbidity and should be considered as the initial procedure of choice.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.251-254
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• 2006

Metallic fixations devices are widely used in the surgical management of fractures and dislocations of shoulder. It is known that Kirschner wire (K-wire) may migrate into the thoracic cavity or other organs may occur. We report a case in which a K-wire previously placed in the clavicle migrated into the thoracic cavity without causing any trauma to the major vascular structures and was removed successfully by thoracoscopic surgery.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.812-816
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• 1985

In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.