• Title/Summary/Keyword: Coarctation

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Transpleural Retroperitoneal Approach for the Coarctation of the Abdominal Aorta (경흉막 후복막 접근에 의한 복부대동맥 축착 수술)

  • Lee, Chul-Burm;Song, Dong-Sub;Kim, Hyuk;Kim, Young-Hak;Kang, Jung-Ho;Lee, Jae-Ung;Kim, Sun-Gil
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.270-273
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    • 2001
  • 신동맥 사이 또는 신동맥 상부에 위치하는 대부분의 복부대동맥 축착은 흉복부절개의 접근으로 수술한다. 우리는 경흉막 후복막 접근으로 개복을 하지 않고 단측단측 흉복부대동맥의우회술을 시행한 1례의 수술을 소개하고자 한다. 경흉막 후복막 접근은 흉복부대동맥의 시야가 매우 좋으며 개복을 할 때보다 더 쉽게 흉복부대동맥의 우회술을 할 수 있고 복강내 장기를 노출하지 않는 장점이 있다.

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Coarctation of Aorta

  • Kim, Hun;Gang, Myeon-Sik;Jo, Beom-Gu;Hong, Seung-Rok
    • Proceedings of the KTCVS Conference
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    • 1988.06a
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    • pp.75-75
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    • 1988
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The Application of a Bi-ventricular Assist Device for a Low Weight (2.4 kg) Neonate with Coarctation of the Aorta and Critical Aortic Stenosis (대동맥 축착증 및 심한 대동맥 협착을 가진 저체중 신생아(2.4 kg)의 수술 전후 발생한 심실 기능 부전의 치료에 대한 양심실 보조 장치 적용 치험 예)

  • Kwak, Jae-Gun;Park, Chun-Soo;Lee, Chang-Ha;Lee, Cheul
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.304-307
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    • 2010
  • A 5-day-old neonate (body weight=2.4 kg) with coarctation of the aorta and critical aortic stenosis underwent an interventional balloon valvuloplasty for aortic stenosis. During the intervention, cardiac arrest occurred due to injury of the right carotid artery by the guide wire. An extracorporeal membrane oxygenator (ECMO) was applied. After 1 day's support, total surgical correction was achieved; however, in the immediate postoperative period, cardiac function was severely depressed. We applied a bi-ventricular assist device (bi-VAD) instead of an ECMO and we were able to wean the patient off the bi-VAD device after 3 days' support. The patient was discharged without severe complications.

Complete Repair of Coarctation of the Aorta and a Ventricular Septal Defect in a Low Birth Weight Neonate (저체중 미숙아에서 시행만 심실중격결손을 동반한 대동맥축착증 완전 교정술)

  • Kwak, Jae-Gun;Jun, Jae-Hyun;Yoo, Jae-Suk;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.480-483
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    • 2008
  • Even though some authors have reported on the advantages of early total correction of complex heart disease, for low birth weight premature neonates, most surgeons prefer a multi-step approach to early total correction due to the many problems, such as the technical problems, the cardiopulmonary bypass management and etc. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,250 gram premature neonate.

Extraanatomic Bypass Graft was Performed in Adult Coarctation (외해부학적(Extraanatomical) 우회로조성술을 시행한 성인 대동맥축착증 - 3예 보고 -)

  • Lee, Dong-Hyup;Jung, Tae-Eun;Lee, Jang-Hoon;Lee, Jung-Cheul;Do, Hyung-Dong;Han, Sung-Sae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.260-263
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    • 2008
  • We performed three cases of extraanatomic bypass graft for treating adult coarctation. Two cases of left subclavian artery to descending aorta bypass graft were done via left thoracotomy for treating 2 patients who had extensive aortic occlusive disease. One case of ascending aorta to descending aorta bypass graft and aortic valve replacement was done via median sternotomy for a patient who had combined arch hypoplasia and aortic valve regurgitation. One patient was reoperated on for aneurysm rupture of an anastomosis site four months after the first operation and two patients have had no specific problems during and after their operations.

Trichostatin A Modulates Angiotensin II-induced Vasoconstriction and Blood Pressure Via Inhibition of p66shc Activation

  • Kang, Gun;Lee, Yu Ran;Joo, Hee Kyoung;Park, Myoung Soo;Kim, Cuk-Seong;Choi, Sunga;Jeon, ByeongHwa
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.467-472
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    • 2015
  • Histone deacetylase (HDAC) has been recognized as a potentially useful therapeutic target for cardiovascular disorders. However, the effect of the HDAC inhibitor, trichostatin A (TSA), on vasoreactivity and hypertension remains unknown. We performed aortic coarctation at the inter-renal level in rats in order to create a hypertensive rat model. Hypertension induced by abdominal aortic coarctation was significantly suppressed by chronic treatment with TSA (0.5 mg/kg/day for 7 days). Nicotinamide adenine dinucleotide phosphate-driven reactive oxygen species production was also reduced in the aortas of TSA-treated aortic coarctation rats. The vasoconstriction induced by angiotensin II (Ang II, 100 nM) was inhibited by TSA in both endothelium-intact and endothelium-denuded rat aortas, suggesting that TSA has mainly acted in vascular smooth muscle cells (VSMCs). In cultured rat aortic VSMCs, Ang II increased p66shc phosphorylation, which was inhibited by the Ang II receptor type I ($AT_1R$) inhibitor, valsartan ($10{\mu}M$), but not by the $AT_2R$ inhibitor, PD123319. TSA ($1{\sim}10{\mu}M$) inhibited Ang II-induced p66shc phosphorylation in VSMCs and in HEK293T cells expressing $AT_1R$. Taken together, these results suggest that TSA treatment inhibited vasoconstriction and hypertension via inhibition of Ang II-induced phosphorylation of p66shc through $AT_1R$.

Extraanatomic Ascending-to-Descending Aorta Bypass Graft for Atypical Coarctation -A case report- (비전형적인 대동맥궁 축착 환자에시 상행 대동맥과 하행 대동맥간 우회로 조성술 -1예 보고-)

  • Kim Kwan-Chang;Kim Chang-Young;Choi Se-Hoon;Son Kuk-Hui;Cho Kwang-Ree;Kim Kyung-Hwan;Ahn Hyuk
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.317-319
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    • 2006
  • Under median sternotomy and left thoracotomy, extra-anatomic aorta bypass between ascending aorta and descending thoracic aorta without cardiopulmonary bypass support has been done effectively and easily without complications for a selected case of atypical coarctation associated with hypoplasia of aortic arch. It should be considered as an alternative operative technique for complex aortic arch reconstruction.

Influence of Anatomy, Associated Anomalies, Age, and Surgical Methods on the Surgical Results of Aortic Coarctation (대동맥교약증 환아의 해부학적 형태, 동반심기형, 연령, 수술방법등이 수술결과에 미치는 영향)

  • 이정렬;김혜순
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.363-372
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    • 1997
  • One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

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Single-Stage Repair of Coarctation of the Aorta and Ventricular Septal Defect in Infants Younger than 6 Months (생후 6개월 이하 환아에서 대동맥 축착증과 심실중격결손의 일차 완전교정)

  • 백만종;김웅한;이영탁;한재진;이창하
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.733-744
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    • 2001
  • Background: The optimal therapeutic strategies for patients with coarctation of the aorta(CoA) and ventricular septal defect(VSD) remain controversial. This study was undertaken to determine the outcome and the need for reintervention following single-stage repair of coarctation with VSD in infants younger than 6 months. Material and Method: Thirty three consecutive patients who underwent single-stage repair of CoA with VSD, from January 1995 to December 2000, at Sejong General Hospital were reviewed retrospectively. Mean age and body weight at repair were 54$\pm$37 days(12 days-171 days) and 3.9$\pm$1.1 kg(1.5~6 kg), respectively. The surgical repair of CoA was performed under deep hypothermic circulatory arrest(CA) in the early period of the study and under regional cerebral perfusion through a direct innominate arterial cannulation without CA in the later period. The technique used in the repair of the CoA was resection and extended end-to-end anastomosis(EEEA; n=16) and extended side-to-side anastomosis(ESSA; n=2) in the early period, and resection and extended end-to-side anastomosis(EESA; n= 15) in the later period. The simultaneous closure of VSD was done with a Dacron patch(n= 16) and autologous pericardium(n=17). Aortic arch hypoplasia was present in 29 patients(88%) and its types were distal(n=18), complete(n=5), and complex(n=6)

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