• Title/Summary/Keyword: Coarctation

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Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft (만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예)

  • Jang, Un-Ha;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.81-84
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    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

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Surgical Management of Coarctation of the Aorta with a Ventricular Septal Defect and Coexisting Partial Anomalous Pulmonary Venous Connection -A case report- (부분 폐정맥 환류 이상과 심실 중격 결손을 동반한 대동맥 축착증의 완전교정 -1예 보고-)

  • Kim Si-Ho;Lee Young-Seok;Woo Jong-Soo;Cho Kwang-Jo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.479-481
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    • 2006
  • A newborn girl with a partial anomalous pulmonary venous connection, coarctation of the aorta, and ventricular and atrial septal defects underwent a complete repair successfully at 49 days of age. In this case, the left upper pulmonary vein was connected to the left innominate vein via an atypical vertical vein.

Atypical Middle Aortic Syndrome in a Middle Aged Woman -A case report- (중년 여자 환자에서 비전형적 Middle Aortic Syndrome의 수술치험 1예)

  • 김우식;배윤숙;정성철;신용철;유환국;김병열
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.80-83
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    • 2004
  • The aortic coarctation is located in the distal thoracic aorta or abdominal aorta, or both and is often called ‘middle aortic syndrome’ or ‘mid-aortic dyspastic syndrome’. Etiology is controversial and most cases are seen in young female women. Severe complication such as cardiac or renal dysfunction as well as cerebral hemorrhage may occur, so aggressive surgical intervention may take effect. Lately we experienced a middle aortic syndrome which was not typical because of the patient's advanced age at the time of clinical presentation. The Axillo-femoral artery bypass graft with 6 mm PTFE vascular graft was done.

Clinical experiences of arterial disease (동백질환의 임상적 고찰)

  • Lee, J.H.;Kim, J.E.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.385-393
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    • 1980
  • From 1959 to 1980, for about 21 yrs, the authors have experienced of 69 cases of arterial diseases, and analyzed the diseases. They are Aneurysm 16 Iatrogenic thrombosis after angio & cardiac Cath. 20 Coarctation 3 Primary arteritis 9 Traumatic injury 9 Occlusive disease 12 But PDA (107 cases) & Buerger's disease are excluded in this study.

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Modified Norwood Procedure without Circulatory Arrest and Myocardial Ischemia - Report of 2 cases - (완전순환정지와 심근허혈 없이 시행한 변형 Norwood 술식 - 2 례 보고 -)

  • 백만종;김웅한;전양빈;김수철;공준혁;류재욱;오삼세;나찬영;김양민
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.547-551
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    • 2001
  • The effects of deep hypothermia and circulatory arrest during aortic arch reconstruction are associated with potential neurologic and myocardial injury. We describe a surgical technique that two patients underwent a modified Norwood procedure without circulatory arrest and myocardial ischemia. One was 13-day-old female patient, weighing 3.1kg, having a variant of hypoplastic left heart syndrome and another was 38-day-old male patient, weighing 3.4 kg, diagnosed Taussig-Bing anomaly with severe aortic arch hypoplasia, coarctation of the aorta, and subaortic stenosis. The arterial cannula was inserted in innominate artery directly. During Norwood reconstruction, regional high-flow perfusion into the inominate artery and coronary perfusion were maintained and there were no neurologic, cardiac, and renal complications in two patients. This technique may help protect the brain and myocardium from ischemic injury in patients with hypoplastic left heart syndrome or other arch anomalies including coarctation or interruption.

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Repair of Complex Cardiac Anomaly Associated with Congenital Tracheal Stenosis -1 Case Report- (선천성 기관 협착증을 동반한 복잡 심기형의 완전 교정술 -1예 보고-)

  • Park, Jeong-Jun;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.88-91
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    • 1997
  • Congenital long-segment tracheal stenosis with complex cardiac anomaly has generally been regarded as a fatal disease This report described the successful concomitant repair of unexpected congenital tracheal stenosis and complex cardiac anomaly with the use of edrdiopulmonary bypass. The patient was a 3-month-old girl with coarctation of aorta, V D, and PDA. The presence of tracheal stenosis was not discovered until when difficulty with endotracheal intubation was encountered at operating room. Thus, we decided concomitant repair of both lesions and performed anterior pericardial tracheoplasty combined with one stage repair of coarctation of aorta, VSD, and PDA under the cardiopulmonary bypass. The patient is doing well without any signs of complication at present, 2 years and 1 month after the operation.

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Repair of Coarctation (including tubular hypoplasia) in Infancy and Children (영아 및 소아 연령에서의 대동맥 교약증의 교정 수술)

  • 한재진
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.474-481
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    • 1990
  • We have experienced 44 cases of coarctation of aorta in the age of infancy and children from April 1986 to September 1989 at Seoul National University Children`s hospital. Patients were thirty males and fourteen females, and their age ranged from one month to ten years[mean 23.84 $\pm$33.06 months] with thirty-two infant cases. In the infantile age, congestive heart failure was the most common chief complaint[18/32], and above that age, frequent upper respiratory infection was most common[8/12]. We experienced thirteen cases of isolated COA, twenty-two cases of COA with VSD, eight cases of COA with VSD, eight cases of COA with intracardiac complex anomalies and one case of COA with atrial septal defect. The associated intracardiac complex anomalies were three Taussig-Bing type double outlet right ventricle, one single ventricle, one transposition of great arteries, one atrioventricular septal defect, one hypoplastic aortic arch with left heart hypoplasia, and one Tetralogy of Fallot. Operative techniques of COA were twenty-three subclavian flap arterioplasty, 12 resection and end to end anastomosis, eight onlay patch angioplasty, and I direct angioplasty after resection of web. Among the cases with other cardiac anomalies, staged operation was done in twenty-nine patients, and single stage total correction was performed only in three patients. There were seven operative mortality[15.9%], all being in infantile age group, and among fourteen cases associated with large VSD[Qp/Qs>2.0, mean pulmonary arterial pressure>50mmHg], four patients were died, but there was no mortality in patients with small VSD. With above results, we are intended to discuss about the interval between staged operation, the fate of VSD after coarctoplasty in case of COA with VSD, causes of death, complications etc.

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Hydrogen sulfide ameliorates abdominal aorta coarctation-induced myocardial fibrosis by inhibiting pyroptosis through regulating eukaryotic translation initiation factor 2α phosphorylation and activating PI3K/AKT1 pathway

  • Yaling Li;Zhixiong Wu;Jiangping Hu;Gongli Liu;Hongming Hu;Fan Ouyang;Jun Yang
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.4
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    • pp.345-356
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    • 2023
  • This study aimed to assess the effects of exogenous hydrogen sulfide (H2S) on abdominal aorta coarctation (AAC) induced myocardial fibrosis (MF) and autophagy in rats. Forty-four Sprague-Dawley rats were randomly divided into control group, AAC group, AAC + H2S group, and H2S control group. After a model of rats with AAC was built surgically, AAC + H2S group and H2S group were injected intraperitoneally with H2S (100 µmol/kg) daily. The rats in the control group and the AAC group were injected with the same amount of PBS. We observed that H2S can improve left ventricular function and the deposition of myocardial collagen fibers, inhibit pyroptosis, down-regulate the expression of P-eif2α in myocardial tissue, and inhibit cell autophagy by activating the phosphatidylinositol 3-kinase (PI3K)/AKT1 signaling pathway (p < 0.05). In addition, angiotensin II (1 µM) H9c2 cardiomyocytes were injured in vitro experiments, and it was also observed that pyroptosis was inhibited after H2S (400 µmol/kg) intervention, the expression of P-eif2α in cardiomyocytes was significantly down-regulated, and the PI3K/AKT1 signaling pathway was activated at the same time. Therefore, increasing the expression of P-eif2α reverses the activation of the PI3K/AKT1 signaling pathway by H2S. In conclusion, these findings suggest that exogenous H2S can ameliorate MF in rats with AAC by inhibiting pyroptosis, and the mechanism may be associated with inhibiting the phosphorylation of eif2α and activating the PI3K/AKT1 signaling pathway to inhibit excessive cell autophagy.

Delayed Post-traumatic Coarctation of Distal Abdominal Aorta - A Case Report - (수직추락후 발생한 복부대동맥 협착 1례 보)

  • Park, Guk-Yang;Lee, Hong-Seop;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.199-201
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    • 1987
  • We have recently experienced a rare case of abdominal aortic injury caused by deceleration force during fall in upright position. The patient was 43-year-old brick-layer fell from 12 meter height and sustained compression fracture of the spine and both legs. The aortic injury was unnoticed at that time. About 2 years later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms, Similar type of abdominal aortic injuries could not be found in the literatures.

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A Clinical Study of Vascular Surgery: 108 cases (혈관수술 108례에 관한 임상적 고찰)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.371-378
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    • 1979
  • The authors have performed operations on vascular system of 108 cases from 1972 through 1979, and analyzed the diseases, surgical procedures and results. They were 1. Arterial system; 45 cases P.D.A. : 20 Occlusive diseases : 13 Coarctation of aorta : 4 Aneurysm : 4 A-V fistula : 2 Trauma : 2 2. Venous system; 6 cases Esophageal varix : 4 S.V.C. syndrome : 1 Varicose vein : 1 3. Arteriovenous shunt for hemodialysis; 57 cases Of the arterial diseases, the worst results came from Burger`s disease. For the bleeding esophageal varices, we have performed ligations of varices or collateral circulations rather than emergency splenorenal shunt with good results. External A-V shunt for hemodialysis had much more complications than the A-V fistula.

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