• Journal of Chest Surgery
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• 제9권2호
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• pp.251-264
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• 1976

Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.

• Journal of Chest Surgery
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• 제30권2호
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• pp.200-204
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• 1997

본 증례는 고유 대동맥 판막, 승모판막, 삼첨판막과 심실중격을 침 범한 심내막염환자의 성공적 치료에 대한 보고이다. 환자는 11세때 심실중격결손폐쇄와 대동맥판막성형술을 받은 16세 남아로서 심내막염으로 항생제치료에도 불구하고 난치성 심부전을 보였다. 수술소견상 이전 수술시 폐쇄한 심실중격폐쇄를 따라 커다란 결손을 보였으며 다발성 천공과 우종을 동반한 대동맥 판막역류, 우종을 동반한 승모판 역류, 대동맥 판륜주위농양, 심실중격의 심근농양, 천공과 우종을 동반한 삼첨 판역류 소견을 보였다. 수술은 모든 감염조직과 괴사조직을 근치적절제후 심실중격결손을 Dacron patch로 폐쇄하면서 대동맥판막륜부위까지 확장보강하였으며, 대동맥판막치환시 확장보강한 Patch에 인공판막을 거치시켜 안전하게 치환할 수 있었다. 승모판막은 치환하였고, 삼첨 판은 자가심낭편으로 재건하였다. 환자는 수술후 6주간 항생제치료후 다른 합병증 없이 건강한 상태로 퇴원하였다.

• Journal of Chest Surgery
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• 제29권3호
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.

• Journal of Chest Surgery
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• 제45권3호
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• pp.148-154
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• 2012

Background: The adequate management of mild to moderate dilatation of the ascending aorta during cardiac operations remains controversial. In this study, we present the short-term outcomes of 90 patients undergoing ascending aortic wrapping with a Dacron graft during other cardiac operations. Materials and Methods: From March 2008 to January 2011, 90 consecutive patients underwent treatment for ascending aortic aneurysm using the external wrapping technique during the concomitant procedure. The study group consisted of 49 male and 41 female patients with a mean age of $58.7{\pm}13$years. The primary cardiac surgical procedures were coronary artery bypass grafting (CABG) in 3, aortic valve replacement in 2, and aortic valvuloplasty in 85 patients (isolated in 62 and combined with CABG or mitral valvuloplasty in 23). The ascending aorta diameter was measured using a computed tomography scan within 4 weeks after surgery, and was compared with the preoperative value. Results: The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within a month after surgery from $46.4{\pm}4.3$ mm to $33.0{\pm}3.5$ mm (p<0.05). There was no early mortality or major surgical complication. During the mean follow-up period of $15.4{\pm}5.2$ months, there was only one late death caused by septic multiorgan failure. Conclusion: Dacron wrapping of the ascending aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of moderately dilated ascending aorta in selected patients.

• Journal of Chest Surgery
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• 제19권3호
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• pp.522-527
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• 1986

There have been several reports of abdominal aortic aneurysm according to increase in life span and greater awareness of the diagnosis in Korea. We had a surgical experience of abdominal aortic aneurysm due to arteriosclerosis in 76 years old male. With abdominal sonogram, he was diagnosed. Aortoiliac bypass was done with double velour Dacron Y graft. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제19권3호
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• pp.475-478
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• 1986

Syphilitic aortic aneurysm is a rare lesion today. We experienced a case of huge syphilitic ascending aortic aneurysm with aortic insufficiency. Surgical correction was done by replacement of ascending aorta with woven Dacron graft and aortic valve replacement under cardiopulmonary bypass. There is no abnormality in postoperative aortography. The postoperative course was uneventful.

• Journal of Chest Surgery
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• 제37권12호
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• pp.999-1002
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• 2004

흉부관통상 환자에서 심장손상이 의심될 때 신속한 이송, 조기 진단 및 체계적인 수술적 치료는 좋은 결과를 얻을 수 있다. 생명을 위협하는 응급상황에서 심장손상의 정도를 진단하는 것은 어려울 수도 있다. 13세 남아가 칼에 의한 흉부 관통상을 입고 흉관으로부터 과도한 출혈이 있어 본원 흉부 외과로 전원되었다. 단순 흉부촬영에서 좌측페야에 균일한 음영 증가가 관찰되었다. 그는 의식이 혼미했으며 생체의 징후는 불안정하여 신속히 수술실로 옮겼다. 소생술 후 정중 흉골절개술을 통해 좌심실 열상을 봉합하였다. 수술 중 시행한 경식도 심초음파에서 심실중격결손에 의한 단락이 발견되었고 좌심실절개하에 데크론 첨포(Dacron patch)를 이용하여 정복하였다. 수술 후 경과는 좋았으며 심실중 격결손을 통한 작은 단락이 있었으나 추적 관찰하기로 하고 퇴원하였다.

• Journal of Chest Surgery
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• 제24권9호
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• pp.926-929
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• 1991

A 31 year-old male patient underwent surgical treatment of the pseudoaneurysm of the ascending aorta complicating after the Bentall operation, He had undergone the replacement of the ascending aorta using the composite valved graft with direct coronary reimplantation under the diagnosis of the annuloaortic ectasia of ascending aorta associated with Marfan syndrome. Eleven months after the operation, he started to feel dyspnea and anterior chest pain, and was diagnosed as pseudoaneurysm around the ascending aortic graft. The second operation consisted of the dacron patch closure of the defect of the aortic graft which was the hole for previous coronary reimplantation, and the anastomosis between the coronary orifice and the aortic graft with the intermediate graft of a 10mm woven dacron tube, and suture closure of the fistula opening from the aneurysm. His postoperative course was uneventful and discharged without complication. He is doing well 10 months postoperatively.

• Journal of Chest Surgery
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• 제9권2호
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• pp.271-275
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• 1976

Truncus arteriosus is a rare and highly lethal cardiac anomaly characterized by a single arterial trunk emerging from the heart and supplying the coronary, systemic, and pulmonary circulations, The first successful correction of truncus arteriosus was reported by McGoon et al. in 1968 and was based on experimental work reported by Rastelli et al. in 1967 in which a conduit consisting of a homograft of the ascending aorta and aortic valve was used to establish continuity between the right ventricle and the pulmonary arteries, Modification of this procedure using a Dacron tube valved with porcine xenograft instead of a homograft have resulted in the current definite treatment for truncus arteriosus. This report describes an 3 years and 4 months old boy with heart failure from type I truncus arteriosus who was diagnosed as the V. S. D. with pulmonary hypertension preoperatively and underwent corrective surgery employing the Rastelli procedure using a Dacron conduit valved with canine xenograft, but died due to massive bleeding from the anastomosis sites in operating room.

• Journal of Chest Surgery
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• 제11권3호
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• pp.342-347
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• 1978

A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.