• Journal of Chest Surgery
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• v.41 no.5
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• pp.647-650
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• 2008

Aortic disease usually recurs after aortic surgery in the form a new aneurysm distal to the previous operation site, and finding a penetrating atherosclerotic ulcer proximal to the previous operation site has rarely been reported. We report here on a case of successful patch repair of a ruptured penetrating ulcer in the distal aortic arch, and this developed late after replacement of the descending thoracic aorta.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.926-933
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• 1993

We experienced 20 patients with Takayasu`s disease who required 22 surgical procedures for critical arterial stenoses, aneurym of descending thoracic aorta, and aortic regurgitation from 1986 to 1993.Five patients had type I arteritis, seven patients had type II , seven patients had type III, and one patients had type IV.15 patients were female and 5 patients were male.Patients` ages ranged from 17 to 47 years and mean age was 29.1 years. The surgical procedures were as follows;autotransplantations of kidney[3], aortic valve replacements[2], ascending aorta-bilateral internal carotid artery bypasses[2], unilateral renal artery bypasses[2], bilateral renal artery bypasses[3], replacement of descending thoracic aorta[1], ascending aorta-abdominal aorta bypass[1], ascending aorta-right internal carotid artery bypass[1], ascending aorta-right internal carotid artery and left subclavian artery bypass[1], left common carotid artery-left-subclavian artery bypass[1], pulmonary artery angioplasty[1], left femoro-bilateral axillary bypass[1] and others[2]. There was no hospital death.Mean duration of follow-up was 42.7 months[ranged from 3 to 96 months].There was one late death and late mortality rate is 5.9%.Two patients was underwent second vascular procedures, one after 5 years and the other after 5 months.The other patients have done well after surgery.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.201-204
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• 1990

The double aortic arch is the commonest anomaly among the vascular rings are relatively rare congenital vascular anomalies. This anomaly is malformation of the aortic arch system may, by compression of the trachea and esophagus, cause respiratory distress and dysphagia. We experienced one case of double aortic arch with right sided descending aorta with predominant right anterior arch treated surgically at Kyung Hee University Medical Center. 1-year-old male patient with acute airway obstruction due to combination of double aortic arch and right descending aorta. The diagnosis was made by simple X-ray & confirmed by barium esophagogram & aortogram. The operative approach was through left thoracotomy & underwent division of the left aortic arch & division of ligamentum arteriosum & suspension of divided proximal end of anterior arch to anterior thoracic wall. The postoperative courses was uneventful and doing well on the 3 years.

• 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.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.610-618
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• 1995

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.488-496
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• 1988

Thirty-seven patients of aortic aneurysm underwent operations during January 1984 December 1987 at our hospital. Twenty-six patients had aneurysms involving ascending aorta, three patients had aneurysms involving both ascending aorta and abdominal aorta. and eleven patients had aneurysms involving descending thoracic or abdominal aorta. Among the patients who had aneurysms involving ascending aorta, annuloaortic ectasia with aortic regurgitation were thirteen and all of these underwent ascending aorta graft replacement + AVR with composite graft. The patients who had aortic regurgitation due to ascending aortic dissection were three and all of these underwent intraluminal ringed graft insertion at ascending aorta + aortic valve resuspension. Intraluminal ringed graft insertion was safe, simple, and fast method in the operation for aortic aneurysm. Eleven patients were underwent this operation and the results were good. Major causes of death of the patients who underwent aortic aneurysm operation are underlying cardiovascular diseases or delayed rupture of the aneurysm or complications related newly appeared aneurysm. Among our patients, dissection progressions were appeared in two but neither severe nor complicated. And no patient died from delayed rupture of aneurysm or complications related newly appeared aneurysm. All patients were followed up via OPD and were controlled hypertension or heart failure if present. Operative mortality is 18.9\ulcornera in all, 23% in patients who had aneurysms involving ascending aorta and 7.6` who had aneurysms involving descending thoracic or abdominal aorta. Comparing with other reports, our operative mortality is still high but improved steadily. So we recommend aggressive surgical management of the aortic aneurysm.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.465-467
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• 2016

The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.578-581
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• 2007

A 59-year old female patient was admitted due to massive hemoptysis. 6-months previously, we performed ascending aorta graft interposition for terating Debakey type 1 acute aortic dissection. Chest CT scan showed the fistula between the descending thoracic aorta and the left lower lobe. We performed descending thoracic aorta graft interposition under cardiopulmonary bypass. She recovered well without any postoperative problems. Distal aorto-bronchial fistula after a previous aortic operation is very rare. We report here the good results of treating aorto-bronchial fistula because we recognized this lesion early and performed an early operation.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.238-245
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• 2015

Background: Some patients show favorable changes in the descending aortic false lumen after conventional repair of acute type A dissection, although the incidence of favorable changes has been reported to be low. We aimed to investigate the incidence of positive postoperative changes in the false lumen and the factors associated with positive outcomes. Methods: In 63 patients who underwent surgery for type A acute dissection as well as serial computed tomography (CT) scanning, morphological parameters were compared between the preoperative, early postoperative (mean interval, 5.4 days), and late CT scans (mean interval, 31.0 months) at three levels of the descending thoracic aorta. Results: In the early postoperative CT images, complete false lumen thrombosis and/or true lumen expansion at the proximal descending aorta was observed in 46% of the patients. In the late images, complete thrombosis or resolution of the proximal descending false lumen occurred in 42.9% of the patients. Multivariate analysis found that juxta-anastomotic false lumen thrombosis was predictive of favorable early changes, which were in turn predictive of continuing later improvement. Conclusion: Even after conventional repair without inserting a frozen elephant trunk, the proximal descending aortic false lumen showed positive remodeling in a substantial number of patients. We believe that the long-term prognosis of type A dissection can be improved by refining surgical technique, and particularly by avoiding large intimal tears at the anastomosis site during the initial repair.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.337-341
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• 1996

A 40-year-old male patient who had ascending aortic pseudoaneurysm Involving right coronary artery obstruction and thoracic descending aortic pseudoaneurysm was successfully managed by two-stage operation. Repair of intimal tear of ascending aortic pseudoaneurysm with a patch of woven dacron vascular graft and right coronary artery bypass graft with great saphenous vein were performed in first stage operation. On 28 days postoperatively, Repair of intimal tear of descending aortic pseudoaneurysm with a patch of woven dacron vascular graft was done under the femorofemoral partial cardiopulri!onary bypass in second stage operation. The patient was discharged at postoperative 13th days without any evident.