• Journal of Chest Surgery
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• 제23권4호
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• pp.804-810
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• 1990

Pulmonary thromboembolism originated mostly from the venous thrombus, especially deep vein thrombosis in the lower extremities, which migrated upward and lodged the pulmonary vasculatures, Massive pulmonary thromboembolism usually leads to in \ulcornerhospital mortality if the patient was not treated properly. Under the cardiopulmonary bypass, a 49-year old man was treated successfully by emergent pulmonary embolectomy of pulmonary thromboembolism, which originated from the deep vein thrombosis in the right leg. Ligation or filtering device insertion of the inferior vena cava was not performed. The patient’s postoperative course was uneventful and discharged on postoperative 15th day He continued to receive oral anticoagulation with aspirin and persantin, which had been started on the third postoperative day. And he was well till recent days through the outpatient follow-up. The clinical courses of this patient are described, and massive pulmonary embolism and its management are discussed.

• Journal of Chest Surgery
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• 제41권2호
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• pp.273-276
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• 2008

심장 정지에 있어서 체외 심폐 보조가 1983년도에 도입된 이래로 심장 정지의 치료에 응급 경피적 심폐 보조가 사용되어 왔다. 다량의 급성 폐동맥 색전증은 사망률이 높고, 특히 수술 중 발생한 경우는 외과의와 마취의에게 힘든 문제를 제기한다. 본 증례는 수술 도중에 발생한 다량의 폐동맥 색전증으로 인한 심장 정지에 대하여 효과적인 치료수단으로써 응급 체외 순환기를 사용한 56세의 여자 환자에 대하여 기술하였다. 환자는 와파린을 복용하면서 퇴원하였고, 패동맥 색전증의 재발없이 외래추적 중이다.

• Tuberculosis and Respiratory Diseases
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• 제76권3호
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• pp.127-130
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• 2014

The risk of dying from a pulmonary embolism (PE) is estimated to be about 30% if inotropic support is required and no cardiopulmonary arrest occurs. Fibrinolysis in massive PE is regarded as a life-saving intervention, unless there is a high risk of bleeding following the use of the fibrinolytic therapy. Rivaroxaban is an oral factor Xa inhibitor, however its anticoagulation effects before or after administration of fibrinolytics in massive PE are still unknown. Two patents were admitted: 61-year-old woman with repeated syncope, and a 73-year-old woman was admitted with dyspnea and poor oral intake. Systemic arterial hypotension with radiologic confirmation led to a diagnosis of massive PE in both patients. Rivaroxaban was administered before in one, and after firbrinolytic therapy in the other. One showed similar efficacy of rivaroxaban with currently used anticoagulants after successful fibrinolysis, and the other one without antecedent administration of the fibrinolytic agent showed unfavorable efficacy of rivaroxaban.

• Tuberculosis and Respiratory Diseases
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• 제45권3호
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• pp.654-660
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• 1998

Pulmonary embolism is one of the moot common acute pulmonary disease in the adult general hospital population However, the disease is still frequently unsuspected and underdiagnosed due to the nonspecificity of both clinical findings and laboratory tests. The chest radiography in a patient suspected acute pulmonary embolism do not provide adequate information to establish or exclude the diagnosis of pulmonary embolism. Even in the case of infarction, there is no pathognomonic clues on the chest film. Rarely infarction presents unusual roentgenologic manifestation such as lobar consolidation, coin lesion, multinodular opacity, or massive pleural effusion Especially, lobar consolidation in pulmonary embolism might mislead into the diagnosis of pneumonia. We experienced a case of pulmonary embolism presenting lobar consolidation in a 62 years old woman, originated from deep vein thrombosis. She took a compression stocking and underwent anticoagulant therapy with excellent outcome.

• Journal of Chest Surgery
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• 제42권4호
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• pp.492-496
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• 2009

배경: 급성 폐색전증은 그 치료가 어려우며 대량의 색전증이 발생하여 심인성 쇼크를 동반할 경우 치명적인 결과를 초래할 수 있다. 과거 폐색전증 환자의 수술적 치료는 마지막 수단으로 여겨져 왔다. 하지만 저자들은 폐색전증 제거술을 시행한 7예의 경험을 토대로 치료 대안으로서 수술의 필요성을 검토하고자 하였다. 대상 및 방법: 8년간 본원에서 폐색전 제거술을 시행한 환자들의 의무 기록을 바탕으로 후향적 연구를 시행하였다. 입원 기간 및 마지막 외래 진료까지 경과 관찰하였다. 결과: 7명의 환자(남자 4명, 여자 3명)가운데 4명의 환자가 대량 폐색전증이었으며 나머지 3명은 아급성 폐색전증이었다. 3명의 환자는 수술 전 체외막산소공급장치를 삽입하고 수술을 받았다. 사망한 환자 없이 모두 퇴원하였으며 수술 후 시행한 심초음파 결과상 6명의 환자에서 폐동맥 고혈압 소견 없었다. 결론: 폐색전증 제거술은 대량의 폐색전증 환자에서 낮은 사망률로 시행할 수 있으며 저자들은 수술 전심인성 쇼크 상태인 환자에서 체외막산소공급장치가 생존율을 향상시킬 것으로 생각된다.

• Journal of Chest Surgery
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• 제20권1호
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• pp.139-147
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• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• Journal of Chest Surgery
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• 제23권4호
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• pp.811-815
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• 1990

Successful emergency pulmonary embolectomy with the cardiopulmonary bypass was performed in a 41 \ulcorneryear old male who suffered massive pulmonary embolism after longterm bed rest due to the injury of left knee. Temporary cardiopulmonary bypass provided 120 minutes of circulatory support while complete removal of bilateral pulmonary emboli accomplished using Forgarty catheter and Gall stone forceps. Also, manual compression of the lungs was necessary to remove distal branching emboli. The patient had smooth and uneventful hospital course without complications and discharged from hospital taking coumadine on the 13th day after the operation.

• Journal of Chest Surgery
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• 제34권4호
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• pp.373-376
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• 2001

만성 폐색전증으로 혈전 제거술을 하고 난 다음 기관지내 대량 출혈은 빈도는 적으나 상당히 높은 사망률을 보이는 합병증 중의 하나이다. 기관지내 대량 출혈이 생겼을 때 체외 막 산소화 장치와 각각 다르게 조절한 인공호흡기 2대를 이용하여 특별한 휴유증 없이 잘 치료한 경험을 하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제52권12호
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• pp.1392-1395
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• 2009

폐혈관 공기 색전증은 인공 환기 요법으로 치료 받는 신생아에서 드물게 발생하지만 매우 치명적인 합병증이다. 저자들은 특징적인 임상소견, 방사선소견을 보이며, 중증의 태아 수종과 폐형성 저하증을 동반한 초극소 미숙아에서 발생한 폐혈관 공기 색전증 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제43권4호
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• pp.433-436
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• 2010

폐절제후 발생하는 급성폐동맥색전증은 매우 드물지만 높은 사망률을 보인다. 이는 폐절제후 발생하는 가장 위험한 합병증 중에 하나이다. 폐엽절제 후 아무런 합병증 없이 회복 중이던 환자에서 갑자기 발생한 급성폐동맥색전증으로 보존적 치료에도 악화되어 응급 색전제거술로 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 발표하는 바이다.