• Journal of Chest Surgery
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• 제46권6호
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• pp.464-466
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• 2013

Floating thrombi in the aortic arch are very rare and an unusual source of systemic embolism. Herein, a case of a 3-cm thrombus in the aortic arch is reported. It was a floating, highly mobile thrombus attached to the lesser curvature of the aortic arch. The patients had a hypercoagulable disorder induced by protein C and S deficiency. The thrombus was operatively removed with a favorable outcome.

• Journal of Chest Surgery
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• 제33권2호
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• pp.190-192
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• 2000

A 53-year-old male patient who had suffered from acute myocardial infarction before a week was admitted due to postinfarction angina A mobile pedunculated left ventricular thrombus of 2.0-cm diameter which was overlooked in cardiac catheterization and ventriculographic study was diagnosed with transthoracic two-dimensional echocardiography. There was no exact clinical finding of left ventricular aneurysm and the thrombus was placed in the akinetic and hypokinetic apical portion. For preventing systemic embolism that was removed through a left ventriculotomy just prior to coronary artery bypass grafting.

• 대한임상검사과학회지
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• 제51권1호
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• pp.114-118
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• 2019

이중초음파는 비침습적으로 목동맥 질환을 진단하고 추적검사를 하는데 이용되고 있다. 목동맥 질환 중 유동성 혈전과 목동맥박리는 심혈관질환 환자에서 매우 드물게 관찰되는 증례이다. 특히, 목동맥박리는 혈관의 가장 안쪽 내막에 열상이 발생하여 일어나는데, 목동맥 안에 참속공간과 거짓속공간이라고 불리는 2개의 속공간이 관찰된다. 본 연구는 유동성 혈전, 자발성 목동맥박리 및 타카야수동맥염에서 관찰된 목동맥박리를 포함하여 임상에서 드물게 관찰되는 3 증례를 보고하고자 한다.

• Journal of Chest Surgery
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• 제37권5호
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• pp.448-451
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• 2004

개심술 후 폐색전증을 동반한 우심방 혈전의 발생 예는 매우 드물다. 10개월 전 심방중격결손 수술을 받았던 54세 여자 환자가 좌측 흉막통과 호흡곤란을 주소로 응급실에 내원하였다. 폐관류주사 검사에서 다발성 분절성 관류 결손 소견을 보였고 경식도 초음파 검사에서 우심방 벽에 위치하는 크고 줄기가 있는 움직이는 종괴가 발견되었다. 헤파린 치료 시작 13일 후 시행한 심초음파 검사에서 크기가 전혀 줄어들지 않아 개심술하에 종괴를 제거하였다. 병리 소견에서 우심방 기질성 혈전으로 밝혀졌고, 수술 후 환자는 별 문제 없이 회복되었으며 퇴원 후 와파린 치료를 받고 있다.

• Journal of Chest Surgery
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• 제44권1호
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• pp.72-75
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• 2011

Aortic thrombi are important because it can cause the central and peripheral embolizations. Aortic thrombi can occur anywhere in the aorta but extremely rare in ascending aorta without atherosclerosis, aneurysm, cardiosurgical or traumatic state. Systemic sclerosis (SSc) is an autoimmune disorder of connective tissue and it can involve multisystem. Enhanced coagulation pathways, decreased fibrinolysis, and endothelial dysfunction probably contribute to vascular events in SSc. We report a case of a highly mobile thrombus in the ascending aorta, presented as an acute embolic stroke in the patient with systemic sclerosis. Surgical removal was performed to prevent recurrent embolic events.

• Journal of Chest Surgery
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• 제26권7호
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• pp.521-525
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• 1993

Sixty-three patients who underwent open mitral commissurotomy at Sejong General Hospital during last 10 years from the August, 1983 to June, 1993 were reviewed There were fifty-one women and twelve men, and the mean age was 34.2 years. According to the NYHA classification, the distribution of patient preoperatively was as follows: class I, 5 patients ; class II, 26 patients ; class III, 30 patients ; class IV, 2 patients, and mean duration of symptome was 4.5 years. The mean mitral valvular area measured with echocardiogram preoperatively was 0.92cm2. All patients underwent open mitral commissurotomy and 41 patients required additional procedures for relief of subvalvular stenosis or other valvular disease. There were no operative death. 63 patients had three different types of mitral stenosis : type I, mobile cusps without subvalvular change [21 patients] ; typeII, thickened cusps with subvalvular change [34 patients] ; type III, rigid cusps with severe subvalvular change [8 patients]. The valvular calcification was seen in 11 patients [17%] and 15 patients [24%] had left atrial thrombus. The duration of follow-up was from 1 month to 168 months [mean, 39.6 months] and there were no late death. Six patients required reoperation and one patient had embolic episode. Conclusively,the open mitral commissurotomy represents a safe surgical precedure for treating mitral stenosis, allowing a complete removal of atrial thrombosis if present, and even when associated with subvalvular changes.

• Investigative Magnetic Resonance Imaging
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• 제20권2호
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• pp.114-119
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• 2016

We report a case of vegetation in a 4-year-old female with infective endocarditis, diagnosed by late gadolinium-enhanced (LGE) cardiovascular magnetic resonance (CMR) imaging. The patient had a history of primary closure for ventricular septal defect and presented with mild febrile sensation. No remarkable clinical symptoms or laboratory findings were noted; however, transthoracic echocardiography demonstrated a 14 mm highly mobile homogeneous mass in the right ventricle. On LGE CMR imaging, the mass showed marginal rim enhancement, which suggested the diagnosis of vegetation rather than thrombus. The extracellular volume fraction (${\geq}42%$) of the lesion was higher than that of normal myocardium. Based on the patient's clinical history of congenital heart disease and pathologic confirmation of the lesion, a diagnosis of infective endocarditis with vegetation was made.

• Journal of Chest Surgery
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• 제32권1호
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• pp.70-74
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• 1999

승모판의 기계판막치환술 후 판막이나 좌심방 내 혈전증은 판막 기능장애나 혈전색전증을 일으킨다. 조기 진단과 적절한 치료는 중요하지만 임상에서 쉽지 않다. 혈전용해 치료는 혈전증으로 인한 재수술의 위험성을 줄일 수 있어 혈전증 치료에 적절한 한 방법이 될 수 있다. 본 보고는 저분자량 헤파린과 와파린으로 혈전용해 치료를 한 3명의 환자를 보고하고자 하였다. 한 명의 임산부를 포함한 2명의 환자는 판막 혈전증으로 인한 판막폐쇄와 개폐운동 장애가 있었고 다른 한 명은 내원 5일전 혈전색전증으로 뇌경색이 발생한 좌심방내 혈전증 환자였다. 환자들은 프락시파린 0.3cc (7,500 ICU AXa)을 하루에 2∼3번씩 피하로 투여하여 치료를 받았다. 퇴원 당시 판막과 좌심방 내 혈전은 완전히 혹은 거의 완전히 용해되었고 판막의 개폐운동은 정상이었다. 혈전용해 때부터 외래 추적 기간동안 특별한 부작용은 없었다.