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Congenital Aortic Stenosis: Report of 2 Cases (선천성 대동맥 판막 협착증 치험 2예)

  • 송명근
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.194-198
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    • 1978
  • Congenital aortic stenosis, a relatively uncommon congenital heart disease, may cause heart failure and may be fatal. In recent years, increased clinical awareness and improved diagnostic and operative technique has made accurate diagnosis and successful treatment possible. Recently we experienced 2 cases of congenital aortic stenosis, and which was corrected surgically. The first case was 9 years old boy, and second case was 16 years male. Preoperative diagnosis was entertained by angiography and cardiac catheterization in both cases. In each case, aortic valve opening was widened by incision along the fused commissure between the combined left and right coronary cusp on one side, and the noncoronary cusp on the other side. Post-op. pressure gradient between the aorta and left ventricle markedly reduced, in the first case, 50mmHg, and in the 2nd case, 55mmHg.Both patients discharged with good results 2 weeks after open heart surgery.

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Surgical Treatment of the Morgagni Hernia: report of one case (Morgagni 탈장증 수술 1예)

  • 김송명
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.429-433
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    • 1979
  • Morgagni hernia is a rare condition of the congenital diaphragmatic hernia which Is located at the anteromedial portion of the diaphragm, and is located immediately posterior to the sternum. Its cause is considered by embryologic defect and the abdominal organs are passed through a defect. The incidence is predirected women over 50 years old. Its synonym is hernia of subcostosternal, retrosternal, parasternal, rectocostoxiphoid, anterior diaphragmatic or Larrey`s. This report presents a symptomatic Morgagni hernia of ten months old male child on whom the diagnosis was established and was operated at the Busan Gospel Hospital. This patient was admitted with the chief complaints of mild cyanosis, frequent upper respiratory infections and protrusion of the right lower anterior chest. Herniorrhaphy was performed through the upper abdominal midline incision, hernial contents of the omentum and the colon, and sac as noticed from the Larrey`s space measuring 4 x 2 cm. in diameter and oval in shape. Interrupted sutures without difficulty repaired the defect. The cyanosis was disappeared and the patient had uneventful course of post-operative period. The patient was discharged at 7th. postoperative day. This case presentation with a brief review of literatures is given.

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An operation for the correction of Membranous obstruction of Inferior Vena Cava using Total Circulatory Arrest (전혈류 정지술을 이용한 하공정맥 폐색증의 교정수술)

  • Kim, Jhin-gook;Na, Myung-Hoon;An, Hyuk
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.773-779
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    • 1987
  • MOVC is an uncommon disease which can be corrected by surgical method if early detected. A case of a 34-year-old male with MOVC is reported. Operation was done on cardiopulmonary bypass with circulatory arrest under moderate hypothermia. The incision was done both on the RA extending to level of suprahepatic IVC and on the IVC just proximal to the right renal vein. And then, thrombectomy and membranectomy under the direct visualization was done. Total circulatory arrest was used intermittently in order to get good visual field and for preventing blood loss. The Postop. course was good except one episode of hepatic encephalopathy which was persisted for 12 hours and then controlled by conservative measures.

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Mediastinal Lipoma: One Case Report (종격동 지방종 1례 보고)

  • Lee, Young
    • Journal of Chest Surgery
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    • v.4 no.2
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    • pp.87-90
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    • 1971
  • The mediastinal lipoma is an extremely rare tumor in children. Since the orininal description by Fothergill in 1781, about 120 cases have been reported in the world literature. Of these, less than 10 have been reported in children below the age of 12. We had experienced a posterior mediastinal lipoma in 3 year old boy. He did not complain of any subjective symptoms. Routine X-ray film revealed a huge round homogenous mass density in the posterior mediastinum. On posterior thoracotomy incision,bright yellow,well encapsulated, partly 1obular adipose mass was found in the posterior mediastinum. The tumor mass was removed easily,being proved to be lipoma on histopathologic examination. His postoperative course was uneventful and discharged on the 12th postoperative day.

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Supra-Arterial Myotomy without Cardiopulmonary Bypass for Myocardial Bridging -One case report- (심폐바이패스없이 관상동맥 심근교의 수술치험 -1례 보고-)

  • 김재현;최세영;유영선;이광숙;윤경찬;박창권
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.181-184
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    • 1999
  • Systolic coronary arterial narrowing, secondary to myocardial bridging which is capable of producing chest pain, myocardial infarction and ventricular fibrillation is a known but an uncommon entity. A supra-arterial myotomy in a case of myocardial bridge causing medication-refractory angina is described. Under the partial sternotomy incision, we performed a supra-arterial myotomy in the left anterior descending coronary artery without cardiopulmonary bypass. The postoperative course was uneventful.

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Circumferential Resection and End to End Anastomosis of Mediastinal Trachea for Long Tracheal Stenosis (주기관 긴 협착증 환자의 수술 치험)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.588-592
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    • 1992
  • Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

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Surgical Treatment of "Dumb-bell" Neurosarcoma and Intrathoracic Meningocele Associated with Von Recklinghausen`s Disease -A case report- (신경섬유종증을 동반한 신경성 육종과 흉강내 뇌척수막류의 치험 1례)

  • 최순호
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.946-950
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    • 1995
  • Neurosarcoma is relatively rare, but is seen frequently in association with stigmata of neurofibromatosis ie., Cafe au lait pigmentation and cutaneous neurofibromatosis. Both advanced age and association with neurofibromatosis increase the likelihood of malignant degeneration to neurosarcoma. It also may be dumb bell-shaped with intraspinal extension. Thoracic meningocele is rare and represents a protrusion of the dural sac through an abnormally large or malformed intervertebral foramen. The patient is usually asymptomatic, with evidence of paravertebral mass on the chest rentgenogram. In one operation we removed a "Dumb-bell" neurosarcoma and intrathoracic meningocele in a 52 year old woman using a cervical laminectomy with a trap-door incision. She was discharged at 17 days after the operation with a sequelae of excision of nerve roots C8 and T1. Postoperative radiation therapy was performed during the follow-up period.up period.

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Surgical Treatment for Acute Caustic Injury of the Hypopharynx, Esophagus, and Stomach -Two Cases- (하인두 및 위의 손상을 동반한 급성 부식성 식도손상의 외과적 치료)

  • Kim, Hyeong-Gon;Lee, Sam-Yun;Choe, Jong-Beom
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.935-938
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    • 1995
  • Two cases of severe caustic injury of the hypopharynx, esophagus, and stomach are presented. Restoration of digestive continuity was accomplished by retrosternal isoperistaltic interposition of the transverse and left colon on the post-injury 73rd and 66th day respectively. The upper oro-colon continuity was made by a cervical approach, a vertical incision at the posterior hypopharyngeal wall, and interrupted one-layer sutures using 3-0 Dacron suture materials. The distal continuity was made by colojejunostomy between the transposed colon and proximal jejunum. There was no event after the operation in both cases. The posterior vertical hypopharyngotomy and hypopharyngocolostomy at the early post-injury period may be the preferred procedure to obtain normal deglutition in patients with esophageal stricture associated with hypopharyngeal injury.

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Descending Necrotizing Mediastinitis - A Case Report - (Descending necrotizing mediastinitis;치험 1례)

  • 류삼열
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1228-1231
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    • 1991
  • One of the most lethal forms of mediastinitis is descending necrotizing mediastinitis, in which infection arising from the oropharynx spreads to the mediastinum. Despite the development of computed tomographic scanning to aid in the early diagnosis of mediastinitis, the past 30 years, in large part because of continued dependence on transcervical mediastinal drainage, Although transcervical drainage is usually effective in the treatment of acute mediastinitis due to a cervical esophageal perforation, these approach in the patient with descending necrotizing mediastinitis fails to provide adequate drainage and pre-disposes to sepsis and a poor outcome. In addition to cervical drainage, aggressive, early mediastinal exploration - debridement and drainage through a subxiphoid incision or thoracotomy - is advocated to salvage the patient with descending necrotizing mediastinitis.

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A Single Left Lung Transplantation in Dog -One Case Report- (황견에서 좌측 폐이식수술 -1례 보고-)

  • 이두연
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.238-240
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    • 1994
  • We performed post-operative hemodynamic evaluation and lung perfusion scan after left lung transplantation in dog. The heart & lungs were extracted from donor dog while the both lungs were flushed with 4oC Euro-Collin`s solution after heparinization & infusion of prostaglandin E1.In the recipient dog, anastomosis of the left atrial cuff was performed by continuous 4-0 Prolene everted suture, and bronchial anastomosis by telescope method with 4-0 Prolene continuous suture. The end-to-end anastomosis of left main pulmonary arteries was performed with continuous 6-0 Prolene suture. After closure of left thoracotomy incision, the lung perfusion scan was performed post operative 2 days for evaluation of the function of the transplanted lung which showed good perfusion. The dog was sacrificed in the post-operative 5 days for autopsy.

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