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Systemic-Pulmonary Shunts Using Microporous Expanded Polytetrafluoroethylene (Polytetrafluoroethylene 을 이용한 체-폐동맥 단락술)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.314-319
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    • 1985
  • Nineteen patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] graft between September, 1983, and April, 1985. Age ranged from 3 months to 18 years, and seven of them were less than 12 months old. There were seventeen Great Ormond Street type of modified Blalock-Taussig shunts, and two central polytetrafluoroethylene shunt [ascending aorta-right pulmonary artery]. There was one postoperative death [1/19=5.3%] in a 10 Kg child born with pulmonary atresia and ventricular septal defect associated with patent ductus arteriosus. He had another anomaly of imperforated anus. Relief from cyanosis was achieved in other eighteen patients with variable degree. Eighteen survivors have been followed up from 1 month to 19 months. Clinical status, auscultation, oxygen partial pressure of arterial blood, and hemoglobin have been used to establish shunt patency in all survivors. By above criteria, all survivors have good patent shunt.

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Palliative Treatment with Celestin`s tube in Advanced Esophageal Cancer (진행성 식도암의 Celestin`s tube 를 이용한 고식적 치료)

  • 백광제
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.529-533
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    • 1985
  • Though esophageal cancer was not a common disease, early metastasis and direct extension to adjacent organ were important on the treatment of disease. Therefore, palliative operation was often useful in advanced esophageal cancer. Between June 1985 through July 1985, we treated three cases of inoperable esophageal cancer with Celestin`s endo-esophageal tube by esophageal intubation. Three operations were done under general anesthesia. Celestin`s tube were inserted via oral cavity and additional traction on stomach were applied. After complete insertion of tube was done, the distal end of Celestin`s tube was modified in length. Also stay suture was applied between tube and stomach wall was applied. Postoperative esophagogram revealed good esophageal patency through Celestin`s tube. Clinically, swallowing difficulty was much improved after operation.

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In Situ Saphenous Vein Arterial Bypass - A case report - (자연위치의 복재정맥을 이용한 하지동맥 우회술 1례 보)

  • Lee, Hong-Seop;Park, Guk-Yang;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.187-190
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    • 1987
  • The Saphenous vein is still the graft of choice for bypass of small calibered peripheral arteries, and many recent studies revealed that the "In Situ" technique had higher rate of long term patency than the conventional "reversed" one. A 71-year-old male who had atherosclerotic obstruction in the superficial femoral and popliteal trifurcation underwent In Situ saphenous vein arterial bypass. The saphenous vein is exposed by a long medial skin incision over the course of the vein. All branches of vein are ligated. A olive-tipped metal needle is introduced into the vein from above and everts the valves. The patient has been followed for 2 months after operation. The graft remained pulsatile and the gangrenous areas on the toe proceeded to heal. We think In situ vein bypass offers an excellent and safe method of revascularization of the arterial occlusion below the knee although it is technically demanding and the time consuming. time consuming.

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Fatal Aortic Tumor Embolism Presenting as Acute Paraplegia

  • Jin, Sung-Chul;Cho, Do-Sang;Song, Jun-Hyeok
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.72-74
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    • 2006
  • We report a case of fatal aortic tumor embolism presenting as acute paraplegia. A four-year-old girl was referred from a local hospital with sudden paraplegia and a poor medical condition. A neighbor had noticed her fall from a bike, and she could not walk. She had no previous illness. Emergency spine MRI revealed no remarkable findings. During the process of evaluation, her general condition deteriorated progressively. Chest and abdominal CT showed a large mass in the left lung field, and a diagnosis of aortic occlusion was made. An emergency transfemoral embolectomy was attempted. However, the patency of the aorta was not recovered. On pathological examination of tissues taken from the embolectomy, a pleuro-pulmonary blastoma was found. The patient died 22 hours after the onset of her symptoms. We describe a possible mechanism for the tumor embolism. To the best of our knowledge, this is the first case report of aortic occlusion caused by an embolic malignancy, presenting as acute paraplegia.

Accurate Placement of Parieto-occipital Ventricular Catheter Using CT Parameters (CT 지표를 이용한 두정-후두부 뇌실 도관의 정확한 삽입)

  • Min, Hyung-Sik;Song, Jun-Hyeok
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.886-890
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    • 2000
  • Objective : placement of ventricular catheter is important to achieve long-term patency of the shunt system. We describe a method of calculating the insertion site, trajectory, and the length of the ventricular catheter using CT parameters in shunt surgery. Patients and Methods : These can be rapidly obtained using a caliper from a scout cut and two axial scans at lateral ventricular and upper 3rd ventricular level. To compare this technique with traditional one, we analyzed 40 consecutive patients who underwent shunt surgery. Results : Of 20 patients undergoing ventriculoperitoneal shunt insertion using this technique, none had poor location of the proximal catheter. In the counterpart, 9 patients had poor location(p=0.001). The number of patients who required revision surgery were also lower in the group using this technique, but it was not statistically significant (4 versus 2, p=0.422). Mean follow-up period was shorter in this technique group. Conclusion : This technique provides an accurate placement of the proximal catheter without special instrument or additional expenses.

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NUMERICAL STUDY ON BLOOD FLOW CHARACTERISTICS IN A ARTERIOVENOUS GRAFT WITH DELIVERED DOSE DURING HEMODIALYSIS (인조혈관 동정맥루의 혈액 투석량에 따른 인조혈관 내부 유동 특성에 관한 수치해석 연구)

  • Kim, J.Y.;Ro, K.C.;Ryou, H.S.
    • Journal of computational fluids engineering
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    • v.16 no.4
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    • pp.84-91
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    • 2011
  • Hemodialysis is essential for patients with end stage renal failure. It is important to improve the patency rate and to minimize occurrence of the stenosis. Also, the blood flow to the artificial kidney can affect the blood flow characteristics through arteriovenous graft. Thus, the delivered dose are important factors for analyzing hemodynamic characteristics during hemodialysis access. In this study, the numerical analysis was performed for the effect of the delivered dose during hemodialysis access on the blood flow through the graft. As a result, The adverse pressure gradient occurred in case of a larger delivered dose through a catheter than standard dose and the flow instability increased. Also the circulation flow appeared largely at anastomotic site of the vein when the delivered dose was exceeded about half blood flow of inlet blood flow.

Surgical experience of Takayasu`s arteritis: one case report (Takayasu 동맥염의 수술치험 1례 보)

  • Im, Jin-Su;Choe, Hyeong-Ho;Jang, Jeong-Su
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.709-714
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    • 1984
  • The Takayasus arteritis is the obstructive disease in the principal branches arising from the aortic arch, and it can cause circulatory disturbances in the head or arms. We have experienced a case of complete obstruction of the left subclavian artery, the patient was undergone surgical repair with Knitted-Dacron patch graft between the left common carotid artery and the left subclavian artery. After operation, there were no symptoms except hypertension, and also no postoperative complications were seen. In the postoperative aortogram, the patency of the graft was good. The postoperative course was eventful and he has been in good conditions up to now so far.

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Dorsal Cavoatrial Bypass for Budd-Chiari Syndrome Associated with Obstruction of the Inferior Vena Cava (하공정맥 폐색증에 의한 Budd-Chiari 증후군의 수술 치험례)

  • Kim, Hyuck;Kang, Jung-Ho;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.541-546
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    • 1988
  • A 34-year-old female was seen with Budd-Chiari syndrome caused by an obstruction of the inferior vena cava above the hepatic veins. Transatrial dilation or membranotomy was not available due to severe hourglass constriction of the inferior vena cava. Retrohepatic cavoatrial bypass with a low porosity woven Dacron graft[24mm in the diameter] was performed. For increasing the patency of venous graft, we used anticoagulation with warfarin. Postoperative course was uneventful except pleural effusion of the right luring.

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Extra-anatomic bypass for Treatment of Leg Ischemia (하지동맥폐쇄환자에서의 비해부학적 우회술의 임상적 고찰)

  • 조재호
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.846-849
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    • 1994
  • Extra-anatomic bypass is indicated for the limb salvage of patients with threatened limb loss especially those who have high risk of infection and death after general anesthesia. We did extra-anatomic bypass procedure nineteen times over a seven year, two month period on sixteen patients. Their mean follow up period was 41.3 months. Male to female ratio was 7:1. Major complaints were resting pain[36.8%], claudication[31.6%], cyanosis[15.8%] and ulcerative change[15.8%]. Associated diseases were hypertension, tuberculosis, chronic renal failure, atrial fibrillation, complete heart block and laryngeal cancer. Postoperative patency rates were 76.9% at 1 year, 72.7% at 2 years and 70% at 3 years. Limb salvage rate was 78.9%. Postoperative mortality rate was 10.5%.

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Endovascular Rescue of a Narrowed Aorto-Aortic Bypass Graft in a Patient with Takayasu's Arteritis

  • Son, Kuk Hui;Kim, Ji Sung;Kim, Jeong Ho;Chung, Wook-Jin;Ahn, Sujoa;Park, Chul Hyun
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.556-559
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    • 2014
  • We report a case of successful endovascular treatment of a pseudoaneurysm and the obstruction of an aorto-aortic bypass graft, which had been performed to treat Takayasu's arteritis fifteen years prior, at the thoracic aorta. Along with the immediate relief of proximal hypertension that had caused severe heart failure, the successful exclusion of the pseudoaneurysm and the patency of the stem graft were maintained three years after the procedure.