• Journal of Chest Surgery
• /
• 제42권4호
• /
• pp.492-496
• /
• 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
• /
• 제45권5호
• /
• pp.323-325
• /
• 2012

Pulmonary tumor embolism can be a cause of respiratory failure in patients with cancer even though it occurs rarely. We describe a 56-year-old man who underwent a pulmonary tumor embolectomy using cardiopulmonary bypass on beating heart combined with inferior vena cava embolectomy and right radical nephrectomy. Aggressive surgical treatment in this severe case is necessary not only to reduce the fatal outcome of pulmonary embolism in the short run, but also to improve the oncological prognosis in the long term.

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

• Journal of Chest Surgery
• /
• 제23권4호
• /
• pp.804-810
• /
• 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
• /
• 제36권7호
• /
• pp.531-534
• /
• 2003

5년 전 침윤기태(invasive mole)로 진단받았던 43세 여자가 심폐 바이패스 하에 응급 폐색전 제거술을 시행 받았다. 우측 주폐동맥뿐 아니라 좌하엽 폐동맥에도 종양이 침범되어 완전절제는 얻을 수 없었다. 종양 조직검사에서 융모막 암종으로 확진된 후 환자는 6개월 동안 항암치료를 받았고 완전관해 되었다. 드물지만 가임기 여성에서 폐색전이 있을 때 감별진단으로 융모막 암종을 고려해야 한다.

• Journal of Chest Surgery
• /
• 제52권2호
• /
• pp.78-84
• /
• 2019

Background: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of $6.8{\pm}5.4years$ (4.2 years). Methods: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. Results: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial b leeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5-78.5) to 31.0 (25.7-37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63-2.00) to 0.50 (0.50-1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. Conclusion: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

• Journal of Korean Neurosurgical Society
• /
• 제39권1호
• /
• pp.72-74
• /
• 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.

• Tuberculosis and Respiratory Diseases
• /
• 제47권1호
• /
• pp.103-110
• /
• 1999

저자 등은 폐색전증이 확인된 환자에서 지속적인 경구 warfarin 항응고 치료에도 불구하고 색전에 의한 호흡곤란 증상이 악화하여 시행한 색전제거술 후 혈전에서 원발 미상의 미분화 편평 상피 세포암이 확인된 1예를 경험하여 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제21권5호
• /
• pp.911-917
• /
• 1988

Pulmonary thromboembolism originated most commonly from the venous thrombus, especially deep vein thrombus in the leg, which migrated to and occluded the pulmonary vasculatures. The failure of clot lysis and repeated embolic episodes resulted in the hemodynamic compromise -that is- in the increasing in the pulmonary vascular resistance, which would cause the right ventricle failure[Car Pulmonale]. Under the cardiopulmonary bypass, 20 year old male patient was treated successfully by thromboembolectomy of pulmonary thromboembolism with pulmonary hypertension, which originated from the deep vein thrombus in the leg. The results of radiologic studies and clinical evaluations were excellent in that the postoperative lung perfusion scan showed the newly increased perfusion of post-embolectomy territories and in the arterial blood gas finding of 76 from 66[mmHg] in PaO2. The patient was uneventful and discharged on postop. $ 14 days with anticoagulant continued.

• 대한핵의학회지
• /
• 제19권2호
• /
• pp.87-89
• /
• 1985

Unresolved major pulmonary embolism (UMPE) is an uncommon condition which causes pulmonary hypertension, cor pulmonale and death. An accurate and prompt diagnosis of UMPE is very important in the management of such patients with pulmonary embolectomy. Follow-up lung scans can lead to earlier diagnosis of UMPE especially on patients who have a history of acute pulmonary embolism in the past and. present with pulmonary hypertension, respiratory insufficiency and cor pulmonale. We report a case of UMPE strongly suggested by follow-up lung scans and subsequently confirmed by pulmonary angiography and postmortem examination.