• Title/Summary/Keyword: Sternotomy

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THYMOLIPOMA(Report of one case) (흉선지방종-1례 보고-)

  • 백승환
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.561-565
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    • 1990
  • We experienced thymolipoma which is a rare benign mediastinal tumor, an admixture of atrophic thymic tissue and matured adipose tissue. The patient was, 13 years old boy, admitted due to anterior mediastinal mass on routine chest X-ray and complained of mild exertional dyspnea. The physical examination revealed percussion dullness, decreased breathing sound at right anterior hemithorax. The chest PA and lateral views showed both paracardiac mass density and obliteration of retrosternal clear space. The chest CT Scan showed tubular structure containing of thymic tissue and enhanced fatty tissue, suggested thymolipoma. Operation was performed under the impression of thymolipoma. Through median sternotomy, the huge mass was resected. Grossly, the mass was yellowish fatty colored, measured 15X12X10cm, weighed 600gm. Light microscopic examination showed that thymic tissue containing of Hassal`s corpuscles were surrounded by matured adipose tissue, as the characteristic finding of thymolipoma. The postoperative course was uneventful.

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Anterior Tracheoplasty Using Glutaraldehyde-Soaked Autologous Pericardium -One Case Report- (글루타르알데하이드에 담근 자가심막을 이용한 전방기관성형술 -1례 보고-)

  • 이석열;송철민;장원호;박형주;이철세;이길노
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.487-490
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    • 2002
  • A 60-year-old female was admitted to our hospital complaining of dyspnea. In the past history, she had received tracheal diversion due to recurrent aspiration after brain surgery and tracheostomy. Emergency three dimensional spiral tracheal computed tomograhpy revealed distal tracheal stenosis. The operation was performed by anterior tracheoplasty using glutaraldehyde-soaked autologous pericardium through median sternotomy. Herein we report a case of anterior tracheoplasty using glutaraldehyde-soaked autologous pericardium.

Extra-Pericardial Tamponade due to Internal Thoracic Artery Rupture after Blunt Trauma: A Case Report

  • Noh, Donsub;Chang, Sung Wook;Ma, Dae Sung
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.183-186
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    • 2021
  • Cardiac tamponade is an acute life-threatening condition that predominantly involves the intra-pericardial space; however, an expanding mediastinal hematoma can also sometimes cause cardiac tamponade. Here we describe the case of a 45-year-old male driver in whom a traffic accident resulted in rupture of the left internal thoracic artery (ITA), extra-pericardial hematoma, and sternal fracture. After resuscitation, he was scheduled to undergo angio-embolization to repair the ruptured left ITA, but he suddenly developed cardiac tamponade that required a decompressive sternotomy. Nevertheless, the patient had an uncomplicated recovery, and this case suggests that extra-pericardial cardiac tamponade should be considered as a possible consequence of retro-sternal hematoma due to traumatic ITA rupture.

A Minimally Invasive Approach for the Treatment of Mid-Aortic Syndrome in Takayasu Arteritis

  • Ha, Keong Jun;Cho, Won Chul;Kim, Wan Kee;Kim, Joon Bum
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.399-402
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    • 2018
  • A 61-year-old woman who presented with claudication and dyspnea on exertion was found to have severe calcified narrowing of the descending aorta and severe insufficiency of the aortic valve. These findings were compatible with Takayasu arteritis. To treat these hemodynamic abnormalities, extra-aortic bypass surgery combined with replacement of the aortic valve and ascending aorta-to-hemiarch replacement was performed through a separated upper hemi-sternotomy and limited median laparotomy. We present our successful surgical experience with this case.

Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

  • Kim, Seon Hee;Song, Seunghwan;Cho, Ho Seong;Park, Chan Yong
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.372-375
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    • 2019
  • A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

Temporary Right Ventricular Assist Device Insertion via Left Thoracotomy after Left Ventricular Assist Device Implantation

  • Park, Ilkun;Cho, Yang Hyun;Chung, Su Ryeun;Jeong, Dong Seop;Sung, Kiick;Kim, Wook Sung;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.105-108
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    • 2019
  • Right heart failure is a relatively common complication after left ventricular assist device (LVAD) implantation. Severe right heart failure can be managed by temporary right ventricular assist device (RVAD) implantation. However, trans-sternal RVAD insertion requires a subsequent third sternotomy for cannula removal. Herein, we present a case of RVAD insertion via a left anterior mini-thoracotomy after LVAD implantation in a patient with alcohol-induced cardiomyopathy.

Traumatic Tricuspid Regurgitation as a Cause of Failure to Wean from Mechanical Ventilation

  • Jeon, Yang Bin;Park, Chul Hyun;Ma, Dae Sung
    • Journal of Trauma and Injury
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    • v.33 no.4
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    • pp.264-268
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    • 2020
  • A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.

Mini-Bentall Surgery: The Right Thoracotomy Approach

  • Jawarkar, Manish;Manek, Pratik;Wadhawa, Vivek;Doshi, Chirag
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.554-557
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    • 2021
  • Surgeons are increasingly using the right mini-thoracotomy approach to perform aortic valve surgery. This approach has shown better results in terms of blood loss and length of hospital stay than the sternotomy approach. For selected patients requiring aortic root and ascending aorta surgery, a right mini-thoracotomy approach may prove beneficial. In our technique, we placed a 5-cm horizontal skin incision in the right second intercostal space. Femoro-femoral cardiopulmonary bypass was established. A valved aortic conduit was used for aortic root replacement. The patient's postoperative course was uneventful, with a short hospital stay. This technique offers a minimally invasive approach to aortic root and ascending aorta surgery with easy adaptability and reduced costs.

A Case Report of Resection of a Mediastinal Paraganglioma: Why All the Fuss?

  • Staunton, Laura Mary;Casey, Laura;Young, Vincent K.;Fitzmaurice, Gerard J.
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.174-176
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    • 2022
  • Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

Surgical Management of an Isolated Huge Innominate Artery Aneurysm Causing Tracheal Compression: A Case Report

  • Young Kwang, Hong;Won Ho, Chang;Hong Chul, Oh;Young Woo, Park
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.478-481
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    • 2022
  • The innominate artery is an uncommon site for an aneurysm, and tracheal compression caused by an innominate artery aneurysm is a very rare occurrence. An innominate artery aneurysm can cause catastrophic complications, such as rupture or thromboembolism. The most common surgical approach for open repair is median sternotomy with cardiopulmonary bypass, but cerebral ischemic injury and thromboembolism can occur during surgery. We present the case of a male patient who had an isolated giant innominate artery aneurysm causing tracheal compression, which was successfully managed by surgical repair.