• Journal of Chest Surgery
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• v.24 no.3
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• pp.229-244
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• 1991

A bioassay technique and organ bath study were performed to analyze the effects of extracellular $Ca^{2+}$ and $Ca^{2+}$-antagonists on endothelium-derived relaxing factor[s][EDRF] released from the endothelial cells of rabbit aorta. Transverse strips with intact endothelium or damaged endothelium were used for the mechanical contraction experiment using organ bath. Long segment including thoracic and abdominal aorta with endothelium [EDRF donor aorta] was perfused with Tyrode solution which was aerated with 95% $O_2-5%$ $CO_2$ mixed gas and kept at 35oC. The perfusate was bioassayed with a transverse strip of thoracic aorta with damaged endothelium. The test strip was contracted with nor-epinephrine and acetylcholine was used to stimulate the release of EDRF from endothelial cells. The results obtained were as follows; 1] The endothelium-dependent relaxation[EDR] induced by acetylcholine was biphasic; an initial rapid relaxation followed by a slow relaxation. 2] EDR induced by acetylcholine was reduced gradually with the decrease in the concentration of extracellular $Ca^{2+}$. The effect of extracellular $Ca^{2+}$ on EDR was more prominent in the late slow relaxation phase. 3] EDR to acetylcholine was not altered by acute exposure to organic $Ca^{2+}$-antagonists. Pretreatment with verapamil to the EDRF donor aortic segment did not alter the magnitude of EDR. 4] Among the inorganic $Ca^{2+}$-antagonists $Mn^{2+}$ and $Cd^{2+}$ did not inhibit EDR, whereas $Co^{2+}$ and $La^{3+}$ inhibited EDR. 5] The inhibitory response of $Co^{2+}$ to EDR developed when infused directly on the test strip. That of $La^{3+}$, however, was evoked when added to solution perfusing the donor aortic segment. The above results suggest that $Ca^{2+}$-antagonists do not affect EDR and the inhibitory effect of $Ca^{2+}$ results from influencing the action of EDRF on vascular smooth muscle, whereas that of $La^{3+}$ results from its action on the release of EDRF from endothelial cells.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.797-800
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• 1995

Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.645-648
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• 2009

We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal. aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the $4^{th}$ postoperative day.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.301-309
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• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.189-193
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• 2003

The patient was a 30-day-old female infant with symptoms of severe dyspnea and cyanosis, when she was admitted to the ER. The echocardiography revealed DORV with subpulmonary VSD, and the diagnosis of Taussig-Bing anomaly was made. Two days after admission, an urgent operation was performed. The operation consisted of intraventricular tunnel repair and arterial switch operation. She was discharged, and after checking her chest X-ray through OPD, there was no interval change of cardiomegaly. She was then re-admitted, and the angiography revealed coactation of aorta. We performed a resection and end-to-end anastomosis of aorta. She is currently in good condition 11 months postoperatively.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.174-182
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• 1979

This is a report on four cases of successful surgical correction of coarctation of the aorta [COA] in Department of the Thoracic & Cardiovascular Surgery, Hanyang University Hospital. The first case was a postductal type of coarctation of the aorta associated with Patent ductus arteriosus [PDA], Persistent left superior vena cava [LSVC] and richly developed collateral circulation. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. The coarctation of the aorta was corrected with following procedure: Partial resection of the aortic wall with diaphragmatic structure lust above and below the coarctating line of the aorta, and then the defect of the aortic wall was closed by lateral aortographic suture. PDA was closed by ligation procedure. The second case a preductal type of coarctation of the aorta associated with PDA, LSVC, ventricular septal defect [VSD] and poorly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Correction of coarctation of the aorta was performed under the establishment of tube bypass because of poor collateral circulation. After resection of coarctating short segment, end to end anastomosis was performed without any tension. PDA was closed by division procedure. Simple suture closure of VSD was performed by open heart surgery two weeks after correction of COA. The third case was a long segment COA without any other anomaly. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.5 cm] of the aorta. The fourth case was a long segment COA associated with aortic insufficiency and richly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.0 cm] of the aorta. Both blood pressure and peripheral pulse on the arm and the legs returned to normal postoperatively in all patients.

• Journal of Chest Surgery
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• v.57 no.4
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• pp.387-389
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• 2024

• Journal of Chest Surgery
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• v.27 no.11
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• pp.961-964
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• 1994

The pulmonary sequestration is an uncommon congenital anomaly characterized by the presence of nonfunctioning lung tissue supplied by aberrant artery from the aorta or its branches and usually has no communication with the normal bronchial tree. The patient was 35 year old female and had no specific complaints. The lung mass was found incidentally and was continned to be intralobar pulmonary sequestration by aotography whitch showed aberrant blood supply from thoracic aorta at the T. vertebra level. The right lower lobectomy was done.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.6-12
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• 2014

Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.122-125
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• 2016

Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications.