• Journal of Chest Surgery
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• 제10권1호
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• pp.90-97
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• 1977

This is a report of a. case in which a long narrow segment coarctation of the aorta was successfully corrected with Teflon graft. The patient was 30 year old man with hypertensive symptoms that occurred 7 years prior to operation. Blood pressure measured 230/110 mmHg in the arms and 110/80 mmHg in the legs. Pulses were strongly tensive in radial artery, but very weak in femoral artery and even absent in dorsal pedis artery. Final preoperative diagnosis was made by aortography which showed a long narrow segment between aortic arch and descending thoracic aorta and highly developed collateral circulations. A long hypoplastic narrow segment was located proximal to the ligament arteriosus, and diaphragmatic stenosis of the aorta was located just distal to the ligamentum arteriosus. After prosthetic correction of the coarctation of the aorta, blood pressure were measured 130/ 80 mmHg in the arms and 150/100 mmHg in the legs. Peripheral pulses were palpated normally, and the postoperative course was uneventful.

• 대한한의학방제학회지
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• 제11권2호
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• pp.125-134
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• 2003

We have examined the relaxational response to the water extract of Angelica gigas $N_{AKAI}$ (AG), Gingko biloba $L_{INNE}$ (GB), Acanthopanax senticosus $H_{ARMS}.$ (AP) and Augumented-Four-Substance Decoction (AG-FSD, GB-FSD, AP-FSD) in isolated thoracic aorta from sprague dawley(SD) rat. Rat thoracic aorta was investigated in vessel segments suspended for isometric tension recording by polygraph. Responses to AG, GB, AP and AG-FSD, GB-FSD, AP-FSD were investigated in vessels precontracted with 5-hydroxytryptamine(5-HT) were compared in vasodilation effect. We found that the thoracic aorta segments responded to AG, GB, AP and AG-FSD, GB-FSD, AP-FSD with a dose-dependent vasodilation. The 5-hydroxytryptamine induced contraction at $10^{-4}M$ were inhibited by 26.3%, 75.8%, 87.5% and 6.9%, 22.6%, 30.8% after addition of the 0.1 g/mL water extract of AG, GB, AP and AG-FSD, GB-FSD, AP-FSD. In conclusion, AG, GB, AP and AG-FSD, GB-FSD, AP-FSD induced relaxation in the isolated rat thoracic aorta were composed of dose-dependent relaxation. AP-FSD has very potent vasodilation.

• 약학회지
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• 제37권6호
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• pp.605-614
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• 1993

To investigate the endothelial dependence of angiotensin II(A II)-induced responses in the systemic and pulmonary arterial system of acute renal hypertensive rats of 2-kidney, 1-ligation type (RHRs), A II-induced vasocontractile and pressor effects were evaluated in isolated arteries and in vivo, respectively. A II dose-dependently contracted intact thoracic aorta and pulmonary artery (E$_{max}$:40% at 10$^{-7}$M and 80% at 3$\times$10 $^{-8}$M, respectively) from normotensive rats(NRs), which was significantly increased by removal of endothelial cells or pretreatment with EDRF inhibitors. In NRs, A II increased mean systemic and pulmonary arterial pressure(33 and 5.6mmHg at 0.1 $\mu\textrm{g}$/kg, respectively), the effect being significantly increased (P<0.01) by L-NAME(30mg/kg, i.v.). However, A II-induced contraction of intact thoracic aorta and pulmonary artery(E$_{max}$: 33% at 10$^{-7}$M and 93% at 3$\times$10$^{-8}$M, respectively) from RHRs were not changed after endothelial function was disrupted as above; similarly, pressor effects of A II on the systemic and pulmonary arterial pressure in RHRs did not altered by L-NAME. A II tachyphylactic responses for intact thoracic aorta from NRs and RHRs(65 and 87% at 10$^{-8}$M, respectively) were greater than those for pulmonary artery(19 and 19% at 10$^{-8}$M, respectively). Distruption of endothelial function significantly (P<0.01) depressed A II tachyphylaxis for thoracic aorta, but not for pulmonary artery. These results suggest that vascular reactivity to A II is not altered in RHRs, and it is greater for pulmonary arterial system than for systemic arterial system. A II reactivity is EDRF-dependent in both arterial systems of NRs, but EDRF-independent for RHRs. Finally, EDRF is one of the major factors underlying A II tachyphylaxis for thoracic aorta, but not for pulmonary artery.

• Journal of Chest Surgery
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• 제24권1호
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• pp.36-40
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• 1991

Between November, 1981 and July, 1989, 4 patients, 3 male and 1 female patients ranging in age from 36 to 45 years, were operated on for aortic insufficiency associated with uncomplicated annuloaortic ectasia. All patients were in New York Heart Association class III. Two patients had clinical stigmata of the Marfan syndrome. The surgical treatment consisted of. supracoronary replacement of ascending aorta with vascular graft and replacement of the aortic valve in our first case. and composite graft replacement of the ascending aorta and aortic valve with reimplantation of the coronary arteries in subsequent 3 cases. Our first patient developed aneurysm of proximal aorta and pseudoaneurysm of distal aortic anastomosis 5 years postoperatively. One patient among the three patients with Ben-tall operation, died of ventricular fibrillation and myocardial failure during immediate postoperative period. Remaining 2 patients were in NYHA class I with follow-up of 16 months and 20 months respectively.

• Journal of Chest Surgery
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• 제45권5호
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• pp.330-333
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• 2012

Aortoenteric fistula is a rare but potentially fatal condition causing massive gastrointestinal bleeding. In particular, double primary aortoenteric fistulae are vanishingly rare. We encountered a 75-year-old male patient suffering from abdominal pain, hematochezia, hematemesis, and hypotension. His computed tomography images showed abdominal aortic aneurysm and suspected aortoenteric fistulae. During surgery, we found two primary aortoenteric fistulae. The one fistula was detected between the abdominal aorta and the third portion of the duodenum, and the other fistula was detected between the abdominal aorta and the sigmoid colon. We conducted the closure of the fistulae, the exclusion of the aneurysm, and axillo-bifemoral bypass with a polytetrafluoroethylene graft. The patient was discharged with no complications on the 21st postoperative day.

• Journal of Chest Surgery
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• 제34권5호
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• pp.414-417
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• 2001

흉부 대동맥의 비 외상성 자연 파열은 매우 드물지만, 발생시 응급수술이 요하는 위중한 질환이다. 본원에서는 전산화 단층 촬영과 경식도 초음파로 진단하고 부분 대동맥궁 치환술로 성공적으로 치료된 후 흉부 대동맥의 비 외상성 지연 파열 1례를 체험하였기에 문헌고찰과 더불어 보고하는 바이다.

• Journal of Chest Surgery
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• 제48권1호
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• pp.70-73
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• 2015

Lower limb ischemia caused by multiple stenosis of the thoracoabdominal aorta is one of the rare clinical manifestations of Takayasu arteritis. The optimal management of such mid-aortic syndrome related with Takayasu arteritis has not been established to date. Here we report a case of extra-anatomic aortic bypass through minimally invasive techniques to treat lower limb ischemia caused by Takayasu arteritis.

• Journal of Chest Surgery
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• 제40권8호
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• pp.578-581
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• 2007

6개월전 제1형 급성 대동맥 박리증으로 상행대동맥 치환술을 받은 59세 여자환자가 대량 객혈을 주소로 내원하였다. 하행 흉부대동맥과 좌하엽간의 누공이 의심되어 응급수술을 시행하였다. 체외순환하에 인공도관을 이용하여 하행대동맥 치환술을 시행하였으며 수술 후 별다른 합병증 없이 회복되었다. 대동맥 수술 후 원위부에 생기는 대동맥-기관지루는 매우 드문 합병증으로 조기진단 및 수술로 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제41권2호
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• pp.260-263
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• 2008

3예의 성인 대동맥축착증 환자에서 외해부학적(extraanatomical) 우회로조성술을 시행하였다. 축착 전 후의 광범위한 대동맥협착을 동반한 2예에서는 좌측 개흉술을 통해 좌쇄골하동맥에서 하행대동맥으로 우회술을 시행하였다. 대동맥판막폐쇄부전과 대동맥궁 발육부전이 동반된 대동맥축착 1예에서는 정중 흉골절개술을 통해 상행대동맥과 심장 뒤 하행대동맥간의 우회로술과 대동맥판막치환술을 동시에 시행하였다. 1예에서 술 후 4개월째 문합부 주위 동맥류의 파열이 있어 재수술을 시행하였으며 2예에서는 술 후 특별한 합병증이 없었다.

• Journal of Chest Surgery
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• 제46권1호
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• pp.33-40
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• 2013

Background: Total arch replacement (TAR) is being more widely performed due to recent advances in operative techniques and cerebral protective strategies. In this study, the authors reviewed the relationship between TAR and early- and mid-term changes of the false lumen after TAR in acute type A aortic dissection. Materials and Methods: Twenty-six patients (aged, $54.7{\pm}13.3$ years) who underwent TAR for acute type A dissection between June 2004 and February 2012 were reviewed. The relationship between the percentage change in the aortic diameter and the false lumen patency status was assessed by examining the early and late postoperative computed tomography imaging studies. Results: There were two in-hospital mortalities, one late death, and three follow-up loses. The mean follow-up duration for the final 21 patients studied was $54{\pm}19.0$ months (range, 20 to 82 months). The incidence of false lumen thrombosis within 2 weeks of surgery in the proximal, middle, and distal thoracic aorta, and the suprarenal and infrarenal abdominal aorta were 67%, 38%, 38%, 48%, and 33%, respectively, and 57%, 67%, 52%, 33%, and 33% for those examined at a mean of $49{\pm}18$ months after surgery, respectively. The false lumen regressed in 11 patients (42.3%). The aortic diameters were larger in the patients with a patent false lumen than those with a thrombosed false lumen at all levels of the descending aorta (p <0.05). Conclusion: TAR and a more complete primary tear-resection can be accomplished with a relatively low-risk of morbidity and mortality. Enlargement of the distal aorta significantly correlated with the false lumen patency status.