• Title/Summary/Keyword: Thoracic defect

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Massive Rhabdomyolysis Following Cardiopulmonary Bypass

  • Kim, Young Sam;Yoon, Yong Han;Kim, Joung Taek;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.181-184
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    • 2014
  • Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Delayed Iatrogenic Diaphragmatic Hernia after Left Lower Lobectomy

  • Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.456-459
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    • 2017
  • A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed. The diaphragmatic defect was repaired via VATS. The postoperative course was uneventful, and he was discharged with resolved digestive tract symptoms.

Airway Improvement with Medium-Term Compression Duration after Right Pulmonary Artery Anterior Translocation

  • Jang, Woo Sung;Kim, Jae Bum;Kim, Jae Hyun;Choi, Hee Jeong
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.57-60
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    • 2018
  • Left main bronchus compression occasionally occurs in patients with cardiac disease. A 19-month-old female patient weighing 6.7 kg was admitted for recurrent pneumonia and desaturation. S he had an atrial septal defect (AS D) with a right aortic arch. Her left main bronchus had been compressed between the enlarged right pulmonary artery (RPA) and the descending thoracic aorta for 14 months. We conducted ASD closure and RPA anterior translocation via sternotomy. The left main bronchus compression was relieved despite the medium-term duration of compression.

Surgical Resection of the Aneurysm of the Thoracic Aorta: Report of A Case (흉부대동맥의 동맥류 절제 치험례)

  • 김영태
    • Journal of Chest Surgery
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    • v.6 no.1
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    • pp.51-56
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    • 1973
  • This is one case report of successful resection of the aneurysm of the thoracic aorta, which det-ected by thoractomy unexpectedly, in the Department of Thoracic Surgery, Hanyang University Hospital. The patient was a 34 years old woman and subjective complaints was not related with the aneurysm. Chest film showed a small round hazy shadow in the left margin of the upper posterior mediastinum. A saccular aneurysm located on the descending thoracic aorta, 7cm distal to the left subclavian artery and arouse from the antero-lateral wall of the aorta. Excision of the saccular aneurysm was performed by cross clamping the descending aorta above and below the aneurysm, and then the defect of the aortic wall was closed by aortorrhaphy with continuous suture. Crossclamping time was required 15 minute. Histopathologically, the wall of the aneurysm consisted of all layers of the arterial wall, that is, intima, media and adventitia. Postoperative course was uneventful and aortogram showed good continuity of the blood flow of the entire aorta.

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Intracardiac Repair of Scimitar Syndrome (Scimitar 증후군의 외과적 치험)

  • Hur, J.;Chang, B.H.;Lee, J.T.;Kim, K.T.
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1476-1481
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    • 1992
  • This presents a case of anomalous pulmonary venous drainage from the right lung to the inferior vena cava [scimitar syndrome], which was corrected with an intracardiac approach. Autogenous pericardium was used to create an intracardiac tunnel redirecting flow from the anomalous vein to the left atrium through a surgically enlarged atrial septal defect. The postoperative results have veen satisfactory.

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An Adult Right-sided Bochdalek Hernia Accompanied with Hepatic Hypoplasia and Inguinal Hernia

  • Choi, Yun Kyung;Ahn, Jae Ho;Kim, Kwan Chang;Won, Tae Hee
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.348-350
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    • 2012
  • We herein report a very rare case of adult right-sided Bochdalek hernia accompanied with hepatic hypoplasia and inguinal hernia. A 29-year-old man was admitted with right-sided pneumothorax. A computed tomography was performed and revealed large right sided Bochdalek hernia with hepatic hypoplasia. Under thoracolaparotomy, the defect was closed with Gore-Tex soft tissue patch. After the operation, left-sided inguinal hernia was found. However, it turned out that it had been present during infancy and spontaneously resolved during adolescence. This is the first report of right-sided Bochdalek hernia with hepatic hypoplasia and inguinal hernia in an adult.

Congenital Cardiac Anomaly Combined with the VATER Association - A case report - (VATER 증후군에 동반된 선천성 심장기형 치험 1례)

  • Ban, Dong-Gyu;Kim, Hyuck;Jee, Heng-Ok;Chung, Won-Sang;Kang, Jung-Ho;Kim, Young-Hak;Lee, Chul-Bum;Ham, Shi-Young;Kim, Nam-Su
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.858-860
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    • 2001
  • VATER is a complex anomaly of multiple organs and often combined with cardiac anomalies. However, it can be cured with active surgical intervention. We achieved successful result with aggressive surgery in the patient with VATER and report it with references.

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Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

  • Oh, Hyun Kong;Kim, Nan Yeol;Kang, Min-Woong;Kang, Shin Kwang;Yu, Jae Hyeon;Lim, Seung Pyung;Choi, Jae Sung;Na, Myung Hoon
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.283-286
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    • 2014
  • A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.

Preserved Respiratory Function after Reconstruction of a Large Chest Wall Defect

  • Kim, Yu Jin;Kim, Yoon Ji;Lee, Jae-Ik
    • Archives of Reconstructive Microsurgery
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    • v.24 no.1
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    • pp.28-31
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    • 2015
  • A case report of a patient who developed radiation-induced sarcoma in the left chest wall is presented. The patient had partial mastectomy and adjuvant radiation therapy (total dose, 5,220 cGy) and chemotherapy. Five years later, she visited with rapidly growing mass with central ulceration in the irradiated chest wall. The mass was diagnosed as malignant fibrous histiocytoma. The chest wall mass resected en bloc ($23{\times}18cm$) including five consecutive ribs. After the defected thoracic cage was reinforced using a polytetrafluoroethylene patch, omental flap and split thickness skin graft was done for soft tissue coverage. We applied negative pressure wound closer system for effective suction of omeantal exudate. The wound healed without complications. The patient suffered no perioperative pulmonary complications. Pulmonary function tests showed no significant changes. Each of Gore-Tex, omental flap, negative pressure wound therapy and skin graft is widely used method. However, If these methods are used in combination, we can reconstruct the large defect of chest wall including multiple ribs without any repiratory function problems.

A Clinical Evaluatuin on Open Heart Surgery of Congenital and Acquired Heart Disease (선천성 및 후천성 심질환의 개심술)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.33-42
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    • 1979
  • The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

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