• Journal of Chest Surgery
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• v.49 no.5
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• pp.401-404
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• 2016

The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.402-406
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• 2002

The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. 1 recommend operating on the iliac vein first rather than the lower venous tree.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.526-532
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• 1983

This is a report of one case of Loffler`s eosinophilic endocarditis associated with mitral insufficiency and LV thrombi treated surgically at the department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital. This patient was a 42 year old female and she has complains of dyspnea, palpitation, orthopnea and generalized edema. Above symptoms has been going for 4 months and NYHA classification was IV. On examination, blood eosinophil was 45 to 50% [WBC-9800 ]. MI and LV thrombi were confirmed by LV ventriculography and echocardiography. Pulmonary congestion and congestive cardiac failure were diagnosis by X-Ray examination, EKG finding and clinical feature and others there were no organic functional disturbance. Mitral valve replacement was performed with Ionescu-Shiley pericardial valve [29mm] replacement. Adjust thumb sized grayish brown colored two thrombi were excluded, lodged in the apex and septal endocardium of LV. Endocardial fibrosis was reliably confirmed under the gross pathology in the heart. The patient had smooth postoperative course and there were no operative complication.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.390-395
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• 1990

Renal cell carcinoma frequently extends into the vena cava and occasionally, even into the right atrium. We experienced 2 cases of renal cell carcinoma extending into the inferior vena cava by radical nephrectomy and complete removal of thrombi in the cava by joint approach with urologic surgeons. In the literature, improvement of survival by complete removal of tumor thrombi in the vena cava was documented and joint approach of cardiovascular surgeons and urologic surgeons result in appropriate surgical approach.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.204-212
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• 1982

The presence of left atrial thrombus in mitral stenosis has been reported to be associated with several factors. These are age, sex, presence of atrial fibrillation, episodes of congestave heart failure, calcification of mitral valve, embolic episode, etc. Since none of these single factor has been always related to the presence of left atrial thrombus, related risk factors to left atrial thrombosis were studied in patients with mitral stenosis using chi square test. We had operated on 191 cases of mitral valvular heart disease from Jan. 1978 to June 1981 at Severance Hospital, Yunsei University College of Medicine. The left atrial thrombi were present in 41 cases among 191 cases of mitral valvular heart disease and it was present in 31 cases among 89 cases of pure mitral stenosis. Only 10 cases among 74 cases of mitral stenoregurgitation had left atrlal thrombi, whereas no left atrlal thrombus was found in patients with pure mitral regurgitation. Related risk factors studied herein were sex, episodes of congestive heart failure, atrial fibrillation, pulmonary capillary wedge pressure, mitral valve area calculated by Gorlin and Gorlin`s formula cardiac output and left atrial dimension by echocardiogram. In this study presence of atrial fibrillation was deemed to be one of the most potential risk factors and other factors of age, duration of symptoms, episode of embolization, calclfication of mitral valve, associated aortic and tricuspid valve disease, ejection fraction of left ventricle by cineangiocardiogram and echocardiogram were not significantly related to the presence of left atrlal thrombi in a statistical viewpoint.

• Journal of Yeungnam Medical Science
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• v.28 no.2
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• pp.180-186
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• 2011

Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.72-75
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• 2011

Aortic thrombi are important because it can cause the central and peripheral embolizations. Aortic thrombi can occur anywhere in the aorta but extremely rare in ascending aorta without atherosclerosis, aneurysm, cardiosurgical or traumatic state. Systemic sclerosis (SSc) is an autoimmune disorder of connective tissue and it can involve multisystem. Enhanced coagulation pathways, decreased fibrinolysis, and endothelial dysfunction probably contribute to vascular events in SSc. We report a case of a highly mobile thrombus in the ascending aorta, presented as an acute embolic stroke in the patient with systemic sclerosis. Surgical removal was performed to prevent recurrent embolic events.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1097-1101
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• 1998

Renal cell carcinoma involves the inferior vena cava(IVC) in approximately 5-10% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Circulatory arrest with cardiopulmonary bypass is an operative technique that recently has been used to assist in resection of tumors that extend into the vena cava above the level of hepatic veins. We performed removal of tumor thrombi of IVC in 4 patients. All of them who had the renal cell carcinormas with infrahepatic vena caval extension were performed by standard surgical technique without cardiopulmonary bypass. But in one patient, inferior vena caval thrombectomy was done using circulatory arrest because of the recurred extension of the tumor thrombi within the vena cava above the insertion of the hepatic vein. All patients were recovered without any significant problems.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.970-974
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• 2003

There has been an improvement in the prognosis of tumor thrombi invading the inferior vena cava(IVC) and the right atrium(RA) of renal cell carcinoma with radical nephrectomy and tumor thrombectomy with the aid of cardiopulmonary bypass in the last 10 years. A 30 year old woman was diagnosed with right renal tumor with tumor thrombi invading the right renal vein and the IVC above the right renal vein to the RA. She received radical nephrectomy and removal of tumor thrombi in the infrarenal IVC under hypothermic total circulatory arrest using the cardiopulmonary bypass. The tumor recurred 12 months after the initial operation, she received a second operation for tumor removal from the retroperitoneum, suprarenal IVC, and RA. She died 11 months after the second operation due to lung metastases and recurred hepatic vein tumor extended to the RA and right ventricle.

• Korean Journal of Veterinary Research
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• v.22 no.2
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• pp.211-219
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• 1982

Chickens from 10 to 32 weeks of age were inoculated with P. multocida via seven routs(intravenous, intramuscular, intraperitoneal, subcutaneous, into ear, intranasal, per oral). The development or distribution of disseminated intravascular coagulation (DIC) in multiple organs and the role of P. multocida endotoxins in disease process of fowl cholera were studied. The histological diagnosis of DIC was made by demonstration of fibrinous in arterioles, capillaries, venules and medium-sized blood vessels. The presence of fibrinous thrombi in blood vessels of multiple organs was observed in chickens which died within approximately 3 days post inoculation. Fibrinous thrombi were observed most frequently in the lung(90% of all cases with DIC) followed by liver (70%), kidney (60%), heart(20%), spleen, brain, pancreas, thymus and thyroid gland. The density of fibrinous thrombi (i.e. the number of thrombi per section) was greatest in the lung, followed by spleen, kidney, liver and heart. It is thought that the widespread hemorrhage of acute fowl cholera is also caused by P. multocida endotoxin which initiates DIC in variety of organs. The cause of death for the chickens after infection with acute fowl cholera is probably due to an endotoxin (septic) shock accompanied with DIC in multiple organs.