• Journal of Chest Surgery
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• 제26권6호
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• pp.496-500
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• 1993

Takaysu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries. The end stage pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch, left common carotid artery and left subclavian artery. The patient was 27 year-old female and she was admitted because of headache and neck pain. Aortogram revealed fusiform dilatation of left common carotid artery with focal narrowing on it`s distal portion. The patient underwent surgical resection and replacement of Dacron tube graft between distal and proximal left common carotid artery. 3 months after operation, she was readmitted because of shoulder pain and headache. Aortogram revealed focal narrowing of proximal left common carotid artery and total obstruction of left subclavian artery which caused subclavian steel syndrome. Aorto-left common carotid and aorto-left subclavian bypass graft replacement were done.

• Journal of Chest Surgery
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• 제26권10호
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• pp.808-811
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• 1993

Leriche syndrome ia a common entity which causes ischemia of the lower extremities. Since the introduction of aortic resection and homograft replacement by Oudot in 1951, reconstructive procedures to restore distal blood flow by either endarterectomy or, later, with prosthetic graft have become standardized. Recently we experienced a case of Leriche syndrome. A 50 year-old male patient admitted with intermittent claudication, impotence, and symmetrical atrophy at lower extremities. Aortogram revealed complete obstruction at infrarenal abdominal aorta and Doppler sonogram revealed only minimal blood flow at left femoral artery.Successful surgical treatment was accomplished with endarterectomy at proximal left renal artery and a bypass from abdominal aorta at the level of both renal arteries to both external iliac arteries with bifurcated Gore-tex vascular graft. After bypass operation, we did palpate with arterial pulse at both popliteal artery.He was recovered without complication.

• Journal of Chest Surgery
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• 제25권1호
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• pp.105-111
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• 1992

Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

• Journal of Chest Surgery
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• 제52권3호
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• pp.186-188
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• 2019

We report an unusual case of delayed bleeding after open surgical repair of a thoracoabdominal aortic aneurysm. A 79-year-old man developed a massive retroperitoneal hematoma 49 days after Crawford type III thoracoabdominal aorta replacement. During emergency surgery, a tear was found in the prosthetic vascular graft caused by a sharp bony spur arising from the second lumbar vertebral body. This rare, but potentially lethal, complication indicates that attention should be paid to sharp bony structures during open repair of the descending aorta.

• Journal of Chest Surgery
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• 제57권1호
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• pp.99-102
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• 2024

This article presents a straightforward hybrid arch technique for treating residual type B aortic dissecting aneurysms following type A repair (replacement of the ascending aorta) that employs a frozen elephant trunk (FET) straight vascular prosthesis. The debranch-first method involves only cutting and sewing the previous ascending graft, inserting the FET from zone 0, and debranching the arch vessels using a trifurcated graft. This technique is less invasive as it eliminates the need to manipulate the dissected distal arch aneurysm. We successfully applied this technique to 3 patients, with no instances of in-hospital death, stroke, or paraplegia. The debranch-first technique, combined with zone-0 FET insertion, simplifies the redo repair of residual type B aortic dissection.

• Journal of Chest Surgery
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• 제15권2호
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• pp.222-229
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• 1982

The aneurysmal dilatation of ascending aorta with the aortic regurgitation presents typical surgical problems. Over the years, various surgical procedures had been used for the management of the dilated segment of sending aorta and the aortic regurgitation. The surgical technique Is still in the state of evolution. The one method is the super coronary replacement of the ascending aorta with vascular graft and replacement of the aortic valve with preservation of the coronary ostia as advocated by Miller and his colleague at Stanford University, so called conventional technique". The other is the replacement of aortic valve and the dilated segment of the ascending aorta using a composite graft and transplantation of the coronary ostia as described by Bentall and DeBono in 1968. The controversy appears to evolve around 3 technical problems. One is bleeding from the grafted area. Two is later development of the aneurysmal dilatation of the subcoronary aortic wall when non-composite graft is employed. Three is a management of the coronary arteries. The purpose of this article is to present our experience with 7 cases of annuloaortic ectasia in whom both of these surgical techniques at that employed and to review some of the problems that encountered during the management of these patients .

• Journal of Chest Surgery
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• 제11권3호
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• pp.342-347
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• 1978

A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

• Journal of Chest Surgery
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• 제11권3호
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• pp.333-341
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• 1978

A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.37-43
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• 2000

Vascularized tissue coverage is necessary for treatment of soft tissue defect with bone and tendon exposure on hand and foot dorsum, which cannot be successfully covered with simple skin graft or local flap. The temporal fascia is one of the most ideal donor for coverage of soft tissue defect of dorsum of hand or foot in term of ultra-thin, pliable and highly vascular tissue. Also, this flap offers the advantage of a well-concealed donor site in the hair-bearing scalp and smooth tendon gliding. We have experienced 11 cases of reconstruction for soft tissue defect in the hand or foot using temporal fascial flap with skin graft. All cases survived completely and we could gain satisfactory functional results. There were no specific complications except one donor site alopecia We think that the free temporal fascial flap coverage is a highly reliable method for soft tissue defect in hand and foot dorsum. However, the potential pitfalls is secondary alopecia and requirement of skin graft after its transfer.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.82-88
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• 2011

Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.