• Title/Summary/Keyword: anastomosis

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Axillo-Axillar bypass with Gore-Tex graft for a pulseless disease. (액와동맥간 Bypass Graft 를 이용한 무맥증 수술치험 1례)

  • 이신영
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.466-469
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    • 1985
  • The patient was 17 years old female who complained of coldness of right arm and occasional dizziness, since 4 months prior to admission. On physical examination, the right radial, brachial and common carotid arterial pulses were not palpable. Aortography revealed narrowing of innominate and right common carotid arteries, and complete obstruction of right subclavian artery. The right axillary artery was faintly visualized on the delayed film. Axillo-axillar bypass was done using Gore-Tex graft of 8 mm I.D.. By bilateral subclavicular incision, both side axillary arteries was exposed. End to side anastomosis was made between graft and right axillary artery and the graft was brought out to the left side, subcutaneously, over the sternum, and the anastomosis was made between graft and left axillary artery. Postoperatively, both radial pulses were equally palpable. On follow-up visiting, there were no subjective symptoms and blood pressure in both arms was equal.

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Coronary Artery Numerical Flow Analysis for Determination of Bypass Graft Geometric Parameters

  • Kim, Hyung-Min;Kim, Woong
    • Journal of Mechanical Science and Technology
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    • v.19 no.3
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    • pp.905-912
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    • 2005
  • A computational investigation of blood flow in a coronary artery grafted by artificial bypass was performed to determine such geometric parameters as the curvature of radius, approach length, and angle of end-to-side anastomosis. Transient flow features in the host artery were computed using FVM and SIMPLE algorithms. We compared flow distributions and wall shear stresses in two simple models, planar and non-planar, and confirmed that the non-planar bypass model was more conducive to suppressing intimal hyperplasia. Our non-planar model with $60^{\circ}$ of anastomosis and a 1.0 diameter approach length and radius of curvature predicts a relatively small, spatially-extended high-OSI (>0.01) zone, as well as an increased average wall shear stress on this zone.

Coarctation of the aorta: report of 2 cases (대동맥 축착증 -2례 보고-)

  • Kim, Byeong-Ju;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.448-455
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    • 1984
  • Coarctation of the Aorta is a congenital constriction of aorta of varying degree, usually located at or near the aortic ismuth with frequent associations of other cardiac anomalies. Various modes of surgical corrections, such as resection and end-to-end anastomosis, graft interposition, angioplasty using prosthetic patch or subclavian flap have been used according to the status of coarctation and age of the patient. We have experienced two cases of surgically treated coarctation of the aorta, one of which was preductal coarctation with hypoplastic aortic arch and ventricular septal defect in a 4 year old boy, and the other case was juxtaductal type with aortic regurgitation. Subclavian flap angioplasty with additional pulmonary artery banding procedure was done in the first case and wedge resection with end-to-end anastomosis and aortic valve replacement [St. Jude valve, 23mm] 20 days later of first operation in the other case. The first case developed massive tarry stool on 3rd POD, probably due to mesenteric arteritis with resultant bowl ecrosis, and expired the next day. Recovery was uneventful with the second case.

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Colon Interposition in Children after Failed Tracheoesophageal Fistula Repair

  • Park, Samina;Kang, Chang-Hyun;Kim, Hye-Seon;Park, In-Kyu;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.452-454
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    • 2011
  • The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other.

Three-Dimensional Flow in an End-to-Side Vascular Anastomosis: Steady and Pulsatile Flow (End-to-Side 혈관문합에서의 삼차원유동: 정상유동 및 맥류유동)

  • Kim, Young-H.
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.05
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    • pp.115-118
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    • 1994
  • Three-dimensional steady and pulsatile flows in an end-to-side anastomosis were investigated using a finite difference method in order to understand the flow dynamics in the preferential development of distal anastomotic intimal hyperplasia or thrombosis. Steady flow results revealed that a double helical vortex was formed in the host artery and flow recirculations near tow and heel regions were limited due to the secondary flow. Oscillating wall shear stress with significant secondary flow might be the flow dynamic reason of developing intimal hyperplasia or thrombosis.

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Acute Pulmonary Edema and Congestion in the Right Upper Lobe after Waterston-Cooley Shunt for Tetralogy of Fallot: A Case Report (활로4증후에서 Waterston-Cooley 문합수술후에 발생한 우상엽 폐수종: 1례 보고)

  • 송충웅
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.113-117
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    • 1977
  • The tetralogy of Fallot is one of the most frequent and serious congenital cardiac malformation accompanied cyanosis. For relief of cyanosis, the Waterston operation is a successful, palliative procedure in infant & young child under age of five with obstructive lesions of the right: side of the heart who require a systemic-pulmonary arterial shunt for survival. A patient, aged 3 and weighing 13 kg., who had been cyanotic since one month after birth,. was admitted to the University of Severance Hospital under a diagnosis of tetralogy of Fallot, The side to side anastomosis between the right pulmonary artery & the ascending aorta was performed in March 1976. The anastomotic channel was made only 4 ram. in diameter, thereafter massive unilateral pulmonary congestion on the side of the anastomosis developed shortly after operation. And the. patient died of congestive heart failure within a hour. And so the purpose of this report is describe the immediate & late effect of systemic-pulmonary shunt for T.O.F. with review of literatures.

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Anomalous origin of the right pulmonary artery from the ascending aorta - a new modified surgical technique - (상행대동맥에서의 우폐동맥 이상기시증에 대한 교정수술 1례: 직접문합의 한 변형)

  • 진성훈
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.416-422
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    • 1987
  • Anomalous origin of a pulmonary artery from the ascending aorta is a rare congenital cardiovascular anomaly which usually involves the right pulmonary artery. For operative reconstruction, the surgical technique of choice used to be a direct end-to-side anastomosis of the ectopic pulmonary artery to the main pulmonary artery. A case of right pulmonary artery arising from the ascending aorta associated with a contralateral patent ductus arteriosus is presented, with description of a new modified surgical technique. The operation was done on cardiopulmonary bypass with deep hypothermia. After closure of PDA, a side-to-side anastomosis between the RPA and MPA, roofed with Gore-Tex patch, was established. The postoperative course was excellent, and the postoperative angiography revealed complete anatomic correction.

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One Stage Eepair of Interruption of Aortic Arch with VSD in Neonate (신생아에서 심실중격결손증을 동반한 대동맥궁 결손증의 일단계 완전 교정술 -3례 치험-)

  • 전희재
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.610-618
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    • 1995
  • Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

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Finger Tip Replantation (수지 첨부 절단의 재접합술)

  • Kong, Byeong-Seon;Kim, Yong-Jin
    • Archives of Reconstructive Microsurgery
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    • v.12 no.2
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    • pp.105-111
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    • 2003
  • It has been known that the vessels of the finger tip are very small and have many branches, so the anastomosis of this vessel is very difficult. But when this operation achieves success, the replanted finger tip provides adequate soft tissue, restoration of the length, sensory and nail. The authors describe the result of finger tip replantation in 94 patients, 103 finger tips, from October 1999 to June 2002. We performed the salvage procedure in all cases. The success rate of finger tip replantation was 74.8%. We achieved higher success rate, when we succeeded anastomosis of the central artery. The function of the replanted fingers was good. The average TAM was 80% and patient satisfaction was high. We be live that we can achieve higher success rate by anastomosing central artery and performing delicate salvage procedure.

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Circumferential Resection and End to End Anastomosis of Mediastinal Trachea for Long Tracheal Stenosis (주기관 긴 협착증 환자의 수술 치험)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.588-592
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    • 1992
  • Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

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