• Journal of Chest Surgery
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• 제21권1호
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• pp.158-163
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• 1988

12 Patients with thoracic aortic aneurysm were operated between May 1985 to Sept. 1987 at the our department, Hanyang University Hospital. We retrospectively evaluated the surgical results and considered diagnosis, surgical approach and perioperative problems of thoracic aortic aneurysm. There are 9 males and 3 females in the patients. The age ranged from 23 to 61 years with the mean age at 40.6 years. The cause of the aneurysm was atherosclerosis in 5, Marfan`s syndrome in 4, syphilis In 1, trauma in 1 and annuloaortic ectasia in 1 case. According to DeBakey`s classification, Type I was 1 case, Type II was 5 cases and Type III was 6 cases. Among 6 patients with ascending aortic aneurysm, Bentall`s operation in 4 cases and ascending aorta reconstruction using to Dacron Tube Graft in 2 cases were performed successfully. 6 cases with descending aortic aneurysm were managed by prosthetic graft replacement. Chylothorax was observed in 1 patient and postoperative hemorrhage necessitating reopening of the chest occurred in 4 of operative survivors. There were 2 hospital deaths; one patient was dead during the operation and one patient was dead during the post-operative course due to low cardiac output syndrome

• Journal of Chest Surgery
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• 제44권4호
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• pp.292-293
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• 2011

Surgical repair of the tetralogy of Fallot is one of the most successful operations in the treatment of congenital heart diseases. We report the case of a 65-year-old man who had an aortic valve replacement at the time of complete repair of the tetralogy of Fallot at the age of forty-three. He subsequently had progressive aortic root and ascending aorta dilation to 9 cm. The aortic root and ascending aorta replacement was done using a composite valve-graft and was performed along with other procedures. Thus, meticulous follow-up of aortic root and ascending aorta after corrective surgery for tetralogy of Fallot is recommended following initial curative surgery.

• Journal of Chest Surgery
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• 제19권1호
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• pp.134-139
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• 1986

Seventeen patients underwent operations for aneurysm of ascending aorta with aortic regurgitation from August 1979 to October 1985. 10 patients underwent complete replacement of the ascending aorta and the aortic valve with a composite graft and implantation of coronary ostia on the graft. Seven patients underwent supracoronary noncomposite graft replacement and aortic valve replacement. The patients ranged in age from 25 to 55 years [mean 37.6 years]. There were 11 male and 6 female patients. All patients had aortic incompetence and aneurysmal dilatation of the ascending aorta. Seven of the patients has concomitant aortic dissection in ascending aorta and one had dissection in abdominal aorta. Eight patients had signs of Marfan syndrome and the other 3 patients had cystic degeneration in the medial layer of the aorta. There was one hospital death[5.8%]. He died of sepsis on the 23rd postoperative day. All survivors showed improvement in NYHA functional classification in the 34.9 patient-year follow-up period.

• Journal of Chest Surgery
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• 제25권8호
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• pp.877-884
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• 1992

From October, 1986, to June, 1992 16 patients, 13 male and 3 female patients ranging in age 28 to 70 years, were operated on for thoracic aortic aneurysm, The etiology of these patients was atherosclerotic in 10, cystic medial necrosis in 4, and trauma in 2 cases, All patients were treated by use of CPB and circulatory arrest was applicated in one patient, Ten patients had aneurysms involving ascending aorta and six patients had descending aortic aneurysm, Among ten patients with ascending aortic aneurysm, annuloaortic ectasia with aortic regurgitation were seven and all underwent surgery with composite technique [Bentall operation], The other six patients with descending thoracic aneurysm were performed graft replacement. There was no early mortality but two late deaths occurred due to cerebral hemorrhage and renal problems at POD 3mo and 39mo respectively, We obtained satisfactory long-term results and overall survival rate at 5 year was 74.7%.

• Journal of Chest Surgery
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• 제24권7호
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• pp.685-692
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• 1991

Twelve patients underwent surgical interventions for aortic aneurysms consecutively from September 1986 to September 1990 in the Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. They were all men ranging in age from 25 to 68 years with the mean age of 48 years. Five patients of them had aneurysms involving ascending aorta, one aneurysm involving both ascending and descending aorta, four aneurysms involving descending thoracic aorta, and the others had aneurysms involving abdominal aorta. According to morphological classification, six cases of them were in dissection and the others in fusiform aneurysms. All the cases were pathologically true aneurysms and four of them were in acute status. According to causal classification, seven patients of them had atherosclerosis, three cystic medial necrosis, and the others had syphilis and trauma respectively. Six patients with ascending aortic aneurysm had annuloaortic ectasia with aortic regurgitation and underwent ascending aortic graft and aortic valve replacement[Bentall`s operation]. The others with descending thoracic and abdominal aortic aneurysms underwent Dacron graft replacement. Both hemorrhage necessitating reopening of the chest and wound dehiscence were observed in three patients and hoarseness in one patient. Cerebrovascular accident occurred three and a quarter years postoperatively in one patient and he died two days later. The others were followed up via OPD and have been doing well postoperatively.

• Journal of Chest Surgery
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• 제17권4호
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• pp.753-761
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• 1984

Most patients having annuloaortic ectasia are associated with marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. A 19 year old male patient complaining of tightness on left posterior chest wall underwent cardiac angiography in which demonstrated annuloaortic ectasia with ascending aortic aneurysm and aortic insufficiency. The patient had corrective operation replacing the ascending aorta and aortic valve with a composite graft[Dacron prosthesis containing a Bjork-Shiley aortic valve] within the aneurysmal sac. The coronary orifices were anastomosed to the tubular Dacron prosthesis [30 mm in diameter] by means of a second smaller Gore-Tex tube [8mm in diameter]. The aneurysmal sac was trimmed by removing the redundant wall and then wrapped outer wall of the Dacron prosthesis. Postoperatively, mediastinal bleeding was temporarily observed in the operative day and satisfactory blood pressure was maintained with small dose of dopamine. One week later, large amount of serous effusion was drained out of the retrosternal space making partial disruption of the skin which was healed well by daily local dressing. The patient discharged in good condition on postoperative 29th day with no residual complications and is doing very well on the 4 months follow-up.

• Journal of Chest Surgery
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• 제28권8호
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• pp.788-791
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• 1995

Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

• Journal of Chest Surgery
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• 제33권8호
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• pp.676-680
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• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Journal of Chest Surgery
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• 제20권2호
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• pp.367-373
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• 1987

Dissecting aneurysm has long been recognized as an ominous and highly lethal form of aortic disease. Aortic dissection are characterized by longitudinal separation of aortic media and extension proximally, distally or both from the site of intimal tear. DeBakey and associates defined three types based on where the process originates and how far extends. In type I, intimal tear is located in the ascending aorta and extend beyond the descending aorta. We experienced a case of dissecting aneurysm, Type I of DeBakey`s classification which dissection extend to the left iliac artery. The patient was 61 years old woman and suffered from excruciating pain on admission. Excision of aneurysm and ascending aorta reconstruction using to Dacron Vascular Prosthesis were performed under extracorporeal circulation. The post-operative course was uneventful and follow up is continued.

• Journal of Chest Surgery
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• 제22권1호
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• pp.90-94
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• 1989

Ten patients underwent operation for aortic aneurysms from Jan. 1983 to April 1988 at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Hospital. There were 7 males and 3 females in this series. The age ranged from 16 to 70 years with the mean age of 45 years. The cause of the aneurysm was atherosclerosis in 8 patients, mycosis in 1 patient and unknown in 1 patient. There were two patients with ascending aortic aneurysm treated by Dacron graft replacement, with no hospital death. One patient with aortic arch aneurysm was received Dacron graft replacement under cardiopulmonary bypass and died on the 21st postoperative day because of cerebral edema. There were three patients with descending aortic aneurysm. The aneurysm in two patients was successfully repaired by Dacron graft. One additional patient with ruptured aneurysm died at operation because of ventricular fibrillation. Four patients with abdominal aortic aneurysm were underwent Dacron graft replacement and the results were good.