• 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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• 제34권11호
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• pp.870-874
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• 2001

Takayasu 동맥염은 만성 비특이성 동맥염으로 젊은 여자에 호발하며 대동맥궁의 분지 혈관이나 신동맥 등 여러 혈관들을 광범위하게 침범하여 폐쇄를 일으키는 질환으로 알려져 있다. 최근 나이가 많은 52세의 여자 환자에서 신동맥 이하의 복부 대동맥에만 국한적으로 침범하여 삭did(cord-like) 폐쇄를 일으킨 Takayasu 동맥염의 비교적 드문 예를 경험하고 18mm PTFE(polytetrafluoroethylene) 인조혈관을 이용하여 하행 흉부 대동맥과 총장골동맥 분기 직상부 복부 대동맥 사이에 측단 우회술을 시행하여 좋은 결과를 얻었기에 보고한다.

• Journal of Chest Surgery
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• 제38권12호
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• pp.852-855
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• 2005

생후 85일 된 대동맥궁 단절이 동반된 총동맥간 환자에서 완전순환정지 없이 1차 완전 교정술을 성공적으로 시행하였다. 대동맥 단절 교정은 국소순환하에 상행 및 하행대동맥을 문합하였고 우심실유출로 재건은 Shelhigh 판막도관을 이용하였다. 술 후 혈관에 의해 일시적으로 좌측 기관지가 눌리는 합병증이 발생하였으나 자세변화와 흉부물리치료로 호전되었다. 술 후 13개월 뒤에 판막도관의 협착으로 우심실 유출로에 대한 재수술이 필요했으며 환아는 현재 건강한 상태로 첫 교정술 후 14개월째 외래 추적중이다.

• Journal of Chest Surgery
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• 제41권2호
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• pp.260-263
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• 2008

3예의 성인 대동맥축착증 환자에서 외해부학적(extraanatomical) 우회로조성술을 시행하였다. 축착 전 후의 광범위한 대동맥협착을 동반한 2예에서는 좌측 개흉술을 통해 좌쇄골하동맥에서 하행대동맥으로 우회술을 시행하였다. 대동맥판막폐쇄부전과 대동맥궁 발육부전이 동반된 대동맥축착 1예에서는 정중 흉골절개술을 통해 상행대동맥과 심장 뒤 하행대동맥간의 우회로술과 대동맥판막치환술을 동시에 시행하였다. 1예에서 술 후 4개월째 문합부 주위 동맥류의 파열이 있어 재수술을 시행하였으며 2예에서는 술 후 특별한 합병증이 없었다.

• Korean Journal of Radiology
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• 제22권10호
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• pp.1690-1696
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• 2021

Objective: To describe the anatomic locations and imaging features of posterior lung herniation in unilateral pulmonary agenesis and aplasia, focusing on radiograph-CT/MRI correlation. Materials and Methods: A total of 10 patients (seven with pulmonary agenesis and three with pulmonary aplasia, male: female = 1:9, mean age 7.3 years, age range from 1 month to 20 years) were included. Chest radiographs (n = 9), CT (n = 9), and MRI (n = 1) were reviewed to assess the type of lung underdevelopment, presence of anterior and posterior lung herniation, bronchus origin, supplying artery, and draining vein of the herniated lung. Results: Pulmonary agenesis/aplasia more commonly affected the left lung (n = 7) than the right lung (n = 3). Anterior lung herniation was observed in nine of the 10 patients. Posterior lung herniation was observed in seven patients with left pulmonary agenesis/aplasia. Two patients showed posterior lung herniation crossing the midline but not beyond the aorta, and five patients showed the posteriorly herniated right lower lobe crossing the midline to extend into the left hemithorax farther beyond the descending thoracic aorta through the space between the esophagus and the aorta. This anatomical configuration resulted in a characteristic radiographic finding of a radiolucent area with a convex lateral border and a vertical medial border in the left lower lung zone, revealing a tongue-like projection on CT and MRI. Conclusion: Posterior lung herniation occurs in unilateral left lung agenesis/aplasia. Approximately 70% of the cases of posterior lung herniation reveal a unique radiolucent tongue-like projection in the left lower lung zone on imaging studies, which is caused by the extension of the posteriorly herniated right lung farther beyond the descending aorta.

• Journal of Chest Surgery
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• 제43권3호
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• pp.308-311
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• 2010

성인에서 종종 대동맥 축착증은 다른 심장 내 질환과 동반된다. 이러한 환자들에서 가장 적절한 수술적 방법을 결정하는 것은 매우 어렵다. 저자들은 대동맥 축착증 및 대동맥 판막부전을 동반한 대동맥근부 확장병변을 가진 환자에서, Bentall 수술 및 상행 대동맥-하행 대동맥간 우회로술을 정중 흉골절개를 통해 동시에 시행하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제18권3호
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• pp.461-465
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• 1985

Rupture of the aorta following blunt trauma of the thorax may occur more frequently than has generally been recognized. Actual complete transection of the aorta usually results in immediate death but varying degrees of lesser disruption permit increased chance of survival. Chronic traumatic aneurysms are so designated following a period of 3 months from the traumatic incident. The exact time required for the acute process and hematoma to convert into an aneurysm is unknown. Because a thoracic surgeon encounters so few of these aneurysms, it is difficult for him to arrive at sound dicta of management from his personal experience. It is not surprising that controversy exists concerning the therapeutic approach to the aneurysm which is asymptomatic and is discovered months or years after the causative injury. In the hope of improving the surgical treatment of patients with this condition, we reported one case with chronic traumatic aneurysm of the descending thoracic aorta.

• Journal of Chest Surgery
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• 제21권3호
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• pp.588-593
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• 1988

We experienced a case of interrupted aortic arch[Type A] associated with PDA, VSD, mitral regurgitation and single coronary artery. The patient was 7 years old boy, who showed congestive heart failure[NYHA functional class III]. One stage total correction was performed under profound hypothermia with total circulatory arrest. Aortic continuity was established using PDA with anterior wall of main pulmonary artery flap. VSD was closed with Dacron patch and mitral regurgitation repaired by Reed`s annuloplasty method. The postoperative cardiac catheterization revealed no pressure gradient between ascending aorta and descending aorta, decreased pulmonary artery pressure and trivial residual shunt[Qp/Qs: 1.28]. The aortogram showed good continuity of the aorta without narrowing of the anastomotic site. During the period of 1 year follow up, heart failure symptoms were nearly subsided.

• 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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• 제50권1호
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• pp.47-49
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• 2017

Percutaneous closure of atrial septal defect (ASD) has become an increasingly common procedure. Serious complications of the procedure, such as cardiac migration, are rare, and usually occur <72 hours after device placement. In this report, we present the case of a patient who underwent successful surgical treatment for the migration of an ASD occluder device to the thoracic aorta 12 months after ASD closure.