• Title/Summary/Keyword: emergency repair

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Tracheoinnominate Artery Fistula after Tracheal Reconstruction and Tracheostomy (기관재건술 및 기관절개술 후 발생한 기관무명동맥루)

  • 김동원
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.57-60
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    • 2002
  • Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

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Hybrid Approach of Ruptured Type B Aortic Dissection with an Aberrant Subclavian Artery in a Single Patient with Turner Syndrome: A Case Report

  • Son, Shin-Ah;Lim, Kyoung Hoon;Kim, Gun-Jik
    • Vascular Specialist International
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    • v.34 no.4
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    • pp.121-126
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    • 2018
  • Turner syndrome, also described as 45, X, may present with most serious cardiovascular anomalies including risk of aortic dissection and rupture. In emergency situation, management for aortic dissection with complicated anatomy accompanying vascular anomaly is challenging. Here, we report a rare case of ruptured type B aortic dissection with aberrant subclavian artery and partial anomalous pulmonary venous connection in a Turner syndrome. Through right carotid-subclavian artery bypass and thoracic endovascular aortic repair, successful hybrid endovascular management correlated with a favorable result in this emergency situation.

Emergency Pulmonary Artery-to-Systemic Artery Shunt to Break the Positive Feedback Loop of a Pulmonary Hypertensive Crisis after Neonatal Coarctation Repair

  • Shin, Yu Rim;Yang, Young Ho;Park, Young-Hwan;Park, Han Ki
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.232-235
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    • 2019
  • A 2.5-kg neonate with coarctation of the aorta and a small left ventricle experienced a severe pulmonary hypertensive crisis. An emergency pulmonary artery-to-systemic artery shunt was placed to break the positive feedback loop caused by pulmonary hypertension and functional mitral stenosis. This shunt provided immediate relief of suprasystemic pulmonary hypertension and the resultant low cardiac output.

Evaluation of Physical Properties and Long-term Stability of Expansion Materials for Emergency Repair by Temperature (긴급복구용 팽창재료의 온도에 따른 물리적 특성 및 장기 안전성 평가)

  • Park, Jeongjun;Kim, Kisung;Kang, Hyounhoi;Kim, Ju-Ho;Hong, Gigwon
    • Journal of the Society of Disaster Information
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    • v.14 no.1
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    • pp.79-88
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    • 2018
  • In this study, the changes of the expansion and strength according to the temperature of the emergency repairing expansion material were examined by cup foaming test and uniaxial compressive strength test, and the accelerated compression creep test was carried out to confirm the long term stability. Ramp & Hold test and accelerated compressive creep test were performed to evaluate the creep performance. The short - term creep test was used to determine the initial creep strain of the expanding material. The isothermal method using time - To evaluate the long - term compressive creep performance.

Emergency Reexploration for Bleeding after Open Heart Surgery wth Cardiopulmonary Bypass -A Report of 16 Cases- (개심술후 출혈로 인한 응급개흉술의 임상적 고찰)

  • 유재현
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1068-1073
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    • 1991
  • Bleeding after open heart surgery with cardiopulmonary bypass was a cause of concern. requiring reexploration of the chest in approximately 8 percent of patients who have had operations on the heart. From April., 1983 to October, 1991, 16 patients[2%] out of 777 patients who underwent open cardiac surgery had emergency reexploration with bleeding at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. In 12 cases[75%], reexploration was performed for continuous bleeding and the reminder[4 cases] were performed for suspected tamponade & hypotension. There were 9 cases[56%] of congenital heart disease and 7 cases of acquired heart disease. The mean blood loss were 997$\pm$472ml /sq. M in total cases and 1442$\pm$ 647ml /sq. M in cases repair of cyanotic heart disease. The mean interval till reoperation was 16.6hr [1hr~72hr] and 41 hr[12~72hr] in tamponade cases and 8.4hr[1hr~24hr] in continuous bleeding cases. The bleeding sites were identified in 7 cases: aortotomy site in 2 cases, ventriculotomy site, SVC, thymus, pleura and sternum wiring site in each other case. But no specific sites was found in the remaining 9 cases. The 8 cases had complications but all except 1 cases with hypoxic brain damage were recovered without sequale. We conclude that emergency thoractomy after open heart surgery may be lifesaving and-/or diminishing complications with bleeding if performed promptly with excessive bleeding, tamponade and unexpected hypotension.

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Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car - Report of 2 cases - (자동차의 사이드미러가 흉강에 박힌 채로 내원한 흉부관통상 - 2례 보고 -)

  • Kim, Soo Sung
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.47-51
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    • 2007
  • Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

Delayed Ascending Aorta Replacement in Blunt Chest Trauma with Aortic Injury

  • Son, Shin-Ah;Kim, Gun-Jik;Do, Young Woo;Oh, Tak-Hyuk
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.24-28
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    • 2018
  • Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.

Bronchoaortic Fistula (기관지 대동맥루)

  • 정일영
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1137-1140
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    • 1992
  • Bronchoartic Fistula Secondary to Pulmoanry Tuberculosis Bronch-aortic fistula is a exceptionally rare complication of pulmonary tuberculosis. We report herein, a case of 39 years woman who underwent successful repair of aor-tobronchofistula. She was admitted because of massive hemoptysis via emergency room, she had several bouts of massive hemoptysis prior to hospitalization. Thoracic-aortic pseudoaneurysm had detected by chest CT by chance. The eroded, perforated descending aorta was repaired with patch aortoplasty during temporarily clamping, followed by Left lower lobectomy and omentopexy. Pathological examination revealed pulmonary tuberculosis of superiror seg. of lerg lower lobe and aortitis. The patient had uneventful recovery was well at OPD follow-up check.

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A System Effectiveness Simulation Model for Underwater Battery Propulsion Systems (수중 배터리 추진시스템 효과도 시뮬레이션에 관한 연구)

  • Ko, Yong-Seog;Yun, Won-Young
    • IE interfaces
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    • v.11 no.2
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    • pp.25-37
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    • 1998
  • In this paper, a simulation model is proposed to evaluate the system effectiveness of underwater battery propulsion systems which consist of motors, main switchboard, generators and batteries. The various operating environments such as emergency situations, equipment's failure and repair, and system performance degradation due to equipment's failures affect the system effectiveness and the environment elements are considered as the input parameters in the simulation model. Some simulation results with estimated data are studied.

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Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma (일개 응급센터에 내원한 외상성 혈관손상 환자의 임상적 특성)

  • Park, Yong Myeon;Yeom, Seok Ran;Jeong, Jin Woo;Han, Sang Kyun;Jo, Suck Ju;Ryu, Ji Ho;Kim, Yong In;Chung, Sung Woon
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.5-11
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    • 2009
  • Purpose: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. Methods: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. Results: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. Conclusion: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'ritical pathway'to improve the outcomes of patients with blunt abdominal vascular injury.