• 제목/요약/키워드: right pulmonary artery

검색결과 406건 처리시간 0.025초

Waterston 수술이 Gas 값과 폐조직에 미치는 영향 (Blood Gas Analysis and Lung Histopathology in Waterston Operation)

  • 김세화;이홍균
    • Journal of Chest Surgery
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    • 제5권2호
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    • pp.87-96
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    • 1972
  • Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.

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폐 내엽형 격절부:1례 보고 (Intralobar Puhnonary Sequestration - Report of one case -)

  • 김승규
    • Journal of Chest Surgery
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    • 제25권5호
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    • pp.541-543
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    • 1992
  • We experienced a case of intralobar pulmonary sequestration preoperatively confirmed. The 10 years old male patient was admitted beacuse of recurrent episode of coughing and production of purulent sputum. the chest X-ray showed a dense mass containing a large cyst with air-fiuid level in right lower lung field. An aortogram was performed and revealed that the sequestrated portion of the RLL was supplied by an aberrant large artery arising directly from the lower thoracic aorta. After division and ligation of the aberrant artery in pulmonary ligament, the right lower lobectomy was performed and the patient`s postoperative course was uneventful.

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Successful Dual-Patch Closure of a Fistula between the Right Pulmonary Artery and the Left Atrium

  • Joshi, Abhishek Shrinivas;Aironi, Balaji Dattatray
    • Journal of Chest Surgery
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    • 제54권1호
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    • pp.65-67
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    • 2021
  • A fistula between the right pulmonary artery and the left atrium is a very rare congenital anomaly, for which there is no definitive embryogenetic explanation. Patients present with cyanosis or clubbing, and the treatment strategy is to close the fistula, which can be done by an open surgical technique or by percutaneous intervention. Although rare, this condition should be considered in the differential diagnosis when evaluating a patient with central cyanosis.

베체트 질환에 발생한 폐동맥류 -치험 1예- (Pulmonary Artery Aneurysm in Behcet's Disease)

  • 박승일;원준호;이종국
    • Journal of Chest Surgery
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    • 제32권7호
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    • pp.660-664
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    • 1999
  • 현재 베체트병은 여러 기관을 침범하는 질환으로 인식되고 있으며 구강 및 음부 궤양, 안병변과 피부병변 을 주증상으로 하고 심혈관계, 호흡기계, 소화기계, 중 颯키麗\ulcorner 비뇨기계 등을 침범하여 다양한 증상을 나타 내고 있다. 베체트병에서의 폐동맥의 침범은 드물지만 다량의 객혈이 발생될 수 있으며 동맥류의 파열에 의 한 사망의 위험성이 높다. 29세의 남자 환자가 6개월간 지속된 객혈과 동반된 호흡곤란을 주소로 내원하였 다. 우측폐하엽에 종괴가 발견되어 우측 중엽 및 하엽 절제술을 시행 받았다. 수술소견상 우측 폐하엽에 4$\times$ 5$\times$4 cm의 박동 원형종괴가 있었으며 우중엽 및 우하엽의 폐동맥이 종괴와 연결이 되어 있었다. 병리소견과 병력상 베체트병에 의한 폐동맥류를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

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대동맥중격결손증[수술치험 1예] (Aorticopulmonary Window: one case report)

  • 최영호
    • Journal of Chest Surgery
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    • 제14권3호
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    • pp.302-306
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    • 1981
  • Aorticopulmonary window is a rare anomaly among congenital heart disease. Various terms have been suggested including A-P window, A-P fenestration, fistula, aorticseptal defect etc. The defect lies usually between the left side of the ascending aorta and right wall of the pulmonary artery just anterior to the origin of the right main pulmonary artery. We have experienced one case of aorticopulmonary septal defect which was diagnosed as V5D with pulmonary hypertension in 1 4/12 year old, 7.2 Kg, male patient. Operation was done under the hypothermic cardiopulmonary bypass using 5t. Thomas cardioplegic solution. Vertical right ventriculotomy over the anterior wall of RVOT revealed no defect in the ventricular septum, and incision was extended up to the main pulmonary artery to find the source of massive regurgitation of blood through MPA. Finger tip compression of the aorticopulmanary window was replaced with Foley bag catheter balloon, and the $7{\times}10$ mm aorticoseptal defect located 15mm above the pulmonic valve was sutured continuously wih 3-0 nylon suture during azygos flow of cardiopulmonary cannula which was located distal to the window resulted massive air pumping systemically, and temporary reversal of pumping was tried to minimize cerebral air embolism. Remained procedure was done as usual, and pump off was smooth and uneventful. Postoperatively, patient was attacked frequent opistotonic seizure with no recovery sign mentally and p.hysically. Vital signs were gradually worsen with peripheral cyanosis and oliguria, and cardiac activity was arrested 1485 minutes after operation. Autopsy was performed to find the sutured window and massive edema of the brain.

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우측 폐동맥 형성부전증 - 1예 보고 - (Right Pulmonary Artery Agenesis - A case report -)

  • 김혁;위장섭;김영학;정원상;남승혁;강정호
    • Journal of Chest Surgery
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    • 제40권1호
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    • pp.52-55
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    • 2007
  • 편측에 발생하는 폐동맥 형성부전증은 드문 선천성 기형으로 일반적으로 활로씨 4징과 같은 선천성 심혈관계 질환과 흔히 동반된다. 독립적으로 발생하는 폐동맥 형성부전증은 매우 드문 질환이고, 증상이 없는 경우가 많다. 이 질환은 흉부방사선촬영에서 우연히 의심되는 경우가 많으며 동반된 증상은 객혈, 피가 묻어 나오는 객담, 재발하는 폐감염, 운동 시 호흡곤란 등이다. 최근 저자들은 소량의 객혈과 지속적으로 피가 묻어 나오는 객담을 주소로 내원한 27세 남자 환자를 치험하였다. 저자들은 우측 폐전적출로 환자를 효과적으로 치료하였기에 관련된 문헌과 함께 보고하는 바이다.

좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고- (Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report-)

  • 권중혁
    • Journal of Chest Surgery
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    • 제12권2호
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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Familial Chromosome No. 9 Pericentic Inversion Producing Scimitar Syndrome

  • Kim, Jong-Wan;Kim, Young-Yoo;Shin, Jong-Chul;Lee, Won-Bae
    • Journal of Genetic Medicine
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    • 제3권1호
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    • pp.1-4
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    • 1999
  • Scimitar syndrome is a rare congenital anomaly that is characterized by hypoplasia of the right lung and the right pulmonary artery with anomalous pulmonary venous drainage to the inferior vena cava. The scimitar vein is usually visible on chest radiographs, but may be obscured by the heart. It is essential for surgical correction to establish the point of drainage of the anomalous vein and associated anomalies. There are recent reports of familial total anomalous pulmonary venous return suggesting heritable forms of this anomaly. Although genetic factors are believed to have important roles in congenital heart disease, few genes involved in heart development have been located. We report a case of familial chromosome 9 inversion with Scimitar syndrome in an offspring who presented with dextrocardia. Evaluation with magnetic resonance cineangiograph imaging demonstrated an anomalous pulmonary vein draining into the inferior vena cava above the diaphragm and hypoplasia of the right lung and the right pulmonary artery. Chromsome analysis showed pericentric inversion of chromosome 9, inv 9 (p13, q21), in the patient and his mother as well. A brief review of the related literature is also included.

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Rastelli씨 수술법을 이용한 완전 대혈관전위증(S. D. D.) -치험 1예- (Successful Surgical Correction of Complete Transposition of Great Arteries (S.D.D.) : 1 Case Report)

  • 강면식;조범구
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.442-447
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    • 1980
  • A 8-year-old boy underwent surgical correction of complete transposition S.D.D. of great arteries combined with subaortic ventricular septal defect and pulmonary stenosis [infundibular and valvular]. The operation consisted of an internal baffling connecting the left ventricle to the aorta through the ventricular septal defect. The pulmonary stenosis was corrected with the method of external connection, the right ventricle to the pulmonary artery using the conduit valve [20 mm] contained Hancock due to abnormal distribution of left coronary artery of which conduit due to abnormal distribution of left coronary artery of which the circumflex branch crossed the portion of right ventricular outflow tract. This case was suitable for corrective surgery-Rastelli operation-and the patient`s condition in very good until present [post-operative 5 months].

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