• 제목/요약/키워드: venous

검색결과 1,300건 처리시간 0.034초

삼방심의 외과적 치료 -수술치험 24례- (Surgical Treatment of Cor Triatriatum)

  • 김영태;노준량
    • Journal of Chest Surgery
    • /
    • 제27권4호
    • /
    • pp.259-265
    • /
    • 1994
  • Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

  • PDF

하지 심부정맥 혈전의 외과적 제거 (Surgical Technique thor the Removal of Deep Vein Thrombi of the Lower Extremities)

  • 이상호;최준영;김성호;김병균;장인석;이정은;옥창대;김종우;나재범
    • Journal of Chest Surgery
    • /
    • 제35권5호
    • /
    • pp.402-406
    • /
    • 2002
  • 하지 정맥의 심부정맥 혈전 제거술의 통례적 수기는 포가티 풍선 카테타를 이용하는 것이었다. 풍선 카테타는 정맥 내에 존재하는 판막의 방해 때문에 수기 상 불편한 것이 단점이다. 겸자(겸자, stone-forceps, Fig. 1)를 사용하면 장골-대퇴정맥 내의 혈전을 판막의 방해를 받지 않고 용이히 제거할 수 있다. 이 기구가 혈전을 꺼내는 동안 판막을 열어 제쳐주기 때문이다. 판막이 열린 상태를 유지 해주므로 이 기구는 장골정맥으로부터의 역혈류(back-flow)를 판단하는 데에도 유용하다. 서혜부 절개 이하의 하지 정맥 내 혈전은 종아리와 허벅지 근육을 효과적으로 압박하는 것만으로 성공적으로 제거할 수 있다. 수술의 순서는 장골 정맥 쪽을 먼저 하는 것을 권한다.

$^{99m}Tc-phytate$를 이용한 LeVeen 복막대정맥문합폐쇄의 진단 (Evaluation of Peritoneo-venous Shunt Patency with $^{99m}Tc-phytate$)

  • 허달영;정준기;이종석;이창수
    • 대한핵의학회지
    • /
    • 제19권2호
    • /
    • pp.93-95
    • /
    • 1985
  • A simple imaging procedure has been devised for patients with peritoneo-venous shunts when ascites reaccumulates and a decision must be made on whether or not to revise the shunt. We recently experienced a patient with reaccumulated ascites in whom obstruction of peritoneo-venous shunt was suspected. 5 mCi of $^{99m}Tc-phytate$ was injected into the peritoneal cavity and imaging of the abdomen was performed $1\sim30$ minutes later. With a proper funtioning shunt, radioactivity in the liver and spleen were easily identifiable in this case. If the shunt is obstructed, tracer activity will remain in the peritoneal cavity and thus can not be identifiable in the liver or spleen. Conclusively, radionuclide methods might be very useful for evaluation of peritoneo-venous shunt patency.

  • PDF

Spontaneous Bilateral Supratentorial Subdural and Retroclival Extradural Hematomas in Association with Cervical Epidural Venous Engorgement

  • Cho, Chul-Bum;Park, Hae-Kwan;Chough, Chung-Kee;Lee, Kyung-Jin
    • Journal of Korean Neurosurgical Society
    • /
    • 제46권2호
    • /
    • pp.172-175
    • /
    • 2009
  • We describe a case of 36-year-old man who presented with a subacute headache preceded by a 1-month history of posterior neck pain without trauma history. Head and neck magnetic resonance imaging (MRI) studies disclosed bilateral supratentorial subdural and retroclival extradural hematomas associated with marked cervical epidural venous engorgement. Cerebral and spinal angiography disclosed no abnormalities except dilated cervical epidural veins. We performed serial follow-up MRI studied to monitor his condition. Patient's symptoms improved gradually. Serial radiologic studies revealed gradual resolution of pathologic findings. A 3-month follow-up MRI study of the brain and cervical spine revealed complete resolution of the retroclival extradural hematoma, disappearance of the cervical epidural venous engorgement, and partial resolution of the bilateral supratentorial subdural hematoma. Complete resolution of the bilateral supratentorial subdural hematoma was confirmed on a 5-month follow-up brain MRI. The diagnosis and possible mechanisms of this rare association are discussed.

신생아 신정맥 혈전증 2례 (Two cases of Neonatal Renal Venous Thrombosis)

  • 임중섭;백경훈;한효정;이준호;정해일;최용;고광욱;김인원
    • Childhood Kidney Diseases
    • /
    • 제1권2호
    • /
    • pp.161-165
    • /
    • 1997
  • Renal venous thrombosis (RVT) in neonatal period is a rare disease and usually complicated to clinical situations with reduced renal blood flow and hypercoagulability ; like acute blood loss, sepsis, shock, and birth asphyxia. RVT should be suspected in sick babies with hematuria, anemia, thrombocytopenia, enlarged kidney and acute renal failure. And the diagnosis can be confirmed by renal ultrasonography. We report two cases of neonatal renal venous thrombosis with review of literatures. One case, associated with E. coli sepsis, recovered completely, and the other, follwed respiratory distress in the neonate, revealed permanent renal functional impairment.

  • PDF

Venous Anastomosis with Dorsal Veins Using Additional Incisions after Wound Closure in Metacarpophalangeal Joint Level Replantation

  • Cho, Sang Hyun;Bahar-Moni, Ahmed Suparno;Whang, Jong Ick;Seo, Hyeung Gyo;Park, Hyun Sik;Kim, Ji Sup;Park, Hyun Chul
    • Archives of Reconstructive Microsurgery
    • /
    • 제25권1호
    • /
    • pp.12-14
    • /
    • 2016
  • In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.

개심술 후 저류공기의 효과적인 제거를 위한 동정맥도관의 설치 (Arterio-Venous Line Connection for Effective Intracardiac Deairing after Open Heart Surgery)

  • 정성운;김종원;박준호
    • Journal of Chest Surgery
    • /
    • 제36권11호
    • /
    • pp.834-838
    • /
    • 2003
  • 배경: 개심술 후 공기 제거는 매우 중요한 시술이다. 그러나, 심장 내의 공기 분포, 시술로 인한 합병증, 심폐바이패스의 시간 연장으로 여전히 제한적이다. 인위적으로 동정맥루를 만들어 공기를 제거하고 그 효과를 경식도초음파로 확인하였다. 대상 및 방법: 심폐바이패스 완료 직전에 압력표준변환선을 동맥과 정맥회로에 설치해둔 마개에 연결하면 동맥과 정맥사이에 작은 동정맥루가 형성된다. 심장 내의 공기정도와 공기제거시간은 경식도 초음파와 압력표준변환선으로 확인하였다. 결과: 간단한 방법으로 심폐바이패스의 시간단축, 수분 내에 공기가 제거되는 것을 경식도초음파로 확인하였다. 결론: 동맥과 정맥 사이에 작은 연결관으로 동정 맥루를 만드는 것은 매우 간단하며 개심술 후 공기 제거와 공기색전증 예방에 효과적인 방법이다.

Totally Implantable Venous Devices (TIVD)의 불완전 제거 2예 (Incomplete Removal of Totally Implantable Venous Devices : Report of 2 Cases)

  • 손상용;이한별;김수홍;박태진;정규환;김현영;김웅한;정성은
    • Advances in pediatric surgery
    • /
    • 제18권1호
    • /
    • pp.18-23
    • /
    • 2012
  • Totally implantable venous devices (TIVD)는 장기간 항암 화학 요법이나 총 정맥 영양, 수액치료가 필요한 환자에서 많이 사용된다. TIVD는 매우 유용하고 안전한 장치이지만, 이와 관련된 다양한 합병증이 보고 되어 왔다. 저자들은 카테터의 혈관 내 유착에 의해 TIVD의 제거가 불완전하게 된 2예를 경험하였기에 보고하는 바이다.

  • PDF

Deep Vein Thrombosis 진단을 위한 Impedance Plethysmography의 시뮬레이션 연구 (A Simulation Study of Impedance Plethysmography for Diagnosing Deep Vein Thrombosis)

  • 이전;이경중
    • 대한전기학회논문지:시스템및제어부문D
    • /
    • 제50권10호
    • /
    • pp.494-501
    • /
    • 2001
  • In this study, the effects of vascular parameter changes and electrodes on VOP measurement based on IPG were simulated mathematically. For the evaluation of the effects of hemodynamic changes on VOP, a mathematical model, which consists of cardiovascular system model and venous occlusion model, was developed and the model solution representing the blood flow and pressure in measuring point was found by 2nd order Runge-Kutta method. And, with sensitivity coefficients obtained from finite element solution of electric field in measuring point, the effects of electrode system on measurement were evaluated. As increasing the resistance, the venous capacitance was not changed but the venous outflows were decreased and the decreased compliance reduced the venous capacitance. And, for several configurations of round electrodes and band electrodes, the sensitivity coefficients were computed using the electric field distribution along deep vein. In conclusion, the proposed mathematical cardiovascular model could be applied to the simulation study on the effects of hemodynamic parameters on DVT diagnosis with IPG. And, also the sensitivity coefficients could provide effective electrode configuration for exact measurement of VOP.

  • PDF

Cerebellar Hemorrhage due to a Direct Carotid-Cavernous Fistula after Surgery for Maxillary Cancer

  • Kamio, Yoshinobu;Hiramatsu, Hisaya;Kamiya, Mika;Yamashita, Shuhei;Namba, Hiroki
    • Journal of Korean Neurosurgical Society
    • /
    • 제60권1호
    • /
    • pp.89-93
    • /
    • 2017
  • Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus.