• Journal of Chest Surgery
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• v.30 no.7
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• pp.686-692
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• 1997

This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .

• Journal of Chest Surgery
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• v.43 no.4
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• pp.424-427
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• 2010

Recently, stent-graft insertion has been widely used along with surgery for treatment of thoracic and abdominal aortic aneurysm. However, use of stent-graft insertion is controversial in descending aortic dissection. We report here on our experience of a patient who received a stent-graft for descending aortic dissection that nearly ruptured. Based on CT findings at three months follow up, results were satisfactory.

• Journal of Biomedical Engineering Research
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• v.20 no.5
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• pp.601-608
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• 1999

동맥의 일부분의 팽창하는 동맥류는 높은 사망률을 야기하는 혈관계 질환이다. 동맥류의 발생 및 파열에는 동맥류 내부의 혈류의 유동에 의한 혈관벽 전단 응력 및 압력이 주용한 원인 중 하나로 의심되고 있다. 복부대동맥류 내부의 혈류 유동 특성을 밝히기 위해서 동맥류의 최대 확장부가 복부동맥의 1.5배, 2배인 유리 모델을 제작하였다. 정상류 상태에서 다양한 레이놀즈수에 대해서 속도 및 난동도를 입자영상속도계를 이용하여 측정하였다. 경계층 박리로 인한 재순환 부분이 끝나는 재부착점은 동맥류 최대 확장부 후부에서 발생하였으며, 이 위치는 레이놀즈수의 변화에 따라 바뀌었다. 축방향 속도의 난동은 최대 확장부 후부에서 크게 나타났으며, 이 위치에서 난동에 의한 부가적 응력이 크며 혈관벽 구조변화가 발생하리라 예측된다. 동맥류 내부의 압력분포는 수치해석에 의해 계산되었다. 동맥류 내부 압력은 크기가 증가함에 따라 커졌으며 압력은 동맥류 최대 확장부 후부에서 발생하는 재부착점에서 최대값을 나타내었다. 동맥류 최대확장부 후부는 압력이 최대값을 가지며, 전단력의 변화 및 난동이 큰 지역이므로 동맥류의 파열이 발생하기 쉬운 지역으로 예측된다.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.532-535
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• 1999

Background: The purpose of this study was to evaluate and analyze the surgical techniques and postoperative complications in patients undergoing operations for descending thoracic aortic aneurysms. Material and Method: The data of 22 major operations between March 1987 and August 1997 were retrospectively reviewed. Result: There were 18 men and 4 women with a mean age of 49 years (range 33 years to 82 years). The cause of the aneurysm was aortic dissection in 13 patients, atherosclerosis in 3, mycotic in 3, trauma in 2 and uncertain in 1. The operative techniques were resection and graft replacement in 16, axillofemoral bypass graft in 2, femorofemoral bypass graft in 2, exclusion, aneurysmorrhaphy in 1 and transfemoral stent insertion in 1. During the operation, 16 cases were performed under total aortic clamp. Among the 16 patients, femorofemoral bypass was used in 14 cases and previously made shunt in 2 cases. The mean total aortic clamp time was 91 minutes and the mean extracorporeal circulation time was 116 minutes. One death occurred in an excluded patient on the 52 postoperative day due to a rupture of the aneurysm. Postoperative complications were paraplegia in 1 case, acute renal failure in 1 case and acute respiratory failure in 1 case. Conclusion: Although surgical treatment of the descending thoracic aneurysm has many postoperative complications, good surgical results can be achieved with a proper patient selection and fine surgical techniques.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.402-408
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• 1998

A 56-year old female underwent total aortic arch replacement March 1995, because of an expanding chronic Debakey type I aortic dissection. This aortic dissection had an intimal tear at the origin of the right carotid artery. Retrograde and antegrade propagation of dissection resulted in aortic arch blood flow separation and expanding pseudolumen to the abdominal aorta. Sudden anuria(ARF) developed 3 hours later postoperatively and renal doppler ultrasonography and aortography showed diminished blood flow of renal arteries. We performed balloon aortic dilatation but failed. She could be restored good renal flow after intimal flap fenestration resection and thrombectomy of the abdominal aorta. This patient could be discharged in a state of mild CRF after 2 months of ICU care for respiratory and renal failure.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.584-589
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• 2002

Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.

• The Journal of the Korea Contents Association
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• v.9 no.6
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• pp.266-274
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• 2009

An abdominal aortic aneurysm occurs most commonly in older individuals (between 65 and 75), and more in men and smokers. The most important complication of an abdominal aortic aneurysm is rupture, which is most often a fatal event. An abdominal aortic aneurysm weakens the walls of the blood vessel, leaving it vulnerable to bursting open, or rupturing, and spilling large amounts of blood into the abdominal cavity. surface modeling is very useful to surgery for quantitative analysis of abdominal aortic aneurysm. the 3D representation and surface modeling an abdominal aortic aneurysm structure taken from Multi Detector Computed Tomography. The construction of the 3D model is generally carried out by staking the contours obtained from 2D segmentation of each CT slice, so the quality of the 3D model strongly defends on the precision of segmentation process. In this work we present deformable model algorithm. deformable model is an energy-minimizing spline guided by external constraint force. External force which we call Gradient Vector Flow, is computed as a diffusion of a gradient vectors of gray level or binary edge map derived from the image. Finally, we have used snakes successfully for abdominal aortic aneurysm segmentation the performance of snake was visually and quantitatively validated by experts.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.687-690
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• 1984

Aortic dissection, a condition characterized by hemorrhage into the media and variable extension along the length of the aorta, has long been recognized as a catastrophic Cardiovascular event. Recent developments in diagnostic and therapeutic skills have improved the prognosis considerably, but there is still controversy as to how cases should be managed. We experienced a case of dissecting aortic aneurysm [DeBakey Type III ], which were managed using intensive medical treatment. The period of follow up was about 11 years. At last, patient was died by progression of dissection into proximal aorta and resulted in aortic insufficiency and congestive heart failure.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.557-558
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• 2001

We operated on a Marfan patient who had Stanford type A acute aortic dissection, aortic root aneurysm, and aortic regurgitation. The Yacoub-David aortic root remodeling procedure which preserves native aortic valve and replaces all three aortic sinuses and ascending aorta by a Dacron graft, was applied for this patient. A 24mm Hemashield graft was designed to three tongues at the aortic root end to meet the shape of the Valsalva sinuses. The patient recovered from the procedure uneventfully and there was no aortic regurgitation posto-peratively.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.648-650
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• 2001

Bleeding from anastomotic site in operation for aorta has been troublesome, because it has influence on postoperative morbidity and mortality. Therefore, hemostasis is very important. We describe a simple and effective method for achieving hemostasis of the anastomotic site in aortic surgery. By wrapping around anastomotic site with remnant artificial vascular graft, we have acquired good results.