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Surgical Treatment for Atherosclerosis of Aaortoiliac Artery (대동맥장골동맥의 죽상경화증에 대한 수술적치료)

  • 금동윤;정진악;신화균;이재원
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.133-137
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    • 2001
  • 배경: 하지에 영향을 미치는 죽상경화증은 복부대동맥과 이에 중요분지인 총장골동맥을 침범할 수 있다. 또한 국소분절을 침범할 수 있으나 다중분절은 침범할 수도 있다. 대상 및 방법: 을지의과대학교 흉부외과학 교실에서는 1995년 1월부터 1999년 12월까지 대동맥총장골동맥의 죽상경화증을 주소로 우회술을 시행받은 23례의 환자들을 후향적으로 조사하였다. 결과: 모든 환자는 남자였고 평균연령은 60.15$\pm$8.7세였다. 전 예에서 흡연의 과거력이 있었으며 동반질환으로 당뇨병 8례, 고혈합 7례, 관상동맥질환 6례, 그리고 판막질환 1례였다. 대동맥장골동맥 죽상경화증에 대한 수술방법으로는 대동맥양측대퇴동맥 우회술(7례), 대동맥양측동맥 우회술 및 대퇴동맥슬와동맥 우회술(8례), 대동맥양측대퇴동맥 우회술(2례), 액와대퇴동맥 및 고고동맥 우회술(3례), 고고동맥 우회술(3례)였다. 훌후 합병증으로 후복막상 출혈 3례, 마비성 장폐색 3례, 폐렴3례, 뇌졸중 1례, 급성신부전 2례, 창상감염 2례였다. 해부학적 우회술을 받은 환자중 3례에서 수술 사망이 발생하였다. 결론: 해부학적 우회술은 대동맥장골동맥의 폐쇄성질환에 표준적인 수술방법이지만 또한 해부학적 우회술 역시 술후 유병률 및 사망률이 낮은 좋은 수술법으로 사료된다.

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Supravalvular Aortic Stenosis with Aortic Regurgitation (대동맥판막 폐쇄부전증을 동반한 대동맥판막 상부 협착증)

  • 김정태;이철주;소동문;한정선
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.591-594
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    • 1999
  • Supravalvular aortic stenosis is an uncommon, congenital narrowing of the ascending aorta which originates just distal to the level of the ostium of the coronary artery. We conducted a successful surgical treatment in a 39 year- old female patient with a congenital supravalvular aortic stenosis and aortic regurgitation who did not show signs of William's syndrome. After we performed an inverted Y-shaped aortotomy toward the noncoronary sinus and right coronary sinus, pantaloon shaped prosthetic patch(Vascutek, Ino, USA) was used to repair the narrowing sinotubular junction. The aortic valve was replaced concommittently using Sorin Bicarbon 19mm. Her postoperative course was uneventful. The patient discharged at 9th postoperative day in good health.

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Surgical Management of Aortic Valve Injury after Nonpenetrating Trauma (외상성 대동맥 판막 손상의 수술적 처치)

  • Seo, Yeon-Ho;Kim, Kong-Soo;Kim, Jong-Hun
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.232-235
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    • 2007
  • We present 2 cases of patients who underwent surgical repair and replacement of an injured aortic valve that was secondary to nonpenetrating trauma. Primary repair was undertaken on an 18-year old boy, but he had persistent moderate aortic regurgitation for five years after surgery. Another 64-year old man was treated successfully with surgical replacement of the aortic valve via employing a prosthetic mechanical valve. Attempts at valvuloplasty for the treatment of traumatic aortic valve injury have not been uniformly successful, and prosthetic valve replacement is recommended for repair, except for highly selected cases.

Detection of Arrhythmia Using Heart Rate Variability and A Fuzzy Neural Network (심박수 변이도와 퍼지 신경망을 이용한 부정맥 추출)

  • Jang, Hyoung-Jong;Lim, Joon-Shik
    • Journal of Internet Computing and Services
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    • v.10 no.5
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    • pp.107-116
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    • 2009
  • This paper presents an approach to detect arrhythmia using heart rate variability and a fuzzy neural network. The proposed algorithm diagnoses arrhythmia using 32 RR-intervals that are 25 seconds on average. We extract six statistical values from the 32 RR-intervals, which are used to input data of the fuzzy neural network. This paper uses the neural network with weighted fuzzy membership functions(NEWFM) to diagnose arrhythmia. The NEWFM used in this algorithm classifies normal and arrhythmia. The performances by Tsipouras using the 48 records of the MIT-BIH arrhythmia database was below 80% of SE(sensitivity) and SP(specificity) in both. The detection algorithm of arrhythmia shows 88.75% of SE, 82.28% of SP, and 86.31% of accuracy.

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Carotid Artery Disease in Duplex Sonography: 3 Cases (이중초음파에서 관찰된 목동맥 질환: 3례)

  • Han, Minho;Choi, Junghye;Seo, Gang Sik;Nam, Hyo Suk
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.114-118
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    • 2019
  • Duplex sonography has been used to non-invasively diagnose carotid artery disease and to follow up patients with this disease. In carotid artery disease, carotid mobile thrombus and dissection are rarely detected by duplex sonography in patients with cerebrovascular events. In particular, carotid dissection occurs when a small tear forms in the tunica intima and makes 2 lumens in the carotid artery, including true and false lumens. This study reports 3 rare cases of carotid mobile thrombus, spontaneous carotid dissection, and carotid dissection in Takayasu arteritis.

Retrograde Aortic Dissection after Thoracic Endovascular Aortic Repair for Descending Aorta - 2 case reports- (하행 대동맥 내 스텐트-도관 삽입 후 발생한 역행성 대동맥 박리 - 2예 보고 -)

  • Hong, Soon-Chang;Kim, Jung-Hwan;Lee, Hee-Jeong;Youn, Young-Nam
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.758-763
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    • 2010
  • In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.

A Case Report of Acute Type II Aortic Dissection in a Patient with Marfan's Syndrome and Who Was 24 Weeks Pregnant - A case report - (임신 24주 Marfan 증후군 환자에서의 급성 제II형 대동맥 박리 - 1예 보고 -)

  • Hwang, Ui-Dong;Ryu, Yang-Gi;Lim, Ju-Yong;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.508-511
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    • 2007
  • The causes of aortic dissection are usually hypertension, connective tissue disease such as Marfan syndrome, congenital valvular abnormality such as bicuspid aortic valve, iatrogenic injury, pregnancy and drugs. Previous studies have shown that 50% of all dissections in women less than 40 years age were associated with pregnancy. Almost all aortic dissections during pregnancy occur during the third trimester or during labor and delivery. Marfan's syndrome is a particularly important predisposing factor for aortic dissection during pregnancy. We report here on a case of surgical treatment for acute type II aortic dissection in a Marfan syndrome patient who was 24 weeks pregnant, and we include a review of literature.

Effects of Dietary Quartz Porphyry Supplementation on Moisture Content of Excreta, Intestinal Ammonia Contents and Blood Composition of Growing Broilers (사료내 맥반석의 첨가가 성장중인 육계의 배설물 수분함량, 장내 암모니아 함량 및 혈액성상에 미치는 영향)

  • 손장호;박창일
    • Korean Journal of Poultry Science
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    • v.24 no.4
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    • pp.179-184
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    • 1997
  • Seven-day-old 40 broiler chicks of both sexes were fed the conventional diet containing 0, 0.3, 6 and 0.9% Quartz porphyry(QP) and water ad libitum until 28 days of age. The excreta water content and nitrogen balance were measured during the experimental period. At the end of the trial, blood samples were collected to measure ammonia, glucose, triglyceride, and total cholesterol concentrations. In addition, intestinal ammonia concentrations were measured. The excreta moisture contents decreased significantly(P < 0.05) as QP levels increased(r= -0.96). Ammonia contents in the intestine tended to increase as QP levels increased, but the ammonia concentration in the blood was not affected by the QP levels. The blood glucose concentration was not changed but blood triglyceride concentration was lower in the 0.3% QP treatment than the other groups(P < 0.05), Total cholesterol concentration in the blood tended to increase as QP levels increased. The QP 0.3% treatment showed somewhat higher positive N balance than the other groups. The results of this experiment indicate that the dietary supplementation of QP could offer some benefits to broiler growers.

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Surgical Experience of the Remnant Thoracoabdominal Aortic Replacement after Aortic Surgery (대동맥수술 후 잔존 흉복부대동맥치환술에 대한 임상 경험)

  • Cho, Kwang-Jo;Woo, Jong-Su;Choi, Pil-Jo;Bang, Jung-Hee
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.49-54
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    • 2008
  • Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

Single Stage Replacement of Entire Thoracic Aorta for Chronic Aortic Dissection (만성 대동맥 박리 환자에서 전 흉부 대동맥 동시 치환)

  • 최진호;박계현;전태국;이영탁;박표원
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.865-869
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    • 2001
  • Operations for extensive aortic aneurysm are generally performed as staged operations with or without elephant trunk technique. However, we must consider single stage replacement in cases that are unsuitable for elephant trunk technique. We report a case of successful sing1e stage replacement of the entire thoracic aorta from the aortic valve to the level of diaphragm. The patient was a 35-year-old male who had Marfanoid features and had previously undergone replacement of the ascending aorta for aortic dissection. He recovered without neurologic complication and was discharged on 29th day after the operation. .

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