• Journal of Chest Surgery
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• v.33 no.12
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• pp.974-977
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• 2000

유아에서 흔치 않지만, 선천적 혹은 후천적 원인으로 혈관에 의해 기도가 눌릴 수 있다. 8개월 남자 환아가 승모판 성형술, 동맥관 개존증 결찰 후 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 주기관지가 눌리는 소견이 관찰되었다. 결찰 부위를 완전히 분리하고 하행대동맥을 봉합하여 크기를 줄여 기관지 압박을 해결할 수 있었다. 술 후 환자는 특별한 합병증 없이 퇴원하였으며 외래 추적 관찰 중이다.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.691-694
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• 2003

A 49-year-old woman had thoracic back pain for several years. Chest CT scan and MRI angiography revealed descending thoracic aortic aneurysm with a maximum diameter of 69 mm. Thoracic aortography showed not only the aortic aneurysm, but also coarctation of descending thoracic aorta at the level of aortic hiatus of the diaphragm. Intercostal artery arising Adamkiewicz artery was found in descending thoracic aortic aneurysm just above the coarctation, The aneurysm with coarctation of the aorta was successfully repaired with prosthetic graft replacement under left atrio-femoral bypass.

• Proceedings of the KTCVS Conference
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• 2004.06a
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• pp.160-161
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• 2004

• Journal of Chest Surgery
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• v.42 no.1
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• pp.104-106
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• 2009

Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.604-610
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• 2001

Stanford type A aortic dissection after graft replacement of ascending aorta and/or aortic arch required careful follow-up due to progression of the enlarged false lumen or the recurrence of dissection. From June 1984 to June 200, 124 patients underwent operations for type A aortic dissection. Among them, 6 patients underwent reoperation due to recurred aneurysm or dissection. We evaluated that the causes of reoperation, including Marfan syndrome, the approach and result of reoperation, and strategy to reduce the risk of reoperation. Material and method: The first operation was done on acute stage in 4 cases, and chronic stage in 2 cases. There were Marfan syndromes in 3 cases. The entry site was the ascending aorta for all cases except one who underwent Bentall operation(n=3) or ascending aorta graft replacement(n=2). In one case, Bentall operation and total arch replacement was performed due to chronic type A dissection with multiple fenestrations. Mean interval of reoperation was 67.6months(range 5 months to 14 year 4months) after the first operation. Reoperations were performed with recurrence of dissection(n=4), threatening aneurysmal evolution of persisting dissection(n=1), and false aneurysm with infection(n=1). The redo operation involved the hemiarch in 1 case, distal ascending to total arch and descending thoracic aorta in 4 cases, and only descending thoracic aorta in 1 case. Result: There were Marfan syndromes in 18 patients. The mean age in type A dissection was 56.7 years and that in the first operation of reoperationc ases was 32.2 years. Especially in 3 patients with Marfan syndrome, the mean age was 29 years.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.704-707
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• 2007

Penetrating atherosclerotic ulcer involving the aortic arch has rarely been reported on in the literature. Acute rupture of a penetrating atherosclerotic ulcer involving the distal arch and the proximal descending thoracic aorta was found in a 78-year-old male, and he originally presented with acute-onset shoulder pain and hoarseness. Patch repair of the perforated arch and the proximal descending thoracic aorta was successfully done under total circulatory arrest.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.844-846
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• 1999

Chronic irritation to arterial wall by foreign material may give rise to delayed vascular injury. A 50 years old male patient with kyphoscoliosis had undergone fixation of orthopedic Cotrel-Dubousset(CD) rods and screws. Fourteen months after that surgery, a false aneurysm of the descending thoracic aorta associated with pulsating hematoma in the muscular chest wall developed. The false aneurysm was managed by resecting the diseased aortic segment and replacing the vascular graft.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.213-218
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• 1997

Pseudoaneurysm of the thoracic aorta is potentially fatal. However, reports of such cases are rare even in large series. We report four cases of thoracic aortic pseudoaneurysm who underwent surgical repair, The causes were considered as infection in two cases (VSD repair, descending thoracic aortic aneurysm resection) and blunt chest trauma by traffic accident in two patients. The pseudoaneurysms developed on ascending aorta suspected as sites of arterial and cardiolplegic needle insertion in one patient. The others were located at descending thoracic aorta immediatly below the left subclavian artery. One patient died of sepsis associated with bile peritonitis and others were followed up from 10 to 18 months with specific morbidity. This study suggest that the incidence of pseudoaneurysm of the thoracic aorta followed by open heart or aorctic surgery can be repaired succesfuly and careful inspection of associated injury is very important in cases of traumatic thoracic pseudoaneurysm.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.617-620
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• 1997

Traumatic aneurysm of both the thoracic aorta and the left ventricle are extremely rare in children because it is characterized by high mortality. We report a case which we experienced recently with sucessful outcome. A Five-year-old boy had a blunt trauma by bongo bus. He had pulmonary hemorrage and pericardial effusion complicated by multiorgan failure threatening his life. Aneurysm of LV and Descending aorta were showed by 2-D echocardiogram and MRI. The atient underwent successful corrective surgery 2 and half momths after trauma, the Postoperative status of this patient was uneventful, now he is being followed up the OPD.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.79-86
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• 2009

Background: Background: Computed tomography (CT) is the main tool for detecting abnormalities of the thoracic aorta, but conventional CT only shows the cross-sectional images. These CT images have some limitations fo accuratly measuring the thoracic aortic diameters at various levels. Multidetector computed tomography (MDCT) overcomes these limitations. We measured the thoracic aortic diameter perpendicular to the loop-shaped thoracic aortic course and this was studied in relation to age, gender, height, weight, the body surface area, the body mass index and the presence of hypertension. Material and Method: Thirty hundred thirty one patients (males: 141 patients and females: 190 patients) who had no abnormalities of the thoracic aorta were investigated using MDCT aortography. They were divided into three age categories: 20~39 years old, 40~59 years old and over age 60. The image was reformed with multiplanar reconstruction and the diameter of the aorta was measured perpendicular to the aortic course at 5 anatomic segments. Level A was the mid-ascending aorta, level B was the distal ascending aorta, level C was the aortic arch, level D was the aortic isthmus and level E was the mid-descending aorta. Result: The mean age was 49.5 years old for males and 54.9 years old for females (p<0.05). The mean diameter of the thoracic aorta at level A was 31.1 mm, that at level B was 30.2 mm, that at level C was 26.5 mm, that at level D was 24.0 mm and that at level E was 22.6 mm. The diameters at all the levels were gradually increased with age. Hypertensive patients had larger diameters than did the non-hypertensive population. There was a positive correlation between the ascending aortic diameter (levels A&B) and height and the body surface area, but there were no statistical differences at the aortic arch (level C) and the descending aorta (levels D&E). There were no statistical differences of the weight and body mass index at all levels. Conclusion: The diameters of the thoracic aortas were directly correlated with gender, age and hypertension. Height and the body surface area were only correlated with the ascending aorta. Weight and the body mass index have no statistical difference at all levels. We measured the age related thoracic aortic diameters and the upper normal limits and we provide this data as reference values for the thoracic aortic diameter in the Korean population.