• Journal of Chest Surgery
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• 제45권6호
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• pp.404-407
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• 2012

Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

• Journal of Chest Surgery
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• 제21권5호
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• pp.899-904
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• 1988

In Behcet syndrome, cardiac involvements are rare and have been reported pericarditis, myocarditis, right heart endocardial fibrosis, right ventricle mural thrombus with pulmonary embolism, active endocarditis, granulomatous endocarditis, conduction disturbance, acute aortic insufficiency, mitral valve prolapse. Our three patients underwent AVR because of aortic insufficiency and ascending aorta enlargement combined with Behcet syndrome. Two patients had mitral regurgitation too. So one underwent MAP and the other underwent MVR concomitantly. One who underwent AVR have been well for 50 months. Another who underwent AVR+MAP and redo AVR due to aortic paravalvular leakage was died of congestive heart failure. The other who underwent AVR+MVR and repeated AVR three times because of aortic paravalvular leakage is in condition of aortic paravalvular leakage. Paravalvular leakage is considered to recur due to progressive dilatation and fragility of aortic root that is the result of pathologic change of Behcet syndrome in it. If Open heart surgery is needed in Behcet`s syndrome during inflammatory reaction is active, postoperative complications such as paravalvular leakage or suture line rupture may be prevented with pre- and postoperative anti-inflammatory management.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.49-51
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• 2005

A 61-year-old man with an antecedent febrile illness presented with progressive flaccid paraparesis, but no sensory or sphincter involvement. Magnetic resonance imaging (MRI) of the spine was negative and nerve conduction study (NCS) showed the absence of F-waves in his legs, suggesting $Guillain-Barr{\acute{e}}$ syndrome (GBS). However, abdominal pain after admission led to the consideration of the spinal cord ischemia secondary to aortic dissection confirmed by computed tomography. We report the rare condition of painless aortic dissection simulating GBS.

• Journal of Chest Surgery
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• 제47권3호
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• pp.291-293
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• 2014

Acute aortic dissection (AAD) during pregnancy can be fatal to both the pregnant mother and the baby, particularly in patients with the Marfan syndrome. We report a case of the modified Bentall procedure in surgery for AAD in a 31-year-old pregnant woman at 24 weeks of gestation with the Marfan syndrome. The patient recovered well after the operation, but unfortunately, the fetus could not be saved.

• Journal of Chest Surgery
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• 제40권7호
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• pp.508-511
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• 2007

일반적으로 대동맥 박리의 원인을 살펴보면 고혈압, Marfan 증후군과 같은 결체 조직성 질환, 이엽성 대동맥 판막과 같은 선천성 판막 질환, 침습적 시술, 임신, 마약 등 여러 가지이다. 이러한 대동맥 박리의 원인들 중 임신은 40세 이하 여성에서 나타나는 대동맥 박리 원인의 약 50%를 차지한다. 임신중의 대동맥 박리는 대부분 임신 제 3분기 또는 출산 중에 발생하고 이 중 약 반수에서 Marfan 증후군과 같은 결체 조직성 질환이 동반된다. 저자들은 임신 24주에 급성 제II형 대동맥 박리가 발생한 Marfan 증후군 환자에서 대동맥 판막을 포함한 상행 대동맥 치환술을 시행하고 추후 임신 38주에 제왕절개를 통해 건강한 태아를 출산한 치험 1예를 문헌 고찰과 함께 보고한다.

• Journal of Chest Surgery
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• 제37권1호
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• pp.88-91
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• 2004

Takayasu씨 동맥염 환자에서 대동맥판막 폐쇄부전은 종종 발생하는 합병증이다. 급성 및 진행성 염증으로 대동맥의 뇌혈관 분지에 협착 또는 폐쇄를 가진 환자에서 실신 등의 허혈성 뇌증상은 대동맥판막 폐쇄부전증의 합병으로 더 악화될 수 있다. 양측 경동맥의 폐쇄와 양측 척추동맥의 협착, 우관상동맥의 폐쇄, 대동맥판막 폐쇄부전증으로 실신 및 호흡곤란을 호소하는 34세 남자 환자에서 수술 전후에 스테로이드의 투여, 양측 쇄골하 동맥에 스텐트의 삽입 및 대동맥판막 치환술로써 증상의 호전을 가져올 수 있었다.

• 한국응급구조학회지
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• 제24권3호
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• pp.141-145
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• 2020

The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.

• Journal of Chest Surgery
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• 제44권6호
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• pp.427-431
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• 2011

Successful thoracic endovascular repair for complicated Stanford type B acute aortic dissection in two patients is herein reported. The true lumen flow was immediately restored following stent graft deployment in the descending thoracic aorta with subsequent resolution of the distal malperfusion syndrome. One patient is doing well more than 15 months after surgery and another patient who was treated more recently is also doing well 7 months postoperatively.

• Journal of Chest Surgery
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• 제27권11호
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• pp.907-913
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• 1994

From October 1990 to May 1993, 19 patients underwent replacement of the transverse aortic arch. [10 men, 9 women, mean age 52.5 years] Underlying diseases were acute aortic dissection [10 cases], chronic aortic dissection [4 cases],and aortic arch aneurysm [ 5 cases]. In 19 patients, 10 underwent partial replacement and 9 underwent total arch replacement. The cerebral protection was achieved by profound hypothermia [rectal temperature,16$^{\circ}$ to 2$0^{\circ}C$] associated with total circulatory arrest [mean 35.5 minutes]. In one patient, the aortic arch distal to the left common carotid artery was resected with the distal arch being cross-clamped and in another two patients, the selective cerebral perfusion was also applied during the period of total circulatory arrest via innominate artery and left common carotid artery because of longer total circulatory arrest time. Among 14 patients of aortic dissecton, 10 presented hypertension, 1 presented Marfan syndrome, 1 presented pregnancy-induced hypertension and 2 revealed no evidence of hypertension. All of the above 14 patients complained chest pain. Among 5 patients of aortic arch aneurysm, Be het disease was suspected in only one patient and atherosclerotic aneurysm was proved in another 4 patients. The overall hospital mortality was 32% [6/19]. In aortic dissection, the mortality was 43% [Acute aortic dissection 30%, chronic aortic dissection 75%] and in aortic arch aneurysm, the mortality was 0%. Follow-up was done in all survivors for from 7 months to 36 months[mean,17.3%].

• Journal of Chest Surgery
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• 제26권2호
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• pp.154-157
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• 1993

Aortic dissection of the young woman without Marfan disease is related, in most instances, to pregnancy. We experienced a case of acute type A aortic dissection. The patient was 25 years old woman in 35 weeks of gestational age without evidence of Marfan's syndrome. The challenge of management was successfully met by delivery of the fetus first, followed by aorta surgery. 42 minutes of total circulatory arrest and 104 minutes of total aortic cross clamp time were needed. 34 minutes of selective cerebral perfusion via right axillary artery was used. The patient had uneventful hospital course and was discharged with her healthy baby on 15 th postoperative day.