• Journal of Chest Surgery
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• v.34 no.9
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• pp.692-697
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• 2001

Background: The left main coronary artery surgical angioplasty has become the choice of surgical procedure in isolated LM disease. We have performed 22 cases of LMCA surgical angioplasy since 1996. We report the immediate and long term result of the surgical angioplasty with their postoperative angiography. Material and Method: Between July 1994 and October 2000, 22 patients(11 men and 11 women) were subjected to surgical patch angioplasty of the LMCA, 1 patient had an additional angioplasty performed on the proximal right coronary artery. The LMCA was approached anteriorly with or without transection of the main pulmonary artery(21 cases), and in a patient who had undergone an aortic valve replacement, LMCA was approached superiorly with transection of the ascending aorta. Additional grafting was required in 5 cases. The on-lay patch was used with autologous pericardium in 6 cases and bovine pericardium in 16 cases. Result: There was no operative mortality. There was 30~50% stenosis of the anastomosis site in 3 cases at the postop. coronary angiography. Coronary angiography was reperformed in 5 cases between 5th months and 15th months postoperatively. There was 40~60% stenosis of the anastomosis site in 2 cases. There was one death at 42nd months postoperatively but the cause was unknown. No patient complained of angina with a mean follow up of 48.$\pm$22.5 months. Conclusion: There were only several coronary angiographic results in long term follow-up but we had relatively good clinical results for LMCA surgical angioplasty in the immediate and long term. The excellence of LMCA surgical angioplasty needs the result of the long term follow-up.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.267-272
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• 2003

Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

• Journal of Korean Neurosurgical Society
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• v.51 no.5
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• pp.292-295
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• 2012

Many reports have been published on complications related to middle cerebral artery (MCA) aneurysm surgical clipping procedures. We report an emergency intracranial in situ bypass surgery case which was performed as a rescue procedure after aneurysmal neck laceration during clipping of an MCA large aneurysm. In this case, we performed in situ M3-superficial temporal artery (STA) interposition graft-M3 bypass procedure. If a STA-MCA anastomosis is not available under MCA flow obstruction, we can consider an emergency in situ MCA-MCA bypass procedure with or without an STA interposition graft.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.842-849
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• 1988

Between July, 1987, and September, 1988, 6 patients with coronary occlusive disease received coronary artery bypass surgery at Kyungpook University Hospital. There were five males and one female whose age ranged from 39 to 64 years[mean 54*8.0 years]. Of the 6 patients, 5 suffered from unstable angina, 1 suffered from stable angina. Selective coronary angiography revealed a significant stenosis of the left anterior descending artery in 6 cases, of its diagonal branch in 1 case, of the right coronary artery in 1 case, the circumflex artery in 1 case, and of its obtuse marginal branch in 1 case. The mode of anastomosis were single saphenous vein graft in 3 cases, single left internal mammary artery graft in 1 case, double saphenous vein graft with sequential anastomosis in 1 case, and left internal mammary artery plus saphenous vein graft in 1 case. Of these, 6 grafts to left anterior descending artery were done. There was no operative death, but perioperative myocardial infarction was happened in 1 case. All survivors were free of angina and discontinuing medical therapy during the follow up period[mean 7.8*5.15 months].

• Journal of Chest Surgery
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• v.17 no.3
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• pp.448-455
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• 1984

Coarctation of the Aorta is a congenital constriction of aorta of varying degree, usually located at or near the aortic ismuth with frequent associations of other cardiac anomalies. Various modes of surgical corrections, such as resection and end-to-end anastomosis, graft interposition, angioplasty using prosthetic patch or subclavian flap have been used according to the status of coarctation and age of the patient. We have experienced two cases of surgically treated coarctation of the aorta, one of which was preductal coarctation with hypoplastic aortic arch and ventricular septal defect in a 4 year old boy, and the other case was juxtaductal type with aortic regurgitation. Subclavian flap angioplasty with additional pulmonary artery banding procedure was done in the first case and wedge resection with end-to-end anastomosis and aortic valve replacement [St. Jude valve, 23mm] 20 days later of first operation in the other case. The first case developed massive tarry stool on 3rd POD, probably due to mesenteric arteritis with resultant bowl ecrosis, and expired the next day. Recovery was uneventful with the second case.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.452-454
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• 2011

The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.324-327
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• 1994

Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.22-28
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• 2002

Background and Objectives : The aim of the this study is to determine the efficacy of an external prosthesis made of ringed Polytetrafluoroethylene to prevent Postanastomotic stenosis after surgical correction of extensive tracheal defects in rabbits. Materials and Methods : Thirty rabbits were used, divided into two groups of 15 animals each. Group A rabbits underwent resection of six-ring segments of the cervical trachea and tracheal end-to-end anastomosis. The Procedure used in group B was similar to that used in group A. but the tracheal anastomosis was supported by an external ringed polytetrafluoroethylene prosthesis. After six months, rabbits were killed and tracheas were resected and then compared the postanastomotic tracheal stenosis using morphometry. Results : Anteroposterior diameter, transverse diameter, cross sectional area and intra luminal perimeter of trachea was greater in group B than group A. Also inflammatory changes of mucosa and submucosa were greater in group A than group B. Conclusion : A ringed PTFE as a external stent was effective to prevent tracheal stenosis resulting from the extensive tracheal resection and tracheal reconstruction in rabbits.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.82-93
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• 1995

Three-dimensional reconstruction of computed tomographic image(3D CT) is a well-established imaging modality which has been investigated in various clinical settings. It is commonly performed in case of congenital or developmental abnormalities, and traumatic fracture of skull and face that requires reconstruction of osseous structure. However reporting the 3D CT in laryngeal or tracheal stenosis is rare and its results are obscure. The authors performed 3D CT in six cases of tracheal stenosis and found diagnostic value of 3D CT. A Comparision of diagnostic information obtained from plain X-ray, 2D CT and 3D CT has performed in total six cases of tracheal stenosis. Surgical treatment of the tracheal stenosis was following in these cases : tracheal end to end anastomosis In 1 case, laryngotracheal end to end anastomosis in 2 cases. 3D CT information was compared with operative finding. In two of six cases, satisfactory information was not obtained from 3D CT in evaluating an exact stenosis of trachea. Future, it will be helped in evaluating of tracheal stenosis by 3D CT.

• Journal of Chest Surgery
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• v.14 no.4
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• pp.339-344
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• 1981

Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.