• Title/Summary/Keyword: Aneurysm, thoracic aortic

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Use of Embolic Protection Devices during Hybrid Thoracic Endovascular Aortic Repair for a Shaggy Aorta: A Case Report

  • Kim, Eun Chae;Lee, Jae Hang;Chang, Hyoung Woo;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.513-516
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    • 2021
  • An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV6 Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

Aortobronchial Fistula After Chest Trauma (흉부수상후에 발생한 대동맥기관지루)

  • 김재현;문상호;김삼현;서필원;임수빈;박성식
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.141-143
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    • 2002
  • Few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic: alternatively, they may manifest chest pain, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was repaired with a Hemashield patch and a left upper lobectomy was performed.

Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

  • Choi, Jae-Sung;Oh, Se Jin;Sung, Yong Won;Moon, Hyun Jong;Lee, Jung Sang
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.73-79
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    • 2016
  • Background: The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods: Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results: The mean age was $72.4{\pm}5.1years$, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was $269.8{\pm}72.3minutes$. The mean total length of aortic coverage was $186.0{\pm}49.2mm$. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of $16.8{\pm}14.8months$, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion: TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

Surgical Management of the Aneurysm of the Ascending Aorta with Aortic Regurgitation [A Report of 17 consecutive Patients] (대동맥 판막부전증이 동반된 상행 대동맥류의 외과적 치료: 17례 보고)

  • 조범구
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.134-139
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    • 1986
  • Seventeen patients underwent operations for aneurysm of ascending aorta with aortic regurgitation from August 1979 to October 1985. 10 patients underwent complete replacement of the ascending aorta and the aortic valve with a composite graft and implantation of coronary ostia on the graft. Seven patients underwent supracoronary noncomposite graft replacement and aortic valve replacement. The patients ranged in age from 25 to 55 years [mean 37.6 years]. There were 11 male and 6 female patients. All patients had aortic incompetence and aneurysmal dilatation of the ascending aorta. Seven of the patients has concomitant aortic dissection in ascending aorta and one had dissection in abdominal aorta. Eight patients had signs of Marfan syndrome and the other 3 patients had cystic degeneration in the medial layer of the aorta. There was one hospital death[5.8%]. He died of sepsis on the 23rd postoperative day. All survivors showed improvement in NYHA functional classification in the 34.9 patient-year follow-up period.

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Rupture of the Traumatic Abdominal Aneurysm -Surgical Experience 1 case- (외상성 복부 대동맥류의 파열 -수술치험 1례 보고-)

  • 김범식
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.782-784
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    • 1990
  • We present a case of ruptured abdominal aortic aneurysm caused by blunt injury. The patient was 23-year-old soldier injured by a motor vehicle accident. Injuries sustained a contused abdominal aorta. At the time of aortic repair, the involved segment formed huge pseudoaneurysm, and which had intimal tear. Aorto-iliac graft replacement was carried out with a woven-dacron Y-graft prosthesis, which restored satisfactory circulation to both lower limbs. The postoperative course was uneventful.

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A case of abdominal aortic aneurysm between Celiac axis and both renal arteries (복강동맥과 양측 신동맥 사이에 발생한 복부 대동맥류 치험 : 1예 보고)

  • 조강래
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1209-1213
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    • 1991
  • We have experienced a case of upper abdominal aortic aneurysm in 51 years old man who entered to our hospital with abdominal and lower back pain for three days. The diagnosis was confirmed by abdominal ultrasonography and abdominal aortogram and he was treated by aneurysmectomy, bypass graft and endarterectomy. A brief review of related literature was made.

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Stent-graft Insertion in High Risk Patients with Aortic Dissection Including Intimal Tear of the Aortic Isthmus (대동맥 협부의 내막파열을 가진 고위험군 대동맥박리환자에서 시행한 스텐트 그라프트 삽입)

  • Do, Young-Woo;Kim, Gun-Jik;Cho, Joon-Young;Lee, Jong-Tae
    • 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.

Homograft Aortic Root Replacement for Aortic Regurgitation with Behcet's Disease (Behcet씨 병과 동반된 대동맥판막 폐쇄부전에서 동종이식편을 이용한 대동맥근부 치환술)

  • Baek, Man-Jong;Na, Chan-Young;Kim, Woong-Han;Oh, Sam-Se;Kim, Soo-Cheol;Lim, Cheong;Ryu, Jae-Wook;Kong, Joon-Hyuk;Lee, Young-Tak;Moon, Hyun-Soo;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.274-282
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    • 2002
  • Background: Paravalvular leakage or false aneurysm developed after isolated aortic valve replacement(AVR) for aortic regurgitation(AR) associated with Behcet's disease is one of the most serious complications, and requires subsequent reoperations. We describe the surgical result of homograft aortic root replacement(ARR) for AR associated with Behcet's disease. Material and Method: From January 1992 to December 2001, 6 patients with AR associated with Behcet's disease underwent 7 ARR with homograft and 1 Ross operation. Five patients were male and one was female. The grafts used for ARR were 5 aortic and 2 pulmonic homografts. Ages at operation ranged from 27 to 51 years(mean, 37$\pm$9 years). Two patients underwent ARR with aortic homograft at the first operation. In the remaining 4 patients, ARR using a homograft was performed for paravalvular leakage that developed after AVR, and the mean interval from AVR to ARR was 21 $\pm$29 months(range, 5 to 73.3 moths, median, 7.6 months). Result: There was no early death. All patients were followed up for an average of 18.9$\pm$24.0 months(range, 1.9 to 68.9 months, median, 8.4 months). Two of 4patients who had undergone ARR after AVR required subsequent reoperations for false aneurysm of the ascending aorta and failure of pulmonary homograft. One patient underwent re-replacement of the aortic root, ascending aorta and partial aortic arch with an aortic homograft, the other underwent Ross operation. Conclusion: This study suggests that aortic root replacement using a homograft in aortic regurgitation with Behcet's disease may provide good clinical results and decrease the incidence of paravalvular leakage or false aneurysm after aortic valve replacement. However, the adequate perioperative management and complete removal of the inflarrunatory tissue at operation were also important for the good long-term results.

Surgical Treatment for Aneurysm of Sinus of Valsalva Combined with Ventricular Septal Defect (심실중격결손을 합병한 Valsalva's 동 동맥류 파열의 치험예)

  • 권중혁
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.43-49
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    • 1979
  • This is a case report of surgically treated rupture of Valsalva Sinus aneurysm combined with VSD. He has been relatively healthy until about one month before admission, when during bath, he felt abruptly palpitation, left chest pain and exertional dyspnea. These symptoms have progressed. On admission, thrill was palpable and continuous machinery murmur was audible on 2nd and 3rd intercostal space along the left sternal border. A rupture of Valsalva`s sinus aneurysm was confirmed by aortography and echocardiography but a small VSD was found by cardiotomy in open heart surgery. On 11th Sep. 1978, open heart surgery was performed. Valsalva`s sinus aneurysm came out from right coronary aortic sinus and ruptured into the right ventricle. It sized 1.2X1.5X1.5 cm. Ruptured opening was noted on apex of aneurysm [0.8X0.8cm], VSD [1. 0X0. 3cm in size] was just below the aortic annulus. The aneurysmal sac was removed on neck. After that, VSD and aneurysmal orifice were closed together with interrupted mattress sutures on same plane. The postoperative course was uneventful and discharged three weeks after open heart surgery.

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