• Journal of Chest Surgery
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• 제28권1호
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• pp.31-36
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• 1995

Between January 1984 to June 1994, fourteen patients from 37 to 80 years of age [mean 66.42 11.71 years of age have undergone surgical treatment of abdominal aortic aneurysm in Kyung Hee Univ. Hospital. There were 11 males and 3 female patients. All but one were infra-renal type. The etiology of the aneurysm consisted of twelve atherosclerotic, one inflammatory and one traumatic abdominal aortic aneurysm.Two patients were operated on for ruptured abdominal aortic aneurysm. We performed dacron graft interposition in all patients and one patient was also performed aorto-renal end to side anastomosis. Two patients died of postoperative complications which was a pulmonary insufficiency in one, acute renal failure in another patient.Remaining twelve patients were discharged with good condition and followed up from 2 months to 87 months.[mean $34.58{\pm}29.79$ months.

• Journal of Chest Surgery
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• 제50권4호
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• pp.263-269
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• 2017

Background: Endovascular aneurysm repair (EVAR) has dramatically changed the management of abdominal aortic aneurysms (AAAs) as the number of open aneurysm repairs have declined over time. This report compares AAA-related demographics, operative data, complications, and mortality after treatment by open aneurysm repair or EVAR. Methods: We retrospectively reviewed 136 patients with AAAs who were treated over an 8-year time period with open aneurysm repair or EVAR. Results: The mean age of the EVAR group was higher than that of the open repair group (p=0.001), and hospital mortality did not differ significantly between groups (p=0.360). However, overall survival was significantly lower in the EVAR group (p=0.033). Conclusion: Although EVAR is the primary treatment modality for elderly patients, it would be ideal to set slightly more stringent criteria within the anatomical guidelines contained in the instructions for use of the EVAR device when treating younger patients.

• Journal of Chest Surgery
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• 제55권3호
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• pp.243-245
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• 2022

True aneurysms of the coronary artery after aortic root replacement in Marfan syndrome patients are very rare. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva adds complexity during aortic root surgery. We present a case of a 37-year-old male patient with Marfan syndrome who had an RCA anomaly and a 4.5-cm true aneurysm of the common coronary button 14 years after a previous Bentall procedure. A redo Bentall operation and hemi-arch replacement were successfully performed. The anomalous origin of the RCA from the left sinus of Valsalva was safely divided and anastomosed as separate coronary buttons to the prosthetic composite valve graft. To prevent coronary button aneurysms after aortic root surgery in Marfan patients, the coronary buttons and the corresponding side holes on the prosthetic graft must be reduced to the maximum possible extent.

• Journal of Chest Surgery
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• 제43권5호
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• pp.546-549
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• 2010

70세 남자 환자가 심한 복부 및 배부 통증으로 흉부 대동맥류 파열 의심 하에 전원되었다. 환자는 6개월 전 타 병원에서 하행대동맥류 의심 하에 대동맥 스텐트를 삽입하였던 병력이 있었으나 전산화 단층촬영 소견은 후종격동 악성 종양을 시사하였다. 개흉 후 이와 같은 진단이 확인되었으며 종격동의 육종은 거기에 둘러싸인 대동맥과 함께 성공적으로 절제되었다. 본 증례는 최근 주목을 받고 있는 대동맥 스텐트 그라프트 삽입에 대한 맹목적인 선호에 대하여 주의를 환기시키는 교훈적인 경우라고 판단된다.

• Journal of Chest Surgery
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• 제24권2호
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• pp.202-205
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• 1991

Development of an aneurysm in the thoracic aorta, intercostal arteries, or cerebral vessels is not an uncommon occurrence in patients with coarctation of the aorta. The mechanism whereby coarctation predisposes to aneurysm formation is incompletely understood and we suggest that in this case, an intrinsic factor in the wall of the aorta underlies the formation of aneurysms. Recently we experienced one case of COA associated with the thoracic aortic aneurysm and operation was done successfully. PDA was simply ligated and the aorta was cross-clamped proximally and distally and the area of constriction or aneurysmal site were excised. Postoperative course was uneventful and the patient was discharged 2 weeks after operation. Hypertension at upper extremities was controlled without any antihypertensive drugs after operation and the degree of regurgitation of mitral valve was improved postoperatively but long-term follow-up should be necessary.

• Journal of Chest Surgery
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• 제14권3호
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• pp.291-296
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• 1981

Dissecting aortic aneurysm is a disease which is characterized by hemorrhagic intramural seperation of aortic wall and extension for varlng distances proximally, distally, or both from the site of the intimal tear. Most aortas show some type of medial degeneration most commonly described as cystic medial necrosis. DeBackey classified this disease according to involved aorta and site of intimal tear to 3 basic types, such as type I, II and III. Type III is defined that dissecting process arrises in the descending thoracic aorta just distal to origin of the left subclavian artery and extends distally for a varing distance. We expirienced a case of dissecting aneurysm, type III of DeBackey's classification which dissecting process is limited to the descending thoracic aorta in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. This patient was 40 year old woman and she had suffered from intermittent sharp back pain for 3 years .before admission. Excision of the aneurysm and Dacron graft were placed successfully under the left atrio-femoral bypass with artificial pump. The hospital course was uneventful.

• Journal of Chest Surgery
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• 제32권9호
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• pp.844-846
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• 1999

이물질(foreign body)의 만성적인 자극은 혈관에 지연성 손상을 가져올 수 있다. 척추 측후만증을 교정하고 자 약 14개월 전에 흉추에 CD 금속강과 나사못(Cotrel-Dubousset rods and screws)을 장치했던 환자에서 CD 나사못의 만성적인 자극으로 흉벽의 박동성 혈종을 합병한 가성 대동맥류가 발생하였다. 이 환자에서 가성 대동맥류가 발생한 하행대동맥 부위를 절제하고 인조혈관 대치술로 치료하였기에 보고한다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.816-822
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• 1989

Aneurysms of the descending thoracic aorta can be caused by various etiologies. So, its abrupt rupture leads life-threatening state, it must be operated as soon as possible. Surgical treatment of the descending thoracic aortic aneurysm requires temporary cross-clamping of major artery. The obligatory occlusion of the descending thoracic aorta during management causes proximal arterial hypertension and distal arterial hypotension. The former may leads to left ventricular failure, or cerebrovascular accident, whereas the latter may leads to spinal cord ischemia or renal injury. Some have recommended insertion of temporary shunt around the occluded descending aorta to prevent above problems. Still others would favor expeditious operation employing simple aortic occlusion during the repair of the descending aorta. Recently we had experienced two cases of dissecting aneurysms of descending thoracic aorta which performed aortoplasty with Gore-Tex conduit under simple aortic occlusion. The one was 34-year-old female patient with traumatic dissecting aortic aneurysm [5 em X 5 cm] on the descending thoracic aorta distal to the origin of the left subclavian artery and the other was 58-year-old female patient with atherosclerotic dissecting descending thoracic aortic aneurysm [6 cmX7 cm] and diffuse abdominal aortic aneurysms [3X5 cm]. Both patients performed standard left posterolateral thoracotomy. After the aneurysmal sac was mobilized, occluding vascular clamps were placed on the transverse aorta proximal to the origin of the left subclavian artery, and on the distal descending aorta without adjuvant bypass procedures for 31 and 32 minutes, respectively, and the aneurysmal sac was repaired with 18 mm ringed Gore-Tex conduit graft. Both patients postoperative courses were uneventful.

• Journal of Chest Surgery
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• 제45권4호
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• pp.205-212
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• 2012

Aortic valve sparing operations were developed to preserve the native aortic valve during surgery for aortic root aneurysm as well as surgery for ascending aortic aneurysms with associated aortic insufficiency. There are basically two types of aortic valve sparing oprations: remodeling of the aortic root and reimplantation of the aortic valve. These operations have been performed for over two decades and the clinical outcomes have been excellent in experienced hands. Although remodeling of the aortic root is physiologically superior to reimplantation of the aortic valve, long-term follow-up suggests that the latter is associated with lower risk of developing aortic insufficiency. Failure of remodeling of the aortic root is often due to dilatation of the aortic annulus. Thus, this type of aortic valve sparing should be reserved for older patients with ascending aortic aneurysm and normal aortic annulus whereas reimplantation of the aortic valve is more appropriate for young patients with inherited disorders that cause aortic root aneurysms. This article summarizes the published experience with these two operations. They are no longer experimental procedures and should be part of the surgical armamentarium to treat patients with aortic root aneurysm and ascending aortic aneurysms with associated aortic insufficiency.

• Journal of Chest Surgery
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• 제34권7호
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• pp.557-558
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• 2001

순턴향대학 턴안병원 흥부외과에서는 Stan$\ulcorner$old type A급성 대동맥 박리증, 대동맥 근부 동맥류 및 대동맥 폐쇄부전을 보인 45세 말판 증후군 환자에게 24m Hemashield 도관을 이용하여 Yacoub-David 수술법에 의한 대동맥 근부 개형술(aortic root remodeling procedure)을 시행하였다 수술은 환자의 대동맥 판막을 보존하면서 대동맥등을 포함한 대동맥 근부의 질병조직을 모두 제거한 후, 글이 발살바동 모양으로 3등분된 인조혈관으로 대동맥등으로부터 상행 대동맥가지 대치하는 방법으로 하였다. 환자는 수술 후 양호한 회복을 보였고 대 동맥 판막의 역류는 완전히 교정되었다.