• Title/Summary/Keyword: Aorta, thoracic

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Central-Approach Surgical Repair of Coarctation of the Aorta with a Back-up Left Ventricular Assist Device for an Infant Presenting with Severe Left Ventricular Dysfunction

  • Kim, Tae Hoon;Shin, Yu Rim;Kim, Young Sam;Kim, Do Jung;Kim, Hyohyun;Shin, Hong Ju;Htut, Aung Thein;Park, Han Ki
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.407-410
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    • 2015
  • A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

Surgical Resection of a Posterior Mediastinal Tumor That Was Previously Treated with Aortic Stent-graft under the Misdiagnosis of Aortic Aneurysm -A case report- (대동맥류로 오인되어 스텐트 그라프트가 삽입되었던 후종격동 육종의 수술 치험 -1예 보고-)

  • Kim, Mi-Jung;Park, Kay-Hyun;Lim, Cheong;Chung, Eui-Suk;Lee, Hae-Young;Choi, Jin-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.546-549
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    • 2010
  • A 70-year-old man was transferred to our center due to severe epigastric and back pain with the impression of a ruptured thoracic aortic aneurysm. Six months previously, he had undergone insertion of stent graft into the descending thoracic aorta at another hospital. The findings of the computed tomographic scan suggested a rapidly growing malignant mediastinal tumor rather than a ruptured aneurysm. Exploratory thoracotomy confirmed the diagnosis and the tumor was resected along with the portion of the aorta contained in it. This exemplary case should raise the concern against overzealous application of endovascular aortic repair.

The Effect of Distal Aortic Pressure on Spinal Cord Perfusion in Rats

  • Park, Sung-Min;Cho, Seong-Joon;Ryu, Se-Min;Lee, Kyung-Hak;Kang, Gu
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.73-79
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    • 2012
  • Background: Aortic cross clamping is associated with spinal cord ischemia. This study used a rat spinal cord ischemia model to investigate the effect of distal aortic pressure on spinal cord perfusion. Materials and Methods: Male Sprague-Dawley rats (n=12) were divided into three groups. In group A (n=4), the aorta was not occluded. In groups B (n=4) and C (n=4), the aorta was occluded. In group B the distal aortic pressures dropped to around 20 mmHg. In group C, the distal aortic pressure was decreased to near zero. The carotid artery and tail artery were cannulated to monitor the proximal aortic pressure and the distal aortic pressure. Fluorescent microspheres were used to measure the regional blood flow in the spinal cord. Results: After aortic occlusion, blood flow to the cervical spinal cord showed no significant difference among the three groups. In groups B and C, the thoracic and lumbar spinal cord and renal blood flow decreased. No microspheres were detected in the thoracic and lumbar spinal cord of group C. Conclusion: The spinal cord blood flow is dependent on the distal aortic pressure after thoracic aortic occlusion.

Vasorelaxant Effect of Gangwhal in Korean and Chinese on Rat Thoracic Aorta Rings (강활류(羌活類) 한약재(韓藥材)의 혈관이완(血管弛緩) 효과(效果) 비교(比較) 연구(硏究))

  • Lee, Kyung-Jin;Kim, Deok-Soo;Ham, In-Hye;Kim, Ho-Kyoung;Bu, Young-Min;Kim, Ho-Cheol;Choi, Ho-Young
    • The Korea Journal of Herbology
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    • v.25 no.4
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    • pp.69-75
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    • 2010
  • Objectives : The root and rhizome of "Gangwhal" have been used as a traditional medicine for the treatment of cold, fever, headache, swelling, arthritis, rhinitis, and cardiovascular diseases in Korea and china. In china, Gangwhal is well known as a useful oriental medicinal plant that treats cardiovascular diseases such as stroke, headache and hypertension, but little research exists about the effect of O. koreanum on cardiovascular disease. Therefore we investigated the vasorelaxant effects of O. koreanum and compared the vasorelaxant effects of four species of Gangwhal. Methods : The vasorelaxant effects of the ethanol extracts of Ostericum koreanum (NK and BK), Notopterygium incisium (NI), and N. forbesii (NF) on phenyleprine ($1{\mu}M$) or KCl (60mM) pre-contracted rat thoracic aorta rings were compared. The vasorelaxant effects of the water extract and ethanol extract of NK on phenyleprine ($1{\mu}M$) or KCl (60mM) pre-contracted rat thoracic aorta rings were compared. And the vasorelaxant effects of chloroform, ethylacetate and water fraction of ethanol extract of NK on phenyleprine ($1{\mu}M$) or KCl (60mM) pre-contracted rat thoracic aorta rings were compared. Results : Ethanol extracts of NK, BK, NI and NF relaxed rat thoracic aorta rings with a concentration-dependent manner, and NK showed the greatest vasorelaxant effect. And ethanol extract of NK was much more effective than water extract of NK. Finally, chloroform, ethylacetate and water fraction of ethanol extract of NK also relaxed rat thoracic aorta rings, and chloroform fraction showed the greatest vasorelaxant effect.

Right Aortic Arch with a Retroesophageal Left Subclavian Artery and an Anomalous Origin of the Pulmonary Artery from the Aorta

  • Jeon, Chang-Seok;Shim, Man-shik;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.44-46
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    • 2017
  • We report the case of a newborn with a rare anatomic variation: a right aortic arch with a retroesophageal left subclavian artery and an anomalous origin of the pulmonary artery from the aorta. This variation was diagnosed using echocardiography and computed tomography, and we treated the condition surgically.

Mini-Bentall Surgery: The Right Thoracotomy Approach

  • Jawarkar, Manish;Manek, Pratik;Wadhawa, Vivek;Doshi, Chirag
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.554-557
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    • 2021
  • Surgeons are increasingly using the right mini-thoracotomy approach to perform aortic valve surgery. This approach has shown better results in terms of blood loss and length of hospital stay than the sternotomy approach. For selected patients requiring aortic root and ascending aorta surgery, a right mini-thoracotomy approach may prove beneficial. In our technique, we placed a 5-cm horizontal skin incision in the right second intercostal space. Femoro-femoral cardiopulmonary bypass was established. A valved aortic conduit was used for aortic root replacement. The patient's postoperative course was uneventful, with a short hospital stay. This technique offers a minimally invasive approach to aortic root and ascending aorta surgery with easy adaptability and reduced costs.

Effects of Water Extract of Sobokchuko-tang on Rat Blood Vessels (소복축어탕(小腹逐瘀湯)이 흰쥐 흉부대동맥의 혈관운동성에 미치는 영향)

  • Jung, Yong-Sik;Kwon, Jung-Nam;Min, Sung-Soon;Kim, Jong-Deuk;Lee, Sang-Hee;Kim, Jae-Kyu;Heo, Jeong-Eun;Kim, Young-Kyun
    • The Journal of Internal Korean Medicine
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    • v.27 no.3
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    • pp.629-638
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    • 2006
  • This study was carried out to examine the relaxational response to the water extract of Sobokchuko-tang (SCT) in rat thoracic aorta. Segments of thoracic aorta obtained from rats immediately after delivery were mounted in organ baths superfused on a polygraph. It was found that the thoracic aorta segments responded to the SCT with dose-dependent vasorelaxation. At $10^{-7}M$ phenylephrine-induced contraction, the contractile response of thoracic aortic rings were inhibited by 99.2%. 75.3%. 42.4% and 35.8% after addition of the respective concentration (1O. 30. 100. $300{\mu}g$/ml) of SCT. This vasorelaxation of rat thoracic aorta was endothelium-dependent. The action mechanisms of vasorelaxation are thought to be concerned with the role of NO. cAMP and cyclooxygenase. but not with cGMP.

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Risk Factor Analysis for Spinal Cord and Brain Damage after Surgery of Descending Thoracic and Thoracoabdominal Aorta (하행 흉부 및 흉복부 대동맥 수술 후 척수 손상과 뇌손상 위험인자 분석)

  • Kim Jae-Hyun;Oh Sam-Sae;Baek Man-Jong;Jung Sung-Cheol;Kim Chong-Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.440-448
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    • 2006
  • Background: Surgery of descending thoracic or thoracoabdominal aorta has the potential risk of causing neurological injury including spinal cord damage. This study was designed to find out the risk factors leading to spinal cord and brain damage after surgery of descending thoracic and thoracoabdominal aorta. Material and Method: Between October 1995 and July 2005, thirty three patients with descending thoracic or thoracoabdominal aortic disease underwent resection and graft replacement of the involved aortic segments. We reviewed these patients retrospectively. There were 23 descending thoracic aortic diseases and 10 thoracoabdominal aortic diseases. As an etiology, there were 23 aortic dissections and 10 aortic aneurysms. Preoperative and perioperative variables were analyzed univariately and multivariately to identify risk factors of neurological injury. Result: Paraplegia occurred in 2 (6.1%) patients and permanent in one. There were 7 brain damages (21%), among them, 4 were permanent damages. As risk factors of spinal cord damage, Crawford type II III(p=0.011) and intercostal artery anastomosis (p=0.040) were statistically significant. Cardiopulmonary bypass time more than 200 minutes (p=0.023), left atrial vent catheter insertion (p=0.005) were statistically significant as risk factors of brain damage. Left heart partial bypass (LHPB) was statistically significant as a protecting factor of brain (p=0.032). Conclusion: The incidence of brain damage was higher than that of spinal cord damage after surgery of descending thoracic and thoracoabdominal aorta. There was no brain damage in LHPB group. LHPB was advantageous in protecting brain from postoperative brain injury. Adjunctive procedures to protect spinal cord is needed and vigilant attention should be paid in patients with Crawford type II III and patients who have patent intercostal arteries.

Acting Mechanisms of Extracellular$Ca^{2+}$ and $Ca^{2+}$ - antagonists on Endothelium - Derived Relaxing Factor in Rabbit Aorta. (내피세포성 이완인자에 대한 세포외 $Ca^{2+}$$Ca^{2+}$-길항제의 작용기전)

  • 진성훈
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.229-244
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    • 1991
  • A bioassay technique and organ bath study were performed to analyze the effects of extracellular $Ca^{2+}$ and $Ca^{2+}$-antagonists on endothelium-derived relaxing factor[s][EDRF] released from the endothelial cells of rabbit aorta. Transverse strips with intact endothelium or damaged endothelium were used for the mechanical contraction experiment using organ bath. Long segment including thoracic and abdominal aorta with endothelium [EDRF donor aorta] was perfused with Tyrode solution which was aerated with 95% $O_2-5%$ $CO_2$ mixed gas and kept at 35oC. The perfusate was bioassayed with a transverse strip of thoracic aorta with damaged endothelium. The test strip was contracted with nor-epinephrine and acetylcholine was used to stimulate the release of EDRF from endothelial cells. The results obtained were as follows; 1] The endothelium-dependent relaxation[EDR] induced by acetylcholine was biphasic; an initial rapid relaxation followed by a slow relaxation. 2] EDR induced by acetylcholine was reduced gradually with the decrease in the concentration of extracellular $Ca^{2+}$. The effect of extracellular $Ca^{2+}$ on EDR was more prominent in the late slow relaxation phase. 3] EDR to acetylcholine was not altered by acute exposure to organic $Ca^{2+}$-antagonists. Pretreatment with verapamil to the EDRF donor aortic segment did not alter the magnitude of EDR. 4] Among the inorganic $Ca^{2+}$-antagonists $Mn^{2+}$ and $Cd^{2+}$ did not inhibit EDR, whereas $Co^{2+}$ and $La^{3+}$ inhibited EDR. 5] The inhibitory response of $Co^{2+}$ to EDR developed when infused directly on the test strip. That of $La^{3+}$, however, was evoked when added to solution perfusing the donor aortic segment. The above results suggest that $Ca^{2+}$-antagonists do not affect EDR and the inhibitory effect of $Ca^{2+}$ results from influencing the action of EDRF on vascular smooth muscle, whereas that of $La^{3+}$ results from its action on the release of EDRF from endothelial cells.

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