• Journal of Chest Surgery
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• 제28권8호
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• pp.797-800
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• 1995

Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

• Journal of Chest Surgery
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• 제42권5호
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• pp.645-648
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• 2009

저자들은 우리나라에서는 처음으로 복강경을 이용한 수기보조 방법으로 복부 대동맥류 치환술을 시행하였다. 환자는 67세 남자였으며, 복부 대동맥류의 직경은 약 5.8 cm였다. 첫 단계로 상복부에 6 cm 절개선을 내고, 복강경하에서 집도의의 왼손을 이용하여 대동맥류 주위를 박리하였다. 근위부 문합은 절개창을 통하여 직접 하였으며, 인조혈관의 양쪽 다리를 후복막을 통하여 양족 서혜부에서 총대퇴동맥과 단측문합하였다. 환자는 술 후 6시간 후 경구 식이를 시작하였으며, 술 후 4일째 퇴원하였다.

• Journal of Chest Surgery
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• 제16권3호
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• pp.301-309
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• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Chest Surgery
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• 제36권3호
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• pp.189-193
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• 2003

생후 30일된 환아로 심한 호흡곤란과 청색증을 주소로 본인 응급실로 이송되었다. 심초음파상 Taussig-Bing 기형으로 진단되어 입원 2일째 긴급 수술을 하였다. 수술은 심실중격 결손을 혈류가 좌심실에서 폐동맥으로 가도록 복원하고 대동맥 전위술을 하였다. 퇴원 후 외래에서 시행한 단순 흉부촬영상 심비대의 유의한 감소가 없어 재입원을 한 후 심혈관 촬영술을 하였고, 대동맥 축착이 추가로 관찰되었다. 이에 대한 교정술을 하였으며, 환아는 큰 문제없이 회복되어 11개월 간 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제12권3호
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• pp.174-182
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• 1979

This is a report on four cases of successful surgical correction of coarctation of the aorta [COA] in Department of the Thoracic & Cardiovascular Surgery, Hanyang University Hospital. The first case was a postductal type of coarctation of the aorta associated with Patent ductus arteriosus [PDA], Persistent left superior vena cava [LSVC] and richly developed collateral circulation. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. The coarctation of the aorta was corrected with following procedure: Partial resection of the aortic wall with diaphragmatic structure lust above and below the coarctating line of the aorta, and then the defect of the aortic wall was closed by lateral aortographic suture. PDA was closed by ligation procedure. The second case a preductal type of coarctation of the aorta associated with PDA, LSVC, ventricular septal defect [VSD] and poorly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Correction of coarctation of the aorta was performed under the establishment of tube bypass because of poor collateral circulation. After resection of coarctating short segment, end to end anastomosis was performed without any tension. PDA was closed by division procedure. Simple suture closure of VSD was performed by open heart surgery two weeks after correction of COA. The third case was a long segment COA without any other anomaly. Blood pressure was measured to be hypertensive at the arm, but hypotensive at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.5 cm] of the aorta. The fourth case was a long segment COA associated with aortic insufficiency and richly developed collateral circulation. Normal blood pressure was measured at the arm, but hypotension was observed at the legs. Vascular prosthesis was performed using Teflon graft tube after resecting coarctating long segment [6.0 cm] of the aorta. Both blood pressure and peripheral pulse on the arm and the legs returned to normal postoperatively in all patients.

• Journal of Chest Surgery
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• 제27권11호
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• pp.961-964
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• 1994

The pulmonary sequestration is an uncommon congenital anomaly characterized by the presence of nonfunctioning lung tissue supplied by aberrant artery from the aorta or its branches and usually has no communication with the normal bronchial tree. The patient was 35 year old female and had no specific complaints. The lung mass was found incidentally and was continned to be intralobar pulmonary sequestration by aotography whitch showed aberrant blood supply from thoracic aorta at the T. vertebra level. The right lower lobectomy was done.

• Journal of Chest Surgery
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• 제47권1호
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• pp.6-12
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• 2014

Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.

• Journal of Chest Surgery
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• 제49권2호
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• pp.122-125
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• 2016

Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications.

• Journal of Chest Surgery
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• 제38권5호
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• pp.385-388
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• 2005

대동맥 벽내혈종은 아직까지 확립되지 않은 임상양상이며, 이의 치료 또한 이견이 있다. 본 저자들은 혈심낭을 동반한 파열된 벽내혈종의 수술적 치료를 치험하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제43권1호
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• pp.92-95
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• 2010

고위험군의 대동맥 질환 환자에서 고전적인 수술에 대한 대안책으로서 혈관내 스텐트 그라프트를 고려할 수 있다. 본원에서는 유방암에 대한 항암 방사선 치료로 인한 전 흉부 괴사와 그에 따른 상행 대동맥 파열이 발생한 79세 여자 환자에 대해 혈관내 스텐트 그라프트를 이용하여 효과적으로 치료하였기에 문헌 고찰과 함께 보고하는 바이다.