• Journal of Chest Surgery
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• v.21 no.5
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• pp.889-893
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• 1988

We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.524-527
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• 2009

A stent graft has been accepted as an alternative method for treating aortic diseases or to reduce the extent of surgery. We report here on a one-stage Management of Ascending Aorta Replacement and Percutaneous Endovascular Repair for the seperate aneurysmal lesions on the ascending and descending aorta.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.645-648
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• 2009

We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal. aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the $4^{th}$ postoperative day.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.425-428
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• 2021

Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.36-45
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• 1985

During the twelve-year period from March 1973 through July 1984, 23 consecutive operations for coarctation of the aorta were performed at Seoul National University Hospital. The patients included 19 male and 4 female in the range of 4 months and 16 years old. Associated cardiac anomalies were present in 19 patients [70%] and they were VSD+PDA [9 patients], VSD[2], PDA[1], VSD+ASD+PDA[1], VSD+MS+AS+PDA[1], D-TGA+VSD+PDA[1], P-ECD[1], MS[1], Al[1], and DORV+PDA[1]. The preoperative main symptoms included congestive heat failure, hypertension, subacute bacterial endocarditis and nonspecific symptoms. Congestive heart failure was the most common symptom in the group younger than 2 years and hypertension in the adult group. Operative techniques for coarctation of the aorta were resection and end to end anastomosis in 10 patients, prosthetic patch aortoplasty in 8, subclavian flap aortoplasty in 4, and LSCA-aortic anastomosis in 1. There were 4 operative deaths among the nine patients less than 2 years old[44.4% mortality]: all of these patients had associated cardiac anomalies. And only one operative death occurred in patients older then 2 years old[7.1% mortality]. No hospital death occurred in patients with isolated coarctation of the aorta. Operation of the coarctation was performed primarily in 6 patients associated with ventricular septal defect and subsequently underwent successful VSD closure except one operative death.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.173-177
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• 1998

A 28 years old pregnant woman(Gestational age 35 weeks) had been operated emergency Cesarian section for delivery and emergency graft replacement of ascending aorta and total arch for acute type A aortic dissection. 1 year and 6 months later, she underwent aortic graft replacement from descending thoracic aorta to both common iliac arteries because of further progression of aortic dissection. So far she has a complete artificial graft aorta.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.352-356
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• 1991

From April, 1981, to April, 1990, 20 male and 7 female patients ranging in age from 17 to 63, were operated on for aortic insufficiency with an aneurysm of the ascending aorta. Ten patients were in New York Heart Association functional class II, 7 in class III, and ten in class IV. The surgical treatment in all cases consisted of total replacement of the ascending aorta with composite graft containing a prosthetic aortic valve and reimplantation of the coronary arteries by an intermediate tube graft. In 15 patients an uncomplicated annulo-aortic ectasia existed, and in 12 an aortic dissection; three of the latter group were operated during the acute phase. 17 patients showed typical Marfan syndrome, and 3 patients showed severe ascending aortic aneurysm secondary to the aortic valve disease. The overall operative mortality was 7%[2 deaths]. Those 2 deaths occurred following emergency operation due to associated aortic dissection, but no death during elective operation. All survivors have been followed-up during a period ranging 1 to 108 month[average 34 months]. There was no late mortality. Among the survivors, clinical improvement is readily apparent[2,3 in class I, 2 in class II ]. In conclusion, the treatment of aortic insufficiency associated with an aneurysm of the ascending aorta by insertion of a composite graft and reimplantation of the coronary arteries through an intermediate Dacron tube is a reliable method with low mortality and excellent results.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.968-971
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• 2001

Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.135-140
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• 2009

Background: Chronic rejection after a cardiac allograft usually occurs about six months after the operation. Vasculopathy due to chronic rejection causes atherosclerosis in the coronary artery of the transplanted heart and then this causes myocardial injury. We intended to discover and document those findings that occur in a transplanted ascending aorta. Material and Method: In rats weighting $200{\sim}300gm$ (Spraque-Dawley rat), we carried out heterotopic heart allo-transplantation with the modified Ono-Lindsey method and then the rats were administrated cyclosporine (10mg/kg/day). After three months survival, we acquired biopsy materials from the native ascending aorta and the allo-transplanted ascending aorta and we compared them. We classified each severity of 1) intimal thickening, 2) medial hyperplasia, 3) medial calcification, 4) medial inflammation and 5) chondroid metaplasia, which are specific biopsy findings for chronic rejection after a cardiac allograft. Each severity was classified, according to the opinion of one pathologist, in the native ascending aorta biopsies (n=9) and the allo-transplanted ascending aorta biopsies (n=13). The data of the control group and the study group were statistically analyzed with using the Mann-Whitney test (SPSS version 12.0 window). Result: The important changes of the allo-transplanted aorta were intimal thickening (p<0.0001), medial calcification (p=0.045), medial inflammation (p<0.0001) and chondroid metaplasia (p=0.045), but not medial hyperplasia (p=0.36). Conclusion: Cardiac allograft vasculopathy was seen in the transplanted ascending aorta, the same as was seen in the coronary artery, after allograft cardiac transplantation. We have reached the conclusion that chronic rejection also progresses in the aorta.