• Title/Summary/Keyword: Aortic disease

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Anomalous right coronary artery from pulmonary artery discovered incidentally in an asymptomatic young infant

  • Kim, Kyu Seon;Jo, Eun Young;Yu, Jae Hyeon;Kil, Hong Rang
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.80-83
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    • 2016
  • Isolated anomalous right coronary artery originating from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that is asymptomatic and discovered incidentally in most cases. ARCAPA is generally not considered a fatal defect in infancy or childhood, although cases of sudden death have been reported. Here, we report a 2-month-old female infant who presented with a prolonged fever that was determined to be caused by rhinovirus infection. Myocardial ischemia of the left ventricular posterior wall was already seen on echocardiography, and ARCAPA was discovered incidentally. The patient underwent successful surgical reimplantation of the right coronary artery to the aortic root to re-establish dual ostial circulation.

Posterior reversible encephalopathy syndrome caused by presumed Takayasu arteritis

  • Lee, Ki Wuk;Lee, Sang Taek;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.145-148
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    • 2016
  • Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology that affects mainly the aorta, main aortic branches, and pulmonary arteries. Diverse neurological manifestations of TA have rarely been reported in children. Posterior reversible encephalopathy syndrome (PRES) is a neuroradiological condition that presents with headache, seizure, visual disturbances, and characteristic lesions on imaging. Inflammatory condition and severe hypertension in TA can cause PRES. We report of a 5-year-old girl with presumed TA who presented with PRES and chronic total occlusion in the renal artery. The findings on magnetic resonance imaging suggested PRES. Left nephrectomy was performed for total occlusion of the left renal artery, and the confirmatory diagnosis of TA was based on the pathologic findings of the renal artery.

Ventricular Septal Defect Associated With Patent Ductus Arteriosus -A Report Of 7 Cases- (개방성 동맥관 합병 심실중격결손증 -7례 보고-)

  • 이상호
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.233-239
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    • 1979
  • Ventricular septal defect associated with patent ductus arteriosus is well known cardiac anomaly that can be treated successfully by operation. This anomaly is found at low frequency. Seven cases of the combined malformation were operated on during the period from 1959 to 1978 in the Department of Thoracic Surgery, Seoul National University Hospital. Right heart catheterization and retrograde aortogram can diagnose the disease correctly. Staged operation in one case and one-stage operation in 5 patients were done. In all cases of the open heart surgery the closure of the ductus was done by transpulmonary suture of the PDA opening. Among 6 patients of the open heart surgery 2 operative death [33.3%] and one late death [total 50%] were noted. Four type II and one type I and one Type IV VSDs were found. In one case the anomaly was accompanied with aortic insufficiency by herniation of the right coronary cusp through Type I VSD.

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Evaluation of Myocardial Damage during Open Heart Surgery (enzymatic and electrocardiographic evaluation) (개심술시의 심근손상에 관한 고찰)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.41-47
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    • 1980
  • Fifty one consecutive patients undergoing open heart surgery, twenty eight congenital and twenty three acquired heart disease, were studied between May and August 1979 in Dept. of Thoracic and Cardiovascular Surgery SNUH. During the same time 10 patients of PDA were included in this study as control group. Four out of fifty one OHS patients, two ASD and two pulmonic stenosis patients, were operated without aortic cross-clamp. In all patients, serial determination of total level of creatine phosphokinase [CPK], lactic dehydrogenase [LDH], glutamic oxaloacetic transaminase [SGOT] were made preoperatively, operative day [immediate post-op], and post-operative days up to 7th day. Electrocardiograms were also evaluated serially. Open heart surgery patients were divided into two groups; Group A was aorta clamp time beyond SO minutes, and Group B was below 50 minutes. The peak level of each enzyme was compared, and electrocardiographic changes were also compared between groups. Although the electrocardiographic changes were more frequent in Group A [50%] than Group B [24%], the peak levels of each enzymes were almost same in Group A and Group B.

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Surgical treatment of Takayasu's arteritis : Report of one case (Takayasu씨 동맥염의 수술치험 1예)

  • 조인택
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.489-493
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    • 1986
  • Takayasu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries such as aorta and its branches, pulmonary arteries, and rarely coronary arteries. The late pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. the disease occurs predominantly in females, with the age of onset between 10 and 30 years. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch and all its major branches. The patient was 36 year-old female and she was admitted because of headache, blurred vision, and easy fatigability and motor weakness of upper extremities. Aortogram revealed total obstruction of both carotid arteries at the site of its origin and partial irregular obstructive change in the innominate artery and both subclavian arteries. Bypass graft surgery using Gore-Tex grafts was performed with successful result.

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Total Correction of Mixed Type Total Anomalous Pulmonary Venous Return 1 Case (혼합형 총폐정맥환류이상 수술치험 1례)

  • 편승환;서정욱
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.213-218
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    • 1996
  • Total anomalous pulmonary venous return (TAPVR) is very rare congenital heart disease. 25-year old male was admitted our hospital with dyspnea, headache and syncope as chief complaint. He was confirmed as mixed type TAPVR by echocardiography and cardiac catheterization. In this case, mixed type TAPVR was consisted with supracardiac type connection of left pulmonary vein and cardiac type of right pulmonary vein. Supracardiac type of left pulmonary common channel was anastomosed to the left auricular appendage during total cardiopulmonary bypass with fibrillating heart. Cardiac type of right pulmonary vein was operated during moderate hypothermia and aortic cross clamping. Coronary sinus septum was incised into ASD and closed with Gore-Tex patch so that right pulmonary blood flow directed to the left atrium. The patient's post-operative course was uneventful.

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Undifferentiated Pleomorphic Sarcoma of the Descending Thoracic Aorta Mimicking Pseudoaneurysm with Periaortic Hematoma: a Case Report

  • Kim, Minsu;Bae, Young-A;Byeon, Sun-Ju;Choi, Jung-Ah
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.2
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    • pp.162-166
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    • 2019
  • Undifferentiated pleomorphic sarcoma (UPS) arising from the descending thoracic aorta is a rare type of tumor. To our knowledge, only a few cases have been reported in the literature. We present computed tomography (CT) and magnetic resonance imaging findings of a 43-year-old male patient with undifferentiated pleomorphic sarcoma of the descending thoracic aorta, which showed enhancement on only magnetic resonance imaging (MRI). MRI with contrast enhancement may be useful in differentiating an aortic tumor from atherosclerotic disease.

Staged Surgical Treatment of Primary Aortoesophageal Fistula

  • Hwang, Sun Hyun;Cho, Jun Woo;Bae, Chi Hoon;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.182-185
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    • 2019
  • Aortoesophageal fistula (AEF) is a rare and potentially fatal disease that causes massive gastrointestinal bleeding. Therefore, early diagnosis and treatment are essential to prevent mortality. Controlling the massive bleeding is the most important aspect of treating AEF. The traditional surgical treatment was emergent thoracotomy, but intraoperative or perioperative mortality was high. We report a case of a patient presenting with hematemesis who was successfully treated by a staged treatment, in which bridging thoracic endovascular aortic repair was followed by delayed surgical repair of the esophagus and aorta.

Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

  • Eun Ji Lee;Jihoon T. Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.276-280
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    • 2023
  • Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

A study on improvement of misdiagnosis rate in aortic regurgitation disease by physically correcting EF in 2D echo cardiography (대동맥판 역류질환 진단시 이면성심초음파 박출계수의 보정을 통한 오진율 개선에 관한 연구)

  • Choi, Kwan-Woo;Son, Soon-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2142-2147
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    • 2012
  • This study is aimed at decreasing wrong diagnosis with corrected EF(Ejection Fraction) of 2D echo cardiography by analysing the physical time-resolution difference between Cine MRI and 2D echo cardiography and applying the corrected EF in 2D echocardiography. From February 2010 to December 2011, among the 110 patients who had undergone both 2D echo cardiography and cine MRI only 37 patient were selected suffering aortic valve regurgitation. ED, ES and SV were measured and EF was calculated in each system while normal ranges of Cine MRI and 2D echocardiography were compared to evauate misdiagnosis rate. The correlation of physical time resolution between 2D echocardiography and MRI was evaluated and the differences were corrected with linear regression coefficient which is derived from linear regression analysis. Blandt-Altman plot was used to evaluate the reliability of corrected 2D echo cardiography EF and compare the error among measured values. The values were compared with MRI normal range and misdiagnosis rate was measured again. As a result, misdiagnosis rates of physical time resolution were measured to be 32.4%(12people) before the correction of EF and 18.9%(7people) after the correction. Also, EF confirmed in Blandt-Altman plot were almost the same with MRI EF. In conclusion, when diagnosing aortic regurgitation disease, simply using 2D echocardiography can easily raise the misdiagnosis rates, therefore considering the MRI machine's physical merits, correcting the time resolution difference is important by calculating time resolution wrong diagnosis would decrease and it is considered to be useful in clinical circumstances.