• Journal of Chest Surgery
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• v.22 no.3
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• pp.416-424
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• 1989

We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.

• Journal of Chest Surgery
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• v.45 no.1
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• pp.49-52
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• 2012

A coronary-bronchial artery fistula is a very rare congenital anomaly of the coronary artery whose etiology and pathogenesis have not yet been clarified. Most patients with coronary-bronchial fistulas are asymptomatic; however, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Furthermore, patients with a coronary-bronchial artery fistula rarely manifest life-threatening hemoptysis due to the associated bronchiectasis. We report herein the case of a patient with a coronary-bronchial artery fistula who had bronchiectasis and a history of massive hemoptysis and myocardial ischemia.

• Tuberculosis and Respiratory Diseases
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• v.65 no.6
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• pp.546-549
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• 2008

Bronchial artery aneurysm (BAA) is a rare entity that requires early diagnosis and immediate treatment due to the possibility of a life-threatening massive hemorrhage through rupture. The standard treatment is a surgical resection of the aneurismal artery. However, various embolization techniques, including coil embolization, are currently used as the optimal treatment because they are less invasive. A 65-year-old woman was referred for the treatment of intermittent hemoptysis. A chest CT scan showed an approximately 2 cm sized vascular mass with strong contrast enhancement originating from the right bronchial artery on the bronchiectatic parenchyma. On the angiogram, the inferior portion of the bronchial artery with a hypertrophic aspect and a huge bronchial artery aneurysm was detected on the left side branch. The bronchial artery aneurysm was embolized successfully with coils at the proximal and distal portion of the aneurysm. After coil embolization, the selective bronchial angiogram confirmed complete occlusion. We report this case of a bronchial artery aneurysm that was treated successfully with coil embolization.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.62-66
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• 2007

A bronchial artery aneurysm is a rare condition, which needs optimal treatment due to the possibility of a life-threatening hemorrhage by rupture. The surgical removal of the aneurysm is the standard treatment. However, there are a few reports of coil embolization with a transcatheter. A 69 year-old man was referred for a further evaluation of a mass in the right hilum on chest radiography. He denied any respiratory symptoms. A chest CT scan showed a $3{\times}3{\times}4.5cm$ sized vascular mass with strong contrast enhancement on the right hilar area that originated from the bronchial artery. On the angiogram, the bronchial artery originated from the descending thoracic aorta at the T8 level. A bronchial artery aneurysm was catheterized selectively. and embolized successfully with a coil. After coil embolization, the selective bronchial arteriography confirmed complete occlusion. We report this case of bronchial aneurysm that was treated successfully with coil embolization.

• Journal of Chest Surgery
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• v.51 no.2
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• pp.153-155
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• 2018

Concomitant rupture of the subclavian vessels and the left main bronchus caused by blunt trauma is a serious condition. Moreover, the diagnosis of a tracheobronchial injury with rupture of the subclavian vessels can be difficult. This report describes the case of a 33-year-old man who suffered from blunt trauma that resulted in the rupture of the left subclavian artery and vein. The patient underwent an operation for vascular control. O n postoperative day 3, the left main bronchus was found to be transected on a computed tomography scan and bronchoscopy. The transected bronchus was anastomosed in an end-to-end fashion. He recovered without any notable problems. Although the bronchial injury was not detected early, this case of concomitant rupture of the great vessels and the airway was successfully treated after applying extracorporeal membrane oxygenation.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.430-434
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• 2007

Massive and untreated hemoptysis is associated with a >50% mortality rate. Since bleeding has a bronchial arterial origin in most patients, bronchial artery embolization (BAE) has become an accepted treatment in massive hemoptysis. The possibility of bleeding from pulmonary artery should be considered in patients in whom the bleeding focus cannot be found by Bronchial angiogram. Indeed, the bleeding occurs from a pulmonary artery in approximately 10% of patients with massive hemoptysis. The most common causes of bleeding from the pulmonary artery are pulmonary artery rupture associated with a Swan-Ganz catheter, infectious diseases and vasculitis. We report a rare case of a fistula between the right upper lobar pulmonary artery and the right upper lobar bronchus in a 71-year-old woman who presented with massive hemoptysis.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.356-363
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• 1992

We have performed left lung transplantations in 15 dogs for one year and six months from June, 1990 to December, 1991 at the Repartment of Thoracic and Cardiovascular Surgery Yonsei University College of medicine, Seoul, Korea. These dogs were sacrificed at from operative day to post-operative 15 days when their general conditions were deteriorated. The gross findings of the transplanted lungs were thrombi in left atrium in three cases, partial occlusion of pulmonary artery or pulmonary veins in three cases, hemorrhage at pulmonary arterial anastomotic site in one case and bronchial anastomotic stenosis in two cases, bronchial anastomotic rupture in one case % no abnormal gross findings in four cases. The microscopic findings of the transplanted lungs were hemorrhagic infarction in one case, perivascular hemorrhage or pulmonary edema in two cases, peribronchial inflammatory cell infiltration & pneumonia in three cases, and alveolar type rejection with infiltration of type II pneumocytes and septal thickening in 3 cases. And also there were no abnormal findings including rejection or inflammatory evidences in six cases. The one among these six dogs survived to 15 days without evidence of rejection or inflammatory reaction & died due to postoperative care accident.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.722-725
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• 1986

Rupture of the main bronchus following closed injury to the chest is a comparatively rare accident. The late recognition of this injury is attended by difficulties in management which may endanger life or expose the patient to distressing months and years of arduous therapy. This case was a 17 year old female who was a high school student. The patient had sustained a crushing injury to her right hemithorax and had been taken to an emergency hospital where right closed thoracostomy had been performed for a tension pneumothorax. She improved following this procedure but massive atelectasis of the right lung developed on the 13th day after trauma and transferred to our hospital. Bronchoscopy disclosed granulation tissue in the right main stem bronchus and end to end anastomosis of the bronchus was performed. Postoperative course was uneventful.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.38-43
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• 1977

With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.905-915
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• 1990

A clinical evaluation was performed on 545 cases of the chest trauma those had been admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 11 years 5 months period from January 1978 to may 1989. Obtained results were as follows: 1. The ratio of male to female was 3.9: 1 in male predominance, and the majority[66.6%] was distributed from 3rd to 5th decade. 2. Nonpenetrating chest trauma was more common than penetrating about 4.6 times, and the most common cause of the nonpenetrating injuries was traffic accident[241/448, 53.8%] and of the penetrating injuries was stab wound[88/97, 90.7%]. 3. Only 79 cases[14.5%] were arrived to our emergency room within one hour after trauma. 4. The most common lesion due to trauma among these admitted patients was rib fracture[390/545, 71.6%], and the others were lung contusion[217/545, 39.8%], hemothorax[35%], hemopneumothorax[19.6%], and pneumothorax[11.8%] et al in decreasing order. 5. The associated injuries those required special treatment of other departments were 223 cases and its distributions were bone fractures[178/545, 32.7%], head injury[5.3%], and abdominal injury[6.6%]. 6. The others, but interesting chest injuries were follows: sternum fracture[3.1%], diaphragm rupture[2.6%], myocardial laceration and rupture[2 cases], bronchial rupture and laceration[2 cases], and traumatic thymoma rupture[1 case]. 7. The incidence of flail chest was 5.8%a[26/448] in the nonpenetrating injury, and the causes were multiple rib fracture which was in rows more than 4 rib fracture[20 cases], and sternum fracture[6 cases]. 8. We could managed the most of the patient with conservative treatment[43.1%] or closed tube thoracostomy[52.7%], but required emergency open thoracotomy in 64 cases