• Title/Summary/Keyword: Bypass, graft

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Takayasu`s Arteritis: A case Report (Takayasu 씨 동맥염 - 치험 1례)

  • 송진천
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.402-406
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    • 1990
  • Recently we have experienced a case of Takayasu’s arteritis involving both common carotid artery, left subclavian artery, left renal artery, and the right pulmonary artery. The patients was 27 year-old female and she was admitted because of neck pain, dizziness and palpitation. Renal artery angioplasty with Griintzig balloon catheter was performed with successful result. And then bypass graft surgery using bifurcated Gore- Text graft was performed with satisfactory result.

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Superior Mesentic Artery Aneurysm -A Case Report- (상장간막동맥류의 수술적 치료 -1례 보고-)

  • 신재승
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.948-952
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    • 1994
  • Superior mesenteric artery aneurysm is the third most common lesion and comprises approximately 5.5 % of all visceral artery aneurysms. The first successful repair was performed by DeBakey and Cooley in 1949. Since then, more than 100 cases have been reported. Fifty to sixty percent of these aneurysms are mycotic in origin. Other less frequent causes include arteriosclerosis, trauma, and medial degeneration. The operations are bypass with autologous tissue or with artificial vascular graft and aneurysmorrhaphy. We have experienced a case of superior mesenteric artery aneurysm which had undergone aneurysmectomy and artificial graft interposition. This is the first domestic case which was successful surgical repaired.

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Benign superior vena cava syndrome -A case report- (양성 상공정맥 증후군 -1예 보고-)

  • 한병선
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.449-452
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    • 1986
  • A patient with benign superior vena cava syndrome caused by the thrombus and fibrotic membrane in superior vena cava is described. Surgical treatment of superior vena cava syndrome remains controversial still. After endvenectomy and thrombectomy of superior vena cava, angioplasty with use of Gore-Tex patch and bypass graft using 10mm diameter Dacron vessel graft from left innominate vein to right atrial appendage were performed. The early postoperative course was uneventful with achievement of good decompression. But 12 months later, the symptoms of superior vena cava syndrome were reoccurred.

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Comparison of Saphenous Vein and PTFE Grafts for Above the Knee Femoropopliteal Bypass Grafting (슬상부 대퇴동맥-슬와동맥 우회이식술에서 복재정맥과 PTFE 이식편의 비교)

  • Kim, Han-Yong;Kim, Jong-Seok;Kim, Myoung-Young;Hwang, Sang-Won;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.127-132
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    • 2010
  • Background: Femoropopliteal artery bypss grafting is an effective form of treatment for infrainguinal artery occlusive disease in those patients who have either intermittent claudication or resting critical ischemia. The objective of this analysis was to evaluate the long-term patency of a femoropopliteal bypass graft that is classified as an above-the-knee saphenous vein graft or an above-the-knee PTFE (polytetrafluoroethylene) graft. Material and Method:From January 1998 to February 2005, 103 above-the-knee femoro-popliteal bypasses were performed on 87 patients. There were 74 male and 13 female patients with a mean age of $65.7{\pm}9.69$ (range: 31~82). The surgical indications were intermittent claudication in 65 cases (74.7%), foot ulceration in 2 cases (2.3%), foot necrosis in 10 ases (11.5%) and toe necrosis in 10 cases (11.5%). For the bypass graft, a reversed saphenous vein was used in 31 limbs and a polytetrafluoroethylene (PTFE) prosthesis was used in 72 limbs (6 mm: 27 limbs, 8 mm: 45 limbs). The perioperative risk factors were diabetes mellitus in 33 cases (37.9%), hypertension in 47 cases (54.0%), a history of ischemic heart disease in 13 cases (14.9%) and smoking in 72 cases (82.8%). Result:There were three perioperative deaths (3.4%) and seven late deaths (8.3%). Major leg amputation was necessary in 12 patients (13.8%) during the entire course of the study. The primary patency rate at 5 years for the vein grafts, the 8 mm-PTFE grafts and the 6 mm-PTFE grafts were 84.7%, 77.4% and 74.2%, respectively and the overall primary patency rate was 78.7%, and there were no significant statistical differences among the graft groups. By using multivariate analysis, the number of patent tibial arteries was determined to be a significant factor that influenced the primary graft patency rate (p<0.005), but risk factors such as diabetes mellitus, ischemic heart disease, smoking and age had no statistically significant affect on the primary graft patency rates. Conclusion: The great saphenous vein is considered the most durable conduit for infrainguinal revascularization, but the overall results of this study show that saphenous vein and PTFE grafts have comparable patency rates when used above the knee in patients with claudication or critical ischemia. The use of PTFE above the knee is a reasonable alternative for a femoro-poplitael bypass and it is associated with acceptable long term patency rates.

Surgical Treatment of Coronary Artery Occlusive Disease (관상동맥협착증의 외과적 치료 -6례 보고-)

  • 이재동
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.842-849
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    • 1988
  • Between July, 1987, and September, 1988, 6 patients with coronary occlusive disease received coronary artery bypass surgery at Kyungpook University Hospital. There were five males and one female whose age ranged from 39 to 64 years[mean 54*8.0 years]. Of the 6 patients, 5 suffered from unstable angina, 1 suffered from stable angina. Selective coronary angiography revealed a significant stenosis of the left anterior descending artery in 6 cases, of its diagonal branch in 1 case, of the right coronary artery in 1 case, the circumflex artery in 1 case, and of its obtuse marginal branch in 1 case. The mode of anastomosis were single saphenous vein graft in 3 cases, single left internal mammary artery graft in 1 case, double saphenous vein graft with sequential anastomosis in 1 case, and left internal mammary artery plus saphenous vein graft in 1 case. Of these, 6 grafts to left anterior descending artery were done. There was no operative death, but perioperative myocardial infarction was happened in 1 case. All survivors were free of angina and discontinuing medical therapy during the follow up period[mean 7.8*5.15 months].

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One Stage Facial Nerve Reconstruction by Great Auricular Nerve Graft bypassing the Petrous Bone - A Case Report - (대이개신경 이식을 이용한 추체골 우회 안면신경 재건술)

  • Park, Hyeon-Seon;Cho, Kyung-Gi;Chung, Sang-Sup
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.42-45
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    • 1993
  • Although various methods had been reported for reanimination of facial nerve palsy, interposition nerve graft remains superior to other methods if there is a wide gap to be bridged. Dott described a excllent facial nerve reconstruction by sural nerve graft bypassing petrous bone. But his method needs two surgical fields and is performed in two stages. Authors desribe a traumatic facial nerve palsy treated by one stage facial nerve reconstruction that is performed in one surgical field by using a great auricular nerve interposition graft and bypass the petous bone.

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Surgical treatment of the aortic aneurysm (대동맥류의 외과적 요법)

  • 신현종
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.90-94
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    • 1989
  • Ten patients underwent operation for aortic aneurysms from Jan. 1983 to April 1988 at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Hospital. There were 7 males and 3 females in this series. The age ranged from 16 to 70 years with the mean age of 45 years. The cause of the aneurysm was atherosclerosis in 8 patients, mycosis in 1 patient and unknown in 1 patient. There were two patients with ascending aortic aneurysm treated by Dacron graft replacement, with no hospital death. One patient with aortic arch aneurysm was received Dacron graft replacement under cardiopulmonary bypass and died on the 21st postoperative day because of cerebral edema. There were three patients with descending aortic aneurysm. The aneurysm in two patients was successfully repaired by Dacron graft. One additional patient with ruptured aneurysm died at operation because of ventricular fibrillation. Four patients with abdominal aortic aneurysm were underwent Dacron graft replacement and the results were good.

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A Case of Surgical Treatment of the Abdominal Aortic Graft Infection with Bilateral Superficial Femoral Vein (양 표재성대퇴정맥을 이용한 복부 인조혈관 감염증 치험 1예)

  • 우종수;방정희;조광조
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.880-883
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    • 2004
  • The graft infection within the abdomen is a notorious condition, which usually develops serious complications of anastomotic rupture or distal embolism that ended in death. There has been many controversies in the treatment of an aortobiiliac graft infection and varying results have been reported. The authors treated a case of aortobiiliac graft infection after abdominal aortic aneurysm surgery. The operation was performed with re-aortobiiliac bypass using bilateral superficial femoral veins. The result was successful.

Descending Thoracic Aorto-bifemoral Artery Bypass Grafting in a Leriche's Syndrome (Leriche's 증후군에서 흉부하행대동맥-양측 대퇴동맥 우회술)

  • Chung, Jae Ho;Son, Ho Sung;Yi, Eun Jue;Son, Kuk Hui;Kang, Moon Chul;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.104-106
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    • 2009
  • Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.

Nafamostat Mesilate: Can It Be Used as a Conduit Preserving Agent in Coronary Artery Bypass Surgery?

  • Yoon, Yoo Sang;Oh, Hyunkong;Kim, Yonghwan;Lim, Seung Pyung;Kim, Cuk-Seong;Kang, Min-Woong
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.413-425
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    • 2013
  • Background: Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine. Methods: Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats. Results: The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group. Conclusion: NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.