• Journal of Chest Surgery
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• 제49권6호
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• pp.465-467
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• 2016

The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.

• Journal of Chest Surgery
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• 제47권1호
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• pp.71-74
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• 2014

For high-risk patients, endovascular aortic aneurysm repair (EVAR) is a good option but may lead to serious complications, which should be addressed immediately. A 75-year-old man with a history of abdominal surgery underwent EVAR for an aneurysm of the abdominal aorta and iliac arteries. During EVAR, iliac artery rupture and graft limb occlusion occurred, and they were successfully managed by the additional deployment of an iliac stent graft and balloon thrombectomy, respectively. We, herein, report a rare case of the simultaneous development of the two fatal complications treated by the endovascular technique.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.172-174
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• 2005

Trauma of the vascular structure is not poplular event. In obstructive atherosclerotic vascular disease, we sometimes have needed bypass surgery. The long length subcutaneous prosthetic vascular graft are vulnerable to injury. But prosthetic vessel rupture after trauma has been rare report. A 68-year-old man was referred to Department of Emergency of the Gyeongsang National University Hospital. After he had had a blunt trauma, he found a newly appearing pulsating mass of 10 cm diameter on his right chest wall. The lesion had a turbulent blood flow in the cavity of the mass by ultrasonographic finding. The lesion was a rupture of superficial prosthetic vascular graft under the skin.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1278-1281
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• 1992

We have experienced two cases of traumatic subclavian artery rupture at the department of thoracic and cardiovascular surgery, Youngdong Severance hospital, Yonsei University college of medicine. One was combined with brachial plexus injury and the other was combined with brachial plexus injury and subclavian vein rupture. They were treated with graft interposition after segmental resection of ruptured subclavian artery and neurorrhaphy for brachial plexus injury. Post operative courses were not eventful.

• Journal of Chest Surgery
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• 제3권1호
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• pp.47-54
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• 1970

This is a report on two cases of aortic prostheses using Nylon tube. (Edwards-Tapp A-G Tube, Chemically treated braided Nylon arterial grafts). Especially, the complications after infection of synthetic graft are discussed with reviewing literature. First case was the patient who came to our hospital with rupture of the right femoral artery at the femoral fossa due to pyogenic necrotic process. After femoral arterial prostheses, good pulsation of dorsal artery of foot was obtained. However, the tube was obstructed after 8 weeks postoperatively due tll the complication of infection. In spite of the tube was removed because of obstruction and foreign body reaction of synthetic graft, an amputation of the leg was not necessary for formation of good collateral circulation. Second case was a case of aortic aneurysmal rupture in thoraco-abdominal junction which developed by the trauma of rib resection for osteomyelitis of the left 12th. rib An implantation of aortic graft was performed at the lowest tho13cic aorta by the way of thoraco-abdominal bypass without arterial pump. However, infection produced pyothorax in the left pleural cavity, exposing the tube within the pyothorax. The rupture of the anastomosed upper line occurred in 8 weeks postoperatively and the patient expired.

• 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.

• Archives of Plastic Surgery
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• 제41권6호
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• pp.734-739
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• 2014

Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants. Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management. Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.

• Journal of Chest Surgery
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• 제24권7호
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• pp.725-731
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• 1991

Four patients with traumatic rupture of aorta underwent operative repair at Seoul national university hospital. All cases were confirmed by preoperative aortography. Rupture site was aortic isthmus or just distal to it. Operations were somewhat delayed due to the low degree of suspicion and difficulties in diagnosis: ranging from 5 hours to 8 days. Operation was performed as same manners in all cases: resection of the ruptured portion and tubular woven dacron graft interposition in conjunction with shunt or bypass procedures, TDMAC-Heparin shunt between ascending and descending aorta was used in 3 cases, and LA-femoral centrifugal pump was used in one case. There were no intraoperative or postoperative mortality. Hoarseness was developed in all patients but paraplegia or other significant complications were not found in any of patients. We concluded that 1] high degree of suspicion is essential in the early diagnosis and treatment of traumatic aortic rupture and 2] any kind of shunt or bypass procedure is necessary in operative repair of traumatic aortic rupture and use of centrifugal pump without systemic heparinization is easier and safer procedure than others for the maintenance of adequate distal flow.

• Journal of Chest Surgery
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• 제41권3호
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• pp.373-376
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• 2008

외상성 흉부 대동맥 파열에 의한 가성대동맥류에 대한 일반적인 치료 방법은 수술이다. 그러나 환자의 전신상태가 개흉술을 통한 수술 또는 체외순환보조를 통한 수술을 시행 받기 어려운 경우에는 다른 치료 방법을 선택해야 한다. 저자들은 두부, 복부, 골반의 광범위한 다발성 손상이 동반되어 수술적 치료를 시행하기 어려웠던 대동맥파열에 의한 가성대동맥류 환자에 대하여 중재적 시술을 통해 스텐트-그라프트를 삽입하여 치료한 1예를 문헌 고찰과 함께 보고하는 바이다.