• Journal of Chest Surgery
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• 제46권1호
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• pp.84-87
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• 2013

A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.

• Journal of Chest Surgery
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• 제26권6호
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• pp.496-500
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• 1993

Takaysu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries. The end stage 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. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch, left common carotid artery and left subclavian artery. The patient was 27 year-old female and she was admitted because of headache and neck pain. Aortogram revealed fusiform dilatation of left common carotid artery with focal narrowing on it`s distal portion. The patient underwent surgical resection and replacement of Dacron tube graft between distal and proximal left common carotid artery. 3 months after operation, she was readmitted because of shoulder pain and headache. Aortogram revealed focal narrowing of proximal left common carotid artery and total obstruction of left subclavian artery which caused subclavian steel syndrome. Aorto-left common carotid and aorto-left subclavian bypass graft replacement were done.

• Journal of Chest Surgery
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• 제48권6호
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• pp.415-418
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• 2015

Right aortic arch with isolation of the left subclavian artery is a rare anomaly. The incidence of bilateral ductus arteriosus is sporadic, and a right aortic arch with isolation of the left subclavian artery in association with bilateral ductus arteriosus is therefore extremely rare. Since the symptoms and signs of isolation of the left subclavian artery can include the absence or underdevelopment of the left arm, subclavian steal syndrome, or pulmonary artery steal syndrome, the proper therapeutic approach is controversial. We report a case in which surgical reconstruction was used to treat isolation of the left subclavian artery with right aortic arch in association with bilateral ductus arteriosus and a ventricular septal defect.

• Journal of Chest Surgery
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• 제17권1호
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• pp.19-25
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• 1984

Aneurysms of the subclavian artery are rare in comparison with other peripheral aneurysm. Most of these aneurysms arise from atherosclerosis, thoracic outlet obstruction, or trauma. We have experienced two cases of false aneurysms occurring the subclavian artery. One was occurred in right subclavian artery distal to right thyrocervical trunk due to trauma [falling] and was corrected with resection of the aneurysm and replacement with right external jugular vein. The other was occurred in the left subclavian artery lateral to the left internal mammary artery with complication of left hemothorax probably due to infection and was corrected with resection of aneurysm and replacement with Dacron graft. Postoperative course of both were uneventful without complication.

• Journal of Chest Surgery
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• 제42권2호
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• pp.252-255
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• 2009

58세 남자 환자가 좌쇄골하동맥협착이 동반된 관상동맥 질환으로 하이브리드술식을 시행받았다. 쇄골하동맥에 대한 스텐트 삽입과 좌내흉동맥의 좌전하행지 문합을 포함한 심폐 바이패스 없이 관상동맥 우회술을 시행하였다. 수술 후 시행한 관상동맥 조영술과 컴퓨터 단층촬영(CT)상에서 이식편의 개방성은 양호하였고 스텐트의 삽입부위는 적절한 것으로 보였고 개방성도 양호하였다. 술 후 8일째 퇴원하였고, 현재 6개월째 외래 경과관찰 중이다.

• Journal of Chest Surgery
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• 제26권3호
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• pp.245-248
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• 1993

Recently we experienced a case of Takayasu`s arteritis involving the major aortic branches. A 30 year-old female patient admitted with the complaints of dizziness, visual disturbance, headache and tingling sensation of upper extremities. Aortogram revealed nearly complete obstruction of the origin site of both common carotid arteries and right vertebral artery, and irregular luminal narrowing of the origin site of innominate artery and left subclavian artery, but opacification of right subclavian artery and left vertebral artery. Successful surgical treatment was accomplished with a bypass from the ascending aorta to the left common carotid artery using a tube graft. The left subclavian artery and right axillary artery were revascularized distal to the stenosis with tube grafts that extended from the aortic graft. Postoperative complications were atelectasis, lymph leakage and left phrenic nerve palsy. She discharged uneventually at postoperative 22 days and most of symptoms were relieved.

• Journal of Chest Surgery
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• 제17권1호
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• pp.12-18
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• 1984

Coarctation of the aorta usually occurs just distal to the origin of the left subclavian artery, but may involve proximal to this vessel. One unusual type of coarctation of the aorta which located proximal to the left subclavian artery is presented. The patient was 23 year old soldier whose primary complaints were occipital headache and dizziness. Examination showed a unilateral hypertension in the right arm. The aortogram demonstrated coarctation between the left common carotid artery and left subclavian artery. On Jun. 14, 1983, patch graft aortoplasty was performed but failed due to pliable poststenotic aortic wall. And bypass graft from origin of the left common carotid artery to the descending thoracic aorta was performed. Postoperative course was uneventful for 4 months follows up periods. We now report a unusual type of coarctation of the aorta and its surgical treatment.

• Journal of Chest Surgery
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• 제47권1호
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• pp.32-34
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• 2014

Anomalous aortic origin of the left subclavian artery (LSCA) from the left pulmonary artery (LPA) is a rare congenital cardiac malformation. We describe a case of LSCA from the LPA via ductus arteriosus in association with a double-outlet right ventricle, which never has been reported previously in Korea.

• Journal of Chest Surgery
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• 제16권2호
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• pp.170-174
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• 1983

Aortic arch syndrome is an unusual disease entity characterized by the narrowing or obliteration of major branches of the arch of the aorta regardless of etiology. We have experienced 2 cases. One of them was 22 years old office girl with 3 months history of headache, intermittent syncope and weakness and claudication on left arm especially during her physical exercise. On physical examination, pulseless on left antecubital and radial artery and blood pressure on left arm was inable to check and coldness with weakness were noted on the same side. Aortic angiography reealed 34% narrowing of left subclavian artery as that of right. But both common carotid artery and both axillary arterial patency were relatively good. Through right supraclavicular and left axillary incision, bypass graft with Gore-tex prosthesis (I.D. 6mm, Length 25 cm) was implanted from right subclavian artery on 2cm distal to origin of right common carotid arery to left axillary artery distal to axillary fossa. End to side anastomosis with preservation of left subclavian artery was done. Postoperative state was stable with blood pressure of 110/70 mmHg on left arm and palpable antecubital and radial pulsation. Another one was 41 year old male patient with 8 months history of pain and numbness on right upper arm and shoulder. On admission, right arm blood pressure was 110/80 mmHg, left arm was 160/110 mmHg, but other physical findings had no abnormalities. Angiography revealed segmental narrowing of right axillary artery on the beginning with 2 cm in length. Operative treatment with right wupraclavicular and right axillary incision, bypass graft with great saphenous vein (Length; 15 cm) from right subclavian artery between scalenus anticus and medius to axillary artery at distal end of axillary fossa was done. The authors report two cases of Aortic arch syndrome treated with bypass graft using Autograft or Gore-tex with good result.

• Journal of Chest Surgery
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• 제40권11호
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• pp.773-776
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• 2007

47세 남자 환자로 양측 하지의 파행을 주소로 내원하였는데 심한 흡연력, 당뇨와 고혈압을 가지고 있었다. 평소 허혈성 심질환의 증상과 뇌혈류의 역류로 인한 증상은 없었지만 상 하지 혈관조영술과 동시에 시행한 관상동맥조영술 검사에서 좌측쇄골하동맥 폐색을 포함한 말초혈관질환과 관상동맥에 심한 협착이 관찰되었다. 수술은 좌측 늑강을 경유한 상행대동맥-좌액와동맥 혈관우회술을 시행 후 우내흉동맥을 좌전하행지에 문합하고 복재정맥을 사선지와 인조혈관에 문합하였다. 하지 말초혈관의 폐색은 술 후 18일에 혈관우회술로 교정되었고 결과는 양호하였다.