• 대한영상의학회지
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• 제82권2호
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• pp.435-439
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• 2021

난원공개존증은 정상 성인에서 흔히 발견된다. 그러나, 임상에서 난원공개존증에 의한 기이색전증은 드물다. 심장 초음파를 이용한 이전 연구에 따르면, 기이색전증은 큰 직경이며, 유스타키오관이 동반되고, 좌우 심방의 압력차가 큰 난원공개존증에서 주로 발생하였다. 저자들은 기이색전증이 발생한 난원공개존증 환자 1예의 특징적인 CT 소견을 제시한다.

• 대한한방내과학회지
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• 제37권5호
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• pp.733-740
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• 2016

Objective: To evaluate the effects of integrative treatment with conventional and Korean medicine on cerebral infarction due to presumed paradoxical embolism through a patent foramen ovale. Methods: We applied acupuncture, herbal medication, western medication, and physical therapy routinely every day and applied fluid therapy provided as needed. The NIHSS, K-MBI, MRS, MMT, and MMSE-K score were determined to assess any improvement in symptoms. Results: Scores appeared to be improved for the NIHSS (9 to 5), K-MBI (94 to 100), MRS (2 to 1), MMT (2+, 4 to 4, 4), MMSE-K (24 to 26). No side effects were observed during the treatment. Conclusions: This study demonstrates that integrative treatment with conventional and Korean medicine may be an effective option for treating cerebral infarction due to a presumed paradoxical embolism through a patent foramen ovale.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.118-121
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• 2015

Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.

• Journal of Chest Surgery
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• 제37권12호
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• pp.1010-1014
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• 2004

급성 폐동맥 혈전색전증은 대부분 혈전용해제나 항응고제 등을 이용하여 내과적으로 치료하나, 폐동맥 혈전색전증에 의한 급성 우심실 부전이 발생하는 경우에는 신속히 수술을 하지 않으면, 단시간 내에 치명적인 결과를 가져올 수 있으며, 우심혈전이 동반되어 있는 경우 그 사망률은 훨씬 높아지고, 개방형 난원공을 통한 역리성 색전증(paradoxical embolism)이 보고되고 있다. 그러나 본 증례에서와 같이 우심방의 혈전이 심방중격결손을 통해 좌심방으로 유입되는 것이 관찰되는 예는 극히 드물다. 직장암으로 저위전방절제술을 받은 63세 남자 환자에서 수술 직후 심부정맥혈전증에 의해 생긴 우심실부전을 동반한 급성 페동맥 혈전색전증을 응급개심술을 통해 좋은 결과를 얻었기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.216-220
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• 2005

폐동정맥루는 폐동맥 고혈압의 유무에 따라 치료가 달라진다. 따라서 폐동정맥루 치료 전 반드시 폐동맥압을 측정하여야 한다. 이에 저자들은 폐동맥 고혈압이 없어 폐동맥 색전술로 치료한 1례와 폐동맥 고혈압이 동반되어 항응고제를 투여하면서 관찰 중인 1례를 보고하는 바이다.

• Journal of Chest Surgery
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• 제19권2호
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• pp.335-340
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• 1986

Pulmonary arteriovenous fistula is unusually congenital malformation consisting of an abnormal connection between a pulmonary artery and vein. It may appear as an isolated anomaly or with hereditary hemorrhagic telangiectasis. In the classic form, symptoms and signs are caused by the abnormal right to left shunt. since severe clinical symptoms such as paradoxical embolism, infection, and spontaneous rupture with massive bleeding may occur, surgical treatment is often indicated. Recently we have experienced a surgical treatment of pulmonary arteriovenous fistula in 54 years old housewife. She was admitted in May 1986 with recurrent hemoptysis for 1 month. On admission, the PaO2 was 65.2 mmHg without specific findings. Pulmonary arteriovenous fistula was confirmed by preoperative pulmonary arteriography. A well circumscribed cystic mass was noted in visceral subpleural and inferior lingular segment of left upper lobe. Left upper lobectomy was performed with good results. Histologically angiomatous dilatation of abnormal vessels embedded in lung parenchyma was noted. Postoperative PaO2 was 90 mmHg. Postoperative results were good.

• Annals of Clinical Neurophysiology
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• 제20권2호
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• pp.105-108
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• 2018

Persistent left superior vena cava (PLSVC) is a common venous anomaly of the thorax and usually drains into the right atrium. Less often it drains into the left atrium and has previously been related to ischemic stroke. We report a case of PLSCV that founded during ischemic stroke evaluation in a 77-year-old woman which was detected on transesophageal echocardiography (TEE) and transcranial Doppler ultrasonography (TCD) with saline agitated test and computed tomography.

• Journal of Chest Surgery
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• 제29권6호
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• pp.660-663
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• 1996

Pulmonary arteriovenous fistula is relatively rare disease, and the most common types are congenital in origin. The clinical presentation of pulmonary arteriovenous fistula ranges from incidental finding on a chest roentgenogram to polycythemia, cyanosis, congestive heart failure, and major neurologic deficits caused by paradoxical embolism. Recently we have experienced a case of asymptomatic, well-localized pulmonary arteriovenous fistula In a 13 years-old female patient, which was successfully treated by thoracoscopic lobectomy.

• Journal of Chest Surgery
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• 제54권3호
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• pp.214-217
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• 2021

In rare cases, levoatrial cardinal vein may occur as an isolated condition without additional congenital anomalies. Depending on the direction and flow of the shunt, this pathology may produce symptoms; alternatively, it may be asymptomatic, as in the case presented in this study. In asymptomatic cases, complications, such as paradoxical embolism and brain abscess, can arise later. In the 11-year-old patient whose case is presented here, the levoatrial cardinal vein was asymptomatic and incidentally detected. The percutaneous closure method was applied first. However, by 16 hours after the procedure, the occluder device had embolized to the iliac artery. Emergency surgery was performed; first, the occluder device was removed, and levoatrial cardinal vein ligation was then performed via a mini-thoracotomy. The symptoms, diagnosis, and treatment modalities of isolated levoatrial cardinal vein are discussed in the context of this case described herein.

• Tuberculosis and Respiratory Diseases
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• 제67권1호
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• pp.52-58
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• 2009

폐동정맥기형은 드문 폐혈관 질환으로 출혈, 뇌농양, 기이 색전증(paradoxical embolism)에 의한 여러 신경학적 합병증의 발생 위험을 증가시켜 치료를 요한다. 과거에는 수술적으로 제거했으나, 최근에는 주로 코일 및 풍선 등의 다양한 색전물질을 이용한 경피적 색전술을 시행하여 치료하는 추세이다. 거대 폐동정맥기형의 경우에는 색전술 시행 과정에서 코일이 전신 순환으로 빠져 나가 장치 색전증 등의 합병증을 일으킬 위험이 높다. 저자들은 호흡곤란을 주소로 내원한 81세 남자 환자에게서, 지속되는 저산소혈증의 원인으로 거대 폐동정맥기형을 진단하고, Amplatzer$^{(R)}$ 혈관폐색장치를 이용한 경피적 색전술로 치료한 1예를 경험하였기에, 문헌 고찰과 함께 보고하는 바이다.