• Journal of Chest Surgery
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• 제47권5호
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• pp.473-477
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• 2014

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor. Herein, we report the case of a 52-year-old male patient who had postprandial abdominal distension and right upper quadrant abdominal pain. The abdominal computed tomography (CT) angiogram showed an IVC mass extending from the infrahepatic to the suprarenal inferior vena cava. The radiologic findings were suggestive of an IVC leiomyosarcoma. Surgical resection and reconstruction with a cryopreserved homograft were performed. The follow-up abdominal CT angiogram revealed the patient to be disease-free 6 months after surgery with patency of the IVC and renal vein.

• Journal of Chest Surgery
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• 제14권3호
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• pp.274-279
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• 1981

We performed three replacement operations of great venous obstruction with Dacron prosthesis from July, 1980 to Nov. 1980. Summary of 3 cases as belows: 1) Inferior vena cava obstruction . 43 years old male was admitted because of abdominal distension and marked superficial collateral circulation on chest and abdomen. Inferior vena cavogram showed complete obstruction of I. V .C. just below hepatic vein. Bypass operation was done between Rt atrium '||'&'||' I. V.C. (just above renal vein) with Woven Dacron prosthesis (22mm in Diameter) under ex tracorporeal ci rculation. 2) Superior vena cava obstruction . 21 years old male was admitted because of facial edema and irritative cough. Well circumscribed lobulated mass was located at ant. superior mediastinum and extended to Rt. thorax in chest P-A view. Woven Dacron prosthesis (10mm in Diameter) was replaced at involved S.V.C. segment after Rt. upper '||'&'||' middle lobectomy with tumor resection. 3) Common iliac vein obstruction (Lt) . 64 years old female was admitted because of generalized edema and tenderness of Lt. lower extremity. Venography of Lt leg showed complete obstruction of common iliac vein. Woven Dacron prosthesis (10mm in Diameter) was replaced at obstruction site.eplaced at obstruction site.

• Vascular Specialist International
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• 제34권4호
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• pp.103-108
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• 2018

Purpose: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. Materials and Methods: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. Results: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08-0.94; P=0.032). Conclusion: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.

• Journal of Chest Surgery
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• 제15권2호
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• pp.250-253
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• 1982

A persistent left superior vena cava draining into the left atrium associated with atresia of the coronary sinus-ostium, ASD, and PDA is a rare congenital anomaly. The patient was a 4 year-old female whose complaints were frequent URI and exertional dyspnea. The congenital heart anomaly was suspected at 2 months of her age. Chest films showed cardiomegaly [C-T ratio, 75%]. EKG, Echocardiography, cardiac catheterization and angiocardiography were performed. Open heart surgery was done under impression of LV-RA shunt, bilateral superior vena cavae, and ASD. At the time of operation, huge LA and RA, inferior vena caval defect of a secundum type ASD [1.5 x 3cm in diameter], absence of innominate vein, atresia of the coronary sinus-ostium, and persistent LSVC draining into LA were noted. Direct suture closure of ASD and ligation of LSVC were done. The patient`s postoperative course was somewhat eventful: systolic murmur at apex remained. Four months after the operation, congestive heart failure attacked a few times. PDA that was overlooked at the time of open heart surgery was detected through postoperative cardiac catheterization in.4 months later. Emergent operation for closure of PDA was performed on the day of recatheterization. After that, patient`s heart failure was easily controlled without any notable problem.

• Journal of Chest Surgery
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• 제31권5호
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• pp.481-487
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• 1998

하행대동맥의 급성박리에 대한 외과적 치료에 대해서는 논란이 많다. 하행대동맥의 급성 박리병변이 수술적응이 될 경우 대동맥 차단시간은 30분 이상 소요될 수 있으므로 척수손상을 예방하기 위해 대동맥 차단부위 하방에 혈류를 유지하기 위한 여러 방법이 소개되었다. 저자들은 파열(혈흉) 및 쇼크의 합병증을 동반한 하행 대동맥의 급성 박리증 8예를 체외순환법을 이용하여 수술하고 그 방법에 대한 안전성과 효용성을 찾고자 하였다. 체외순환방법에 있어서는 대동맥병변의 상하에 2개의 동맥카뉼라를 넣어 대동맥 차단으로 수술 도중 상하체의 혈류공급을 동시에 이루어지도록 하였고, 산화기로 정맥혈의 환류를 위해 우심방이나 좌대퇴정맥에 정맥관을 삽입하였다. 비교적 장시간의 대동맥 차단에도 불구하고 수술후 8예 모두에서 척수손상은 없었다. 2예(25%)의 병원사망(각각 술후 31일과 41일)은 비교적 고령에서 지연성 합병증인 폐농양, 호흡부전증 등에 의해 발생했다. 주위조직의 부종 및 연약함 때문에 수술시간이 연장될 수 있는 급성 하행동맥 박리증에서 체외 순환방법하의 인공혈관 대치술은 대동맥 차단시간의 연장에 의한 척수 허혈손상을 피할 수 있는 안전하고 효과적인 외과적 치료방법이 될 수 있을 것으로 사료된다.