• Journal of Chest Surgery
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• 제27권12호
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• pp.1042-1046
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• 1994

We experienced a case of traumatic aneurysm of descending thoracic aorta by an automobile accident. The patient was 23-year-old-male with a traumatic aortic aneurysm [6x12cm] on the descending thoracic aorta just distal to the origin of the left subclavian artery. Exposure was obtained through a left posterolateral thoracotomy incision in the fourth intercostal space and then partial femoro-femoral cardiopulmonary bypass was established.After aortic cross- clamping, the aneurysmal sac was opened and repaired with interposition of Dacron vascular graft and aortic cross-clamping period lasted for 100 minutes. Postoperative bleeding and vocal cord paralysis were complicated, but bleeding was controlled by reoperation and vocal cord paralysis was improved. Follow up was continued for 14months and postoperative course was uneventful.

• Journal of Chest Surgery
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• 제44권2호
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• pp.148-153
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• 2011

Background: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. Materials and Methods: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. Results: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. Conclusion: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.

• Journal of Chest Surgery
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• 제53권6호
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• pp.411-413
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• 2020

A 34-year-old man who had undergone aortic valve replacement 8 years ago underwent an additional Bentall operation due to mechanical valve dehiscence 2 years later. Subsequently, he was diagnosed with Behçet disease and Batter syndrome. A week after being hospitalized again due to chest pain and dyspnea, a large pseudo-aneurysm was detected on computed tomography. Because of the excessively large size of the pseudo-aneurysm, surgical treatment seemed very risky. Therefore, we planned to perform thoracic endovascular aortic repair (TEVAR) and treated him successfully. However, the patient experienced recurrence of the same symptoms 4 months later, and was found to have type IV endoleak. He received a TEVAR procedure again, and it was successful.

• Journal of Chest Surgery
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• 제30권3호
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• pp.300-307
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• 1997

인제대학교 부속 부산백병 원 흉부외과학교실에서는 지난 87년 10월부터 96년 1월까지 총25례의 흉부 및 복부 대동맥류를 수술로 치험하였다. 환자의 연령은 최소 26세에서 최고 73세(평균연령 52. 5세)였으며 남자가 13명 여자가 12명이였다. 발생 부위에 따라흉부 대동맥류가 18례 복부 대동맥류가7례였다. 원인에 따른 분류에서 16례가 박리성이 였으며 9례가 비박리성 대동맥류였다. 동맥류의 위험 인자로는 고혈압이 가장 많았으며 기타 고지질증, Marfan증후군등이였다. 흉부 대동맥류는 침범 부위에 따라 동맥류 절제술과 인조혈관 대치술 및 관상동맥 이식술등을 증례에 따라적절히 시행하였다. 복부 대동맥류는 동맥류 절제후 침범 부위에 따라 일자 또는 역Y형 인조혈관 을 대 치시켰다. 총 5례의 술후 사망이 있어서 수술 사망률은 20%였으며 생존 환자는 특별한 합병증 없이 퇴원하였다.

• Journal of Chest Surgery
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• 제44권2호
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• pp.142-147
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• 2011

Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.

• Journal of Chest Surgery
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• 제33권10호
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• pp.839-842
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• 2000

Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.

• Journal of Chest Surgery
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• 제10권2호
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• pp.295-298
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• 1977

The incidence of abdominal aortic aneurysm is very rare in this country as other disease of the aorta. Aneurysm can be cased by a variable cause but mainly by arteriosclerosis. It is the disease of aged and degeneration. So recently it may be prevalent due to increase of aged people. In general the natural course of an abdominal aortic aneurysm is very grave so surgical intervention is indicated as soon as possible after the diagnosis. Recently a case of abdominal aortic aneurysm was seen in this clinic with abdominal pain and pulsating mass on the abdomen. This case was confirmed by aortography and treated by graft replacement of the aneurysm with favorable result.

• Journal of Chest Surgery
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• 제52권5호
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• pp.368-371
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• 2019

A unicuspid aortic valve is a rare congenital malformation that frequently presents with valvular dysfunction and dilatation or aortic aneurysm, requiring combined aortic valve surgery and aortic repair. Some patients show severe valve calcification extending into the interventricular septum, possibly resulting in damage to the conduction system during debridement for valve replacement. We present a rare case of severe aortic stenosis with a unicommissural unicuspid aortic valve diagnosed by preoperative transesophageal echocardiography in a 36-year-old man. After composite graft replacement of the aortic valve, aortic root, and ascending aorta, a permanent pacemaker was placed because of postoperative complete heart block.

• Journal of Chest Surgery
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• 제46권5호
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• pp.353-356
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• 2013

A 74-year-old man was diagnosed with aortic root aneurysm and two-vessel coronary disease. Echocardiographic assessment revealed an enlarged sinus of Valsalva 60 mm in diameter with mild aortic regurgitation. Florida sleeve repair was performed using a vascular graft combined with coronary artery bypass grafting. The postoperative course was uncomplicated and follow-up echocardiographic evaluations showed an aortic root diameter of 38 mm without aortic insufficiency up to 1 year after surgery.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.179-184
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• 1989

본원에서는 Marfan씨증후군과 대동맥류, 대동맥판 역류로 진단받은 환자가 1년후 흉통을 주소로 내원하여 대동맥 박리로 이행한 것으로 밝혀져 응급수술을 성공적으로 치룬 1례를 경험하였기에 보고하는 바이다.