• Title/Summary/Keyword: Thoracic complication

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Recurrent Aortobronchial Fistula after Endovascular Stenting for Infected Pseudoaneurysm of the Proximal Descending Thoracic Aorta: Case Report

  • Lee, Sun-Geun;Lee, Seung Hyong;Park, Won Kyoun;Kim, Dae Hyun;Song, Jae Won;Cho, Sang-Ho
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.425-428
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    • 2021
  • Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.

Clinical Analysis of Risk Factors in Pulmonary Complications after Curative Resection of Esophageal Cancer (식도암의 근치적 식도 절제술 후 폐합병증의 발생에 영향을 미치는 위험인자의 임상적 분석)

  • Choi, Phil Jo;Jeong, Sang Seok
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.98-103
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    • 2011
  • Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

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Unilateral Horner's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient (산모에서 요부 경막외 차단후 발생한 편측 호너 증후군과 상지마비 -증례 보고-)

  • Jang, Yeon;Cho, Eun-Chung;Kim, Jung-Tae;Park, Soo-Seog;Lee, Jae-Hee
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.285-290
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    • 1997
  • Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

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Surgical Treatment of Postpneumonectomy Empyema with Bronchopleural Fistula - 2 Cases using Pedicled Omental Flap & Muscle Transposition - (기관지흉막루를 동반한 전폐절제술후 농흉의 수술치료: 유경 대망판과 흉벽근육을 사용한 치험 2례)

  • 김기봉
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.945-949
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    • 1991
  • The treatment of acute and chronic empyema with bronchopleural fistula is remained as serious postoperative complication in thoracic surgery. Although several operative procedures for the treatment of postpneumonectomy empyema have been reported, the method of treating empyema, and in particular empyema associated with fistula, remains controversial. Recently some successful results have been reported by use of the omentum in the patients with thoracic empyema resulting from bronchial fistula. We have performed one-stage operations using the omentum and chest wall muscles in 2 patients, one was acute, and the other was chronic case. Their postoperative courses were uneventful

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Minimally Invasive Approach to Esophageal Perforation after Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Report of 2 Cases

  • Geraedts, Anna C.M.;Broos, Pieter P.H.L.;Gronenschild, Michiel H.M.;Custers, Frank L.J.;Hulsewe, Karel W.E.;Vissers, Yvonne L.J.;de Loos, Erik R.
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.313-316
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    • 2020
  • Esophageal perforation after endoscopic ultrasound-guided fine-needle aspiration for mediastinal staging is a rare but severe complication. We report 2 cases of patients with esophageal perforation who were treated using video-assisted thoracoscopic surgery in combination with esophageal stenting. Through these cases, the feasibility of minimally invasive thoracic surgery was evaluated.

Single Stage Replacement of Entire Thoracic Aorta for Chronic Aortic Dissection (만성 대동맥 박리 환자에서 전 흉부 대동맥 동시 치환)

  • 최진호;박계현;전태국;이영탁;박표원
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.865-869
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    • 2001
  • Operations for extensive aortic aneurysm are generally performed as staged operations with or without elephant trunk technique. However, we must consider single stage replacement in cases that are unsuitable for elephant trunk technique. We report a case of successful sing1e stage replacement of the entire thoracic aorta from the aortic valve to the level of diaphragm. The patient was a 35-year-old male who had Marfanoid features and had previously undergone replacement of the ascending aorta for aortic dissection. He recovered without neurologic complication and was discharged on 29th day after the operation. .

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Tracheostomy Assisted with Emergency Bypass System in Severe Tracheal Stenosis (고도 기관 협착에서 응급 체외 순환기를 이용한 기관절개술)

  • Choi, Si-Young;Kim, Yong-Hwan
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.874-877
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    • 2007
  • Airway management is difficult problem in severe tracheal stenosis. A total airway obstruction during the procedure resulted in a fatal outcome. We suggest a tracheostomy assisted with an emergency bypass system as a possible method for avoiding this complication.

Prediction of the Prosthetic Valve size by use of Supraaortic Cineangiogram (Cineangiogram 을 이용한 대동맥판막의 수술전 인공판막 치수의 예)

  • Lee, Young-Thak;Ahn, Hyuk;Park, Jae-Hyung
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.60-64
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    • 1987
  • We compared between prosthetic aortic valve size and aortic annulus size in supravalvular aortic cineangiogram in 30` RAO view postoperatively. Retrospectively, supraaortic cineangiogram of 27 patients among the patients underwent aortic valve replacement only or double valve replacement from April, 1986 to January, 1987 was examined and measured the aortic annulus size. In comparing the two values, the cases within 1mm is 22, and the cases within 2mm is 25, correlation coefficient yield r = 0.92. In two cases, the difference between two values is within 3mm We concluded that to prevent the complication from mismatching the prosthetic aortic valve size to patient`s annulus size [e.g. left ventricular failure, hemolysis, limited exercise tolerance], prediction of the prosthetic valve size preoperatively by use of cineangiogram is useful.

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Percutaneous Cardiopulmonary Bypass Support in a Patient with Acute Myocardial Infarction by Stent Thrombosis Complicated with Ventricular Tachycardia (스텐트 혈전에 의한 재발성 심실성 빈맥을 동반한 급성 심근경색에 경피적 심폐순환보조)

  • Kim Sang-Pil;Lee Jun-Wan
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.399-402
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    • 2006
  • Stent thrombosis is a rare complication after percutaneous coronary intervention (PCI), but it might be related to fatal outcomes. We report a case of patient who suffered from acute myocardial infarction complicated with cardiogenic shock and ventricular tachycardia caused by stent thrombosis and successfully resuscitated by percutaneous cardiopulmonary bypass support.

Total Occlusion of the Abdominal Aorta Caused by Detachment of Cardiac Myxoma

  • Hong, Sung-Yong;Park, Kyung-Taek;Choe, Hyun-Min
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.183-185
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    • 2012
  • Abdominal aortic occlusion (AAO) caused by detachment of cardiac myxoma (CM) is a very rare complication in patients with CM. Although the nature of CMs has been well established, detachment of CM may cause unexpected serious complications such as vicious embolic events. Actually, in several cases of AAO caused by detachment of CM, it has been reported that CM fragments easily migrated to the brain, heart, and lungs, and caused lifelong neurological complications despite appropriate surgical therapy. Herein, we report a case of a patient with AAO caused by detachment of CM who underwent CM excision and abdominal aortic thromboembolectomy. Additionally, we have presented the preoperative and postoperative images using 64-multidetector computed tomography.