• Journal of Chest Surgery
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• 제22권3호
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• pp.514-517
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• 1989

Congenital esophageal stenosis is a rare disease in childhood. By virtue of its complex embryological development, the esophagus is the site of many congenital abnormalities. Congenital Esophageal stenosis is one tenth as rare as tracheoesophageal fistula with esophageal atresia and is very rare in the cervical esophagus, which mostly occurred below mid-esophagus. Congenital esophageal web may be caused by the resorption failure of the epithelium following the vacuolization stage in embryonic development in the esophagus. Recently, we experienced 1 cases of congenital esophageal web, as the symptoms of life-long dysphagia. According to her history of dysphagia, radiologic and clinical findings, her esophageal stenosis was considered as congenital. For dilatation and relief of dysphagia, she underwent the Heineke-Mikulicz type of esophagoplasty. The results of surgical treatment were relatively good without any clinical events. So we reported it with its literature review.

• Journal of Chest Surgery
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• 제21권4호
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• pp.721-726
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• 1988

Congenital supravalvar aortic stenosis is an obstruction caused by localized or diffuse narrowing of the aortic lumen commencing immediately above the aortic valve. We experienced a case of diffuse supravalvar aortic stenosis involving ascending aorta from just above the sinuses of Valsalva to the proximal l cm of the innominate artery. Supravalvar aortic stenosis in this patient, in contrast to the form seen in infants and children, was not associated with mental retardation, peculiar faces or the syndrome of hypercalcemia. Diagnosis was confirmed by retrograde left heart catheterization and left ventriculography. Surgical correction was performed by the replacement of oval shaped Woven Dacron patch over the narrow segment of aorta under the cardiopulmonary bypass. Blood pressure was controlled sufficiently with some adjunct of Inderal postoperatively. The patient was discharged with much improvement.

• Journal of Chest Surgery
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• 제3권2호
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• pp.149-152
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• 1970

This is a report of a migrated polyethylene catheter from the arm vein cutdown site into the heart. The patient was a 48 years old male who was operated on for mitral stenosis complicated with pulmonary hypertension. On the 8th postoperative day after open mitral commissurotomy, polyethylene catheter embolization occurred. The catheter was removed successfully with an incision on the proximal basilic vein. The patient recovered uneventfully and discharged without complications.

• Journal of Chest Surgery
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• 제48권1호
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• pp.70-73
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• 2015

Lower limb ischemia caused by multiple stenosis of the thoracoabdominal aorta is one of the rare clinical manifestations of Takayasu arteritis. The optimal management of such mid-aortic syndrome related with Takayasu arteritis has not been established to date. Here we report a case of extra-anatomic aortic bypass through minimally invasive techniques to treat lower limb ischemia caused by Takayasu arteritis.

• Journal of Chest Surgery
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• 제19권1호
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• pp.165-173
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• 1986

During the 4 year period from 1982 through 1985, twelve patients have undergone operations for discrete subaortic stenosis with good short-term clinical result at Department of Thoracic and cardiovascular Surgery, S.N.U.H. According to the cineangiographic and operative findings, nine of the 12 patients were classified as Deutsch type I, the other 3 as type II, and eleven of the 12 had one or more associated anomalies of the cardiovascular system such as PDA[5], VSD[5], left SVC[2], MS[1], COA[1], supramitral membrane[1], DORY[1], right aortic arch[1], DCRV[1], and TOF[1] [one with Shone`s complex], and three of them had secondary cardiac disorders such as aortic regurgitation[3],mitral regurgitation[2], and tunnel shaped dynamic obstruction of left ventricular outflow tract[2]. We have performed membrane resection via oblique aortotomy with retraction of the aortic cusps in 7 cases and via VSD from right cardiac chamber in 5 cases with large VSD and have also performed the operations on the correctable associated anomalies. There was only one operative death in patient with associated TOF due to neurologic complication and no other postoperative difficulties except in one patient with transient heart block resolved spontaneously on postoperative 3rd day. To our knowledge, this article is the first report of operation for discrete subaortic stenosis in Korean literature.

• Journal of Chest Surgery
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• 제39권2호
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• pp.145-149
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• 2006

폐동맥 협착과 심실 중격 결손을 동반한 대혈관 전위를 갖는 환자들에 대한 수술은 Rastelli 수술법이나 Lecornpte 수술법이 전통적으로 시행되어 왔으나, 심실 내 터널에 의한 뒤틀린 좌심실 유출로와 부자연스러운 우심실 유출로에 의해 장기 성적은 만족스럽지 않다. 이에 대한 대안으로 저자들은 이 기형으로 진단된 3세 환아(체중 9.6 kg)에서 반회전 동맥간 전환술(half-turned truncal switch operation)을 시행하였다. 술 후 심초음파 검사에서 좌심실유출로와 우심실유출로가 곧고 넓게 형성되어 향후 좋은 장기 결과가 기대된다.

• Journal of Chest Surgery
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• 제45권2호
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• pp.95-100
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• 2012

Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

• Journal of Chest Surgery
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• 제24권3호
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• pp.280-286
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• 1991

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origins of the coronary arteries It may be localized or diffuse. Enlargement of the aorta with a diamond-shaped patch of the noncoronary sinus of Valsalva was reported in 1961 by McGoon and associates But this reconstruction is asymmetric and the aortic obstruction may remain. In 1977, Dotty and associates reported the extended aortoplasty, the supravalvular ring was incised at two points in the noncoronary and in the right coronary sinuses of Valsalva closed with a tubular Dacron prosthesis of inverted Y-shape tailored to reconstruct the aorta We experienced three cases of the supravalvular aortic stenosis. The 11-year-old female and 4-year-old male with localized supravalvular aortic stenosis in William`s syndrome were operated with an inverted Y-shaped aortotomy toward the non-coronary sinus and the right coronary sinus and closed with "Hemashield`s collagen impregnated Dacron" tube graft, fashioned into "pantaloon" form patch. The 12-year-old male with localized supravalvular aortic stenosis and mitral insufficiency in William`s syndrome were operated with same procedure as two other patient above-mentioned for relief of supravalvular aortic stenosis and with mitral valve replacement. Postoperative course has been good.ourse has been good.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1146-1151
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• 1990

Supravavular aortic stenosis is a congenital narrowing of the ascending aorta just distal to the level of the origins of the coronary arteries, that may be localized or diffuse. Five patients with supravalvular aortic stenosis were operated upon between July, 1986 arid June, 1990. Four of these patients were William`s syndrome [mental retardation, elfin face], and one was isolated supravalvular aortic stenosis. Preoperative diagnosis of the supravalvular aortic stenosis was made by left side cardiac catheterization and angiocardiography. There are three types of supravalvular aortic stenosis such as membranous, hourglass and hypoplastic. Four of our patients were of hourglass type, and one was hypoplastic type. Patch aortoplasty was performed in all cases. Preoperative systolic gradients ranged from 45 to 1SO mmHg [average 102.6 mmHg]: postoperative gradients ranged from 0 to 75 mmHg [average 39 mmHg]. The patient of hypoplastic type has been suffered from mild exercise intolerance even after the operation, and the postoperative echocardiography revealed the systolic gradient of 100 mmHg [preoperative 180 mmHg]. The results of surgery for hourglass type were excellent. But the patient with hypoplastic form would be benefited from some modifications of the operation.

• Journal of Chest Surgery
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• 제13권3호
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• pp.280-284
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• 1980

This is report of two cases of annular constrictive pericarditis. Since January 1959 to December 1979 the authors experienced 48 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic and Cardiovascular Surgery, the National Medical Center in Seoul. These cases simulated valvular heart disease. One case, as mitral stenosis, revealed rumbling apical diastolic murmur [II/VI], atrial fibrillation and right ventricular hypertrophy pattern on E.C.G., the other, as infundibular pulmonic stenosis, presented pressure gradient between right ventricle and main pulmonary artery at infundibular level of 76 mmHg in systole. Both patients underwent operation successfully and one of them was assisted by E.C.C. during pericardiectomy and result was excellent. It is difficult to make the diagnosis of these conditions preoperatively so consideration about these might be important to make the diagnosis accurately.