• Journal of Chest Surgery
• /
• v.15 no.4
• /
• pp.409-413
• /
• 1982

The incidence of syphilitic aortic aneurysm was decreased now a day. The predilection site of cardiovascular syphilis is the thoracic aorta, especially ascending portion. The form of syphilitic aneurysm is characterized by saccular or fusiform. We have experienced 58 year old female complained of intermittent left chest pain for these 2 years. Saccular aneurysm of 7 cm in diameter at the descending thoracic aorta just distal to the left subclavian artery was confirmed with aortogram, and etiologic lesion was suspected as syphilis by her strong positive finding of serum VDRL test. Excision of the aneurysm was done under temporary bypass with heparinized 10mm silicone bypass cannula, and 23 mm Dacron aortic prosthetic graft in 10 cm segment was replaced, and excised aortic segment was confirmed as syphilitic aneurysm on light microscopic examination. Postoperative hospital course was uneventful, and discharged 3 weeks after operation in good normotensive condition. The patient died of CVA 3 months after discharge at home.

• Journal of Chest Surgery
• /
• v.52 no.6
• /
• pp.416-419
• /
• 2019

Flow reversal and thromboexclusion constitute a valuable alternative for aortic surgeons to have within their technical armamentarium for the treatment of aortic aneurysmal disease. Although not usually a preferred treatment for general aortic pathologies, this technique can be considered as a treatment option in select situations, such as mycotic aneurysm, a hostile surgical field, and a poor condition of the patient. Here, we present a case of extra-anatomic bypass and thromboexclusion for recurrent aortic aneurysm after previous extra-anatomic bypass and thromboexclusion surgery.

• Journal of Chest Surgery
• /
• v.22 no.6
• /
• pp.1084-1087
• /
• 1989

Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.

• Journal of Chest Surgery
• /
• v.33 no.8
• /
• pp.676-680
• /
• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Journal of Chest Surgery
• /
• v.27 no.11
• /
• pp.907-913
• /
• 1994

From October 1990 to May 1993, 19 patients underwent replacement of the transverse aortic arch. [10 men, 9 women, mean age 52.5 years] Underlying diseases were acute aortic dissection [10 cases], chronic aortic dissection [4 cases],and aortic arch aneurysm [ 5 cases]. In 19 patients, 10 underwent partial replacement and 9 underwent total arch replacement. The cerebral protection was achieved by profound hypothermia [rectal temperature,16$^{\circ}$ to 2$0^{\circ}C$] associated with total circulatory arrest [mean 35.5 minutes]. In one patient, the aortic arch distal to the left common carotid artery was resected with the distal arch being cross-clamped and in another two patients, the selective cerebral perfusion was also applied during the period of total circulatory arrest via innominate artery and left common carotid artery because of longer total circulatory arrest time. Among 14 patients of aortic dissecton, 10 presented hypertension, 1 presented Marfan syndrome, 1 presented pregnancy-induced hypertension and 2 revealed no evidence of hypertension. All of the above 14 patients complained chest pain. Among 5 patients of aortic arch aneurysm, Be het disease was suspected in only one patient and atherosclerotic aneurysm was proved in another 4 patients. The overall hospital mortality was 32% [6/19]. In aortic dissection, the mortality was 43% [Acute aortic dissection 30%, chronic aortic dissection 75%] and in aortic arch aneurysm, the mortality was 0%. Follow-up was done in all survivors for from 7 months to 36 months[mean,17.3%].

• Journal of Chest Surgery
• /
• v.13 no.3
• /
• pp.262-268
• /
• 1980

Four cases of patients with abdominal aortic aneurysm were experienced in Severance Hospital from July of 1977 to May of 1980. Among them three cases were men who were aged over 60 years. Atherosclerosis was cause of aortic aneurysms. The remained cases were 50 years old woman had inflammatory aneurysm. Excision of the aneurysm and aortoiliac graft was placed successfully. Their postoperative courses were uneventful and they were discharged in good condition.

• Journal of Chest Surgery
• /
• v.48 no.2
• /
• pp.134-138
• /
• 2015

Thoracoabdominal aortic aneurysm accompanied by Leriche syndrome is an extremely rare combination of aortic diseases, the surgical management of which has not been described to date. We report the successful treatment of one such case through open surgical repair of the thoracoabdominal aorta.

• Journal of Chest Surgery
• /
• v.26 no.6
• /
• pp.457-462
• /
• 1993

We retrospectively studied 34 patients who underwent operations of ascending aortic aneurysm and aortic valve replacement from August 1979 to July 1992 at the Yonsei Cardiovascular Center. Eight patients underwent supracoroanry non-composite graft replacement and separate aortic valve replacement[group I]. Twenty six patients underwent valved composite graft replacement with reimplantation of coronary arteries[group II]. Two cases in group II died within 1 month after the operation. Among the 32 survivors 28 patients have been followed up for an average of 59 months ranging from 1 months to 159 months. During the follow up periods, a pseudoaneurysm around the ascending aorta and a newly developed dissecting aneurysm in remaining aorta were noted in group II. There were 6 late deaths: 2 cases in group I and 4 cases in group II. Three cases among the 6 late deaths have stigmata of Marfan`s syndrome[1 cases in group I and 2 case in group II]. There was no statistically significant difference in actuarial survival rates between group I and group II[p > 0.05]. This study suggests that non-composite supracoronary graft interposition with separate aortic valve replacement is a safe surgical technique in patients who have normal aortic annulus and normal position of coronary ostia. However in degenerative disease such as cystic medial necrosis, composite graft replacement is recommended because this procedure eliminates entire abnormal tissue.But it seems to be important that the suture technique and strict follow-up in patients with diseased aortic wall.

• Journal of Chest Surgery
• /
• v.44 no.1
• /
• pp.68-71
• /
• 2011

In treating uncomplicated abdominal aortic aenurysm, endovascular aortic aneurysm repair (EVAR) has been employed as a good alternative to open repair with low perioperative morbidity and mortality. However, the aneurysm can enlarge or rupture even after EVAR as a result of device failure, endoleak, or graft migration. We experienced two cases of aneurismal rupture after EVAR, which were successfully treated by surgical extra-anatomic bypass.

• Journal of Chest Surgery
• /
• v.47 no.6
• /
• pp.548-551
• /
• 2014

Type II chronic dissecting thoracoabdominal aortic aneurysms are a surgically challenging disease. The conventional thoracoabdominal aortic aneurysm repair technique using cardiopulmonary bypass is a high-risk procedure. However, a recently developed endovascular technique may be an alternative treatment for the disease, but faces the obstacle of lesional restriction. This new technique uses a hybrid strategy to overcome the limits of endovascular thoracoabdominal aortic aneurysm repair. Herein, we report on a successful outcome after performing the hybrid visceral debranching procedure.