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Korean Journal of Thoracic and Cardiovascular Surgery

Nikolaos A Papakonstantinou, Charalambos Zisis, Charikleia Kouvidou, Grigoris Stratakos
Radiofrequency ablation is an effective treatment for atrial fibrillation. Pulmonary vein stenosis/occlusion is one of its rare complications. Herein, the case of a 50-year-old man with hemoptysis and migratory pulmonary infiltrations after transcatheter radiofrequency ablation for atrial fibrillation is presented. Initially, pneumonia, interstitial pulmonary disease, or lung cancer was suspected, but wedge resection revealed hemorrhagic infiltrations. Chest computed tomography pulmonary angiography detected no left superior pulmonary vein due to its total occlusion, and left upper lobectomy was performed...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Ahmed Sameh Eleshra, Woon Heo, Kwang-Hun Lee, Shin-Young Lee, Ha Lee, Suk-Won Song
We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Seung Hyun Kim, Hak Ju Kim, Ho Young Hwang
A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Kun Woo Kim, Jae-Ik Lee, Kuk-Hui Son, Eun Young Kim, Kook-Yang Park, Chul-Hyun Park
Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that may present with various symptoms, depending on the nature and severity of other cardiovascular anomalies. Furthermore, contralateral lung surgery in patients with UAPA is extremely rare, and clinical experience is limited. This report describes a case of surgical treatment of contralateral primary lung cancer in a patient with isolated UAPA. A 56-year-old man was diagnosed with primary lung cancer accompanied by isolated UAPA on the contralateral side...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Yong Chae Jung, Kiick Sung, Jong Ho Cho
A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Joon Seok Lee, In Kyu Park, Samina Park, Kwan Yong Hyun, Chang Hyun Kang, Young Tae Kim
We report the rare case of a 58-year-old woman who was diagnosed with fungal empyema thoracis combined with osteoradionecrosis. After 32 months of home care followed by open window thoracostomy, thoracoplasty with serratus anterior muscle transposition and a latissimus dorsi myocutaneous flap was performed successfully. Although thoracoplasty is now rarely indicated, it is still the treatment of choice for the complete obliteration of thoracic spaces.
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Kang Min Kim, Suryeun Chung, Sang Yoon Kim, Dong Jung Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator)...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Min Soo Kim, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim, Jong Ho Cho
Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video- assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Yeiwon Lee, Young Jin Kim, Han Young Ryu, Gwan Woo Ku, Tae Yun Sung, Yoo Sang Yoon, Tae-Kyun Kim
Background: Primary spontaneous pneumothorax (PSP) affects patients without clinically apparent lung disorder found in tall and thin young male. Scoliosis refers to curves exceeding 10° Cobb angle observed through chest X-ray and affects 2% to 4% of adolescents. Both conditions are commonly encountered in primary health care setting. The aim of this study is to access the correlation of thoracic scoliosis and PSP in adolescent. Methods: A retrospective analysis was conducted for patients diagnosed for PSP in Konyang University Hospital between January 2010 and March 2017...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Kang Min Kim, Jae Gun Kwak, Beatrice Chia-Hui Shin, Eung Re Kim, Ji-Hyun Lee, Eun Hee Kim, Jin Tae Kim, Woong-Han Kim
Background: Early extubation after cardiovascular surgery has some clinical advantages, including reduced hospitalization costs. Herein, we review the results of ultra-fast-track (UFT) extubation, which refers to extubation performed on the operating table just after the operation, or within 1-2 hours after surgery, in patients with congenital cardiac disease. Methods: We performed UFT extubation in patients (n=72) with a relatively simple congenital cardiac defect or who underwent a simple operation starting in September 2016...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Efstratios Apostolakis, Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Georgia Apostolaki
Alexander the Great was a world-class leader with tremendous courage. He paid no heed to the dangers of the battlefield, so he was always in the front lines. However, his excessive courage put his life in danger. Herein, we present an analysis of the information contained in the chronicles about a very severe, life-threatening thoracic trauma that nearly killed the great stratelates . The detailed descriptions made by Arrianus allow us to conclude that Alexander the Great experienced a nearly fatal case of tension pneumothorax...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Suk Jung Choo, Sung Ho Shinn, Kyung Hwan Kim, Wook Sung Kim, Sam-Sae Oh, Sak Lee
Background: Analyses of the efficacy and safety of transcatheter aortic valve replacement (TAVR) in most countries have been based on outcomes obtained in accordance with national practice guidelines and monitoring protocols. The purpose of this study is to share our experience regarding the process for establishing guidelines and monitoring protocols for the use of TAVR in Korea, in the hopes that it may be helpful to others undergoing a similar process in their own country. Methods: The Korean guidelines for TAVR were established on June 1, 2015 in through a tri-party agreement involving the Department of Health and Welfare, the Korean Society of Thoracic and Cardiovascular Surgery and the Korean Society of Cardiology...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Jae Hyun Kim
Septal myectomy is the gold-standard treatment of hypertrophic cardiomyopathy. However, it involves the risk of incomplete resection of septal muscles or iatrogenic septal perforation depending on the surgeon's practice. Herein, we suggest a few tips for successful septal myectomy and present a relevant case.
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Kanghoon Lee, Hyeong Ryul Kim, Jin Roh, You Jung Ok, Bo Bae Jeon, Young Woong Kim
Erdheim-Chester disease (ECD) is a form of non-Langerhans cell histiocytosis that most commonly involves the skeletal system. We report an unusual case of ECD presenting as an anterior mediastinal tumor without skeletal involvement. A 60-year-old man with no remarkable medical history was referred for evaluation of a mediastinal mass. The patient underwent surgical excision of the tumor via video-assisted thoracoscopic surgery. Histologic examination revealed marked proliferation of atypical histiocytes with sclerosis, and the results of immunohistochemical staining were suggestive of ECD...
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Jeong Min Mun, Jong In Kim, Taek Yong Ko, Sung Dal Park
Myopericytoma is a benign tumor that occurs in soft tissues. Myopericytoma in the lungs is very rare. We report the case of a 63-year-old woman presenting with cavitary masses in the left lung and multiple tiny nodules in both lungs. She underwent surgery, and a histological examination revealed primary pulmonary myopericytoma.
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Seok Beom Hong, Ji Yoon Lee, June Lee, Kuk Bin Choi, Jong Hui Suh
We report the case of a 16-year-old male patient who was involved in a traffic accident and transferred to the emergency department with mild chest pain. We initially did not find evidence of tracheal injury on computed tomography (CT). Within an hour after presentation, the patient developed severe dyspnea and newly developed subcutaneous emphysema and pneumoperitoneum were discovered. Abdominal CT showed no intra-abdominal injury. However, destruction of the right main bronchus was identified on coronal images of the initially performed CT scan...
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Yeiwon Lee, Han Young Ryu, Young Jin Kim, Gwan Woo Ku
Aneurysm and pseudoaneurysm of the dorsalis pedis artery (DPA) are rare vascular entities. Pseudoaneurysms of the DPA are commonly due to blunt trauma, sharp penetrating injury, fracture, or iatrogenic injury. Herein, we report the case of a patient with a rare iatrogenic pseudoaneurysm that occurred after blood sampling. The diagnosis was suspected based on palpitation of a pulsatile mass on the dorsal foot and confirmed by color Doppler ultrasound and computed tomography angiography. Surgical treatment was successfully performed by reconstruction with an autologous venous graft...
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Min Namkoong, Seok Beom Hong, Hwan Wook Kim, Keon Hyon Jo, Jang Yong Kim
Superior mesenteric artery (SMA) aneurysms are rare and often fatal. A 72-year-old man had previously been admitted to the emergency room with epigastric pain and heart murmur. The echocardiographic diagnosis was vegetation on the aortic and mitral valves, with moderate regurgitation from both valves due to infective endocarditis. No aneurysm was detected on abdominal computed tomography, and emergency double-valve replacement was performed. On postoperative day 25, the patient experienced abrupt abdominal pain, and computed tomography revealed a mycotic SMA aneurysm...
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Heemoon Lee, Min Soo Kim, Wook Sung Kim, Yong Han Kim, Sung Ho Cho, Jae Jin Lee
A 71-year-old female patient was admitted to the emergency department with sudden aggravation of chest pain and severe dyspnea. Computed tomography showed extensive pulmonary thromboembolism. Venoarterial extracorporeal membrane oxygenation (ECMO) was instituted due to sudden bradycardia and hypotension. An emergency operation was performed. However, chronic pulmonary thromboembolism combined with an acute pulmonary embolism was detected in the operating room. Embolectomy and endarterectomy were performed. ECMO was then discontinued...
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
You Jung Ok, Young-Hwue Kim, Chun Soo Park
We report a case of high-output chylothorax associated with thrombo-occlusion of the superior vena cava (SVC) and left innominate vein (LIV) following an arterial switch operation in a neonate. The chylothorax was resolved by 3 weeks after surgical reconstruction of the SVC and LIV using fresh autologous pericardium. We confirmed the patency of the SVC and LIV with a 1-year follow-up computed tomographic scan at our outpatient clinic.
June 2018: Korean Journal of Thoracic and Cardiovascular Surgery
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