Aortic Root Replacement with Valve Preservation in a Patient with Annuloaortic Ectasia / 대한흉부외과학회지

Patients with aortic root disease, frequently seen in Marfan syndrome have progressive dilatation of the aortic sinuses and dilatation and distortion of the aortic annulus, leading to aortic incompetence. They are currently treated with composite graft replacement of the ascending aorta and aortic valve and reimplantation of the coronary arteries. Recently, we experienced an aortic root replacement with aortic valve preservation in a patient with annuloaortic ectasia. The ascending aorta and sinus was excised except the aortic annulus and aortic valve. The aortic valve was reimplanted inside of a collagen-impregnated tubular Dacron graft. The coronary arteries were also reimplanted. The patient was followed up for six months and reevaluated with the echocardiography. Postoperative Doppler echocardiography revealed normal aortic valve function. With this technique, it is possible to preserve the native aortic valve if the aortic leaflets are anatomically normal.

Supraarterial Myotomy for Myocardial Bridges: Two Cases Report / 대한흉부외과학회지

Myocardial bridges as an anatomical arrangement in which an epicardial coronary artery becomes engulfed, for a limited segment, by myocardial fibers. These diseases are recognized primarily because of their systolic narrowing or milking effect as seen on coronary angiography. The most frequent site of myocardial bridging is the middle segment of left anterior descending artery. Myocardial bridges have an ischemic effect capable of causing : angina pectoris, myocardial infarction, ventricular fibrillation, or even sudden death in athletes. We report 2 patients having a milking effect of the middle segment of left anterior descending artery who were suffered from angina. The operation procedure was a simple supraarterial myotomy over the embedded segment of the LAD under cardiopulmonary bypass. Angina and milking effect were disappeared after the operation.