• Journal of Chest Surgery
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• v.20 no.3
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• pp.544-547
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• 1987

Pulmonary vein wedge angiography was applied to two patients of 2 years old TOF with PFO. Left pulmonary artery was not visualized by standard right ventriculogram and catheter was not entered into main pulmonary artery. Through PFO and left atrium, pulmonary vein wedge angiography at left lower pulmonary vein was done. The ipsilateral pulmonary artery & its trees in both cases and the contralateral pulmonary artery in one case were well visualized. Dangerous complication, such as massive bronchoconstriction due to extravasation of contrast material into the bronchus, was not developed. Mild coughing was occurred, but well tolerable in both cases. We recommended a dose of 0.8 mL/Kg of contrast material at a rate of 2 to 3 mL/sec and 1 to 2 mL/Kg of flush solution at the same rate by the hand, and routine use of pulmonary vein wedge angiography in cyanotic patients whose pulmonary artery was not visualized by the standard angiography.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.669-680
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• 1999

Background: Pulmonary thromboembolism(PTE) is a life threatening disease that needs early diagnosis. Spiral CT angiography depict thromboemboli in the central pulmonary vessels with greater than 90% sensitivity and specificity, which approaches the results of pulmonary angiography in the Prospective Investigation of Pulmonary Embolism Diagnosis(PIOPED) study. This study was performed to evaluate the findings and the diagnostic value(clinical utility) of the spiral CT angiography with 2D image(multiplanar reformation) and 3D images(Shaded surface display, Minimal intensity projection) in the pulmonary thromboembolism. Methods: We retrospectively analysed spiral CT angiography and pulmonary angiography, lung scan and clinical recordings of 20 patients who had PTE diagnosed by spiral CT angiography(n=19 cases) or pulmonary angiography(n=l case) from September 1997 to August 1998. Among 20 patients who had underwent spiral CT angiography, 14 patients could be performed lung perfusion scan at the same time. We analyzed the vascular and parenchymal change in spiral CT angiogram. Results: Anatomical distribution of PTE was as follows: 1) left lung(n= 103)

• Korean Journal of Veterinary Research
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• v.47 no.2
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• pp.247-254
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• 2007

This study was performed to identify the normal anatomic orientation of pulmonary arteries and to obtain the normal baseline parameters and the optimal contrast material delivery methods of computed tomographic pulmonary angiography (CTPA) on normal beagle dogs. Based on the contrast injection flow rate, the contrast volume, and the administration methods, the experimental groups were divided into 4 groups such as group 1 : 2 ml/s, 3 ml/kg, and monophasic administration; group 2 : 5 ml/s, 3 ml/kg, and monophasic administration; group 3 : 5 ml/s, 4 ml/kg, and monophasic administration; group 4 : 5 ml/s and 2 ml/kg in first phase, 0.3 ml/s and 2 ml/kg in second phase, as biphasic administration. Normal anatomic orientation of pulmonary arteries in CTPA was evaluated through reformatted and 3D images after retro-reconstruction. Normal parameters for great arteries and peripheral pulmonary arteries were obtained on the factor of basement hounsfield unit (HU) values, contrast enhanced HU values, delay time, and peak time. And the optimal contrast delivery methods were evaluated on the factor of contrast enhanced HU values, image quality, and artifact. The monophasic administration with 5 ml/s contrast injection flow rate and 3 ml/kg contrast volume was optimal in canine CTPA.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.583-587
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• 1988

Bilateral coronary artery-pulmonary artery fistula is very uncommon congenital heart disease which occupy small percentage of all coronary arterio-venous fistulas. We experienced a case who was 52 years old female with bilateral coronary artery-pulmonary artery fistula. She complained exertional dyspnea k angina[coronary steal syndrome]. On physical examination, any cardiac murmur was not audible. There was no 0y step-up in right heart catheterization. But selective coronary angiography revealed tortuous aberrant vessels which originated from the canal branch of the right coronary artery k the left anterior descending coronary artery. Both aberrant vessels traversed the right ventricular outflow tract, and conjoined just proximal the pulmonic annulus and drained into the main pulmonary artery. The operation was performed under the extracorporeal circulation with beating heart. The procedures were suture-ligation of the draining orifice in main pulmonary artery & the feeding vessels on the right ventricular outflow tract. Postoperatively her complaints were completely disappeared and the selective coronary angiography revealed no left-to-right shunt.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.315-320
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• 1992

Pulmonary arteriovenous fistula is a rare congenital vascular malformation resulting from abnormal capillary development with incomplete formation of vascular septum normally dividing the primitive connections between the venous and arterial plexuses. Recently we have experienced a case of the bilateral pulmonary arteriovenous fistula in 7 years-old female patient. On admission, clinical manifestations were cyanosis of lips, clubbing and cyanosis of digits, and exertional dyspnea. The PO2 in arterial blood gas analysis was 43.3mmHg. In left upper and right lower lobe pulmonary arteriovenous fistulas were confirmed by bilateral pulmonary angiography. Left upper lobectomy and wedge resection of right lower lobe were performed respectively. Postoperative results were good.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1070-1075
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• 1992

Bilateral intralobar and extralobar pulmonary sequestration is an extremely rare anomaly. At present, four pathologically proven cases and two possible cases have been reported in the literature insofar as we know. We have found no previous reports in the literature in which simultaneous bilateral intralobar and extralobar pulmonary sequestration were present. We report a first case presenting as bilateral intralobar and extralobar pulmonary sequestration, recently performed staged bilateral resection, and emphasize the importance of computed tomography and angiography in diagnosis and operation.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.432-437
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• 1987

Pulmonary atresia with intact ventricular septum is a extremely rare congenital cardiac anomaly. With the history of cyanosis and failure to thrive, this anomaly should not be excluded and emergency management is necessary. Our patient was 69 day-old male with pulmonary atresia which was confirmed by cardiac angiography. Prostaglandin E1 was used for maintenance of pulmonary blood flow preoperatively. Right ventricular outflow reconstruction with pericardial patch and concomitant pulmonary valvotomy were done on beating heart for palliation. With this method, growing of right ventricle and tricuspid annulus are highly expected.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.429-439
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• 2003

• Journal of Chest Surgery
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• v.33 no.4
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• pp.290-300
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• 2000

Background: To evaluate the diagnostic accuracy of EBT(Electron Beam Tomography) in the diagnosis of conotruncal anomaly and to determine whether it can be used as a substitute for cardiac angiography. Material and Method: 20 patients(11M & 9F) with TOF(n=7, pulmonary atresia 2), DORV(n=7), complete TGV(n=4), & corrected TGV(n=2) were included. The age ranged from 7 days to 26 years(median 60 days). We analyzed the sequential chamber localization, the main surgical concenrn in each disease category (PA size, LVED volume and coronary artery pattern for TOF & pulmonary atresia, the LV mass, LVOT obstruction, coronary artery pattern for complete TGV, and type of VSD and TV-PV distance for DORV, etc) and other associated anomalies(e.g., VSD, arch anomalies, tracheal stenosis, etc). Those were compared with the results of echocardiography(n=19), angiography (n=9), and surgery(n=11). The interval between EBT and echocardiography/angiography was within 20/11 days, respectively except for an angiography in a patient with corrected TGV (48 days). Result: EBT correctly diagnosed the basic components of conotruncal anomalies in all subjects, compared to echocardiography, angiography or surgery. These included the presence, type and size of VSD(n=20), pulmonic/LV outflow tract stenosis(n=15/2), relation of great arteries and the pattern of the proximal epicardial coronary arteries(16 out of 20). EBT proved to be accurate in quantitation of the intrapericardial and hilar pulmonary arterial dimension and showed high correlation and no difference compared with echocardiography, angiography, or surgery(p>0.05) except for left pulmonary arterial & ascending arterial dimension by echocardiography. LVED volume in seven TOF(no difference: p>0.05 & high correlation: r=0.996 with echocardiography), and LV mass in 4 complete TGV were obtained. Additionally, EBT enabled the cdiagnosis of subjlottic tracheal stenosis and tracheal bronchus in 1 respectively. Some peripheral PA stenosis were not detected by echocardiography, while echocardiography appeared to be slightly more accurate than EBT in detecing ASD or PDA. Conclusion: EBT can be a non-invasive and accurate modality of for the evaluation of most anatomical alteration including peripheral PS or interruption in patients with conotruncal anomalies. Combined with echocardiography, EBT study provides sufficient information for the palliative or total repair of anomalies.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.767-771
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• 1995

The bronchial artery-pulmonary vein malformation should be called the systemic artery-to-pulmonary vein arterioveonus malformation in the lung. Although pulmonary arteriovenous malformation has been well documented in intrapulmonary arteriovenous malformation, the systemic artery-to-pulmonary vein arteriovenous malformation is rare. Most patients with systemic artery-to-pulmonary vein arteriovenous malformation is asymptomatic and the diagnosis of these anomaly may be done by continuous murmur or abnormal chest X-ray on the physical examination. The pathogenesis of this condition is congenital malformation which explains these anastomoses between the pulmonary vein and accessory brachial arteries and acquired malformation which explains development of new blood vessel to supply large enough to cause significant systemic-pulmonary shunts due to inflammation secondary to infection, trauma, or previous surgery. We experienced a case of the bronchial artery-pulmonary vein malformation which was detected on angiography in 20-year-old women whose chief complain is hemoptysis. This massive hemoptysis was controlled by selective brachial artery embolization with Gelfoam and Ivalon particles.