• Title/Summary/Keyword: 관상동맥혈관

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Parametric Vessel Modeling for Simulation of Coronary Artery Bypass Graft (관상동맥우회시술 시뮬레이션을 위한 동적 혈관 매개변수모델링)

  • Song SooMin;Lee Yubu;Choi YooJoo;Kim MyoungHee
    • Proceedings of the Korea Society for Simulation Conference
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    • 2005.11a
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    • pp.130-137
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    • 2005
  • 본 논문은 심장이 수축$\cdot$이완함에 따라 그 형태와 위치가 변하는 관상동맥의 구조와 그 움직임을 사실적으로 표현하기 위한 매개변수적 모델링 기법을 제안한다. 완성된 모델은 관상동맥의 움직임을 관찰함으로써 심장질환 판단에 도움을 주고, 심장시술 시뮬레이션 및 시술계획수립에 사용될 수 있다. 매개변수적 기법으로 생성된 모델은 메쉬 정점의 인덱스만으로 모델간 매칭을 위한 대응점을 찾을 수 있으므로, 시간대별로 달라지는 정점의 위치를 쉽게 추적함으로써 모델의 움직임을 표현할 수 있다. 그러나 이러한 기법으로 생성된 모델은 분리, 접합 등의 변형조작이 어렵고, 트리형태 객체에 적용하기 힘든 단점이 있다. 본 논문에서는 이를 극복하기 위해 분할된 혈관영역의 골격데이타에서 찾아낸 분기점을 중심으로 Generalized Cylinder를 이용하여 실린더 형태의 각 혈관세그먼트를 모델링 한 후, 분기영역을 3개의 하프파이프(half pipe)와 2개의 삼각형 패치로 연결하여 모델링하였다. 완성된 모델은 다시점 관상동맥데이터에 적용하였고, 각 시점에서 구해진 정점의 위치를 선형보간함으로써 부드러운 혈관의 움직임을 나타내었다.

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Coronary Artery Transfer for Anomalous Origin of Left Coronary Artery from Right Coronary Sinus (좌 관상동맥 이상기시의 수술적 치료)

  • 이준완;이재원;김종우
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.514-517
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    • 2003
  • Anomalous aortic origin of left coronary artery is a rare congenital coronary anomaly that can cause clinical manifestations such as ischemic chest pain, arrhythmic syncope or even sudden cardiac death. We describe a case of anomalous aortic origin of left main coronary artery presented as a cardiogenic shock which was successfully treated by coronary artery transfer.

Bilateral Coronary Artery to Pulmonary Artery Fistula - Two case report- (양측성 관상동맥-폐동맥루 -2예 보고-)

  • 김혁;박지권;강정호;정원상;전석철;김경수;김영학
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.925-928
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    • 2004
  • Bilateral coronary artery to pulmonary artery fistulas are very rare anomaly. Echocardiography, cardiac catheterization and coronary angiography of two patients having chest pain and dyspnea showed bilateral coronary to pulmonary artery fistulas. One patient had left anterior descending coronary artery stenosis and the other patient had cystic tumor. We report the good results of the surgical treatment of two patients with bilateral coronary to pulmonary artery fistulas.

Thoracodorsal Artery as an Alternative in Complete Arterial Coronary Revascularization -3 Cases- (완전동맥도관 관상동맥 우회술에서 대체동맥편으로 사용한 흉배동맥 -3례보고-)

  • 정철현;허재학;장지민;김욱성;장우익;이윤석
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.898-901
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    • 2002
  • It is now widely accepted that the complete arterial coronary revascularization has better short and long term results compared to coronary bypass surgery using arterial graft mixed with vein graft mainly due to its superior patency rate. However, sometimes the internal thoracic artery and other conventionally used grafts might be unavailable or it may require caution in using bilateral internal thoracic artery especially in diabetic patient because of the possible risk of the mediastinitis or other associated morbidities. Moreover, there could also be a shortage for arterial graft in case of coronary reoperation. We report our first three cases using thoracodorsal artery(TDA) as an alternative graft in complete arterial coronary revascularization.

Surgical Angioplasty of Left Main and Proximal Left Anterior Descending Coronary Artery (좌주관상동맥및 좌전하챙지기시부의 수술적 혈관 성형술)

  • 이원용;김응중
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.861-866
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    • 1996
  • Surgical angioplasty of isolated stenosis of the left main coronary artery(LMCA) restores a more physiologic flow to the myocardium, allows percutdneous transluminal coronary angioplasty (PTCA) of distal coronary stenoses at a later stage, and is a less time consuming and convenient procedure than the conventional coronary artery bypass grafting(CABG) . Between Jul. 1994 and Dec. 1995, 7 surgical angioplasty had been performed. LMCA stenoses involved ostium in 2 patients, middle third in 3, and dis- tal third in 2. In 2 patients, the origin of left anterior descending coronary artery was involved in conjunction with LMCA. T e additional coronary artery stenoses were found in 2 cases. One patient was emergently operated after coronary angiography following his cardiac arrest. LMCA was approached anteriorly in all patients. The pulmonary artery was transected in 3 patients for a better exposure. The onlay patch consisted or autologous or bovine pericardium. There was no postoperative myocardial infarction or mortality. Left ventricular functions were well preserved in all patients. Postoperative coronary angiography revealed widely patent LMCA in 5 cases, and mild narrowing of distal anastomotic sites in 2 cases. Provided that well defined indications are followed correctly, surgical angioplasty can be a safe alternative to conventional CABG.

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Aortic Dissection during the Coronary Artery Bypass Grafting -A case report- (관상 동맥 우회술 중 발생한 대동맥 박리증 -1예 보고-)

  • 박지권;양주민;김영학;강정호;정원상;김경수;신진호;김혁
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.865-867
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    • 2004
  • Development of intraoperative aortic dissection during coronary artery bypass surgery is extremely rare with catastrophic outcomes resulting in high rates of morbidity and mortality. The prognosis is highly dependant upon prompt diagnosis and emergent treatment. We report our experience on a 72 year old female patient who successfully received ascending aortic graft replacement for acute intraoperative aortic dissection during coronary artery bypass procedure.

Comparison of Multidetector Computed Tomography with Coronary Angiography for Evaluation of Coronary Artery Bypass Grafts (관상동맥조영술과 MDCT를 이용한 관상동맥 이식편의 비교평가)

  • Yoo, Byung-Su;Shin, Yoon-Cheol;Kim, Kun-Il;Kim, Eung-Jung;Chee, Hyun-Keun
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.42-47
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    • 2006
  • Background: The new Multidetector Computed Tomography (MDCT) is useful in visualization of complex coronary artery anatomy. We investigated usefulness comparing of invasive coronary angiography with noninvasive MDCT in judgment of functional degree of coronary arteries grafts after coronary artery bypass graft operation. Material and Method: We analyzed the patency of 52 conduits from 15 patients whom consented to take both 32 Channel MDCT and coronary angiography from November 2003 to November 2004. Comparisons were performed for sensitivity, specificity, positive prediction value and negative prediction value between coronary angiography and 3 dimensional reconstruction image using MDCT. Result: The average graft used was 3.4 $\pm$ 0.8 per patient. Average heart rate during MDCT was 86/minute (Range, 60$\∼$110/minute) without administration of $\beta$-blocker. All patients could hold breath as much as necessary. The average graft patency obtained through corollary angiography was 96.2$\%$. In MDCT group, the sensitivity, the specificity, the positive predictive value and the negative predictive value for diagnosis was 100$\%$, 98.0$\%$, 100$\%$ and 66.6$\%$ respectively. Conclusion: The effectiveness of 32 Channel MDCT may be compared to coronary angiography in grasping about patency and bloodstream of graft conduits after coronary artery bypass graft. Also MDCT has the advantage of noninvasiveness and inexpensiveness compared to coronary angiography.