• Title/Summary/Keyword: 관상

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Clinical outcome of coronary artery bypass surgery according to using cardiopulmonary bypass machine (심폐기 사용여부에 따른 관상동맥우회술의 임상성과)

  • Cho, Yeon-Hee;Kim, Hyung-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.146-155
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    • 2018
  • This study was conducted to evaluate the clinical outcomes of coronary artery bypass surgery for ischemic heart disease according to use of a cardiopulmonary bypass machine. The subjects were 10,981 patients who underwent coronary artery bypass grafting for ischemic heart disease from July 2008 to June 2012. Analysis data were retrospectively collected using health insurance claims data. The results of the study showed that mean time to surgery (280 min vs 357 min, p<0.0001) and intubation time (about 24 hours vs 40 hours, p<0.0001) were significantly shorter in the Off-Pump CABG (OPCAB) group than in the On-Pump CABG (ONCAB) group. The rate of reoperation because of postoperative bleeding and hematoma was lower in the OPCAB group (2.7% vs 8.3%, p<.0001). The odds ratio of risk adjusted 30 days mortality rate was 0.339 (0.266-0.434) and the postoperative length of stay was decreased in the OPCAB (p<0.0001). Overall, the 30 days mortality and reoperation rates were lower in the OPCAB, as was the resources use.

Introduction of Hindfoot Coronal Alignment View (후족부 관상면 배열 영상에 대한 고안)

  • Moon, Il-Bong;Jeon, Ju-Seob;Yoon, Kang-Cheol;Choi, Nam-Kil;Kim, Seung-Kook
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.225-228
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    • 2006
  • Purpose: Accurate clinical evaluation of the alignment of the calcaneus relative to the tibia in the coronal plane is essential in the evaluation and treatment of hindfoot pathologic condition. Previously described standard anteroposterior, lateral, and oblique radiographic methods of the foot or ankle do not demonstrate alignment of the tibia relation to the calcaneus in the coronal plane. The purpose of this study was to introduce hindfoot coronal alignment view. Material : 1) Both feet were imaged simultaneously on an elevated, radiolucent foot stand equipment. 2) Both feet stood on a radiolucent platform with equal weight on both feet. 3) Both feet are located foot axis longitudinal perpendicular to the platform. 4) Silhouette tracing around both feet are made, and line is then drawn to bisect the silhouette of the second toe and the outline of the heel. 5) The x-ray beam is angled down approximately $15^{\circ} to $20^{\circ} Result : 1) This image described tibial axis and medial, lateral tuberosity of calcaneus. 2) Calcaneus do not rotated. 3) The view is showed by talotibial joint space. Conclusion: Although computed tomographic and magnetic resonance imaging techniques are capable of demonstrating coronal hindfoot alignment, they lack usefulness in most clinical situations because the foot is imaged in a non-weight bearing position. But hindfoot coronal alignment view is obtained for evaluating position changing of inversion, eversion of the hindfoot and varus, valgus deformity of calcaneus.

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A Hybrid Procedure for Coronary Artery Disease with Left Subclavian Artery Stenosis (쇄골하 동맥협착이 동반된 관상동맥질환 환자에서의 하이브리드 술식)

  • Chang, Yong-Jin;Lee, Jae-Won;Jung, Sung-Ho;Je, Hyoung-Gon
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.252-255
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    • 2009
  • We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.

Combined Repair of Coronary Artery Disease and Left Subclavian Artery Occlusion (관상동맥질환에 병발한 좌측쇄골하동맥폐색의 치험)

  • Kim, Sang-Ik;Kim, Byung-Hun;Noh, Jeong-Sup
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.773-776
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    • 2007
  • A 47-year-old male with hypertension, diabetes mellitus and heavy smoking, but no anginal symptoms, presented with claudication of the lower extremities. Extremity angiography with coronary angiography revealed peripheral arterial lesions including a left subclavian artery occlusion with coronary artery disease. The patient underwent an initial off-pump coronary artery bypass with an ascending aorto-axillary bypass. The right internal mammary artery was anastomosed to the left anterior descending coronary artery. The greater saphenous vein graft was connected from the ascending aorto-axillary bypass graft to the diagonal branch. At postoperative day 18, femorofemoral and bilateral femoropopliteal bypasses were performed. We report a case of the combined repair of coronary artery disease and a left subclavian artery occlusion.

Surgical Removal of a IVUS Catheter that was Fractured During PCI (경피적 관상동맥 중재술 시 골절된 혈관 내 IVUS 카테터의 외과적 제거)

  • Kim, Young-Hak;Kim, Hyuck;Song, Young-Joo;Chung, Won-Sang;Kang, Jeong-Ho
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.768-771
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    • 2008
  • The use of IVUS provides information about the lumen and arterial wall, the location and extent of atherosclerotic plaque and the state of the arterial wall after PCi. The use of IVUS after insertion of an intracoronary stent has currently increased, while conflicting evidence exists concerning the long-term benefits of IVUS. We report here on a case of surgical removal of an entrapped and fractured IVUS catheter during insertion of intracoronary stents, and we include a review of the relevant literature.

Impact of Risk Factors, Autonomy Support and Health Behavior Compliance on the Relapse in Patients with Coronary Artery Disease (관상동맥질환 위험요인, 자율성 지지 및 건강행위 이행이 관상동맥질환자의 재발에 미치는 영향)

  • Park, Ae Ran;So, Hyang Sook;Song, Chi Eun
    • Korean Journal of Adult Nursing
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    • v.29 no.1
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    • pp.32-40
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    • 2017
  • Purpose: The purpose of this secondary data analysis was to identify factors influencing a relapse among patients with coronary artery disease (CAD). Methods: Of 250 participants enrolled in the original study 75 were selected as there was no relapse for more than one year following the initial treatment and 54 were selected because there was a relapse. Data were analyzed using ${\chi}^2$ test, t-test or F test to determine if there were any significant differences in the study variables relative to the status of relapse. Predictors were calculated by logistic regression. Results: Autonomy supported by healthcare providers was the significant predictor for relapse in patients with CAD. Patients with low autonomy supported by healthcare providers was 3.91 times more likely to relapse than patients with high autonomy supported. Patients with diabetes were at greater risk of recurrence. Conclusion: Secondary prevention of CAD is a major task for patients with CAD. Behavioral strategies for cardiovascular risk reduction are essential and autonomy supported by healthcare providers should be included in their strategies.

Transmyocardial Laser Revascularzation for Patients with Recurrent Angina after CABG -Report of 3 cases - (관상동맥 우회로술 후 재발한 협심증의 경심근 레이저 혈류 재건술 치험 3례)

  • Lee, Ho-Seok;Park, Kay-Hyun;Jun, Tae-Gook;Park, Pyo-Won;Chae, Hurn
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.576-580
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    • 2000
  • Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.

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Cor Triatriatum with Coronary Artery Disease in an Old Man -A case report- (고령환자에서 관상동맥 질환을 동반한 삼심방심의 수술치험 -1예 보고-)

  • 천종록;이응배;조용근;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.58-61
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    • 1999
  • Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

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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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평지방막에 융합된 관상동맥의 $Ca^{2+}$ - activated $K^{+}$ 통로의 특성

  • 김희정;박진봉;류판동;이문한;임병용;홍기환
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.185-185
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    • 1994
  • 관상동맥은 전기적으로 자극하여도 활동전위가 쉽게 유발되지 않는 조직인데, 이는 세포내의 $Ca^{2+}$에 의해서 활성화되는 $K^{+}$통로때문이라고 여겨지고 있다. 저자들은 단일 이온통로 수준에서 이러한 관상동맥 $K^{+}$ 통로의 성질을 조사하고, 아울러 $K^{+}$ 통로 개방제를 포함한 몇가지 약물이 $K^{+}$ 통로에 미치는 영향을 알아보고자 본 연구를 수행하였다. 막소포는 돼지의 심장에서 관상동맥을 분리하여 균질화 및 원심분리하여 준비하였으며, sucrose 20/30%에 있는 층을 취하여 분주한 후 -7$0^{\circ}C$로 보관하여 사용하였다. 평지방막은 1-palmitoyl, 2-oleoyl-phosphatidyl ethanolamine과 1-palmitoyl, 2-oleoyl phosphatidylcholine (4:1)을 n-decane에 녹인지방액(25mg/m1)을 200 $\mu\textrm{m}$의 구멍에 칠하여 만들었다. 단일 $K^{+}$ 통로는 막소포 (1-5$\mu\textrm{g}$/ml)를 평지방막의한쪽에 추가하고 자석으로 저어 융합이 되도록 하였으며, 통로의 활성은 막의 양쪽에 150 mM KCI, 10 mM HEPES-KOH, 0.5 mM EGTA, 0.6 mM $CaCl_2$ (pH 7.2)로 된용액이 존재하는 상태에서 막전압을 다르게 하며 기록하였다. 단일 이온 통로 전류는 amplifier를 통하여 VCR tape에 녹화하여 후에 분석에 이용하였으며, 동시에 종이기록지에 기록하였다. 단일이온통로 활성의 분석은 pClamp (Ver5.5)를 이용하여 수행하였다. 관상동맥에서 가장 흔히 기록되는 이온통로는 막전압과 $Ca^{2+}$의 농도에 의하여 변하는 $K^{+}$ 통로이었는데 pCa 4.0과 -10 mV에서 초기 활성도(Po)는 0.1에서 0.8까지 다양하였다. 전류와 전압과의 관계는 -60 - +60mV의 전압범위에서 직선형이었다.

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