• Journal of Chest Surgery
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• 제22권5호
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• pp.829-833
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• 1989

Congenital coronary arteriovenous fistula is relatively uncommon, but with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Recently we experienced one case of congenital coronary artery fistula which originated from the right coronary artery. The case was 25 year-old-male, who complained of dyspnea on exertion and continuous murmur was heard, and diagnosed as right coronary artery fistula by the cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated from aorta to the middle segment at acute margin of the right ventricle, which the hen-egg sized aneurysm was noticed. The dilated coronary ostium and fistular site were obliterated with several horizontal mattress sutures. And the dilated tortuous right coronary artery with aneurysm was excised. Postoperative course was uneventful and discharged without problem.

• Journal of Chest Surgery
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• 제21권4호
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• pp.716-720
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• 1988

Since Krause first described coronary arteriovenous fistula in 1865, there have been nearly 300 additional patients with this malformation reported in the literature. Increasing numbers of patients with this anomaly are being recognized each year resulting from the widespread use of cardiac catheterization and selective coronary arteriography in the evaluation of a variety of cardiac problems. A 9 month old male was admitted with the chief complaint of cardiac murmur and frequent URI and diagnosed as coronary A-V fistula at the distal portion of left anterior descending coronary artery to the apex of the right ventricle by cardiac catheterization and aortography. On the operative field, the left anterior descending coronary was markedly dilated about 1.5 cm in diameter from the aorta to the apex of the heart. The fistula opening was closed with 5-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia[28*C]. Postoperative course was uneventful and the patient was discharged without problem.

• Journal of Chest Surgery
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• 제27권5호
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• pp.399-401
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• 1994

We experienced one case of surgical treatment of A-V fistula between the right common iliac artery and the right common iliac vein after lumbar laminectomy. The average vascular surgeon does not have extensive experience with this disorder owing to its rarity. Arteriovenous fistula of the aorta and its major branches present an unparalleled challenge in patient care. Because of their central location, blood flow through these fistulas may be massive;the associated complications are usually dramatic, resulting in severe refractory congestive heart failure, massive venous hypertension, or extensive hemorrhage during an illfated surgical repair.For this reason, it behooves one to become well acquainted with the problem in order to avoid morbid complications and thus ensure optimal patient care.

• Journal of Chest Surgery
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• 제27권6호
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• pp.509-512
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• 1994

Congenital coronary arteriovenous fistula is a ~are condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography is being recognized with increasing frequency. Surgical correction is strongly recommended to prevent the development of congestive heart failure,angina, subacute bacterial endocarditis, myocardial infarction, and pulmonary hypertension, as well as coronary aneurysm formation with subsequent rupture or embolization. I report a case of congenital coronary arteriovenous fistula of the left main coronary artery to the fight atrium in a 23 year old female, which is associated with bacterial endocarditis with right atrial vegetation.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1167-1172
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• 1991

Since March 1988 we have performed 133 arteriovenous fistulae for hemodialysis in 121 patients with chronic renal failure. Of the 133 cases of arteriovenous fistulae, follow-up evaluation was possible for 80 cases which performed in 69 patients. The relation between blood flow and patency rate and duration of arteriovenous fistula was examined. The overall 6 - 12 - 18 -, and 24 - month patency rates of arteriovenous fistulae were 82%, 64%a, 62%, and 57%, respectively. The maximum blood flow was 150 ~ 350ml /min[mean 217.1$\pm$44.27]. The patency duration was evaluated in patients divided into three groups owing to maximum blood flow through the fistulae. The range of maximum blood flow was 150 ~ 200ml /min for group A, 200 ~ 250ml /min for group B, and above 250ml /min for group C. The mean duration of the patency was 10.7$\pm$7.60 months in group A, 14.9$\pm$9.82 months in group B, and 21.6$\pm$11.16 months in group C[p<0 05]. With increased maximum blood flow, the duration of the patency was longer in group A than group B and C [r=0.39, p<0. 05]. The maintenance blood flow was 100 ~ 250ml /min[mean 179.2$\pm$37.26 ml/min]. When the maintenance blood flow was above 200ml /min, long-term patency rate was higher than the group below 200ml /min[r=0.48, p<0.01]. In the same range of blood flow, patency duration of the patients with using their own blood vessels were longer than the patients with using vascular graft for A-V fistula. We concluded that the patency of the arteriovenous fistulae was closely correlated with the blood flow through the fistulae.

• Journal of Chest Surgery
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• 제21권5호
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• pp.877-881
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• 1988

A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.

• Journal of Chest Surgery
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• 제27권9호
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.280-285
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• 2000

Posterior transarticular screw fixation for atlantoaxial instability due to trauma or rheumatoid arthritis provides immediate rigid fixation of the C1-2 vertebral segment while preserving motion between the occiput and C1. This technique provides more resistance to translational and rotational forces than wiring technique. However, the technique of transarticular screw fixation is inherently demanding because of the complex anatomy of the occipitocervical region and vertebral artery(VA) at risk for arterial damage. VA injury may lead to serious subsequent neurological deficits and possibly death from bilateral VA injury. We report a case of a vertebral artery-to-epidural venous plexus fistula after posterior transarticular screw fixation which was treated with balloon occlusion.

• 재활간호학회지
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• 제19권1호
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• pp.1-11
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• 2016

Purpose: To determine the effects of 10 % lidocaine spray and aroma hand massage on pain, anxiety, blood pressure, and pulse during arteriovenous (AV) fistula needling in hemodialysis (HD) patients. Methods: This study used a quasi-experimental design. Forty HD patients were assigned to either 10 % lidocaine spray group (n=21) or aroma massage group (n=19). 10 % lidocaine was sprayed 3 times around AV fistula 10 minutes before. Aroma hand massage was performed for 5 minutes with fluids containing 2 % of lavender, peppermint, and geranium concentrate mixture. Pain, anxiety, blood pressure, and pulse were measured during AV fistula needling without any intervention on the first week and during interventions on the second week. Data were analyzed with ${\chi}^2$ test, Fisher's exact test, t-test, paired t-test and MANCOVA. Results: Pain and anxiety were significantly decreased in both the lidocaine spray group and aroma massage group. Aroma hand massage was more effective to reduce pulse during AV fistula needling. Conclusion: The results suggest that 10% lidocaine spray and aroma hand massage may be effective to reduce pain, anxiety, and pulse during AV fistula needling in HD patients.

• Journal of Chest Surgery
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• 제25권12호
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• pp.1563-1569
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• 1992

From Jan. 1981 to Dec. 1991, we had treated 25 patients with congenital coronary art-eriovenous fistulas [CAVF] in Seoul National University Hospital. A retrospective review was made to delineate the course and the management of CAVF and to clarify the role of surgical treatment. Fifteen patients were male and 10 were female with The mean age of 17.4 years[from 3 months to 58 years]. The most frequent symptom was dyspnea on exertion[56%]. Other symptoms were angina and palpitation. Sixty-eight percent of the patients were symptomatic. Fifty-three percent of patients less than 20 years old were symptomatic and 100% of patients over 20 years old were symptomatic. Three patients had multiple CAVFs. The fistula drained into the right ventricle in 13, pulmonary artery in 9, left ventricle in 4, right atrium in 2, and left atrium in 1. Thirteen patients had other associated cardiac lesions. The mean pulmonary-to-systemic blood flow[Qp /Qs] in the isolate CAVF group was 2.19. All patients were operated on to correct the fistulas and other associated cardiac lesions. All patients were followed from 1 month to 11 years without late death. Postoperative complication rate was 24% -significant arrhythmia [3], recurred CAVF[1], psychosis[1], pneumonia [1]. Symptomatic improvement was evident postoperatively. Below 20 years old, 94% of patients were asymptomatic, but above 20 years old, symptoms persisted in 25%. In summary, early elective repair of CAVF is indicated in all patients because of higher complication rate and frequent persistent symptoms in older patients.