• Title/Summary/Keyword: 혈관 조영술

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Hybrid Operation of a Kommerell’s Diverticulum with Left Aberrant Subclavian Artery (비정상 좌측 쇄골하동맥을 동반한 Kommerell 게실의 하이브리드 수술법)

  • Kim, Hye-Won;Lee, Jae-Won;Jung, Sung-Ho;Jung, Jae-Seung;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.458-461
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    • 2010
  • A 53-year-old woman had right aortic arch, Kommerell’s diverticulum and aberrant left subclavian artery (LSA) without any compressive symptoms. Hybrid operation was performed. This consisted of LSA bypass using a 6 mm ringed Gore-Tex graft between the left common carotid artery and aberrant LSA via a left supraclavicular incision, and stent graft insertion into the aortic arch via the right femoral artery. Postoperative computed tomography as well as intraoperative angiography demonstrated successful occlusion of Kommerell’s diverticulum and bypass of the aberrant LSA. There were no complications related to the operation or the intervention.

Surgical Treatment of Pulmonary Artery Sarcoma -One case report- (급성 폐동맥 색전증으로 오인된 폐동맥 육종 -1예 보고-)

  • Park, Kuhn;Kwon, Jong-Bum;Lee, Jong-Ho;Kang, Jae-Kul;Kim, Hwan-Ook;Jo, Keon-Hyon;Wang, Young-Pil
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.597-600
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    • 2004
  • We report a rare case of pulmonary artery sarcoma mimicking pulmonary artery thromboembolism in a 57-year-old man who suffered with 2-month dyspnea and exacerbated for 1 week. He was transferred from private clinic and he was diagnosed as acute pulmonary artery thromboembolism on the basis of chest CT. Chest CT, pulmonary artery angiogram, and perfusion scan were examined. We performed surgical excision with aid of CPB. The final pathologic report was that the mass was a pulmonary artery sarcoma. We experienced one case of pulmonary artery sarcoma and reported it with reference.

A Case of Moyamoya Disease in a Child with Alagille Syndrome (Alagille 증후군 환아에서 발생한 Moyamoya병 1례)

  • Lim, Mi Rang;Lee, So Yaun;Kim, Deok Soo;Kim, Kyung Mo;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.86-90
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    • 2003
  • Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

Usefulness of 3D Rotational Angiography for Cerebral Vascular Diameter Measurement (뇌혈관 직경측정을 위한 3차원 회전 혈관조영술의 유용성)

  • Seung-Gi, Kim;Sang-Hyun, Kim
    • Journal of radiological science and technology
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    • v.46 no.1
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    • pp.9-14
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    • 2023
  • When measuring cerebrovascular with 3D rotational angiography, the accuracy was verified by comparing the actual size and measurement size, respectively. It is intended to help select therapeutic materials and instruments during cerebrovascular intervention by comparing the average error rates for measured values in the 3DRA and CTA methods by examining with protocols such as brain CTA, which are always performed in emergency situations. The mean error rate between the groups of measurers was ±3.655% for radiation technologist and ±3.331% for university students, and the mean error rate of the student group was within tolerance (±10%), and the independent sample T-test result t =0.879, p=0.394 (p>0.05) showed no statistically difference between the two. In addition, the average error rate measured by both groups by 3DRA was measured below ±5% within the tolerance error rate (±10%), and most of CTA was measured within the tolerance range (±10%), but showed an average error rate of up to 5.65%, and the independent sample T-test result was statistically more accurate than 3DRA. Both the 3DRA method and the brain CTA method for measuring cerebrovascular size could be accurately measured within tolerance, but it would be better to measure cerebrovascular blood vessels using a more accurate 3DRA method during cerebrovascular intervention.

Beyond Coronary CT Angiography: CT Fractional Flow Reserve and Perfusion (전산화단층촬영 관상동맥조영술: 분획혈류예비력과 심근관류 영상)

  • Moon Young Kim;Dong Hyun Yang;Ki Seok Choo;Whal Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.3-27
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    • 2022
  • Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.

Early Results of Coronary Artery Bypass Grafting Using Multiple Arterial Grafts (다동맥이식편을 이용한 관상동맥우회술의 조기성적)

  • Lee, Jae-Won;Ryu, Sang-Wan;Kim, Kun-Il;Choo, Suck-Jung;Song, Hyun;Kim, Jong-Ook;Song, Myeong-Gun
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.45-50
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    • 2001
  • 배경: 관상동맥우회술은 허혈성 심질환 환자에서 증상을 완화하고 급사를 방지할 수 있는 효과적인 치료방법으로 확립되었다. 그러나 80년대에 들어와 지금까지 사용되었던 대복재정맥편에 비해 동맥이식편의 장기개통율이 월등함이 알려지면서 좌내유동맥과 함께 사용할 수 있는 동맥이식편에 대한 관심이 증가하였다. 본원에서는 1998년부터 다동맥이식편을 이용하여 관상동맥 우회술을 시행하고 있으며, 조기성적에 대해 대복재정맥을 사용한 경우와 비교하고자 하였다. 대상 및 방법: 1998년 6월부터 1999년 5월까지 본원에서 관상동맥우회술을 시행받았던 355명의 환자중 심정지액을 이용하여 시행했던 153명을 대상으로 하였다. 76명의 단일 동맥편을 사용한 환자를 I군, 두 개 이상의 다동맥편을 사용한 77명의 환자를 II군으로 분류하여 수술전후 임상기록, 심초음파 및 관상동맥 조영술 소견등을 후향적으로 분석하였다. 결과: 술전 양군간에는 II군의 환자가 I군의 환자에 비해 더 젊고 흡연자가 많다는 것 이외에는 통계학적으로 차이는 없었다. 술후 조기사망은 각 군에서 1례씩 있었고 환자당 문합갯수에 통계학적으로 차이가 있는 것 이외에는 수술과정 및 술후 결과에서 차이는 없었다. 결론: 다동맥편을 이용한 관상동맥우회술을 시행한 결과 본원에서 학습기(learning period)임에도 불구하고 조기성적에 있어 대복재정맥을 이용한 경우와 차이가 없었다. 물론 중기 및 장기성적에 대한 지속적인 추적관찰이 필요하겠으나 이러한 조기성적은 동맥이식편을 이용한 관상동맥우회술이 환자의 장기생존에 도움을 줄 수 있으리라 사료된다. 또한 이러한 결과를 토대로 완전 동맥이식편 관상동맥우회술로의 전환이 이루어질 수 있으리라 생각된다.

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Right Coronary Artery to Left Ventricular Fistula with a Giant Right Coronary Artery Aneurysm - A case report - (거대 우관상 동맥류를 동반한 우관상 동맥에서 좌심실로 유출되는 관상 동맥루 - 1예 보고 -)

  • Kang, Joon-Kyu;Huh, Jae-Hak;Chang, Ji-Min;Song, Cheol-Min
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.296-299
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    • 2010
  • A right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm is a very rare condition. This requires surgical treatment because of the possibility of rupture of aneurysm, heart failure and infective endocarditis. A 47 years old male patient with dyspnea on exertion for 3 months was diagnosed as having a right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm according to the CT and coronary artery angiography. We resected the aneurysm and performed a coronary artery bypass graft.

Middle and Long Term Results of 34 Cases of Emergency Coronary Artery Bypass Graft Surgery (응급 관상동맥 우회술 34예의 중장기 성적)

  • 손정환;김응중;지현근;신윤철;김건일;최광민;이원진;이원용
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.741-747
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    • 2003
  • Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

Cardiac Surgery Using CPB in Moyamoya Disease - A Case Report- (모야모야 환자에게서의 인공심폐기를 이용한 개심술 -1예 보고-)

  • 이기복;김응중;신윤철;박종운;이원진;박진흥;손정환;지현근
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.772-775
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    • 2003
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries, but the etiology remains unclear. Angiographic characteristics include bilateral stenosis or occlusion of the terminal portions of the intracranial internal carotid arteries and bilateral development of fine collateral vessels at the base of the brain known as ‘Moyamoya vessels’. Cardiac surgery using cardiopulmonary bypass due to coronary artery disease and others among patients with moyamoya disease is very rare, and cardiac surgery for such patients has a potential risk of intraoperative and perioperative brain ischemia. We successfully treated a patient who underwent artrial septal defect closure and coronary artery bypass graft using the cardiopulmonary bypass, so we report this case with a brief literature review.

Obturator Bypass Surgery in a Patient with an Infected Femoral Artery Pseudoaneurysm with Sepsis (패혈증을 동반한 감염된 대퇴동맥 가성동맥류 환자에서 폐쇄공우회술을 이용한 치험)

  • Jun, Hee Jae;Han, Il Yong;Yoon, Young Chul;Lee, Yang Haeng;Hwang, Youn Ho;Cho, Kwang Hyun
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.107-110
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    • 2009
  • Infection of the both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, and both these complications can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation. We experienced a case of obturator bypass in a patient with an infected femoral artery pseudoaneurysm and accompanying sepsis, and this occurred after performing a transfemoral angiogram in an A-V fistula of the carotid artery, and the patient also displayed intracranial hemorrhage.