• Title/Summary/Keyword: 협심증

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Bleeding Tendency and Transfusion Feature after CABG (관상동맥 우회술후 출혈경향과 수혈양상)

  • 이재원;김상필;송명근
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.581-585
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    • 1998
  • Postoperative autotransfusion is known as an effective method for blood conservation. We tried to examine whether the autotransfusion of shed mediastinal blood in patients with unstable angina would be valuable for reducing postoperative homologous transfusion by observing the hourly tendency of bleeding and transfusion. Between August and October, 1997, 26 patients with unstable angina underwent coronary arterial bypass surgery by a single surgeon at Asan Medical Center. In retrospective analysis, we found 90% of the patients received homologous transfusions and 85% of them were in the intensive care unit at the same day after operation. In many patients, the cause of transfusion was not anemia but volume replacement. Mean bleeding through the chest tubes was 340 cc for the first 5 hours and 69%(18 pts) showed more than 200 cc of bleeding, the amount generally considered as a initiating point for autotransfusion. Despite the adoption of multiple methods for blood conservation, 90% of the patients needed homologous transfusion. Moreover, many of them had received unnecessary transfusions. We conclude that some kind of blood for transfusion is needed during the immediate postoperative period, and the adoption of postoperative autotransfusion may help in reducing homologous transfusion.

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Combined Surgery of Pulmonary Resection and Coronary Artery Bypass Grafting (CABG) (폐절제와 관상동맥 우회술의 동반 수술 치험 3예)

  • Kim Jin Sun;Lee Young Tak;Kim Jhingook;Kim Kwhanmien;Choi Yong Soo;Sung Kiick;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.253-257
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    • 2005
  • The patients with primary lung cancer who have symptoms of angina pectoris commonly have underwent coronary artery bypass grafting (CABG) prior to lung resection. Recently, there are attempts to conduct simultaneous operation of CABG and lung resection to reduce disadvantages of staged operation, such as repeated general anesthesia, two wound incisions and delay of lung operation. These attempts generally report good results. Three patients underwent lung resection and CABG simultaneously, and had good post operative status without recurrence of cancer and angina pectoris. We conceive these as worthy cases to report.

Clinical Analysis of Coronary Artery Bypass Graft Surgery According to Cardiac Protection (관상동맥 우회로술시 심근보호법에 따른 수술결과의 임상분석)

  • 이서원;이계선
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.961-965
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    • 1997
  • From October 1991 to April 1996, 27 patients underwent aortocoronary bypass graft. There were 17 men, 10 women. The mean age was 65 years(range 45 to 76). The preoperative clinical status were chronic stable angina in 11 cases, unstable angina in 13 cases and postinfarction angina in 3 cases. The involved ri k factors were as follows: Hypertension in 7 cases, Diabetes Mellitus in 5 cases and any other diseases in 3 cases We divided these patients into two groups in this survey: The A group was 15 patients who were managed with cardioplegia from 1991 to 1994. The B group of 12 patients was done with intermittent aortic clamping without cardioplegia from 1995 to 1996. The mean numbers of graft per patient was 2.0 in A group and 2.83 in B group. The ischemic time per graft was 27.3 minute in A group and 18.5 minute in B group respectively. The morbidity was occlusion of grafted vessel in one patient and one of postoperative angina in A group. The total mortality was 14.8%(4/27), but mortality of B group was 8.35 (1/12)

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Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Pathophysiology and Role of Coronary CT Angiography in Stable Angina (안정형 협심증의 병태생리 및 관상동맥 CT 혈관조영술의 역할)

  • Jong Eun Lee;Hye Mi Park;Yongwhan Lim;Won Gi Jeong;Yun-Hyeon Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.42-53
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    • 2022
  • The clinical concept of coronary artery disease (CAD) has seen a paradigm shift over the last decade. CAD is mostly a progressive disease, and patients with CAD can develop acute coronary syndromes at any point in disease progression. In this clinical context, a new term, "chronic coronary syndrome," was published in the 2019 European Society of Cardiology guidelines, reflecting the importance of early diagnosis and active management. Recent advances have been made in the evaluation of CAD using coronary CT angiography (CCTA). The clinical usefulness of CCTA in patients with stable angina or chronic coronary syndrome begins with the detection of early asymptomatic CAD. The characterization of atherosclerotic plaque and its role in determining treatment strategies for CAD have been demonstrated for all stages of the disease. This review describes the pathophysiology of stable angina to aid in the understanding of the clinical applications of CCTA.

Determinants of Successful Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 성공율에 영향을 미치는 인자에 대한 고찰)

  • Choi, Kyo-Won;Kweon, Jun-Young;Kim, Young-Jin;Lee, Tae-Il;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seup;Lee, Hyun-Woo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.230-239
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    • 1994
  • In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients (89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug. 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A (95.7%), type B (89.5%). There was signfifcantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bend > $45^{\circ}$ and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors. Stenosis severity, thrombus, lesion location at a bend > $45^{\circ}$, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.

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고혈압이 있는 당뇨병 환자의 약물요법

  • 최경묵
    • The Monthly Diabetes
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    • s.151
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    • pp.28-29
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    • 2002
  • 당뇨병은 당뇨병 자체의 문제뿐 아니라 동맥경화성 심장질환(협심증, 심근경색 등) 및 뇌혈관질환(중풍)을 일으키는 중요한 위험인자가 되므로 그 치료가 중요시되고 있다. 동맥경화성 심장질환과 뇌혈관질환은 우리 나라 뿐 아니라 대부분의 산업화된 현대 사회에서 사망의 가장 중요한 원인으로 꼽히는데 당뇨병뿐 아니라 고혈압, 고지혈증, 흡연 등과도 연관된 것으로 잘 알려져 있다.

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건강관리코너 - 고혈압이야기

  • Kim, Tae-Ho
    • 방재와보험
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    • s.104
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    • pp.30-32
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    • 2004
  • 최근서구화된 식이 및 생활 습관과 급변하는 사회적 환경으로 인한 스트레스 증가 등으로 협심증, 심근경색, 뇌졸증 등의 심혈관 질환의 급격한 증가가 가장 중요한 한국인 성인 사망 원인으로 떠오르고 있다. 또한 국내 성인의 약 20~25%가 고혈압을 가지고 있는 것으로 조사되고 있는 현 시점에서 심혈관 질환의 중요한 요인인 고혈압에 대하여 간단히 살펴보기로 한다.

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특집 예고 없이 찾아오는 심장질환, 생명을 위협한다! - 급증하고 있는 '허혈성 심장질환' _사망률 3위 심장질환, 해마다 무서운 속도로 증가

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.256
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    • pp.8-9
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    • 2011
  • 당뇨병환자의 주요 사망원인은 동맥경화성 관상동맥질환이다. 당뇨를 가지고 있으면 협심증 심근경색 등과 같은 심장질환에 걸릴 위험이 더욱 증가해, 재발 및 사망률이 높아진다. 사망원인의 가장 많은 부분을 차지할 만큼 매우 위험한 질환이지만 대부분의 당뇨병환자가 심장질환에 관해 부주의한 경우가 많고 심각하게 생각하지 않고 있다.

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