• 제목/요약/키워드: Cardiovascular protection

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Use of Embolic Protection Devices during Hybrid Thoracic Endovascular Aortic Repair for a Shaggy Aorta: A Case Report

  • Kim, Eun Chae;Lee, Jae Hang;Chang, Hyoung Woo;Kim, Dong Jung;Kim, Jun Sung;Lim, Cheong;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.513-516
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    • 2021
  • An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV6 Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

Surgical Treatment of an Innominate Artery Aneurysm Using Near-Infrared Spectroscopy for Cerebral Monitoring: A Case Report

  • Jeon, Byeng Hun;Lee, Chul Ho;Bae, Chi Hoon;Jang, Jae Seok;Cho, Jun Woo
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.517-520
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    • 2021
  • Innominate artery aneurysms are challenging for surgeons to treat because of the requirement for brain protection during surgery. In innominate artery aneurysms, the endovascular approach does not require cardiopulmonary bypass, but patients who can be treated using this approach are limited in number, and the long-term results of endovascular treatment are unclear. Here, we report our experience of successfully treating a patient with an innominate artery aneurysm using near-infrared spectroscopy without cardiopulmonary bypass support or hypothermic circulatory arrest.

마그네슘 농도변화에 따른 흰쥐의 심근 보호효과 (Protective Effect on the Rat's Myocardium with Changes in Magnesium Concentrations)

  • 홍치욱;조규석;유세영
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.11-16
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    • 1997
  • The Increasing use of coronary perfusates for the protection of the human heart during ischemic cardiac arrest has placed great emphasis on the need for a rational and safe formulation. For the purpose of this study isolated rat hearts were connected to retrograde nonworking perfusion system proposed by Langendorff, and then perfused for 20 minutes by coronary infusates of magnesium concentration of 1.66 m Mol per liter(group A, n: 10) or 15mMo1 per liter(group B, n: 10). After 20 minutes perfusion, cold cardioplegic solution (modified St. Thomas'Hospital solution) was infused for 2 minutes, and prepared within 4$^{\circ}C$ Krebs-Henseleit solution. Finally, 20 minutes of cononay reprsfuslon was reestablished after I hour of cold ischemic cardiac arrest. Hemodynamic parameters (heart rate, left ventricular pressure, $\pm$ dp/dt max. and coronany flow) and enzymes assay (creatine phosphokinase, lactic dehydrogenase and flutamic oxaloacetic transaminase) were performed each other at whic rat heart was perfused for 20 minutes and reperfused for 20 minutes thereafter. There were significant differences in the recovery rate of heart rate, systolic left ventricular pressure, + dp/dt max, and coronary flow and reperfusion-perfusion ratio of creatine phosphokinase(P < 0.05). But, there were no signicant differences in the recovery rate of dp/dt max, and reperfunion-perfusion ratio of lactic dehydrogenase and glutamic oxaloacetic acid (P > 0.05).

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심혈관계 질환 치료제 후보물질 발굴을 위한 Soluble Epoxide Hydrolase 억제평가 방법 개발 (Development of Soluble Epoxide Hydrolase Inhibitor Screening Methods for Discovery of Drug Candidate in Cardiovascular Diseases)

  • 이관호;김봉희;김상겸
    • 약학회지
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    • 제56권1호
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    • pp.42-47
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    • 2012
  • Soluble epoxide hydrolase (sEH) is a metabolic regulator of epoxyeicosatrienoic acids (EETs). EETs have many beneficial effects, vasodilation, anti-diabetes, anti-inflammation, cardiovascular protection, renal protection. Therefore, selective sEH inhibitors have a potential for treating these diseases. In the present study, screening methods for sEH inhibitors using PHOME ((3-phenyl-oxiranyl)-acetic acid cyano-(6-methoxynaphthalen-2-yl)-methyl ester) and 14-15-EET as substrates were established. To determine selectivity, microsomal epoxide hydrolase (mEH) inhibition assay was also developed using styrene oxide as a substrate of microsomal epoxide hydrolase. Our results obtained from 12-[[(tricyclo[3.3.1.13,7]dec-1-ylamino)carbonyl]amino]-dodecanoic acid (AUDA) used as a positive sEH inhibitor and valpromide used as a positive mEH inhibitor showed that these methods are useful for discovery of drug candidates.

개심수술중 심근 미세구조의 변화 (Changes of Myocardial Ultrastructure During Open Heart Surgery)

  • 허진;공준혁;이종태
    • Journal of Chest Surgery
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    • 제33권9호
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    • pp.707-715
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    • 2000
  • Background: Cold blood cardioplegic solution has been used to protect myocardium during open heart surgery with the hypothesis stating that it provides more oxygen supply to myocardium compared to crystalloid caridoplegic solution. We repeatedly infused cold blood cardioplegic solution to achieve myocardial protection. We biopsied a small portion of papillary muscle of patients with mitral valve replacement or double valve replacement during aortic cross-clamp time and evaluated the method of myocardial protection through the observation of changes in ultrastructure. We then analysed the relationship between changes in ultrasructure and peak postoperative CK-MB value and SGOT value. Material and method: We report observation on changes of myocardial ultrastructure, postoperative CK-MB and SGOT, and electrocardiogram in 31 patients who underwent cardiac operation. There were 11 males and 20 females, and they ranging in age from 28 to 69 years(mean score was 2.08$\pm$0.560, it was 2.37$\pm$0.558 at 40 minutes, and it was 2.36$\pm$0.523 at 70minutes. Mitochondrial score increased significant at 40 minutes. Mean value of postoperative peak CK-MB and SGOT were 37.3$\pm$17.061IU, 144.5$\pm$125.5IU respectively. We were not able to find any new Q were in EKG after the operation. There was no significant relationship between myocardium mitochondrial score and mean value of postoperative peak CK-MB and SGOT. Conclusion: In conclusion, with this study the cold blood cardioplegic solution was incomplete in preserving ultrastructure of myocardium even with satisfactory results in serum enzyme and EKG evaluation.

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승모판막수술 시 히스티딘를 함유한 결정성 심정지액(Histidine-tryptophan-ketoglutarate Solution)과 저온 혈성 심정지액이 심근기능 보존에 미치는 영향 비교 (A Comparison of the Effects of Histidine-tryptophan-ketoglutarate Solution versus Cold Blood Cardioplegic Solution on Myocardial Protection in Mitral Valve Surgery)

  • 최용선;방서욱;장병철;이삭;박철희;곽영란
    • Journal of Chest Surgery
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    • 제40권6호
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    • pp.399-406
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    • 2007
  • 배경: 개심술 시 불충분한 심근 보호로 인한 허혈과 재관류 손상은 술 후 심실 기능과 예후에 영향을 미친다. 본 저자들은 승모판막 수술에서 HTK 용액과 냉혈 혈성 심정지액이 심근 보호와 임상 결과에 미치는 영향을 전향적으로 비교 분석하였다. 대상 뜻 방법: 승모판막폐쇄부전으로 승모판막수술을 받는 70명의 환자 중 8명의 환자를 제외한 31명에서 HTK 용액을(HTK군), 31명에서 냉혈 혈성 심정지액을(CBC군) 사용하였다. 수술 중과 후에 환자의 혈역학, 심혈관계 약물과 심장박동조율기의 사용, 임상경과 및 합병증을 관찰하였다. 모든 환자에서 최소 6개월 이상 사망률과 이환율을 추적 관찰하였다. 결과: 혈역학적 변수는 평균폐동맥압, 중심정맥압과 폐모세혈관쐐기압이 체외순환으로부터 이탈 후 시기에 HTK군에서 유의하게 낮았던 점을 제외하고는 모든 시기에서 군 간 차이가 없었다. 심근수축제와 심장박동조율기의 사용은 모든 시기에서 군 간 차이가 없었다. 수술 후 1일과 2일째 CK-MB 수치는 HTK군에서 $77{\pm}54,\;41{\pm}23$ (ng/mL)로 CBC군의 $70{\pm}69,\;44{\pm}34$ (ng/mL)와 유의한 차이가 없었다. 6개월 이상의 추적관찰 중 임상경과는 비슷하였다. 결론: 이상의 결과에서 HTK 용액은 냉혈 혈성 심정지액과 비슷한 심근 보호효과를 가짐을 확인할 수 있었다.

자연기흉의 외과적 치료 (Surgical Treatment of Spontaneous Pneumothorax)

  • 허용;김경훈;김철환;박성동;박해홍;문준호;김병열;이정호
    • Journal of Chest Surgery
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    • 제27권12호
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    • pp.1002-1007
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    • 1994
  • The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.

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