• Journal of East-West Nursing Research
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• v.24 no.2
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• pp.119-129
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• 2018

Purpose: The aim of this study was to examine the effect of providing information using a mobile internet terminal on anxiety, discomfort and satisfaction with education among patients undergoing a coronary angiogram. Methods: Data were collected from July 27, 2016 to February 23, 2017. A total of 64 participants (34 for the experiment group and 30 for the control group) admitted to a department of cardiology internal medicine for coronary angiography were recruited. Data were analyzed by SPSS Window 22.0 Program. Results: Information provided through mobile internet terminal did not affect anxiety and objective and subjective discomfort of the participants for coronary angiography, it was effective in satisfaction with education. Conclusion: Based on the results, it is indicated that video education using a mobile internet terminal could be an effective method to improve nurses' work efficiency and quality and to raise satisfaction with education.

• International Journal of Vascular Biomedical Engineering
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• v.1 no.1
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• pp.13-23
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• 2003

Backgrounds: The present study in angulated coronary stenosis was to evaluate the influence of velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, as well as their effect of evolving in-stent restenosis using human in vivo hemodynamic parameters and computed simulation quantitatively and qualitatively. Methods: Initial and follow-up coronary angiographies in the patients with angulated coronary stenosis were performed (n=80). Optimal coronary stenting in angulated coronary stenosis had two models: < 50 % angle changed(model 1, n=43), > 50% angle changed group (model 2, n=37) according to percent change of vascular angle between pre- and post-intracoronary stenting. Flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre/post-intracoronary stenting were calculated from three-dimensional computer simulation. Results: Follow-up coronary angiogram demonstrated significant difference in the percent of diameter stenosis between two groups (group 1: $40.3{\pm}30.2$ vs. group 2: $25.5{\pm}22.5%$, p<0.05). Negative WSS area on 3D simulation, which is consistent with re-circulation area of velocity vector, was noted on the inner wall of post-stenotic area before stenting. The negative WSS was disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2 (p<0.01) Conclusions: The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation termed as WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric change, such as angular difference between pre / post-intracoronary stenting might give proper information of optimal hemodynamic charateristics for vascular repair after stenting.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.492-495
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• 2008

A functional single lung caused by lung diseases or pneumonectomy can result in anatomic and physiologic changes that may interfere with the conduct of subsequent coronary artery bypass surgery. Since. this type of case is extremely rare, there has not been any report on this in Korea. A 71-year-old female with a history of a destroyed left lung from pulmonary tuberculosis 13 years ago was admitted for evaluation of her increasing chest pain that she'd experienced for 2 weeks. Since coronary angiographies demonstrated 80% stenosis of the left main os, $90{\sim}95%$ stenosis of the p-LAD, 90% stenosis of the m-LCx and 90% stenosis of the RCA, coronary artery bypass surgery (CABG) was planned. Off-pump CABG with vein grafts through a median sternotomy was performed and the patient recovered the same as other CABG patients without complications.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.59-64
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• 1993

To evaluate the usefulness and differences in diagnosing coronary artery disease (CAD) between men and women of intravenous dipyridamole $^{99m}Tc$-MIBI myocardial SPECT, we obtained $^{99m}Tc$-MIBI myocardial SPECT and compared with the findings of coronary angiographies. Ninety eight male and 37 female patients who underwent dipyridamole $^{99m}Tc$-MIBI myocardial imaging within one month of cardiac catheterization were studied. Scans were considered abnormal if perfusion defect was detected and the defect size was more than 12% for left anterior descending artery (LAD) and circumflex (LCX) and 8% for right coronary artery (RCA) territories. Lesions${\geqq}$50% luminal diameter narrowing were considered significant CAD. Overall sensitivity for detection of CAD was 94.3% in men and 96.4% in women; specificity was 70% in men and 52.6% in women (P=not significant, ns). Vessel-matched sensitivity was 75.3% in men and 72.7% in women (P=ns): specificity was 84.6% in men and 67.9% in women (P < 0.025). For individual coronary artery, the sensitivity in men and women was 87.7%, 81.8% for LAD; 78%, 83.3% for RCA and 52.2%, 46.7% for LCX (P=ns): the specificity was 80%, 40% for LAD (P<0.01), 82.5%, 68.4% for RCA, 88.9%, 86.4% for LCX (P=ns). The hemodynamic parameter after intravenous dipyridamole in men and women were significantly changed; the heart rate was increased and systolic, diastolic blood pressure was decreased. Adverse effects were reported in 58.8% of men and 72.7% in women (P=ns). The incidence of chest pain and headache were higher in women. There was no significant difference in the incidences of nausea, abdominal pain, dizziness, facial flushing, dyspnea. In conclusion, dipyridamole $^{99m}Tc$-MIBI myocardial SPECT is a safe, noninvasive test for evaluation of CAD. There was no gender difference to detect CAD, but more false-positive rate in women especially in the territory of LAD.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.307-314
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• 1992

The internal mammary artery has been advocated for use in bypass grafting owing to its superior long-term patency when compared to saphenous vein grafts. Concern exists that the flow through internal mammary artery may be inadequate during periods of peak myocardial demand when the internal mammary artery graft was used for proximal left anterior descending artery stenosis. This flow adequacy was investigated in 13 consecutive patients with a mean proximal left anterior descending artery stenosis of 84.2% who were selected for coronary bypass using internal mammary artery. We checked flow and diameter of left internal mammary artery without intraluminal dilatation just before anastomosis to left anterior descending artery during cardiopulmonary bypass. Clinical results were evaluated postoperatively with clinical symptoms, echocardiographies, stress tests, and coronary angiographies. The mean internal mammary artery flow measured just before anastomosis was 38ml/ min[range of 20 to 80ml /min] and its mean internal diameter 1.4mm. Maximal workload was improved from preoperative value of 6.3$\pm$2.5METS to postoperative value of 9.1$\pm$1.4 METS in 9 patients who Paired-test can be used. Cardiac symptoms recurred in two patients after bypass surgery, but they were not related to left internal mammary artery grafts. All patients were discharged in postoperatively 9.3 days[range of 7 to 20 days] after operation without mortality. Thus, on the basis of these findings, the internal mammary artery is a reasonable graft that we can routinely use for proximal left descending artery stenosis if internal diameter of the internal mammary artery is more than 1.0mm and its flow is more than 20ml /min at mean arterial pressure of 50 to 60mmHg during cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.56-63
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• 2004

Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.659-665
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• 2003

The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6％ (272/276) for ITAs and 97.0％ (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9％ (234/244) for ITAs and 88.6％ (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0％) immediate postoperatively and 7 of the 88 patients (8.0％) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.191-196
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• 2005

We analysed the characteristics of anastomotic sites after coronary artery bypass grafting (CABG) using coronary angiographies (CAGs) performed at one and five years postoperatively in the same patient population. Material and Method: Among the 219 patients who underwent isolated CABGs between January 1995 and December 1997, follow-up coronary angiograms were performed in 149 ($75.3\%$) patients at one year and in 115 ($58.1\%$) patients at five years postoperatively. FitzGibbon grading system was used to evaluate the anastomotic sites. Result: The patency rates of arterial grafts at one- and five-year were $96.5\%$ (192/199) and $93.1\%$ (134/144), which were higher than those of saphenous vein grafts (SVGs) ($82.9\%$ (224/270) and $77.5\%$ (141/182), respectively) (p=0.01). Although there were significant decreases in the patency rates between one- and five-year CAGs of both arterial and venous grafts, the proportion of FitzGibbon grade B among the SVGs was increased from $5.2\%$ (one-year) to $8.2\%$ (five-year), suggesting the progression of vein graft disease (p < 0.01). Conclusion: The patency rate of the arterial graft was higher than that of SVG in both one- and five-year CAGs. The attrition rate of saphenous vein graft was higher than arterial grafts.