• 제목/요약/키워드: Coronary Artery Disease

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관상 동맥 질환을 동반한 모야모야 병 1례의 증례 보고 (Coronary Artery Disease Affected by Moyamoya Disease - A case report -)

  • 김학제;조원민;류세민;황재준;손영상;최영호
    • Journal of Chest Surgery
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    • 제35권3호
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    • pp.231-234
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    • 2002
  • 모야모야 병은 혈관 내막의 이형성증으로 인하여 양측 내경동맥의 원위부나 뇌혈관의 근위부 폐쇄와 이로인한 측부 혈관의 발달로 인한 비정상적인 혈관망을 가지는 질환이다. 그러나 모야모야 병이 전신 혈관을 침범하는 질환이라는 보고들이 나오고 있으며, 실제로 신동맥이나 관상동맥을 침범한 모야모야 환자들에 대하여 보고가 되고 있다. 고려대학교 구로병원 흉부외과학 교실에서는 관상동맥을 침범한 모야모야 병 환자 1례를 경험하였다. 환자는 35세 여자로 내원 6개월 전부터 NYHA class ll의 호흡 곤란과 흉통이 있었고, 내월 1개월 전부터는 신체 우측 부위의 감각 이상이 발생되어 내원하였다. 내원하여 시행한 뇌혈관 조영술과 관상동맥 조영술 등의 검사에서 뇌혈관계의 이상을 보이는 모야모야 병과 이로 인한 뇌경색 및 좌측 관상동맥 기시부의 협착으로 인한 협심증을 진단받았으며, 뇌경색에 대하여는 약물 치료를, 협심증에 대하여는 관상동맥 우회술을 시행하였다. 수술 시야에서의 관상동맥 소견은 해부학적 이상 소견이나 전형적인 혈전이나 동맥 경화의 소견 등은 관찰되지 않았고, 전반적으로 부드럽고 혈관 내벽의 비후 소견을 보이는 등 모야모야 병의 병리학적 특성을 보여주어 이 환자의 협심증은 모야모야 병이 관상동맥을 침범하여 발생된 것으로 결론지었다. 따라서 모야모야 병 환자의 경우에는 전신 혈관에 대한 검사 및 치료가 병행되어야 할 것이며, 위와 같은 경험은 아마도 국내의 첫 보고인 것으로 사료된다.

관상동맥질환자를 위한 위험요인관리 프로그램 분석 (The Analysis of Risk Factor Management Programs for Patients with Coronary Artery Disease)

  • 방소연;박미영
    • 재활간호학회지
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    • 제16권1호
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    • pp.27-36
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    • 2013
  • Purpose: This study was performed to analyse the trends of risk factor management programs for patients with coronary artery disease. Methods: Using PubMed, 35 intervention studies related to risk factor management programs among randomized controlled trials searched with the key words of coronary artery disease and coronary heart disease. Collected studies were analysed according to the characteristics of studies and participants, method and content of intervention, and outcome indicator and its effects. Results: The mean period of intervention was $28.7{\pm}26.8$ weeks, the mean frequency was $3.0{\pm}2.0$ times per week, and the duration of one session was below 60 minuets in 65.8% of the reviewed studies. The interventions were counselling, exercise, education, and cognitive behavior therapy. Counselling was applied most frequently in previous studies. The outcomes of intervention had been measured with anthropometric, physical, physiological, psychological, behavioral, and cognitive aspects, but the effect of the intervention was inconsistent among the studies. Conclusion: Based on the results of this study, systematic and comprehensive cardiac rehabilitation program consisted of counselling, exercise, and education should be developed and performed for health management and relapse prevention of patients with coronary artery disease.

심장판막증에 동반된 관상동맥루 -1례 보고- (Coronary Artery Fistula Associated with Valvular Heart Disease)

  • 백완기
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.158-161
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    • 1990
  • A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

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폐동맥에서의 좌관동맥 이상기시증 -성인형 1례 보고- (Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery - A Case of Adult Type -)

  • 정태은
    • Journal of Chest Surgery
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    • 제21권5호
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    • pp.905-910
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    • 1988
  • Anomalous origin of the coronary artery from the pulmonary artery is a rare congenital coronary artery disease and the origin of the left coronary artery from the pulmonary artery represents the commonest form of these unusual lesions. Because of differences in symptomatology, clinical course and prognosis, this malformation has been divided into infant type[Bl-and-White-Garland syndrome] and adult type on the basis of the absence or presence of collateral circulation between the right and left coronary artery. The latter type has been reported relatively few cases. A 21-year-old male was admitted to the Yeungnam University Hospital, due to study of incidentally noticed heart murmur. At that time he was asymptomatic and past medical history was noncontributory. Chest roentgenogram was within normal limit and electrocardiogram was consistent with hypertrophy of left ventricle. Echocardiogram and aortogram demonstrated markedly dilated and tortuous right coronary artery and anomalous origin of the left coronary artery from the pulmonary artery. To prevent arteriosclerosis, progressive myocardial infarction, infection and aneurysmal rupture, Takeuchi operation which establish a two coronary system by transpulmonary arterial reconnection of the anomalous left coronary artery was done. Postoperative course was uneventful.

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관상동맥질환에서 Gated Blood Pool Scan을 이용한 좌심실 확장기능의 분석 (Analysis of Left Ventricular Diastolic Function in Coronary Artery Disease with Gated Blood Pool Scan)

  • 최창운;임상무;정준기;이명철;박영배;서정돈;이영우;고창순
    • 대한핵의학회지
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    • 제20권2호
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    • pp.39-45
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    • 1986
  • Resting gated blood pool scan was used to derive left ventricular functional changes in normals (N=13, mean age=43) and in patients with coronary artery disease (N=50, mean age=53). Peak filling rates, average filling rates, and ejection fractions were significantly depressed in coronary artery disease. (p<0.0005, each other). And in coronary artery disease with normal ejection fraction (N=21), peak filling rates and average filling rates were depressed also, and peak filling rates of coronary artery disease with normal ejection fraction were abnormal in 61.2% and average fillin rates were abnormal in 71.4%. It appears that (1) resting peak filling rates and average filling rates were sensitive and easily obtainable parameters of the diastolic dysfunction assosiated with coronary artery disease, (2) a significant proportion of coronary artery disease patients without any evidence of abnormal systolic function have depressed resting peak filling rates and average filling rates of the left ventricle.

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중국 관상동맥질환자의 심장재활지식, 교육요구도 및 자가간호행위 (Relationship of Knowledge of Cardiac Rehabilitation, Educational Needs, and Self Care in Inpatients with Coronary Artery Disease in China)

  • 림금란;김희경;이현주
    • 한국간호교육학회지
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    • 제15권2호
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    • pp.260-273
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    • 2009
  • Purpose: The purpose of this study was to investigate the knowledge of cardiac rehabilitation, educational needs, and self care in inpatients with coronary artery disease in China and to provide basic data for development of cardiac rehabilitation programs. Method: From Jan. 16th to Feb. 26th, 2009, 104 patients with coronary artery disease were hospitalized in general hospitals in K and H city in China. They were interviewed with a structured questionnaire. The data was analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation analysis. Results: In inpatients with coronary artery disease in China, the score of knowledge of cardiac rehabilitation was average ($66{\pm}.18$), and the score of educational needs was high ($4.27{\pm}.49$). The score of self care was average ($3.12{\pm}.58$). The regular exercise group (p= .005) had a high knowledge of cardiac rehabilitation, the nonsmoking group (p= .022) and regular exercise group (p= .037) did well by themselves. Educational needs also affected the overall knowledge of inpatients with coronary artery disease (r= .288, p= .003). Conclusion: This study suggests that knowledge of cardiac rehabilitation and educational needs should be considered in enhancing cardiac rehabilitation programs designed for inpatients with coronary artery disease in China.

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu;Song, Hyun;Lee, Seok In;Moon, Mi Hyung;Kim, Hwan Wook;Jo, Gyun Hyun
    • Journal of Chest Surgery
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    • 제47권2호
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    • pp.106-110
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    • 2014
  • Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

관상동맥협착증의 외과적 치료 -6례 보고- (Surgical Treatment of Coronary Artery Occlusive Disease)

  • 이재동
    • Journal of Chest Surgery
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    • 제21권5호
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    • pp.842-849
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    • 1988
  • Between July, 1987, and September, 1988, 6 patients with coronary occlusive disease received coronary artery bypass surgery at Kyungpook University Hospital. There were five males and one female whose age ranged from 39 to 64 years[mean 54*8.0 years]. Of the 6 patients, 5 suffered from unstable angina, 1 suffered from stable angina. Selective coronary angiography revealed a significant stenosis of the left anterior descending artery in 6 cases, of its diagonal branch in 1 case, of the right coronary artery in 1 case, the circumflex artery in 1 case, and of its obtuse marginal branch in 1 case. The mode of anastomosis were single saphenous vein graft in 3 cases, single left internal mammary artery graft in 1 case, double saphenous vein graft with sequential anastomosis in 1 case, and left internal mammary artery plus saphenous vein graft in 1 case. Of these, 6 grafts to left anterior descending artery were done. There was no operative death, but perioperative myocardial infarction was happened in 1 case. All survivors were free of angina and discontinuing medical therapy during the follow up period[mean 7.8*5.15 months].

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관상동맥질환자의 건강 임파워먼트, 배우자지지, 외상 후 성장이 건강증진행위에 미치는 영향 (Influence of Health Empowerment, Spousal Support, and Post-traumatic Growth on Health Behavior in Patients with Coronary Artery Disease)

  • 정은;이경심;양승경;조장현
    • Journal of Korean Biological Nursing Science
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    • 제24권2호
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    • pp.113-121
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    • 2022
  • Purpose: The purpose of this study was to identify influence of health behavior in patients with coronary artery disease. Methods: A cross-sectional descriptive design included 150 patients treated with percutaneous coronary intervention in S hospital in S city. Data were collected by using self-questionnaires July 5-August 26, 2021 and were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regression with SPSS 23.0. Results: Factors significantly influencing health behavior in patients with coronary artery disease were health empowerment (β = .48, p< .001), and post-traumatic growth (β = .20, p= .013). The explanatory power of related variables was 39%. Conclusion: Based on the this study, it was found that health empowerment and post-traumatic growth had a significant effect on the health behavior of patients with coronary artery disease. Thus, it is necessary to promote the health behavior of patients with coronary artery disease through the development of intervention programs to improve health empowerment and post-traumatic growth.

양측 관상동맥-폐동맥간 동맥루 치험 1례 (Bilateral Coronary Artery-Pulmonary Artery Fistula - Reports of a Case-)

  • 문경훈
    • Journal of Chest Surgery
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    • 제21권3호
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    • pp.583-587
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    • 1988
  • Bilateral coronary artery-pulmonary artery fistula is very uncommon congenital heart disease which occupy small percentage of all coronary arterio-venous fistulas. We experienced a case who was 52 years old female with bilateral coronary artery-pulmonary artery fistula. She complained exertional dyspnea k angina[coronary steal syndrome]. On physical examination, any cardiac murmur was not audible. There was no 0y step-up in right heart catheterization. But selective coronary angiography revealed tortuous aberrant vessels which originated from the canal branch of the right coronary artery k the left anterior descending coronary artery. Both aberrant vessels traversed the right ventricular outflow tract, and conjoined just proximal the pulmonic annulus and drained into the main pulmonary artery. The operation was performed under the extracorporeal circulation with beating heart. The procedures were suture-ligation of the draining orifice in main pulmonary artery & the feeding vessels on the right ventricular outflow tract. Postoperatively her complaints were completely disappeared and the selective coronary angiography revealed no left-to-right shunt.

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