• 제목/요약/키워드: Coronary arteries

검색결과 249건 처리시간 0.03초

Technique of Coronary Transfer for TGA with Single Coronary Artery

  • Kim, Tae Ho;Jung, Jae Jun;Kim, Yong Han;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • 제47권6호
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    • pp.529-532
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    • 2014
  • An eight-day-old neonate was diagnosed with dextro-transposition of the great arteries, atrial septal defect, patent ductus arteriosus, and a single sinus origin of the coronary arteries. The single coronary artery originated from the left sinus (sinus 2), had a proximal left circumflex arterial branch, and passed anteriorly to the right side of the aorta, further branching into the right coronary and left anterior descending arteries. We successfully performed an arterial switch operation and coronary transfer by tube graft reconstruction with autologous aortic tissue to treat the dextro-transposition of the great arteries and atrial septal defect with a single-sinus origin of the coronary arteries.

적하수오(赤何首烏)가 고(高)Cholesterol식이(食餌)에 의하여 유발(誘發)된 가토(家兎) 관상동맥(冠狀動脈)의 죽상경화(粥狀硬化)에 미치는 영향(影響) (Effect of Polygoni Multiflori Radix on the Atherosclerotic Coronary Artery of Rabbits Induced by High Cholesterol Diet)

  • 이원철
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.425-436
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    • 1995
  • In order to evaluate the effect of Polygoni Multiflori Radix on the atherosclerosis induced by high cholesteol diet, rabbits were fed with 4% cholesterol diet, 4% cholesterol-4% Polygoni Multiflori Radix diet during 12 weeks. After 12 weeks, histological changes in coronary artery of rabbits were studied. The results were obtained as follows; 1. At the area % of lumen in coronary arteries, Polygoni Multiflori Radix group showed significant inhibitory effect against decrease of area % in control group. 2. At the atheroma formation in coronary arteries, Polygoni Multiflori Radix group showed decrease effect as compared with control group. 3. At the mucoprotein formation in wall of coronary arteries, Polygoni Multiflori Radix group showed decrease effect as compared with control group. 4. At the lesion of elastic fibers in coronary arteries, Polygoni Multiflori Radix group didn't show effective changes as compared with control group.

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Troponin-Positive Non-Obstructive Coronary Arteries and Myocardial Infarction with Non-Obstructive Coronary Arteries: Definition, Etiologies, and Role of CT and MR Imaging

  • Seung Min Yoo;Sowon Jang;Jeong A Kim;Eun Ju Chun
    • Korean Journal of Radiology
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    • 제21권12호
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    • pp.1305-1316
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    • 2020
  • In approximately 10% of patients with acute myocardial infarction (MI), angiography does not reveal an obstructive coronary stenosis. This is known as myocardial infarction with non-obstructive coronary arteries (MINOCA), which has complex and multifactorial causes. However, this term can be confusing and open to dual interpretation, because MINOCA is also used to describe patients with acute myocardial injury caused by ischemia-related myocardial necrosis. Therefore, with regards to this specific context of MINOCA, the generic term for MINOCA should be replaced with troponin-positive with non-obstructive coronary arteries (TpNOCA). The causes of TpNOCA can be subcategorized into epicardial coronary (causes of MINOCA), myocardial, and extracardiac disorders. Cardiac magnetic resonance imaging can confirm MI and differentiate various myocardial causes, while cardiac computed tomography is useful to diagnose the extracardiac causes.

Simple Anastomotic Techniques for Coronary Artery Bypass Surgery in Patients with Small Coronary Arteries or a Marked Size Discrepancy Between the Coronary Artery and Graft

  • Lee, Mi Kyung;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.485-488
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    • 2016
  • Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%.

Differential Vasorelaxant Effects of KR-30075, a New Cyclic AMP-phosphodiesterase Inhibitor, on Guinea-pig Pulmonary, Bovine Coronary and Renal Arteries

  • Jung, Yee-Suk;Kwon, Kwang-Il;Zee, Ok-Pyo
    • Archives of Pharmacal Research
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    • 제13권2호
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    • pp.136-141
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    • 1990
  • The vasorelaxant effects of KR-30075 in guinea-pig pulmonary, bovine coronary and renal arterial strips contracted by either$K^+$depolarization, phenylephrine, or prostaglandin $F_{2a}$($PGF_{2a}$) were evaluated. KR-30075 was more potent than imazodan as a vasorelaxant against $PGF_{2a}$-induced contractions in bovine coronary and renal arteries, whereas against$K^+$induced contractions KR-30075 was less potent than imazodan in guieapig pulmonary arteries and more potent in bovine coronary arteries. KR-30075 was more potent against contractions induced by phenylephrine or $PGF_{2a}$ than the contractions induced by $K^+$ This profile of activity for KR-30075 was similar to that of imazodan and dissimilar from the calcium entry blocking agent nifedipine. There was no vascular selectivity of KR-30075 between bovine coronary and renal arterial strip preparations. In conclusion, this study shows that KR-30075 represents the vasorelaxant effects on guinea-pig pulmonary, bovine coronary and renal arteries without specific vascular selectivity. The vasorelaxant profile of KR-30075, with different sources of vascular smooth muscle, is unlike that of calcium entry blocking agent and more similar to the profile of the agent that inhibit cyclic nucleotide phosphodiesterase.

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Effects of the Endothelium on the Contractile Responses to Norepinephrine in Isolated Proximal and Distal Coronary Artery of Pigs

  • Kim, Jong-Hoon;Jeon, Byeong-Hwa;Chang, Seok-Jong;Park, Hae-Kun
    • The Korean Journal of Physiology
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    • 제27권1호
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    • pp.27-35
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    • 1993
  • Effects of the endothelium on the contractile responses to norepinephrine (NE) were investigated in isolated helical strips of the proximal and distal coronaries artery of pigs. The helical strips were immersed in Tris-buffered Tyrode's solution equilibrated with 100% $O_2$ at $35^{\circ}C$ and its isometric tension was measured. NE relaxed the strips precontracted with acetylcholine from both the proximal and distal coronary artery. NE-induced relaxation, which might be induced mainly by $\beta$-adrenoceptor function was dominant in the distal coronary arteries. NE-induced relaxation was converted to a contraction after $\beta$-adrenoceptor blockade with propranolol $(3{\times}10^{-6}M)$. ${\alpha}$-adrenoceptor-mediated contraction by NE was greater in the proximal coronary artery than the distal coronary artery. Quantitatively, ${\alpha}_1$-adrenoceptor mediated contraction by NE was greater than ${\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries. NE-induced relaxation was decreased by rubbing of endothelium in both arteries. ${\alpha}_1-and\;{\alpha}_2$-adrenoceptor mediated contraction by NE were potentiated by rubbing of endothelium in both arteries. Pretreatment with methylene blue, an inhibitor of soluble guanylate cyclase, increased ${\alpha}_1-\;and\;{\alpha}_2$-adrenoceptor mediated contraction by NE in both arteries with endothelium. From the above results, we suggest that the effect of activation of $\alpha$-adrenoceptors by NE may be modulated by endothelium in the proximal and distal coronary arteries of pigs. This effect may be mediated via endothelium derived relaxing factor.

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대혈관전위로 동맥치환술을 시행했던 환자에서 발생한 관상동맥 압박 -1예 보고- (Coronary Artery Compression after an Arterial Switch Operation for Transposition of the Great Arteries - A case report-)

  • 유재석;곽재건;김용진
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.360-362
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    • 2008
  • 대혈관전위 환자에서 동맥치환술 시행 시 관상동맥의 위치는 수술의 성적 및 환자의 예후에 매우 중요한 요소이다. 본 증례는 과거 대혈관전위로 동맥치환술을 시행 받았던 환자에서 발생한 관상동맥 압박에 대한 보고이다. 14세 남자 환자로 운동 시 협심증을 주소로 내원하였고, 영상학적 검사 결과 좌관상동맥 기시부가 대동맥과 폐동맥 사이에 위치하여 눌리고 있는 양상이어서 수술적 치료를 결정하였다. 수술은 좌관상동맥 기시부를 대동맥에서 버튼 절제한 후 좌외측으로 재이식하여 폐동맥에 눌리지 않도록 하였다. 수술 후 관상동맥의 대혈관에 의한 압박 소견은 사라졌으며 환자는 현재까지 합병증이나 증상 재발 없이 추적 관찰 중이다.

심장의 수축운동과 관상동맥 혈류와의 위상차가 관상동맥 혈관의 동맥경화 민감성에 미치는 영향 (Influence of Cardiac Contraction and its Phase Angle with Coronary Blood flow on Atherosclerosis of Coronary Artery)

  • 김민철;이종선;김찬중;권혁문
    • 대한의용생체공학회:의공학회지
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    • 제23권6호
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    • pp.437-449
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    • 2002
  • 관상동맥은 체순환 동맥과 비교하여 매우 다른 유동조건을 갖는다. 본 연구에서는 이러한 관상동맥의 유동조건이 다른 혈관과 비교하여 동맥경화의 생성과 발전에 어떤 영향을 미치는지를 협착된 혈관 모델의 혈류역학적 전산유체해석을 통해 분석하였다. 연구 결과, 협착된 관상동맥 모델의 유동장과 벽면전단응력의 분포는 복부 대동맥 및 고동맥과 비교하여 큰 차이점을 보였다. 관상동맥은 혈관 지름이 혈류량에 비해 상대적으로 작으므로 큰 벽면전단응력값을 보이는 반면에, 혈관 협착부 목 후방부에 하나의 보텍스만 보이는 단순한 유동장 분포를 보였다. 한편, 복부대동맥과 고동맥 모델은 협착부 목 전반부와 후방부에 여러 개의 보텍스를 나타내는 복잡한 유동장을 형성하였다. 관상동맥 모델에서는 임피던스 페이즈앵글이 음의 큰 값을 가질 때에 벽면전단응력의 크기가 증가하고 재순환영역이 증가함이 관찰되었다. 그러므로 심장의 수축운동과 -110。에 이르는 관상동맥의 큰 음의 임피던스 페이즈앵글 값은 동맥경화를 촉진시키는 유동환경을 조성함을 알 수 있었다.

협착된 관상동맥과 복부 대동맥의 유동 특성 비교 (Flow comparison between Stenosed Coronary and Abdominal Arteries)

  • 김민철;이종선;김찬중
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 추계학술대회논문집B
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    • pp.585-590
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    • 2001
  • The hemodynamic characteristics were compared using commercial CFD code for the stenosed coronary and abdominal arteries. Numerical calculations were carried out in the axisymmetric arteries over the stenotic diameter ratios ranging from 0.25 to 0.875 (6 cases) employing the typical physiological flow conditions. In case of the coronary artery, there was only one recirculation zone observed distal to the stenosis throat during the major portion of the period. However, in case of the abdominal aorta, there were complex recirculation regions found proximal and distal to stenosis throat. For both models, the wall shear stresses(WSS) increased sharply in the converging stenosis, reaching a peak just upstream of the throat, and became negative or low values in the post-stenotic recirculation region. As the results, the oscillatory shear index(OSI) was abruptly increased at the stenosis throat. For the coronary stenosis model, the second peak in the OSI was observed distal to the stenosis. The distance between the first peak and the second peak was increased as the degree of the stenosis was raised. On the orther hand, the abdominal stenosis model showed a complex oscillatory behavior in the OSI index and did not showed such a strong second peak. As the degree of stenosis was increased, recirculation regions of the both arteries were extended much longer and flow pattern became more complex.

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The Effects of a Vasodilator on Transluminal Attenuation Gradient at Coronary Computed Tomography Angiography

  • Moon Sung Kim;Eun-Ju Kang;Hyun Jin Kim;Moo Hyun Kim;Ki-Nam Lee
    • Korean Journal of Radiology
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    • 제21권12호
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    • pp.1285-1293
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    • 2020
  • Objective: To evaluate the effects of vasodilators on contrast enhancement and transluminal attenuation gradient (TAG) of coronary arteries at coronary computed tomography angiography (CCTA). Materials and Methods: We retrospectively reviewed CCTA scans of patients who underwent double-acquisition CCTA; CCTA without a vasodilator, and CCTA during a intravenous (IV) infusion of nitrate. Among them, we enrolled 19 patients who had no significant atherosclerotic lesions or coronary spasms. In the control group, 28 patients were enrolled who showed normal coronary arteries on CCTA, which was acquired by a conventional method (sublingual vasodilator). We measured the TAG and Hounsfield units for each of the three major epicardial coronary arteries (reported as 'ProxHU') and then compared the results between the nitrate administration methods (CT without vasodilator [CTpre], CT with IV vasodilator [CTiv], and CT with sublingual vasodilator [CTsub]). Results: The mean TAG showed a significant difference between the coronary arteries (right coronary artery [RCA] > left anterior descending artery [LAD] > left circumflex artery [LCX], p < 0.05), while there was no difference in ProxHU of each coronary artery in all three types of nitrate administration methods (p > 0.05). The TAG of CTpre group showed steeper slope than those of vasodilator groups (CTiv and CTsub) on LAD and LCX ([LAD: CTpre = -22.1 ± 6.66, CTiv = -16.76 ± 5.78, and CTsub = -16.47 ± 5.78, p = 0.005], [LCX: CTpre = -31.26 ± 17.43, CTiv = -23.74 ± 14.06, and CTsub = -20.94 ± 12.15, p = 0.051]), while that of RCA showed no significant differences (p = 0.600). When comparing proxHU, CTiv showed higher proxHU than that of CTpre or CTsub, especially on LCX (CTpre = 426.7 ± 68.3, CTiv = 467.9 ± 84.9, and CTsub = 404.9 ± 63.3, p = 0.013). ProxHU showed a negative correlation with TAG on all three of methods (r = -0.280, p < 0.001). Conclusion: TAG in CCTA was significantly affected by vasodilator administration. Both TAG and ProxHU of coronary arteries tend to increase with vasodilator administration on CCTA.