• Journal of Chest Surgery
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• v.43 no.3
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• pp.296-299
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• 2010

A right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm is a very rare condition. This requires surgical treatment because of the possibility of rupture of aneurysm, heart failure and infective endocarditis. A 47 years old male patient with dyspnea on exertion for 3 months was diagnosed as having a right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm according to the CT and coronary artery angiography. We resected the aneurysm and performed a coronary artery bypass graft.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.706-709
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• 2006

Proximal coronary artery stenosis after direct coronary artery ostial perfusion is an infrequent but life-threatening complication. We had been experienced 3 cases of proximal coronary artery stenosis related to direct ostial perfusion since September, 2000. And now we report the cases.

• Journal of Chest Surgery
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• v.44 no.5
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• pp.358-360
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• 2011

We present a patient with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), which was diagnosed and corrected in her 60 s. The patient is the oldest documented survivor of ALCAPA who underwent a surgical repair. ALCAPA should be corrected surgically to restore the dual coronary system at any age and this case shows that the surgical procedure may be performed safely even in an elderly patient.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.243-245
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• 2022

True aneurysms of the coronary artery after aortic root replacement in Marfan syndrome patients are very rare. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva adds complexity during aortic root surgery. We present a case of a 37-year-old male patient with Marfan syndrome who had an RCA anomaly and a 4.5-cm true aneurysm of the common coronary button 14 years after a previous Bentall procedure. A redo Bentall operation and hemi-arch replacement were successfully performed. The anomalous origin of the RCA from the left sinus of Valsalva was safely divided and anastomosed as separate coronary buttons to the prosthetic composite valve graft. To prevent coronary button aneurysms after aortic root surgery in Marfan patients, the coronary buttons and the corresponding side holes on the prosthetic graft must be reduced to the maximum possible extent.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.360-362
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• 2008

An adequate location of the reimplanted coronary arteries is one of the most important prognostic factors for an arterial switch operation for treating TGA (transposition of great arteries). We report here on a case of malposition of the reimplanted coronary artery in a 14-year-old boy who had undergone an arterial switch operation. He had chest pain and dyspnea on exertion. The imaging study showed that the ostium of the left main coronary artery, which was between the neo-pulmonary artery and the neo-aorta, was compressed by the great arteries. We excised the left main coronary artery with a button incision from the aorta and reimplanted it on the left lateral side of the aorta. The patency of the left main coronary artery os after the operation was good and it was not compressed by the surrounding arteries.

• Journal of Ginseng Research
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• v.34 no.4
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• pp.314-320
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• 2010

The previous reports have showed that ginseng saponins, which are the active ingredients of Panax ginseng, cause the relaxation of artery that are contracted due to a various of hormones or potassium ($K^+$). Recently, we also showed that ginsenosides differentially regulate channel activity. The purpose of this study was to examine whether ginseng saponins affect contraction induced by $K^+$, serotonin (5-HT), or acetylcholine (Ach) in porcine coronary vessel. Treatment with concentrations of ginseng saponins caused a relaxation of 25 mM KCl-induced porcine coronary artery contraction. Also, ginseng saponin induced a significant dose-dependent relaxation of $3\;{\mu}M$ 5-HT-induced porcine coronary artery with the endothelium. In the porcine artery with the endothelium, ginseng saponins induced a relaxation by $3\;{\mu}M$ 5-HT in a concentration-dependent pattern. Ginseng saponins induced relaxation of both 25 mM KCl- and $3\;{\mu}M$ 5-HT-induced coronary artery contraction in the absence and presence of the endothelium. In contrast, treatment with $100\;{\mu}g/mL$ ginseng saponin did not induce relaxation in coronary artery contraction induced by Ach ($0.01\;{\mu}M$ to $30\;{\mu}M$) in the presence of the endothelium, but did cause significant relaxation of coronary artery contractions by Ach ($0.01\;{\mu}M$ to $30\;{\mu}M$) in the absence of the endothelium. These findings indicate that ginseng saponin (> $100\;{\mu}g/mL$) significantly inhibits porcine coronary artery contractions caused by $K^+$, 5-HT, and Ach. Therefore, in this study, we demonstrated that ginseng saponin may show beneficial roles on abnormal coronary contraction.

• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.503-507
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• 2007

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) has rarely been reported on in adults because 90% of the untreated infants die in the first year of life. We report here on a case of AICAPA that was detected in a 41-year-old woman and she was successfully treated by direct re-implantation of the anomalous coronary artery into the aorta.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.114-118
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• 2017

Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion. KD is a systemic disease that affects many organs and presents with thromboembolism and vasculitis. In a patient with KD, physicians should evaluate the vascular system, including the coronary arteries.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.488-493
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• 1998

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35ⓡ). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm(range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm(range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm(range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four(mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm(range 1.74~4.89) and 2.19 mm(range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six(mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm(range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm(range 1.02~3.60) and 2.30 mm(range 1.39~4.39). 5) The right coronary artery dominant was 163 cases(93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people. half of the people.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.787-791
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• 2001

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.