• Journal of Chest Surgery
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• 제28권3호
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• pp.253-257
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• 1995

Forty-eight patients with significant left main coronary artery obstruction underwent coronary artery bypass graft between September,1989 and September,1993. They consisted of 29 males and 19 females with the mean age of 58 [range 33 - 78 . Seventeen patients[35% had stenosis in left main coronary artery only and twenty-nine[61% had associated lesions in other coronary artery systems as well.Two[4% had isolated left coronary ostial lesion. The operative mortality was 4.17% [2/48 which is comparable to the mortality of overall coronary artery bypass surgery cases during the same period[p >0.05 . Perioperative myocardial infarction was occurred in two patients[4.17% . And the infarction rates between the two groups also showed no difference[p >0.05 . The forty-six survivors showed significant improvement in exercise tolerance as well as symptomatology. We conclude that surgery for left main coronary artery disease can be done with no increased risk through careful anesthesia,surgery, and aggressive postoperative care in the critical period.

• Journal of Chest Surgery
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• 제23권1호
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• pp.61-72
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• 1990

From Nov. 1987 to Aug. 1989, 12 patients with coronary occlusive disease underwent coronary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. The results were as follows: 1. There were 9 males and 3 females ranged in age from 25 to 69 years with a mean of 50.4 years. 2. The prevalent locations of coronary artery stenosis were left anterior descending branch [9 cases], right coronary artery[4 cases], first diagonal branch[3 cases], left circumflex artery [2 cases] in order of frequency. 3, Among 12 cases, 5 cases had an episode of previous myocardial infarction respectively. 4. We performed triple bypass operation in 3 cases, double bypass in 2 cases and single bypass in 7 cases using great saphenous vein. 5. Postoperative complications were cerebral embolism[1, died], pleural effusion[1], temporary cardiac arrest[1], supraventricular tachycardia[1] and late gastric ulcer bleeding[1]. 6. The follow up periods were ranged from 8 months to 30 months and all survivors were on antiplatelet medication showing free of angina.

• Journal of Chest Surgery
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• 제49권6호
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• pp.461-464
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• 2016

Coronary artery disease has historically been a contraindication to lung transplantation. We report a successful combined bilateral lung transplantation and off-pump coronary artery bypass in a 62-year-old man. The patient had a progressive decline in lung function due to idiopathic pulmonary fibrosis and a history of severe occlusive coronary artery disease.

• Journal of Chest Surgery
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• 제27권3호
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• pp.191-195
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• 1994

Twenty-four patients with left main coronary artery stenosis exceeding 50% underwent coronary artery bypass grafting from January 1991 through June 1993. Four patients [17%] had stenosis only in left main coronary artery and 20 patients [83%] had associate lesion[s] in left anterior descending , circumflex, or right coronary artery. Sixteen patients [67%] had higher degrees of stenosis [>70%] in left main coronary artery. Preoperatively 18 patients [75%] had unstable angina pectoris even during aggressive medical treatment. Preoperatively aggressive medical treatment was performed to relieve the symptom in patients with unstable angina. All patients were perioperatively treated with continuous infusion of isosorbide dinitrate to stabilize symptomatic and hemodynamic states. Twenty patients underwent elective coronary bypass surgery and 4 patients urgent operations due to severe unstable angina. There was no thirty-day mortality or late death. Angina recurred in 1 patient, but coronary angiographic study showed good patency of grafts and the symptom was relieved with medical treatment. We concluded that coronary artery bypass grafting can be safely performed by perioperative efforts, including continuous infusion of isosorbide dinitrate, for hemodynamic stabilization in patients with left main coronary artery stenosis.

• Journal of Chest Surgery
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• 제47권1호
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• pp.43-46
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• 2014

Phlegmasia cerulea dolens (PCD) is one of the most critical disorders of acute deep vein thrombosis in that it can cause permanent disability secondary to the compartment syndrome. Although several etiological factors have been proposed, PCD after coronary artery bypass surgery is extremely rare and its definitive pathophysiology is still under debate. We herein present a case of PCD that resulted in the compartment syndrome after coronary artery bypass surgery. Early recognition and decompression of PCD are crucial for saving the affected limbs.

• Journal of Chest Surgery
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• 제12권3호
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• pp.297-305
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• 1979

Occlusive coronary artery disease presents a potential threat to a significant population in the United States. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. Operative vascular procedures have increased steadily in number over the past 20 years in the United States. There have been many isolated case reports about coronary artery surgery, but these had little clinical impact. Nowadays, major three coronary bypass surgery has developed principally at three cardiac centers in the United States since 1967. Among three coronary bypass operation, the aorta-coronary artery saphenous vein bypass graft was first demonstrated by Favolaro and Effler at the Cleveland Clinic in 1967. We experienced one case of coronary artery disease, which was treated successfully by aorta-coronary saphenous vein graft with mild hypothermia under extracorporeal circulation in May, 1977. Saphenous vein was removed from above the knee and was 2.5 mm in diameter. The left ventricle was not vented for the left ventricle was not overdistended. Temporary artificial pace-maker-Medtronic-was implanted for the prevention and treatment of post-operative arrhythmia and heart block in post-operative first day. He is a 57 year old male businessman who had been suffered from hypertension [200 mmHg in systolic pressure] since 4 years ago, who had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain with choking sensation for 50 days. This symptom was aggravated exposing cold weather, or cold water, but was respond to rest. Pre-operative ECG revealed no any other ischemic sign except sinus bradycardia. Significant S-T segment depression was noted at lead II, AVF after double 5 minutes exercise, indicating positive Master`s test. Serum cholesterol was slight elevated to 253 mg/dl. Final pre-operative diagnosis was made by coronary arteriogram, which showed about 1.0-cm segmental 90 % occlusive atherosclerotic lesion in the proximal part of right coronary artery above the origin of acute marginal artery. Left coronary artery revealed good patency and there was no collateral circulation between right and left coronary artery .Hospital course was not eventful. He was discharged with good result on the post-operative day. He has been free from chest pain for longer than 2 years. And also the arterial flow in the coronary bypass graft is auscultated with the pocket-sized ultrasonic velocity detector, which shows the patency of the coronary bypass graft good.

• Journal of Chest Surgery
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• 제39권7호
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• pp.553-555
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• 2006

고혈압과 고지혈증 그리고 허혈성심질환을 가진 62세 여자 환자가 심폐기를 이용하지 않는 관동맥우회술을 시행한 뒤 척추신경경색이 발생하였다. 심폐기를 이용하지 않는 관동맥우회술을 시행하는 경우 신경계 합병증의 발생 빈도는 통상의 관동맥우회술보다 낮다고 알려져 있다. 특히 관동맥우회술후 척추신경경색의 발생은 매우 드물다. 심폐기를 이용하지 않는 관동맥우회술을 시행한 후 척추신경경색이 발생한 1예를 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제33권6호
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• pp.487-493
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• 2000

Background: Early patency of the coronary artery bypass grafting is determined mainly by surgical technique and status of coronary artery. We analyzed the early result, focusing on the relationship between postoperative angiographic findings and the patency rate. Material and method: During the period of July 1997- August 1999, 86 cases of CABG were performed and the postoperative coronary artery angiography was done in 76 cases on postoperative day 7 to assess the graft patency. Result: Overall graft patency was 90.2% on the angiographic finding. Factors influencing the early graft occlusion were the surgeon's experience, small coronary artery size less than 1.5mm in diameter, coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site(p<0.001). Operative mortailty was 2.3%. Early recurrence of the symptom was 19.8% during the follow up period. Conclusion: We examined the postoperative coronary angiography and found that the surgeon's experience, small coronary artery size less than 1.5mm in diameter, bypass surgery on the coronary arteries related to pre-operative myocardial infarction, and local atheroma at the anastomosis site were the factors for the graft occlusion.

• Journal of Chest Surgery
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• 제30권3호
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• pp.326-329
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• 1997

관상동맥 우회수술은 일반적으로 저체온하에 인공심폐기를 사용하여 체외순환을 하면서 심정지상태에서 시행하는 것이 일반적 인 방법이다. 그러나 선택적 인 병변에 한 하여는 체 외순환을 하지 않고 정상적인 심박동 상태에서 관상동맥 우회 술을 사용하는 방법이 시도되고 있다. 저자들은 우관상동맥에 100%협착을 보이고 경미한 운동시 심한 흉통을 호소한 환자에서 체외순환 없이 관상동맥 우회 술을 성공적으로 시행하였기 에 문헌고찰과함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권1호
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• pp.64-67
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• 2011

Constrictive pericarditis is a rare complication after coronary artery bypass grafting In most cases pericardiectomy is required as a definitive treatment. However, there are several types of constrictive pericarditis such as transient cardiac constriction. Some types of constrictive pericarditis can only be managed with medical therapy. We report a 72-year-old female patient who developed subacute transient constrictive pericarditis with persistent left pleural effusion as a result of postcardiac injury syndrome. The patient went through coronary bypass surgery that was successfully treated with postoperative steroid therapy.