• Title/Summary/Keyword: Coronary grafting

Search Result 238, Processing Time 0.018 seconds

Analysis of Bypass Grafting Effects in Stenosed Coronary Arteries (협착이 발생된 관상동맥에 대한 이식우회로술의 효과분석)

  • Kim, Hyoung-Ho;Suh, Sang-Ho;Lee, Jeong-Sang
    • Transactions of the Korean Society of Mechanical Engineers B
    • /
    • v.36 no.2
    • /
    • pp.153-159
    • /
    • 2012
  • Bypass anastomosis is frequently adopted for surgical treatments of stenosed coronary arteries. Optimal coronary bypass grafting should be investigated to improve the patency in arterial bypass techniques. The objective of this study is to analyze the effects of Y-grafting bypasses and T-grafting bypasses for various bifurcation and anastomotic angles. In order to find the optimal geometric configuration, the hemodynamic characteristics are obtained and compared with each other for different geometries. We found that both the left anterior descending artery (LAD) and left circumflex artery (LCX) blood flows were distributed evenly when the bypass grafting angle and bifurcated angle were $30^{\circ}$ and $15^{\circ}$, respectively,.

"Off-Pump" Coronary rtery bypass Grafting in Multi-vessel Coronary Disease -Two Cases- (다중 혈관질환에서 심폐바이패스를 이용하지 않은 관상동맥 우회술)

  • 유원희;김기봉
    • Journal of Chest Surgery
    • /
    • v.32 no.12
    • /
    • pp.1123-1126
    • /
    • 1999
  • Coronary artery bypass grafting (CABG) technique has been much developed but CABG under cardiopulmonary bypass has the unavoidable deficits such as generalized inflammatory reaction from cardiopulmonary bypass and myocardial ischemia from aortic-cross clamp. There has been remarkable advancement of CABG without cadiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass in two patients with multivessel coronary disease who were failed to intervene with percutaneous transluminal coronary angioplasty. We herein report the two cases.

  • PDF

Surgical Tratment and Result of Coronary Artery Bypass Grafting in Patients with Left Main Coronary Artery Stenosis (좌주관동맥 병변의 수술방법 및 결과)

  • Choe, Jong-Beom;Jo, Seon-Hwan
    • Journal of Chest Surgery
    • /
    • v.27 no.3
    • /
    • pp.191-195
    • /
    • 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.

  • PDF

The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience

  • Suma, Hisayoshi
    • Journal of Chest Surgery
    • /
    • v.49 no.4
    • /
    • pp.225-231
    • /
    • 2016
  • Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures.

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Revascularization of Left Main Coronary Artery Disease

  • Sangwoo Park;Seung-Jung Park;Duk-Woo Park
    • Korean Circulation Journal
    • /
    • v.53 no.3
    • /
    • pp.113-133
    • /
    • 2023
  • Owing to a large-jeopardized myocardium, left main coronary artery disease (LMCAD) represents the substantial high-risk anatomical subset of obstructive coronary artery disease. For several decades, coronary artery bypass grafting (CABG) has been the "gold standard" treatment for LMCAD. Along with advances in CABG, percutaneous coronary intervention (PCI) has also dramatically evolved over time in conjunction with advances in the stent or device technology, adjunct pharmacotherapy, accumulated experiences, and practice changes, establishing its position as a safe, reasonable treatment option for such a complex disease. Until recently, several randomized clinical trials, meta-analyses, and observational registries comparing PCI and CABG for LMCAD have shown comparable long-term survival with tradeoffs between early and late risk-benefit of each treatment. Despite this, there are still several unmet issues for revascularization strategy and management for LMCAD. This review article summarized updated knowledge on evolution and clinical evidence on the treatment of LMCAD, with a focus on the comparison of state-of-the-art PCI with CABG.

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
    • /
    • v.32 no.12
    • /
    • pp.1127-1130
    • /
    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

  • PDF

Intractable Coronary Spasm Requiring Percutaneous Coronary Intervention after Coronary Artery Bypass Grafting in a Patient with Moyamoya Disease

  • Kim, Hyeon A;Kim, Young Su;Kim, Wook Sung
    • Journal of Chest Surgery
    • /
    • v.54 no.2
    • /
    • pp.150-153
    • /
    • 2021
  • Moyamoya disease (MMD) is characterized by progressive steno-occlusive lesions of the distal or proximal branch of the internal carotid arteries, and cerebrovascular symptoms are its major complications. Extracranial vascular involvement including the coronary artery has been reported, and some case reports have described variant angina or myocardial infarction. However, no report has yet described a case of myocardial infarction after coronary artery bypass grafting (CABG). Here, we present a patient with MMD who suffered cardiac arrest caused by myocardial infarction due to a coronary spasm after offpump CABG and who was discharged successfully after treatment with a veno-arterial extracorporeal membrane oxygenator and percutaneous coronary intervention.

Refractory Coronary Artery Spasm after Minimally Invasive Direct Coronary Artery Bypass Grafting

  • Ju, Min-Ho;Kim, Joon-Bum;Kim, Hee-Jung;Choo, Suk-Jung
    • Journal of Chest Surgery
    • /
    • v.44 no.4
    • /
    • pp.288-291
    • /
    • 2011
  • Postoperative coronary arterial spasm is a rare but potentially fatal complication. A 51-year-old male patient with a history of a reactive ergonovine stress test coronary angiogram developed refractory coronary artery spasm after undergoing minimally invasive direct coronary artery bypass grafting of the left anterior descending coronary artery. The patient was successfully managed with rapid implementation of intra-aortic balloon-pump counter pulsation and extracorporeal membrane oxygenation.

Wrapping of an Ascending Aortic Aneurysm with the Multiple Boot-Straps Technique in a Patient Undergoing Off-Pump Coronary Artery Bypass Grafting

  • Na, Kwon Joong;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong
    • Journal of Chest Surgery
    • /
    • v.48 no.3
    • /
    • pp.206-209
    • /
    • 2015
  • Ascending aortic aneurysms are usually treated with graft replacement under cardiopulmonary bypass. However, if a candidate for off-pump coronary artery bypass grafting has an enlarged ascending aorta, surgeons may consider wrapping it without cardiopulmonary bypass. Here, we report a 78-year-old female who underwent successful wrapping of the ascending aorta concomitant with off-pump coronary artery bypass grafting, using a new wrapping technique that involves multiple bootstraps.

Coronary Artery Bypass Grafting in an Infant after an Arterial Switch Operation

  • Choi, Wooseok;Pyo, Wonkyung;Choi, Eun Seok;Chung, Cheol Hyun
    • Journal of Chest Surgery
    • /
    • v.54 no.2
    • /
    • pp.146-149
    • /
    • 2021
  • Coronary artery bypass grafting (CABG) is rarely performed in infants because of its technical difficulty and unclear long-term results. A 90-day-old male infant weighing 3.5 kg who underwent an arterial switch operation (ASO) for transposition of the great arteries developed left coronary artery insufficiency despite augmentation and reimplantation of the left coronary button. On-pump beating heart CABG was performed using an internal mammary artery graft to revascularize the left anterior descending artery. Postoperative computed tomography angiography revealed that the graft was patent. At 7 months postoperatively, the patient weighed 8.5 kg, and echocardiography revealed good ventricular function. CABG can be an alternative treatment for post-ASO coronary complications in early infancy.