• Anatomy and Cell Biology
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• v.56 no.1
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• pp.155-159
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• 2023

Studies describing the vascular systems and their variations in Situs inversus totalis (SIT) from a whole-body computed tomographic (CT) angiography perspective are lacking. We report a case of SIT in which postmortem CT angiography (PMCTA) was performed as a part of the forensic death investigation and incidentally detected several vascular variations in it. The PMCTA procedure was performed using the multiphase PMCTA protocol. Almost all major vessels were visualized, indeed in a completely reversed pattern. Contrast mixture flow interruptions were noted in the right coronary arterial branches suggesting possible blockage, upon which autopsy revealed >90% vessel occlusions at several locations. As such the cause of death was due to ischemic heart disease. Anomalous origins of the right internal mammary artery; abnormal left thyrocervical trunk and variations in the drainage of testicular veins were noted. Our findings might be helpful to clinicians and add to the body of literature on SIT.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.398-400
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• 1995

Kawasaki s disease is a multisystemic disorder that is an important cause of cardiovascular disease in children. We experienced a case of coronary artery aneurysm secondary to Kawasaki s disease. The patient was 12-year-old female presented as exertional dyspnea & chest pain[NYHA classII . Her coronary angiogram showed saccular aneurysms at proximal right coronary artery and proximal left anterior descending artery. CABG was performed by use of double internal mammary artery.Postoperative E.K.G. showed a normal pattern.She discharged at postoperative 10th day without problem. 4 months after discharge, she had no dyspnea & chest pain in exertion[NYHA class I .

• Journal of Chest Surgery
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• v.33 no.4
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• pp.277-284
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• 2000

Background: Coronary artery bypases grafting in the old aged is associated with high mortality and morbidity, and it is difficult to perform if the coronary artery is diffusely disease. Recently it has been known that platelet derived growth factor(PDGF), especially PDGF-BB, stimulates angiogenesis. Material and Method: New Zealand white rabbit were used. In an attempt to achieve effevtive cardiac revasculatrization without vascular anastmosis, we divided into three groups(group I : Left anterior descending artery(LAD) was occluded by ligature, group II : Bilateral internal mammary vascular pedicles were dissected and implanted into myocardium, group III : The vascular pedicles were implanted into myocardium and PDGF-BB was injected into the myocardial tissue). Two weeks after IMA implantation, the proximal region of implanted LAD was ligated. Four days after LAD ligation angiogram, triphenyl tetrazolium chloride(TTD) staining and hematoxylin eosin staining were performed. Result: 1. Survival rate in group II was significantly higher than that in group I (P<0.05), and survival rate in group III was signficantly higher than that in group II(53% vs 93%, P<0.01). 2. There were significant differences in the ratio of area of necrosis to area at risk between group I and group II, and between group II and group III (P<0.01). 3. Microangiogram for angiogenic response revealed wide area of extensive revascularization with patent vessels in group III. 4. Histologic findings of three groups showed that polymorphonuclear leukocyte infiltration was minimal in group II and none in group III. Conclusion: PDGF-BB can establish functinal cardiac revasculatization through systemic vessels implanted directly into the myocardium.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.995-998
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• 2003

During coronary artery bypass surgery, there are several discrete maneuvers that facilitates localization of the invisible left anterior descending coronary artery. In some cases with intramyocardial left anterior descending artery, long-term patency of a bypassed graft may depend on anastomosing the internal mammary artery graft to the more proximal and superficial site of the intramyocardial left anterior descending artery. We describe an easy technique to locate the proximal superficial left anterior descending artery with a distal coronary arteriotomy and retrograde insertion of a coronary probe.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.320-323
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• 1995

We report a case of recurred Takayasu,s arteritis.The patient was 28-year-old female underwent aorto-left common carotid and aorto-left subclavian bypass graft replacement 1 year ago.Unfortunately, she was readmitted because of newly developing angina and both eye claudication severe headache. Aorto-coronary angiogram showed complete obstruction of left common carotid artery ,stenosis of right carotid artery bifurcation and ostial stenosis of right coronary artery.Bilateral carotid arteries bypass graft with great saphenous vein and right coronary artery bypass graft with right internal mammary artery were done at same the time and she discharged after 21 days without any problem.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.943-946
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• 1999

There was no significant difference in morbidity and mortality between those that received simultaneous operation for coronary artery disease and peripheral vascular disease versus those that received coronary artery bypass graft alone. Simultaneous operation is also cost effective. A 46 year-old patient with resting chest pain and intermittent claudication was diagnosed as unstable angina and Leriche's syndrome. We performed simultaneous revascularization for coronary artery stenosis with internal mammary artery and right gastroepiploic artery and a bifurcated vascular graft interposition between in the aorta, left common iliac and right femoral arteries for Leriche's syndrome. The postoperative coronary angiogram and aortogram revealed a good patency of the arterial conduits and vascular graft. He has been followed for 12 months without any problem.

• Proceedings of the KTCVS Conference
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• 1998.10a
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• pp.19-19
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• 1998

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1263-1266
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• 1996

We have experienced a case of coronary artery bypass surgery without extracorporeal circulation through limited anterior thoracotomy. The lesion was a single vessel disease involving the take off of the left anterior descending artery(LAD) which showed tubular lesion with irregular contour and eccentric stenosis of more than 95% luminal narrowing. Percutaneous transluminal coronary angioplasty(PTCA) seemed to have moderate success rate and moderate complication rate. A segment of left internal mammary artery(LIMA) from the second rib down to the sixth rib was harvested through the bed of resected fourth costal cartilage. Anastomosis between LIMA and LAD was performed under beating condition. The patient was extubated in the operation room and showed excellent postoperative course without complications. The coronary angiography on the postoperative 7th day revealed good patency at the anastomosis site.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.19-25
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• 1984

Aneurysms of the subclavian artery are rare in comparison with other peripheral aneurysm. Most of these aneurysms arise from atherosclerosis, thoracic outlet obstruction, or trauma. We have experienced two cases of false aneurysms occurring the subclavian artery. One was occurred in right subclavian artery distal to right thyrocervical trunk due to trauma [falling] and was corrected with resection of the aneurysm and replacement with right external jugular vein. The other was occurred in the left subclavian artery lateral to the left internal mammary artery with complication of left hemothorax probably due to infection and was corrected with resection of aneurysm and replacement with Dacron graft. Postoperative course of both were uneventful without complication.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.146-149
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• 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.