• Title/Summary/Keyword: Percutaneous bypass

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Factors Associated with Early Adverse Events after Coronary Artery Bypass Grafting Subsequent to Percutaneous Coronary Intervention

  • Kamal, Yasser Ali;Mubarak, Yasser Shaban;Alshorbagy, Ashraf Ali
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.171-176
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    • 2016
  • Background: A previous percutaneous coronary intervention (PCI) may affect the outcomes of patients who undergo coronary artery bypass grafting (CABG). The objective of this study was to compare the early in-hospital postoperative outcomes between patients who underwent CABG with or without previous PCI. Methods: The present study included 160 patients who underwent isolated elective on-pump CABG at the department of cardiothoracic surgery, Minia University Hospital from January 2010 to December 2014. Patients who previously underwent PCI (n=38) were compared to patients who did not (n=122). Preoperative, operative, and early in-hospital postoperative data were analyzed. The end points of the study were in-hospital mortality and postoperative major adverse events. Results: Non-significant differences were found between the study groups regarding preoperative demographic data, risk factors, left ventricular ejection fraction, New York Heart Association class, EuroSCORE, the presence of left main disease, reoperation for bleeding, postoperative acute myocardial infarction, a neurological deficit, need for renal dialysis, hospital stay, and in-hospital mortality. The average time from PCI to CABG was $13.9{\pm}5.4$ years. The previous PCI group exhibited a significantly larger proportion of patients who experienced in-hospital major adverse events (15.8% vs. 2.5%, p=0.002). On multivariate analysis, only previous PCI was found to be a significant predictor of major adverse events (odds ratio, 0.16; 95% confidence interval, 0.03 to 0.71; p=0.01). Conclusion: Previous PCI was found to have a significant effect on the incidence of early major adverse events after CABG. Further large-scale and long-term studies are recommended.

Emergency Surgery after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술후의 응급 관상동맥 우회술)

  • 박영환
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.73-78
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    • 1992
  • From Octorber 1984 through September 1991, 480 patients underwent percutaneous tra-nsluminal coronary angioplasty and 7 of these[1.4%] required coronary artery bypass surgeries in the emergency base. The principal indications for surgery were coronary dis-sections[n=2], acute coronary occlusions[n=3], and ventricular arrhythmias[n=2]. There were two early deaths and one late death. No patient who developed cardiac arrest and had not been resuscitated before surgery survived the operation. The outcome of surgery was related to the preoperative clinical status of patients.

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Coronary Artery Bypass Grafti ng without Extracorporeal Ci rculation One Case Report (체외순환을 사용하지 않은 관상동맥우회술-1례보고-)

  • 임창영;이헌재
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.326-329
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    • 1997
  • Coronary artery bypass grafting(CABG) without cardiopulmonary bypass(CPB) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. The lesion was total(100%) occlusion of proximal right coronary artery(RCA) without any evidence of dis,Base in the rest of coronary arteries. Percutaneous transluminal angioplasty(PTCA) was tried but unsuccessful. We herein report a case of successful CABG to right coronary artery without CPB on a patient with complete occlusion of RCA and symptomatic wit minimal activity.

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Usefulness of ultrasonography radial artery diameter with lumen evaluation (초음파를 이용한 요골동맥의 직경 및 내강 평가)

  • Park Young-Hee
    • Journal of The Korean Radiological Technologist Association
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    • v.27 no.2
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    • pp.175-180
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    • 2001
  • Ⅰ. Background and Objectives : Recently the percutaneous transradial approach for coronary angiography and angioplasty has been using. When the radial artery as a graft for coronary artery bypass surgery was used, pantency increased. Many examination and

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Clinical Analysis of Cardiovascular Surgery -Report of 2094 Cases- (심혈관질환수술에 대한 임상적 고찰 -2094례 보고-)

  • 김병열
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1030-1039
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    • 1988
  • From 1985 through Oct. 1988, we have experienced 5 cases of Aorto-Coronary Bypass Surgery [ACBS] and 3 cases of Percutaneous Transluminal Coronary Anogioplasty [PTCA]under the diagnosis of unstable angina. There were 6 males and 2 females who ranged from 48 to 70 years old. Almost all patients had a evidence of hypertension & hyperlipidemia. Two patients showed old myocardial infarction and remaining patients showed myocardial ischemia on resting state. The patterns of involvement of coronary artery disease were single vessel disease [4 cases], double vessel disease [3 cases], Triple vessel disease [1 case]. Among 5 cases of ACBS, double bypass graft was in 3 cases and single bypass graft was in 2 cases. Mode of anastomosis were all individual anastomosis, using Saphenous vein graft. Postoperative complications were perioperative myocardial infarction [2 cases], postoperative bleeding [1 case], leg wound disruption [1 case]. Perioperative myocardial infarction cases didn*t survive. In cases of PTCA, there were no complications. Follow up periods were ranged from 1 month to 25 months. All survived cases were asymptomatic except one case, who showed Functional Class II.

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Post-Coronary Artery Bypass Grafting Myocardial Ischemia Caused by an Overgrown Left Internal Thoracic Artery Side Branch

  • Kim, Eung Re;Oh, Se Jin;Kang, Hyun-Jae;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.465-467
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    • 2014
  • We present a patient who developed recurrent angina after coronary artery bypass grafting (CABG). Myocardial single-photon emission computed tomography (SPECT) demonstrated deterioration in the myocardial perfusion, and coronary angiography revealed an overgrown side branch of the grafted left internal thoracic artery (ITA); otherwise, there were no significant changes compared with previous imaging studies obtained after the CABG. After percutaneous embolization of the grafted left ITA side branch, the angina was resolved and myocardial SPECT showed improved perfusion.

Surgical Management of Giant Aneurysm of Intracranial Artery Under Circulatory Arrest -one case report- (총순환정지를 이용한 두개강내 거대동맥류 치험 1례)

  • 홍종면;김오곤;이석재;홍장수;민경수;김상태;임승운;송우익
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.80-83
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    • 1999
  • Complete circulatory arrest with profound hypothermia has been an indispensable adjunct to the safe management of selected giant intracranial aneurysms. For the conduct of cardiopulmonary bypass, there are usually two kinds of methods, open and closed chest methods. We could manage one case of huge intracranial aneurysm that was successfully operated under circulatory arrest using the closed chest method, especially with percutaneous insertion of arterial and venous cannulas for cardiopulmonary bypass.

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Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Surgery in Korea

  • Lee, Heeyoung;Lee, Kun Sei;Sim, Sung Bo;Jeong, Hyo Seon;Ahn, Hye Mi;Chee, Hyun Keun
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.60-67
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    • 2016
  • Background: Coronary angioplasty has been replacing coronary artery bypass grafting (CABG) because of the relative advantage in terms of recovery time and noninvasiveness of the procedure. Compared to other Organization for Economic Cooperation and Development (OECD) countries, Korea has experienced a rapid increase in coronary angioplasty volumes. Methods: We analyzed changes in procedure volumes of CABG and of percutaneous coronary intervention (PCI) from three sources: the OECD Health Data, the National Health Insurance Service (NHIS) surgery statistics, and the National Health Insurance claims data. Results: We found the ratio of procedure volume of PCI to that of CABG per 100,000 population was 19.12 in 2014, which was more than triple the OECD average of 5.92 for the same year. According to data from NHIS statistics, this ratio was an increase from 11.4 to 19.3 between 2006 and 2013. Conclusion: We found that Korea has a higher ratio of total procedure volumes of PCI with respect to CABG and also a more rapid increase of volumes of PCI than other countries. Prospective studies are required to determine whether this increase in absolute volumes of PCI is a natural response to a real medical need or representative of medical overuse.

Minimally Invasive Coronary Artery Bypass without Extracorporeal Circulation - One case report - (심폐바이패스없이 제한적 전흉부개흉술로 시행한 관상동맥우회술 1례)

  • 서필원;김삼현;이상민;김영권;박이태
    • 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.

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Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings

  • Cho, Sungsoo;Kang, Tae Soo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.121-126
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    • 2018
  • Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.