• Title/Summary/Keyword: Revascularization

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Repair of Acute Post Infarction Mitral Regurgitation with Papillary Muscle Reimplantation - A case report -

  • Park, Won-Kyoun;Kim, Joon-Bum;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.285-287
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    • 2011
  • A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

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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Isolated Bypass to the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

  • Jun, Hee Jae
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.146-149
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    • 2013
  • Mesenteric ischemic symptoms appear only when two of the three major splanchnic arteries from the abdominal aorta are involved. Recently, we encountered a case of chronic mesenteric ischemia in a 50-year-old female patient caused by atherosclerotic obstruction of the celiac trunk and superior mesenteric artery. She was treated with a retrograde bypass graft from the right common iliac artery to the superior mesenteric artery (SMA) in a C-loop configuration. Complete revascularization is recommended for treatment of intestinal ischemia. When the celiac trunk is a not suitable recipient vessel, bypass grafting to the SMA alone appears to be both an effective and durable procedure for treating intestinal ischemia.

First Results of the Single Heartstring Aortotomy for Multiple Off-Pump Vein Grafts: A Case Series

  • Santos, Rafael Freire dos;Niclauss, Lars
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.403-407
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    • 2020
  • To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

Aorto-coronary Bypass for Unstable Angina - one case report - (불안정형 협심증의 관상동맥 우회수술치험 1)

  • 김형묵
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.393-398
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    • 1987
  • Unstable angina pectoris is often premonitory to an acute myocardial infarction. Surgical revascularization in this syndrome is of great potential benefit and relatively low mortality. A patient with unstable angina pectoris is reported. A 65-year-old man complained of dyspnea and pain in the left anterior chest. The pain was brought on by mild exercise, occurred at rest and sleeping time. The pain worsened over a month period and more aggravated in intensity and duration. Physical examination showed no abnormalities except hypertension and laboratory data were within normal limits. His anginal pain was not relived by nitroglycerin ingestion. Preoperative coronary angiograms revealed significant obstruction [>90%] of left anterior descending coronary artery. Aorto-left anterior descending coronary bypass with autogenous saphenous vein used as conduit was performed. The postoperative course was uneventful and he was discharged on 16th postoperative day in a healthy condition.

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Mycotic Abdominal Pseudoaneurysm due to Psoas Abscess after Spinal Fusion

  • Ryu, Dae Woong;Lee, Sam Youn;Lee, Mi Kyung
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.443-446
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    • 2015
  • A 36-year-old man, who had undergone thoracoscopic anterior spinal fusion using the plate system and posterior screw fusion three months previously, presented to our hospital with left flank pain and fever. Computed tomography indicated the presence of a psoas muscle abscess. However, after two days of percutaneous catheter drainage, a mycotic abdominal aortic pseudoaneurysm was detected via computed tomography. We performed in situ revascularization using a prosthetic graft with omental wrapping. Methicillin-resistant Staphylococcus aureus was identified on blood and pus culture, and systemic vancomycin was administered for one month. Although the abscess recurred, it was successfully treated with percutaneous catheter drainage and systemic vancomycin administration for three months, without the need for instrumentation removal. The patient remained asymptomatic throughout two years of follow-up.

Hybrid Coronary Artery Revascularization for Takayasu Arteritis with Major Visceral Collateral Circulation from the Left Internal Thoracic Artery

  • Sim, Hyung Tae;Kim, Jeong-Won;Yoo, Jae Suk;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.105-109
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    • 2017
  • Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation.

In Situ Sapheneous Vein Arterial Bypass; A Case Report (자연위치의 복재정맥을 이용한 하지동맥 우회술;치험 1례)

  • 문남출
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.881-885
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    • 1993
  • In the last few years there has been a resurgenceof interest in in-situ saphenous vein arterial bypass for lower extremity revascularization because of improved patency rates. we performed 1 in situ bypass oreration using the intraluminal valve-disruption tecnique. A 65-year-old female who had ztherosclerotic obstruction in the superficial and popliteal arteries underwent in situ saphenous vein arterial bypass. After harvesting of saphenous vein, we used LeMaitre retrograde valvulotome for valve-disruption technique. Completion of the arterrigraphy was performed to evaluate bothh the anastomoses. The two side brances were all ligated. In situ saphenous vein arterial bypass has become the procedure of choice for distal reconstruction in severely ischemic lower extremities because of improved long-term patency compared with reversed-saphenous vein bypass procedure.

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Patency Rate of Grafts after Coronary Artery Bypass Surgery (관상동맥 우회수술후 이식혈관의 개존)

  • 노환규
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.42-48
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    • 1992
  • Clinical improvement after coronary artery bypass surgery depends on the complete revascularization and patency of graft vessels. Patency rate and the factors influencing the patency were studied by examining 134 grafts in 55 patients at a mean follow-up of 22.8$\pm$4.2 months, range 15 days and 108 months. Serial studies were performed on 7 patients with 18 grafts. The over-all patency rate was 80.6%, and the rate more than 5 years after surgery was 50.0% with mean interval of 81 months. Patency rate of patients who had taken both aspirin and dipyridamole was higher than of patients who had been treated with aspirin only[80.5% vs 56.5%]. The average serum triglyceride level of patients who had graft stenosis or occlusion in at least one site was significantly higher than that of patients in whom all grafts were patent[262.1mg% vs 174.8mg%]. Patency rate of grafts in patient who had angina was 73.2% and in patients without angina 79.2%. 6 patients underwent successful percutaneous transluminal angioplasty for narrowed or occluded grafts.

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Intraventricular Hemorrhage Long after Successful Encephaloduroarterio Synangiosis in Moyamoya Patient

  • Chung, Moon-Young;Park, Young-Seok;Kim, Dong-Seok;Choi, Joong-Uhn
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.257-260
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    • 2009
  • Intraventricular hemorrhage long after successful encephaloduroarterio synangiosis (EDAS) is very rare. The effect of revascularization surgery for preventing hemorrhagic event of moyamoya disease remains controversial. We report a 17-year-old female with intracerebral hemorrhage and intraventricular hemorrahge 10 years after successful EDAS. Even though cerebral vessels angiography showed good collateral circulations without specific weak points, a cerebral hemorrhage could occur in patient with ischemic type of moyamoya disease long after successful indirect bypass operations. Good collateralization of cerebral angiography or magnetic resonance perfusion image after indirect bypass surgery would ensure against ischemic symptoms, not a hemorrhage. And, thus a life-time follow-up strategy might be necessary even if a good collateral circulation has been established.