• Journal of Chest Surgery
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• 제22권5호
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• pp.829-833
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• 1989

Congenital coronary arteriovenous fistula is relatively uncommon, but with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Recently we experienced one case of congenital coronary artery fistula which originated from the right coronary artery. The case was 25 year-old-male, who complained of dyspnea on exertion and continuous murmur was heard, and diagnosed as right coronary artery fistula by the cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated from aorta to the middle segment at acute margin of the right ventricle, which the hen-egg sized aneurysm was noticed. The dilated coronary ostium and fistular site were obliterated with several horizontal mattress sutures. And the dilated tortuous right coronary artery with aneurysm was excised. Postoperative course was uneventful and discharged without problem.

• Pediatric Infection and Vaccine
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• 제2권2호
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• pp.186-192
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• 1995

We measured plasma concentrations of high density lipoprotein, total cholesterol and triglycerides in 31 patients with history of kawasaki disease during acute stage and convalescence stage. High density lipoprotein cholesterol and total cholesterol concentrations were significantly lower(P<0.001) in samples taken within 11 days of the onset of illness($28.7{\pm}12.4mg/dl$ and $145.20{\pm}29.60mg/dl$) than in the second samples taken 1-2months after onset of disease($51.5{\pm}15.2mg/dl$ and $175.4{\pm}29.0mg/dl$). Change of triglycerides was not significant. There was no correlation between the serum cholesterol cencentration and coronary aneurysm and continued long term surveillance of much population is necessary to monitor lipid level and their relation to development of premature coronary atherosclerosis.

• Journal of Chest Surgery
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• 제54권3호
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• pp.221-223
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• 2021

Giant coronary artery aneurysms are rare and challenging to treat because of variation in the presenting symptoms and the lack of established management guidelines. We report the case of a patient with a 6-cm-wide giant coronary artery aneurysm that was resected, followed by reconstruction using a saphenous vein graft and 18 years of follow-up.

• Journal of Chest Surgery
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• 제32권9호
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• pp.831-834
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• 1999

가와사키병은 1967년 일본에서 처음 발표된 이후 전세계적으로 그 발생이 알려져 왔다. 소아 환자에서 치료받지 않는 경우 약 20%에서 관상동맥류가 발생하며, 그 중 2-3%에서 관상동맥협착이 발생한다고 알 려져 있다. 아직까지 성인에서는 가와사키병의 발생에 대한 보고가 많지 않은 상태이다. 본 증례는 43세 여자환자로 20여년 전 앓았던 것으로 생각되는 가와사키 늉\ulcorner의해 관상동맥류 및 협착증이 발생하여 좌 측 내유동맥, 우 위대망동맥, 대복재정맥을 이용하여 관상동맥 우회술을 시행하였으며, 수술후 5개월간 추적중 양호한 상태이다.

• Journal of Chest Surgery
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• 제30권7호
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• pp.724-728
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• 1997

68세된 남자로 좌측과 후측 흉부에 통증을 주소로 내원하였다. 술전 시행한 흉복부 W scan에서 대동맥류는 좌측 쇄골하동맥에서 횡격막까지 연결되었고 긴박성 파열의 소견도 보였다. 또한 술전 관동맥조영술에서는 좌회선동맥에 95%, 좌전하행지에 50%의 협착소견을 보였다. 수술은 고동맥-고정맥 우회술을 하면서 좌측 제 4늑간을 통하여 측후방 개흉절개를 하여 수술시야를 확보하였고 대동맥을 차단한뒤 대동맥류를 절개하고 인조혈관으로 대치하였다. 그리고 심박동하에서 대복제정 맥을 이용하여 좌회선동맥의 두번째 둔각변연동맥과 좌측 쇄골하동맥 기시부에 관상동맥 우회술을 하였다. 술후 환자는 술중 저혈압성 쇼크와 저산소증으로 다발성 뇌경색의 합병증을 보였다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.748-752
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• 1989

We experienced 6 patients with the sinus Valsalva aneurysm rupture during last 12 years [Jan. 1977-Sep. 1989]. Of them. 5 cases were reviewed. They consist of 3 males and 2 females, and the age ranged from 12 years to 40 years with the mean age of 25 years. 4 patients showed congestive heart failure symptoms. The diagnosis was made by 2D-Echo and cine-angiogram. In 4 patients. sinus Valsalva aneurysm ruptured from the Rt. coronary sinus to the Rt. ventricle, and in one from non-coronary sinus to the Rt. atrium. In 2 cases, resection of the aneurysm and simple stitch closure was made. Resection of the aneurysm k patch closure and AVR in one, closure of the fistula, AVR and patch closure of the associated VSD in one, and closure of the fistula, AVR k TVR in one were made in another 3 cases. There was no postoperative mortality case.

• Journal of Chest Surgery
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• 제25권5호
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• pp.550-554
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• 1992

The selection of an appropriate surgical technique for repair of aneurysm of the ascending aortia with aortic insufficiency is unsettled. The etiology of the disease process has been the best indicator for the type of repair. Placement of a supracoronary graft[seperate graft and valve] is a compromise if the coronary ostia are displaced cephalad by the aneurysm, where as insertion of a valved conduit is difficult and unnecessary if the coronary ostia are normally placed. A 53 year old female patient underwent primary repaiar of proximal dissected layer and aortic valve replacement with 24mm carbomedics, The operative findings consisted of a supravalvular intimal tear, cicumferential dissection, dilated aortic annulus and normal position of coronary ostia. She is good physical activity now llmonths posoperatively.

• Journal of Chest Surgery
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• 제16권2호
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• pp.175-183
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• 1983

Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.159-166
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• 1988

Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dessecting aortic aneurysm is occured, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treament(Modified Bentall's operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.

• Journal of Chest Surgery
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• 제15권1호
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• pp.124-128
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• 1982

Here, we present a case of ruptured sinus Valsalva aneurysm with fistulous communication between the right coronary aortic sinus and the right ventricle in 8 year old boy. Ruptured sinus Valsalva aneurysm is rare. And several reports are describing its pathophysiologic features, clinical findings and management. This patient was asymptomatic and the physical examination revealed palpable thrill and Grade III pansystolic murmur at the 3rd and 4th intercostal space along the left sternal border. There was an oxygen step up from right atrium into right ventricle on the cardiac catheterization reports. On 15th July 1981, an open heart surgery was performed and we found ruptured right coronary sinus Valsalva aneurysm into the right ventricle, which was managed successfully by doing direct pledget sutures. The postoperative course was uneventful.