• 제목/요약/키워드: coronary artery

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관상동정맥루 치험 3예 (Fistula Between Right Coronary Artery and Right Ventricle: Report Of 3 Cases)

  • 곽상룡
    • Journal of Chest Surgery
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    • 제15권1호
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    • pp.112-117
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    • 1982
  • Communications of coronary arteries with the cardiac cavities have first time been described by Krause in 1865 in a case of an accessory artery draining into the pulmonary artery and later Cayla in a case of a right coronary artery entering the right ventricle. The initial cases have been found accidentally at autopsies, however In recent years after the Introduction of angiography and coronary arteriography, the malformation Is diagnosed during life and is corrected surgically. These conditions are unusual entitles since the advent of angiography they are being diagnosed with increasing frequency. Three patients who had surgical correction of coronary-cardiac chamber fistula at our hospital are presented. In the first case and second case, coronary arteriovenous fistula was corrected horizontal mattress suture ligation with pladget under the cardiopulmonary bypass and third case was corrected double ligation with cardiopulmonary bypass standby. The postoperative courses were uneventful. They discharged without any fistula related complica-tions.

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단일 관상동맥 기형이 동반된 급성 대동맥박리의 수술치험 (Aortic Dissection with Aberrant Origin of Single Coronary Artery -Report of 1 case-)

  • 김웅한;안현
    • Journal of Chest Surgery
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    • 제27권12호
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    • pp.1036-1041
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    • 1994
  • Emergency operation was performed in a patient with severe aortic insufficiency caused by type A acute aortic dissection with aberrant high take-off origin of single coronary artery. The single coronary artery was found to arise from an unusual position high in the ascending aorta. Dissection was begun in the aortic root and involved the single coronary ostium. Valve competance was restored by resuspension of the commissures. the false lumen was obliterated with strips of Teflon felt and surgical glue. The aortic tissues were firmly reinforced and sutured. The proximal aortic stump was anatomically reconstructed, and fortunately the aortic valve was preserved and coronary reimplantation avoided. The patient was discharged at postoperative 13 days without specific complications. Postoperative course during the 18 months follow-up was uneventful.

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Coronary-Bronchial Artery Fistula Manifested by Hemoptysis and Myocardial Ischemia in a Patient with Bronchiectasis

  • Lee, Woo-Surng;Lee, Song-Am;Chee, Hyun-Keun;Hwang, Jae-Joon;Park, Jae-Bum;Lee, Jung-Hwa
    • Journal of Chest Surgery
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    • 제45권1호
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    • pp.49-52
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    • 2012
  • A coronary-bronchial artery fistula is a very rare congenital anomaly of the coronary artery whose etiology and pathogenesis have not yet been clarified. Most patients with coronary-bronchial fistulas are asymptomatic; however, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Furthermore, patients with a coronary-bronchial artery fistula rarely manifest life-threatening hemoptysis due to the associated bronchiectasis. We report herein the case of a patient with a coronary-bronchial artery fistula who had bronchiectasis and a history of massive hemoptysis and myocardial ischemia.

Coronary artery vasospasm after atrial septal defect surgery

  • Yoon, Jin Won;Lee, Young Soo;Kim, Dong Keun;Choi, Young Hoon;Kim, Dong-Ju;Lee, Jae Jin;Ahn, Hyo Seung;Cho, Wook Hyun
    • Journal of Yeungnam Medical Science
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    • 제31권2호
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    • pp.122-126
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    • 2014
  • Coronary vasospasm is one of the fatal complications that may occur in patients undergoing open heart surgery. To date, however, there are not many cases in this series and no definite pathophysiology has been documented. We experienced a case of coronary artery vasospasm after atrial septal defect (ASD) surgery and then successfully treated it with both transbrachial intraaortic balloon pump and percutaneous cardiopulmonary support. Only several hours after ASD surgery, the patient exhibited the cardiovascular collapse, the ST-segment elevation, followed by ventricular fibrillation and normal coronary angiography findings. It is important to make a differential diagnosis of coronary artery vasospasm in patients presenting with ST-segment elevation who had no notable coronary artery diseases. This case indicates that clinicians should be aware of the possibility that the coronary artery vasospasm may also occur in patients undergoing ASD surgery.

대혈관전위로 동맥치환술을 시행했던 환자에서 발생한 관상동맥 압박 -1예 보고- (Coronary Artery Compression after an Arterial Switch Operation for Transposition of the Great Arteries - A case report-)

  • 유재석;곽재건;김용진
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.360-362
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    • 2008
  • 대혈관전위 환자에서 동맥치환술 시행 시 관상동맥의 위치는 수술의 성적 및 환자의 예후에 매우 중요한 요소이다. 본 증례는 과거 대혈관전위로 동맥치환술을 시행 받았던 환자에서 발생한 관상동맥 압박에 대한 보고이다. 14세 남자 환자로 운동 시 협심증을 주소로 내원하였고, 영상학적 검사 결과 좌관상동맥 기시부가 대동맥과 폐동맥 사이에 위치하여 눌리고 있는 양상이어서 수술적 치료를 결정하였다. 수술은 좌관상동맥 기시부를 대동맥에서 버튼 절제한 후 좌외측으로 재이식하여 폐동맥에 눌리지 않도록 하였다. 수술 후 관상동맥의 대혈관에 의한 압박 소견은 사라졌으며 환자는 현재까지 합병증이나 증상 재발 없이 추적 관찰 중이다.

당뇨병 환자의 혈당조절 정도에 따른 관상동맥질환 관련 지식과 교육요구도 조사 (Knowledge and Learning Needs Related to Coronary Artery Disease in Diabetic Patient by Glycemic Control)

  • 송민선;김희승;오정아
    • 성인간호학회지
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    • 제19권5호
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    • pp.27-36
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    • 2007
  • Purpose: The purpose of this study was to investigate the knowledge and learning needs on coronary artery disease in diabetic patients by glycemic control. Methods: The subjects consisted of 188 patients at the hospital who had diabetes mellitus. Data was obtained using a knowledge and learning needs questionnaire from January to April 2006. Results: Treatment method, the levels of fasting blood glucose(FBG), and 2-hour postprandial blood glucose(PP2hr) showed meaningful differences between normo-glycemic group(HbA1c < 7%) and hyper-glycemic group($HbA1c{\geq}7%$). The levels of knowledge on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. Etiology and prevention of coronary artery disease were significantly higher in normo-glycemic group than in hyper-glycemic group. The levels of learning needs on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. The learning needs on items of diet control were higher in normo-glycemic group than in hyper-glycemic group. Conclusion: On the base of these results, we should focus on the coronary artery disease education for hyper-glycemic group. Also individual coronary artery disease educational program should be developed for the patients with different level of knowledge and learning needs.

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True Aneurysm of the Common Coronary Button in a Marfan Patient with an Anomalous Right Coronary Artery after a Bentall Procedure: A Case Report

  • Jo, Jeong Jun;Kim, Yun Seok;Kim, Gun-Jik;Kim, Jae Hyun
    • Journal of Chest Surgery
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    • 제55권3호
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    • pp.243-245
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    • 2022
  • True aneurysms of the coronary artery after aortic root replacement in Marfan syndrome patients are very rare. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva adds complexity during aortic root surgery. We present a case of a 37-year-old male patient with Marfan syndrome who had an RCA anomaly and a 4.5-cm true aneurysm of the common coronary button 14 years after a previous Bentall procedure. A redo Bentall operation and hemi-arch replacement were successfully performed. The anomalous origin of the RCA from the left sinus of Valsalva was safely divided and anastomosed as separate coronary buttons to the prosthetic composite valve graft. To prevent coronary button aneurysms after aortic root surgery in Marfan patients, the coronary buttons and the corresponding side holes on the prosthetic graft must be reduced to the maximum possible extent.

생후 3개월에서 7세 미만 정상 소아에서의 관상동맥 직경 (Coronary artery diameter of normal children aged 3 months to 6 years)

  • 유정진;조숙경;박용민;이란;정소정;배선환
    • Clinical and Experimental Pediatrics
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    • 제51권6호
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    • pp.629-633
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    • 2008
  • 목 적 : 가와사끼병에 따른 관상동맥 직경 증가를 판단하기 위하여 필요한 좌주간부 관상동맥(LCA, left main coronary artery), 좌전하행 관상동맥(LAD, left anterior desending coronary artery), 우 관상동맥(RCA, right coronary artery) 각각의 정상 직경에 대한 자료가 아직 국내에 발표되지 않아, 이를 조사하기 위해 본 연구가 계획되었다. 방 법 : 2005년 3월부터 2007년 11월까지 건국대학교 병원을 방문하여 심초음파 검사를 받았으나, 특별한 심질환 소견을 보이지 않았던 생후 3개월에서 7세 미만 소아 43명을 대상으로 하였다. 심초음파 검사 시행 후 저장되었던 영상 자료에서 관상동맥 크기 측정이 이루어졌으며, 체표면적 등의 몸 크기 자료를 독립 변수로 하여 단순 선형 회귀분석이 시행되었다. 결 과 : 체표면적은 LCA($R^2=0.20$, P=0.0038), LAD($R^2=0.41$, P<0.0001), 및 RCA($R^2=0.30$, P=0.0002) 모두의 직경과 의미 있는 관계를 보였다. 회귀 공식에서 y 절편은 각각 1.703, 1.058, 1.007; 회귀 계수는 각각 0.971, 1.175, 1.177; 표준편차는 각각 0.315, 0.221, 0.282 로 추정되었다. 결 론 : 개별 관상동맥 직경과 체표면적과의 의미 있는 관계가 확인되었고, 선형 회귀 공식이 산출되었다. 본 연구 결과를 활용하여, 개별 관상동맥 직경의 Z-score 산출을 국내 자료로서 가능하도록 한 것이 본 연구의 의의라고 할 수 있겠다.

자가정맥편을 이용한 관상동맥 혈관성혈술 (Onlay Patch Coronary Angioplasty with Autologous Saphenous Vein)

  • 류경민;김삼현;박성식;류재옥;서필원
    • Journal of Chest Surgery
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    • 제33권6호
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    • pp.512-517
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    • 2000
  • Background: Onlay vein patch coronary angioplasty has been known to be an option for coronary artery stenosis in the selective iesions Material and method: During the period between July 1997 and August 1999, coronary angioplasty using autologous saphenous vein was done on 16 sites in 14 cases for the stenotic lesion at the bifurcation area and significantly stenosis distal to anastomosis. Result: Early patency of the angioplasty site was 85.7% at postoperative day 7. There was no statistically difference in graft patency, operative parameters, and complications compared to conventional anatomosis(p>0.05). Conclusion: Despite the small number of cases, the patency rate of the coronary patch angioplasty was comparable to the conventional CABG. Coronary artery only patch angioplasty could be performed in highly selected coronary arteries.

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Aorto-Coronary Bypass의 기하학적 형상이 관상동맥의 혈류특성에 미치는 영향 (Effects of the Geometric Dimensions on the Hemodynamics of Aorto-Coronary Bypass)

  • 서상호;노형운;유상신;권혁문;김동수
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 추계학술대회
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    • pp.254-257
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    • 1996
  • An aorto-coronary bypass graft is frequently adopted for the interventional therapy of the diseased atherosclerotic coronary artery grafting. The bypass artery is often occluded due to restenosis and/or anastomotic neointimal fibrous hyperplasia after bypass graft. The optimal aorto-coronary bypass procedure must be studied in order to improve patency rate for the arterial bypass techniques. The objective of this study is to investigate the influences of geometric dimensions of bypass on the hemodynamics around the anastomosis in the stenosed coronary artery with aorto-coronary bypass.

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