• Journal of Chest Surgery
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• 제29권2호
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• pp.251-253
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• 1996

활로 4징증에서 우심 실유출로협 착의 다양한 형태가 수술결과를 좌우하는 가장 중요한 조건이나 드물게 관상동맥의 기시 및 주행이상이 수술을 어렵게 만들며 술후예후에도 영향을 끼친다. 비교적 흔하게 동반되는 관상동맥의 기형은 좌전하행 지가 우관상동맥에서 기시하는 형태이며 단일관상동맥이 매우 드물게 보고되고 있다. 본 병원에서는 좌측 관상동에서 기시한 단일관상동맥에서 우관상동맥이 분지하여 우심실 유출로를 가로지르는 형태의 관상동맥 기형을 동반한 활로4징증을 치첨하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1127-1130
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• 1999

Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

• Journal of Chest Surgery
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• 제49권4호
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• pp.225-231
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• 2016

Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures.

• Journal of Chest Surgery
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• 제21권5호
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• pp.877-881
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• 1988

A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.

• Journal of Chest Surgery
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• 제28권3호
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• pp.253-257
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• 1995

Forty-eight patients with significant left main coronary artery obstruction underwent coronary artery bypass graft between September,1989 and September,1993. They consisted of 29 males and 19 females with the mean age of 58 [range 33 - 78 . Seventeen patients[35% had stenosis in left main coronary artery only and twenty-nine[61% had associated lesions in other coronary artery systems as well.Two[4% had isolated left coronary ostial lesion. The operative mortality was 4.17% [2/48 which is comparable to the mortality of overall coronary artery bypass surgery cases during the same period[p >0.05 . Perioperative myocardial infarction was occurred in two patients[4.17% . And the infarction rates between the two groups also showed no difference[p >0.05 . The forty-six survivors showed significant improvement in exercise tolerance as well as symptomatology. We conclude that surgery for left main coronary artery disease can be done with no increased risk through careful anesthesia,surgery, and aggressive postoperative care in the critical period.

• Journal of Chest Surgery
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• 제26권9호
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• pp.710-713
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• 1993

Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.

• Journal of Chest Surgery
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• 제15권3호
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• pp.366-369
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• 1982

Single coronary artery is rare congenital anomaly with incidence about 0.04%. Above half of single coronary artery is symptomless, and about 41% of cases are associated with another congenital cardiac anomalies . Single coronary artery is sometimes important for cardiac operation to avoid fatal result from cutting of coronary artery during the right ventriculotomy. Among the associated anomaly of the single coronary artery, coronary arteriovenous fistula is very rare. We experienced congenital single coronary artery with coronary arteriovenous fistula drained into the right ventricle, and so we report this case with literatures.

• Journal of Chest Surgery
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• 제57권2호
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• pp.220-224
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• 2024

A coronary artery fistula (CAF) is an abnormal vascular connection between the coronary arteries and the cardiac chambers or major vessels. Although rare, CAFs can lead to substantial coronary morbidity and mortality. This study outlines the surgical management of a CAF originating from the left coronary artery and connecting to the right atrium, in a patient experiencing angina with a marked left-to-right shunt. The surgical approach involved ligation of the coronary artery and reduction of the aneurysmal portion, resulting in the patient's uneventful recovery.

• Journal of Chest Surgery
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• 제18권2호
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• pp.214-219
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• 1985

It is well known that the morphologic feature of coronary artery is variant as finger print. Left coronary artery is divided into the left anterior descending artery and circumflex artery and supplies almost left atrium, left ventricle and interventricular septum. Clinically, the morphologic features of number of branches and the length of the left main coronary artery are important. In Korea, there are few reports about morphologic study of the coronary artery, and the coronary angiogram and open heart surgery are common. Now the author studied the morphology of the proximal part of the left coronary artery in Korean 50 Adult cadavers and obtained the following results: 1. The length of the left main coronary artery is from 5 mm to 16 mm [mean 9.7 mm]. 2. The diameter of the proximal part of the left coronary artery is from 3.2 mm to 7.7 mm [mean 5.3]. 3. The features of the branching are bifurcation [58%] trifurcation [38%] and quadrifurcation [4%]. 4. The diameter of the left anterior descending artery is from 2.7 mm to 8.1 mm [mean 4.5] and circumflex artery from 2.1 mm to 6.2 mm [mean 3.9].

• Journal of Chest Surgery
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• 제28권4호
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• pp.409-411
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• 1995

One patient developing left main coronary stenosis following double valve replacement is reviewed. Angina pectoris developed 5 months postoperatively. Coronary perfusion with a balloon tip perfusion catheter was performed during previous operation and was considered technically satisfactory. Coronary angiography confirmed stenosis of the left main coronary artery. There was no further coronary arterial disease. An anterior approach between the aorta and pulmonary artery to expose the left main coronary artery was used and patch angioplasty was done. Repeat coronary angiography showed a widely patent left main coronary artery with excellent runoff. A careful search for coronary arterial injury should be made in all symptomatic patients following aortic valve replacement.