• 제목/요약/키워드: coronary artery

검색결과 1,466건 처리시간 0.029초

Takayasu 동맥염에 병발한 관상동맥질환 치험 1예 (Surgical Correction of the Coronary Artery Disease in Takayasu`s Arteritis)

  • 정윤섭;송명근
    • Journal of Chest Surgery
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    • 제24권3호
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    • pp.296-302
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    • 1991
  • Coronary artery involvement and myocardial ischemic symptom in Takayasu`s arteritis is uncommon Its presentation as coronary artery narrowing is a potentially lethal but correctable problem. In this case report, a 17-year-old woman of Takayasu`s arteritis with unstable anginal and moderate heart failure is presented. Her coronary angiogram showed that the main trunk of the left coronary artery was moderately narrowed and the proximal portion of the circumflex branch was severely obstructed and the right coronary artery was also narrowed diffusely. Simultaneously the patient had the moderate degree of mitral regurgitation. In order to save her life, the coronary bypass surgery using the saphenous veins and the modified Wooler`s mitral annuloplasty were done urgently, Immediate recovery was uneventful and the postoperative exercise capacity was markedly improved. But the long-term prognosis seems to be uncertain because of 3 reasons: 1] natural progress and complication of Takayasu`s arthritis; 2] fate of the saphenous vein grafts in a relatively young patient with aortitis; 3] residual mitral regurgitation. So long-term follow-up should be needed.

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Neo-ostium Formation in Anomalous Origin of the Left Coronary Artery

  • Han, Woo-Sik;Park, Pyo-Won;Cho, Seong-Ho
    • Journal of Chest Surgery
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    • 제44권5호
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    • pp.355-357
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    • 2011
  • Anomalous origin of a coronary aortic artery is a rare cardiac anomaly. Although it can cause angina, syncope, and palpitations, most patients are asymptomatic. This anomaly requires surgical treatment or intervention because it is associated with sudden death. Several surgical techniques, such as coronary reimplantation, coronary artery bypass grafting (CABG), unroofing, and neo-ostium formation, have been proposed as treatments. We report a case surgically treated with neo-ostium formation in anomalous origin of the left coronary artery from the right coronary sinus.

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery in Adulthood: Challenges and Outcomes

  • Kothari, Jignesh;Lakhia, Ketav;Solanki, Parth;Parmar, Divyakant;Boraniya, Hiren;Patel, Sanjay
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.383-386
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    • 2016
  • Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular arrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.

좌 관상동맥-폐동맥 이상 기시증 수술치험 1례 (Anormalous Origin of Left Coronary Artery from Pulmonary Artery)

  • 조광조;편승환
    • Journal of Chest Surgery
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    • 제30권10호
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    • pp.1024-1027
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    • 1997
  • 좌 관상동맥 폐동맥 이상 기시증은 드문 선천성 심기형으로 유아기에 심부전을 일으키는 질환으로서 수술적인 치료를 하지 않을 경우 대부분 치명적인 것으로 알려져 있다 대혈관 전위의 교정술이 보편화되면서 신생아에서 관상동맥 이식에 대한 기술이 발전되어 근래에는 좌 관상동맥을 대동맥에 이식하여 이중 관상동 맥 체계를 만들어주는 수기가 본 질환의 일차 선택 수술법으로 인정되고 있다. 본 교실에서는 심부전으로 입원한 생후 44일된 여아에서 좌 관상동맥 폐동맥 이상 기시증이 발견되어 좌 관상동맥 대동맥 이식술로 치 료하여 좋은 결과를 얻었으므로 문헌 고찰과 함께 보고하는 바이다.

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Reperfusion Arrhythmia에 관한 연구 III. 관상동맥 폐색시의 혈액동력학적인 변화와 RA발생과의 관계 (A Study on Reperfusion Arrhythmia III. Relationship to Hemodynamics Changes and Occurrence of Reperfusion Arrhythmia after Occlusion of Coronary Artery in Dogs)

  • 최인혁;정인성;최은경;김희은
    • 한국임상수의학회지
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    • 제18권4호
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    • pp.402-410
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    • 2001
  • This study was performed to investigate the hemodynamic changes which occur after occlusion of coronary artery and relation to reperfusion arrhythmias(RA) which occur when occlusion materials were removed form coronary artery in dogs. The occlusion of coronary artery was designed by temporary ligation of left circumflex branch of coronary artery during 30 minutes in 16 dogs. During occlusion of coronary artery, cardiac output(CO), mean aortic pressure (mAP), aortic systolic pressure(ASP), aortic diastolic pressure(ADP). left ventricular systolic pressure(LVSP), left ventricular maximum dp/dt (LV max. dp/dt) and left ventricular end-diastolic pressure (LVEDP) were measured. The occurrence of RA were observed for 5 minute after reperfusion by explained of ligation. As a results, cardiac arrest occurred in 4 dogs during occlusion of coronary artery, and RA was not observed in 5 dogs while it was seen in 5 dogs when explained ligation(reperfusion) after 30 minutes, the rest 2 dogs occurred temporary tachycardia. In hemodynamics changes, LVSP decreased by 10.9% and LV max. dp/dt by 5.4 % in comparison to control value which not ligated coronary artery, and LVEDP increased by 73.3%. The CO/min and mAP also decreased by 10.7% and by 11.3% expectedly. In the relationship to occurrence RA and hemodynamics changes, the LVSP and LV max. dp/dt at the time of occlusion in the RA group decreased by 11.9% and 0.8% in comarison to the control value while the decrease was 7.7% and 10% in the non-RA group. But the LVEDP in creased by 109.1% in the RA group while the decreased was 44.6% in the non-RA group. Referring CO/min, the drop was 8.8% in the RA occurrence group and 12.9% in the non-occurence group. These parameters of LVEDP, LV max. dp/dt, and CO were significant difference(p<0.05). The mAP also decreased by 11.9 in the RA group and by 9.8% in the non-RA group, but these defference were not the significant difference.

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우관상동맥 폐색을 초래한 심근 농양 -1례 보고- (Myocardial Abscess with Coronary Artery Occlusion -One Case Report)

  • 이재익;김기봉
    • Journal of Chest Surgery
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    • 제30권8호
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    • pp.823-826
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    • 1997
  • 심근 농양은 대개 감염성 심내막염이나 패혈증의 합병증으로 생길 수 있다. 심근 농양이 관상 동맥을 압박 하여 심근 허혈을 초래한 경우는 1987년 Cripps 등이 보고한 이래 5-6례 있을뿐이다. 61세 남자 환자가 내원 6주 전부터 시작된 원인을 알 수 없는 발열과 오한을 주소로 내원하였다. 환자는 발열이 시작된지 2주후에 심실 세동 및 이로 인한 심장 마비로 심폐소생술을 시행받은 병력이 있었다. 심에코와 관상동맥 조영 결과 우측 방실구 부위의 심근 농양이 우관상동맥을 외부에서 압박하면서 심근 경색을 초래한 소견을 보였다. 수 술은 농양을 변연 절제하였으며 괴사된 심방벽을 절제한 후 생긴 결손은 자가 심낭을 이용한 patch로 폐쇄하 였고 우측 내유동맥을 우관상동맥의 원위부에 문합하였다. 환자는 합병증없이 퇴원하였으며 수술 중 검체에 서 시행한 농양배양 검사에서는 Salmonella arizona가 동정되었다.

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잠재계층분석을 활용한 관상동맥질환 위험요인의 유형화 (Identifying Latent Classes of Risk Factors for Coronary Artery Disease)

  • 주은실;최지선
    • 대한간호학회지
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    • 제47권6호
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    • pp.817-827
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    • 2017
  • Purpose: This study aimed to identify latent classes based on major modifiable risk factors for coronary artery disease. Methods: This was a secondary analysis using data from the electronic medical records of 2,022 patients, who were newly diagnosed with coronary artery disease at a university medical center, from January 2010 to December 2015. Data were analyzed using SPSS version 20.0 for descriptive analysis and Mplus version 7.4 for latent class analysis. Results: Four latent classes of risk factors for coronary artery disease were identified in the final model: 'smoking-drinking', 'high-risk for dyslipidemia', 'high-risk for metabolic syndrome', and 'high-risk for diabetes and malnutrition'. The likelihood of these latent classes varied significantly based on socio-demographic characteristics, including age, gender, educational level, and occupation. Conclusion: The results showed significant heterogeneity in the pattern of risk factors for coronary artery disease. These findings provide helpful data to develop intervention strategies for the effective prevention of coronary artery disease. Specific characteristics depending on the subpopulation should be considered during the development of interventions.

단일관상동맥 동정맥루 1례 (Coronary artery fistula associated with single coronary artery)

  • 김성만;송민섭;조광현;김철호
    • Clinical and Experimental Pediatrics
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    • 제51권10호
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    • pp.1118-1122
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    • 2008
  • 단일관상동맥에서 우심실로 유출되는 동정맥루는 보고가 매우 드물며 이 경우 치료 방침이나 예후에 대해 명확하지 않다. 저자들은 지속성심잡음이 들려 시행한 심초음파 검사상 단일 좌관상동맥이 확장되어 있으며 우심실로 유출되는 동정맥루를 진단하였으며 관상동맥조영술로 확진하였다. 체외순환하에 우심실에서 동정맥루를 결찰하였다. 18개월 후 추적시 증상은 없었고 관상동맥조영술상 동정맥루의 재발도 없었다.

지지간호가 관상동맥조영술을 받은 관상동맥질환자의 질병관련 지식과 환자역할행위 이행에 미치는 효과 (The Effect of Supportive Nursing Care on the Knowledge Level and Compliance of Sick-Role Behavior in Patients with Coronary Artery Disease after Coronary Angiography)

  • 최옥자;조복희
    • 성인간호학회지
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    • 제19권5호
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    • pp.47-55
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    • 2007
  • Purpose: The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography (CAG). Methods: A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. Results: 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group (t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group (t=4.580, p=.001). Conclusion: The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.

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한국인의 관상동맥질환에 대한 병태해부학적 연구 (Pathoanatomical Study of Occlusive Coronary Artery Disease in Korean)

  • 채헌
    • Journal of Chest Surgery
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    • 제22권3호
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    • pp.384-392
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    • 1989
  • Forty cases of coronary artery bypass grafting treated at the Department of Thoracic and Cardiovascular Surgery, SNUH, Korea were compared with forty cases of the procedure treated at University of Alberta Hospital, Canada, in terms of pathoanatomy. That showed no difference in sex ratio between Korean and Caucasian the average ages, however, were 50.4 years and 60.9 years respectively [p< 0.005]. The leading cause of angina at presentation was unstable angina in Korean, but it was post-infarction angina in Caucasian instead. The incidences of single-vessel disease and double-vessel disease were similar in both countries, but the incidence of so-called triple-vessel disease was higher in Caucasian while left main coronary artery disease was more prevalent in Korean [0.01< P, 0.005]. < The internal diameters of surgically available coronary artery branches had similar characteristics and no significant statistical differences were found between them. The predilection sites of stenoses were proximal left anterior descending artery, left main coronary artery, proximal left circumflex artery and proximal right coronary artery decreasing in incidence respectively, in Korean. The myocardial perfusion score were 6.80 in single-vessel disease, 7.56 in double-vessel disease, 11.27 in triple-vessel disease and 9.77 in left main disease respectively, in Korean.

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