• Title/Summary/Keyword: coronary artery stenosis

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Total Correction of Double-Outlet Right Ventricle with Situs Inversus, Dextrocardia, Subaortic Ventricular Septal Defect, and Pulmonic Stenosis (장기역위증 및 우심증을 동반한 DORV -치험 1예 보고-)

  • Ahn, Hyuk;Kim, Yong-Jin;Roh, Joon-Rhyang;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.274-280
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    • 1979
  • A case of successful surgical correction of double-outlet right ventricle with situs inversus, dextrocardia, subaortic ventricular septal defect, and pulmonic stenosis is described. The great vessels were normally related but in mirror-image arrangement. Another coronary artery anomaly, single origin of coronary artery and a large anomalous coronary artery coursed across the right ventricular outflow tract, was accompanied. Intracardiac repair with a Dacron tunnel conduit and extracardiac jumping graft with a valved conduit gave an excellent result.

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2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)

  • Cherry Kim;Chul Hwan Park;Bae Young Lee;Chan Ho Park;Eun-Ju Kang;Hyun Jung Koo;Kakuya Kitagawa;Min Jae Cha;Rungroj Krittayaphong;Sang Il Choi;Hwan Seok Yong;Sung Min Ko;Sung Mok Kim;Sung Ho Hwang;Nguyen Ngoc Trang;Whal Lee;Young Jin Kim;Jongmin Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.25 no.4
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    • pp.331-342
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    • 2024
  • The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

Changes of Hemodynamic Characteristics during Angulated Stenting in the Stenosed Coronary (관상동맥 협착부에 각이진 스텐트 시술시 혈류역학적 특성변화)

  • Suh Sang-Ho;Cho Min-Tae;Kwon Hyuck-Moon;Lee Byung-Kwon
    • Proceedings of the KSME Conference
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    • 2002.08a
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    • pp.717-720
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    • 2002
  • The present study is to evaluate the performances of flow velocity and wall shear stress in the stenosed coronary artery using human in vivo hemodynamic Parameters and computer simulation. Initial and follow-up coronary angiographics in the patients with angulated coronary stenosis are performed. Follow-up coronary angiogram demonstrated significant difference in the percent of diameter in the stenosed coronary between two groups ($Group\;1:\;40.3{\%},\;Group\;2:\;25.5{\%}$). Flow-velocity wave obtained from in vivo intracoronary Doppler ultrasound data is used for the boundary condition for the computer simulation. Spatial and temporal variations of flow velocity vector and recirculation area are drawn throughout the selected segment of coronary models. The WSS of pre- and post-intracoronary stenting are calculated from three-dimensional computer simulation. Then negative shear stresses area on 3D simulation we noted on the inner wall of the post-stenotic area before stenting. The negative WSS is disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2. The present study suggest that hemodynamic forces exerted by pulsatile coronary circulation termed WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. The local recirculation area which has low or negative WSS, might lead to progression of atherosclerosis.

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Atherogenic Risk Stratification According to Changes in the Geometrical Shape of the Coronary Artery (관상동맥의 기하학적 형상변화에 따른 동맥경화 위험도)

  • Suh, Sang-Ho;Park, Jun-Gil;Roh, Hyung-Woon;Lee, Byung-Kwon;Kwon, Hyuck-Moon
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.34 no.10
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    • pp.893-899
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    • 2010
  • A previous study showed that hemodynamics is correlated with stenosis in the coronary artery. The flow characteristics and the distributions of the hemodynamic wall parameters in the coronary artery are investigated under physiological flow condition. The present study also aims to establish the mechanism of the generation of atherosclerosis by analyzing the hemodynamic variables in the coronary artery where atherosclerosis frequently occurs. The stenosis phenomena due to atherosclerosis are related to not only the biochemical reaction between blood and blood vessels but also the hemodynamic factors sush as flow separation and oscillatory wall shear stress. As the bifurcated angle increases, the size of the recirculation area that appears in the cross section increases and disturbed flow is observed in this area. We speculate that this area is the starting point of atherosclerosis in the coronary artery.

Correlation Analysis Between Stenosis and Calcification of Coronary Artery with Using CCTA (CCTA를 이용한 관상동맥 협착과 석회화의 상관관계 분석)

  • Kim, Sang-Jin
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.427-435
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    • 2009
  • We surveyed 586 patients who had been examined CCTA. Out of those patients, 299 (52%) has stenosis of coronary arteries; 166 males (28%) and 133 females (23%). Among them 246 stenosis patients (82.6%) are in 50's to 70's. The number of patients with 50% or more stenosis in more than 1 coronary artery is 299 including 43 males (33.9%) in their 60's and 39 females (37.5%) in their 70's. When a vessel score is higher than 2 points, 70 patients (50.1%) among 139 have 70% or more stenosis; 32 males (39.5%) in their 60's and 27 females (46.6%) in their 70's. It is noted that 14 patients in their 70's show more cases compared to other ages up to 2 or even 5 times when a vessel score is 3 points. LAD shows 77.6% of stenosis, LCX 47.5% and RCA 60.5%. Frequency of a triple vessel disease is high for patients in their 70's; 15 males (36.6%) and 13 females (56.5%) for both. 196 people (33.4%) in the group with stenosis have calcification, while only 40 (6.8%) in the group without stenosis have it. It means that calcification has a significant, if not absolute, correlation with stenosis of coronary arteries.

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Aortocoronary Saphenous Vein Bypass in Coronary Artery Occlusive Disease (복재정맥을 이용한 관상동맥 우회로 수술 - 12례 보고 -)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.61-72
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    • 1990
  • From Nov. 1987 to Aug. 1989, 12 patients with coronary occlusive disease underwent coronary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. The results were as follows: 1. There were 9 males and 3 females ranged in age from 25 to 69 years with a mean of 50.4 years. 2. The prevalent locations of coronary artery stenosis were left anterior descending branch [9 cases], right coronary artery[4 cases], first diagonal branch[3 cases], left circumflex artery [2 cases] in order of frequency. 3, Among 12 cases, 5 cases had an episode of previous myocardial infarction respectively. 4. We performed triple bypass operation in 3 cases, double bypass in 2 cases and single bypass in 7 cases using great saphenous vein. 5. Postoperative complications were cerebral embolism[1, died], pleural effusion[1], temporary cardiac arrest[1], supraventricular tachycardia[1] and late gastric ulcer bleeding[1]. 6. The follow up periods were ranged from 8 months to 30 months and all survivors were on antiplatelet medication showing free of angina.

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Surgical Angioplasty of Isolated Left Coronary Ostial Stenosis (좌관상동맥 입구협착의 외과적 확장술)

  • 서필원
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.247-252
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    • 1995
  • The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

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Clinical Application of Cardiac Hybrid Imaging in Coronary Artery Disease (관상동맥질환에서 심장 하이브리드 영상의 임상적 이용)

  • Gho, Ihn-Ho;Kong, Eun-Jung
    • Journal of Yeungnam Medical Science
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    • v.26 no.1
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    • pp.15-23
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    • 2009
  • Constant technological developments in coronary artery disease have contributed to the assessment of both the presence of coronary stenosis and its hemodynamic consequences. Hence, noninvasive imaging helps guide therapeutic decisions by providing complementary information on coronary morphology and on myocardial perfusion and metabolism. This can he done using single photon emission computed tomography (SPECT) or positron emission tomography (PET) and multidetector CT (MDCT). Advances in image-processing software and the advent of SPECT/CT and PET/CT have paved the way for the combination of image datasets from different modalities, giving rise to hybrid imaging. Three dimensional cardiac hybrid imaging helped to confirm hemodynamic significance in many lesions, add new lesions such as left main coronay artery disease, exclude equivocal defects, correct the corresponding arteries to their allocated defects and identify culprit segment. Cardiac hybrid imaging avoids the mental integration of functional and morphologic images and facilitates a comprehensive interpretation of coronaty lesions and their pathophysiologic adequacy by three dimensional display of fused images, and allows the best evaluation of myocardial territories and the coronary-artery branches that serve each territory. This integration of functional and morphological information were feasible to intuitively convincing and might facilitate development of a comprehensive non-invasive assessment of coronary artery disease.

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