• Journal of Chest Surgery
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• v.21 no.3
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• pp.583-587
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• 1988

Bilateral coronary artery-pulmonary artery fistula is very uncommon congenital heart disease which occupy small percentage of all coronary arterio-venous fistulas. We experienced a case who was 52 years old female with bilateral coronary artery-pulmonary artery fistula. She complained exertional dyspnea k angina[coronary steal syndrome]. On physical examination, any cardiac murmur was not audible. There was no 0y step-up in right heart catheterization. But selective coronary angiography revealed tortuous aberrant vessels which originated from the canal branch of the right coronary artery k the left anterior descending coronary artery. Both aberrant vessels traversed the right ventricular outflow tract, and conjoined just proximal the pulmonic annulus and drained into the main pulmonary artery. The operation was performed under the extracorporeal circulation with beating heart. The procedures were suture-ligation of the draining orifice in main pulmonary artery & the feeding vessels on the right ventricular outflow tract. Postoperatively her complaints were completely disappeared and the selective coronary angiography revealed no left-to-right shunt.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.793-797
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• 1987

Coronary artery fistula is an uncommon congenital heart defect that is readily amenable to surgical treatment. This fistula usually originates from the right coronary artery, but may arise from the left coronary artery, both coronary arteries, or single coronary artery. And the fistulous communication is most often to right ventricle, right atrium or pulmonary artery. Recently we experienced one case of congenital coronary artery fistula which was associated with patent ductus arteriosus. The fistulous communication, forming aneurysmal dilatation, was noted between the left anterior descending coronary artery and the right ventricular outflow tract. Cardiopulmonary bypass was employed in this case. After an arteriotomy was made on the aneurysmal coronary artery, both the proximal opening and the termination site of the fistulous tract were directly closed with partial aneurysmorrhaphy. The right ventricular chamber was also opened to evaluate the fistulous termination site. Postoperative hospital course of the patient was uneventful and she was discharged without problems.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.297-305
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• 1979

Occlusive coronary artery disease presents a potential threat to a significant population in the United States. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. Operative vascular procedures have increased steadily in number over the past 20 years in the United States. There have been many isolated case reports about coronary artery surgery, but these had little clinical impact. Nowadays, major three coronary bypass surgery has developed principally at three cardiac centers in the United States since 1967. Among three coronary bypass operation, the aorta-coronary artery saphenous vein bypass graft was first demonstrated by Favolaro and Effler at the Cleveland Clinic in 1967. We experienced one case of coronary artery disease, which was treated successfully by aorta-coronary saphenous vein graft with mild hypothermia under extracorporeal circulation in May, 1977. Saphenous vein was removed from above the knee and was 2.5 mm in diameter. The left ventricle was not vented for the left ventricle was not overdistended. Temporary artificial pace-maker-Medtronic-was implanted for the prevention and treatment of post-operative arrhythmia and heart block in post-operative first day. He is a 57 year old male businessman who had been suffered from hypertension [200 mmHg in systolic pressure] since 4 years ago, who had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain with choking sensation for 50 days. This symptom was aggravated exposing cold weather, or cold water, but was respond to rest. Pre-operative ECG revealed no any other ischemic sign except sinus bradycardia. Significant S-T segment depression was noted at lead II, AVF after double 5 minutes exercise, indicating positive Master`s test. Serum cholesterol was slight elevated to 253 mg/dl. Final pre-operative diagnosis was made by coronary arteriogram, which showed about 1.0-cm segmental 90 % occlusive atherosclerotic lesion in the proximal part of right coronary artery above the origin of acute marginal artery. Left coronary artery revealed good patency and there was no collateral circulation between right and left coronary artery .Hospital course was not eventful. He was discharged with good result on the post-operative day. He has been free from chest pain for longer than 2 years. And also the arterial flow in the coronary bypass graft is auscultated with the pocket-sized ultrasonic velocity detector, which shows the patency of the coronary bypass graft good.

• Journal of Chest Surgery
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• v.22 no.3
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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.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.105-109
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• 2017

Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.158-161
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• 1990

A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.252-255
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• 2009

We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.

• Journal of Chest Surgery
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• v.56 no.1
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• pp.49-52
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• 2023

A fistula from the right coronary artery draining into the left ventricle is a rare form of coronary artery fistula. Here, we describe the case of a symptomatic neonate with a large fistula of this type. The neonate was successfully treated with surgical closure of the fistula.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.361-365
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• 1991

We experienced one case of the coronary artery aneurysm. The patient was 67 years old female, who complained of dyspnea on exercise[NYHA functional class III] for two years. Coronary angiogram demonstrated a localized saccular aneurysm on left main coronary artery, just above bifurcation of left anterior descending coronary artery and circumflex artery. On the operative field, the aneurysm was 2cmx2cmx 1.5cm in size with 0.5cm in neck. Resection and aneurysmorrhaphy was done. The patient was recovered and discharged uneventfully. During 8 months follow-up period, she lives in good physical activity and absence of chest pain.

• Journal of Chest Surgery
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• v.49 no.5
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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.