• Journal of Chest Surgery
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• v.28 no.3
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• pp.320-323
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• 1995

We report a case of recurred Takayasu,s arteritis.The patient was 28-year-old female underwent aorto-left common carotid and aorto-left subclavian bypass graft replacement 1 year ago.Unfortunately, she was readmitted because of newly developing angina and both eye claudication severe headache. Aorto-coronary angiogram showed complete obstruction of left common carotid artery ,stenosis of right carotid artery bifurcation and ostial stenosis of right coronary artery.Bilateral carotid arteries bypass graft with great saphenous vein and right coronary artery bypass graft with right internal mammary artery were done at same the time and she discharged after 21 days without any problem.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.125-129
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• 1980

A patient with anomalous coronary artery crossing right ventricular outflow tract in association with Tetralogy of Fallot underwent total correction. The left anterior descending coronary artery was originated from right coronary artery anterior to the pulmonary valve ring. The incision from outflow tract to pulmonary artery tunneled underneath the aberrant artery and patch graft across the pulmonary valve ring to enlarge outflow of right ventricle and stenotic pulmonary valve ring.

• Journal of Chest Surgery
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• v.46 no.1
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• pp.84-87
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• 2013

A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.143-147
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• 1988

Congenital coronary arteriovenous fistula is a communication of a coronary artery with one of the atria, ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. We had a successful surgical experience with 63 year-old-female patient who complained substernal chest pain on exertion for 8 years. On auscultation, a continuous murmur was heard at the left second to third intercostal space along the left sternal border. The right cardiac catheterization was revealed to 4% oxygen step up between right ventricle to main pulmonary artery, and Qp/Qs was 1.3:1. The selective coronary arteriography showed markedly tortuous dilated vessel which originated from left coronary artery draining into the main pulmonary artery. The operation performed to mid portion of tortuous and dilated fistula by multiple ligation with 3-0 Mersilene and suture ligation with pledgetted 3-0 Prolene on distal draining site, Postoperative course were uneventful without any symptoms and complications.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.146-149
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• 2021

Coronary artery bypass grafting (CABG) is rarely performed in infants because of its technical difficulty and unclear long-term results. A 90-day-old male infant weighing 3.5 kg who underwent an arterial switch operation (ASO) for transposition of the great arteries developed left coronary artery insufficiency despite augmentation and reimplantation of the left coronary button. On-pump beating heart CABG was performed using an internal mammary artery graft to revascularize the left anterior descending artery. Postoperative computed tomography angiography revealed that the graft was patent. At 7 months postoperatively, the patient weighed 8.5 kg, and echocardiography revealed good ventricular function. CABG can be an alternative treatment for post-ASO coronary complications in early infancy.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.37-40
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• 2015

The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1024-1027
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• 1997

Anomalous origin of left coronary artery from pulmonary artery(ALCAPA) is a rare fatal congenital anormaly that needs early surgical intervention. Many reports say that the choice of operative procedure is reimplantation of the left coronary artery into the ascending aorta. We experienced the surgical management of a case of the ALCAPA. The patient was 44 days old and 3.45 kg weighed female baby who had a symptom of congest ve heart failure. She underwent implantation of coronary artery on the aorta with cardiopulmonary bypass and recovered without any complications.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.285-288
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• 2015

In coronary artery bypass grafting, a diffusely diseased left anterior descending coronary artery (LAD) is an obstacle to achieving complete revascularization, consequently leading to the possibility of a poor prognosis. Long segmental reconstruction with or without endarterectomy is a revascularization method for treating diffusely diseased coronary arteries. Herein, we report a successful case of long segmental reconstruction of a diffusely diseased LAD using a left internal thoracic artery onlay patch after endarterectomy.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.228-233
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• 1993

Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1441-1450
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• 2021

Anomalous origin of the coronary artery from the pulmonary artery is a rare and potentially fatal congenital heart defect. Up to 90% of infants with an anomaly involving the left coronary artery die within the first year of life if left untreated. Patients who survive beyond infancy are at risk of sudden cardiac death. Cardiac CT and MRI are increasingly being used for the accurate diagnosis of this anomaly for prompt surgical restoration of the dual coronary artery system. Moreover, life-long imaging surveillance after surgery is necessary for these patients. In this pictorial review, multimodal cardiac imaging findings of this rare and potentially fatal coronary artery anomaly are comprehensively discussed, and representative images are provided to facilitate the understanding of this anomaly.