• The Korean Journal of Medicine
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• 제93권6호
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• pp.565-570
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• 2018

Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

• Journal of Physiology & Pathology in Korean Medicine
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• 제33권2호
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• pp.82-88
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• 2019

This systematic review evaluates the clinical effectiveness of acupuncture related to improvement in quality of life and problems after Percutaneous Coronary Intervention(PCI). We searched papers in many databases, including National Discovery for Science Leaders(NDSL), Koreanstudies Information Service System(KISS), Oriental Medicine Advanced Searching Integrated System(OASIS), Research Information Sharing Service(RISS), Public/Publisher MEDLINE(Pubmed), Embase, Cochranelibrary, Chinese Academic Journals(CAJ), Japan Science and Technology Agency(J-STAGE). Initially, 161 studies were found. Of these, 141 studies were excluded following abstract screening. After the remaining 20 papers were scanned, 5 RCTs were selected and analyzed. Among these 5 RCTs, HAMD(Hamilton Rating Scale for Depression) is significantly effective in 1 RCT. In 2 RCTs, LVEF(Left Ventricular Ejection Fraction) is significantly effective. In 2 RCTs, 6MWT(Six-Minute Walk Test) is significantly effective. The review of 5 studies suggests that acupuncture after PCI can be effective in many problems occured after PCI. However, This study couldn't conduct a meta-analysis due to the differences in interventions. Therefore, we hope that systematic reviews with meta-analysis will be published.

• Journal of Chest Surgery
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• 제30권3호
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• pp.326-329
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• 1997

Coronary artery bypass grafting(CABG) without cardiopulmonary bypass(CPB) is now an accepted technique of myocardial revascularization in selective cases of coronary arterial occlusive disease. The lesion was total(100%) occlusion of proximal right coronary artery(RCA) without any evidence of dis,Base in the rest of coronary arteries. Percutaneous transluminal angioplasty(PTCA) was tried but unsuccessful. We herein report a case of successful CABG to right coronary artery without CPB on a patient with complete occlusion of RCA and symptomatic wit minimal activity.

• Journal of Chest Surgery
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• 제41권2호
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• pp.210-215
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• 2008

Background: Drug-eluting stents are contributing to the exponential growth of percutaneous coronary intervention, and even in the patients with left main coronary artery disease, owing to the decreased restenosis rate. Our study aimed at comparing the one-year results after coronary artery bypass grafting versus percutaneous coronary intervention with drug-eluting stents in patients with left main coronary artery disease. Material and Method: Those patients who underwent coronary bypass surgery or stenting at our hospital under the diagnosis of left main coronary artery disease were divided in two groups. The variables for comparison were the preoperative disease severity, the length of the hospital stay, the early mortality and the cumulative incidence of mortality, myocardial infarction and repeated revascularization. Result: There were 101 cases in the surgery group and 78 cases in the stent group. Age, gender, the risk factors, the left ventricular ejection fraction and the proportion of acute coronary syndrome showed no significant differences between the two groups. The surgery group showed a more severe condition according to the Euroscore, a greater incidence of urgency, a longer hospital stay and a greater incidence of multi-vessel disease. The early mortality and one-year cumulative mortality were not different between the groups. The Euroscore-matched comparison for the surgery group (41 patients) and the stent group (78 patients) showed no significant differences in the Euroscore, age, gender, risk factors and the proportion of acute coronary syndrome. The surgery group in the Euroscore-matched comparison showed more multi-vessel disease and a longer hospital stay. The surgery group showed lower early mortality and lower one-year cumulative mortality, but this was statistically insignificant (0% vs 2.6%, respectively, p=0.55; 0% vs 6.6%, respectively, p=0.30). The rates of repeated revascularization and major adverse events (death or myocardial infarct) were lower in the CABG group, but this was not statistically significant (13.3% vs 6.3%, respectively, p=0.48; 10.0% vs 0%, respectively, p=0.09). Conclusion: Percutaneous coronary intervention using drug-eluting stents in low-risk patients with left main coronary artery disease resulted in a shortened length of the hospital stay, as compared with that of the CABG group of patients. However, the patients who underwent percutaneous coronary intervention using drug-eluting stents showed a tendency for an increased rate of repeated revascularization and higher one-year cumulative mortality. Further studies with large populations and longer follow-up will be necessary to reaffirm our findings.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• International journal of advanced smart convergence
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• 제6권3호
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• pp.22-28
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• 2017

With the recent development of technologies to manage vast amounts of data, data mining technology has had a major impact on all industries.. Data mining is the process of discovering useful correlations hidden in data, extracting executable information for the future, and using it for decision making. In other words, it is a core process of Knowledge Discovery in data base(KDD) that transforms input data and derives useful information. It extracts information that we did not know until now from a large data base. In the decision tree, c4.5 algorithm was used. In addition, the C4.5 algorithm was used in the decision tree to analyze the difference between frequency and mortality in the region. In this paper, the frequency and mortality of percutaneous coronary intervention for patients with heart disease were divided into regions.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.57-64
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• 2018

Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

• Journal of Chest Surgery
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• 제56권5호
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• pp.359-361
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• 2023

Coronary ostium obstruction due to dislodgement of the prosthetic valve is a rare and life-threatening complication, and particular caution is required for sutureless aortic valve replacement (AVR) with concomitant valvular surgery. In general, coronary artery bypass surgery is performed when coronary ostium obstruction occurs after AVR, but other options may need to be considered in some cases. Herein, we present a case of coronary artery occlusion in an 82-year-old female patient who had undergone AVR and mitral valve replacement for aortic valve stenosis and mitral valve stenosis at the age of 77 years. A hybrid procedure involving redo AVR and percutaneous coronary intervention after left main coronary ostium endarterectomy was performed. To summarize, we present a case of hybrid AVR in a patient with coronary artery obstruction after AVR that was successfully managed using this method.

• Journal of Chest Surgery
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• 제40권3호
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• pp.209-214
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• 2007

Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.94-98
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• 2018

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.