• Journal of Chest Surgery
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• v.43 no.3
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• pp.296-299
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• 2010

A right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm is a very rare condition. This requires surgical treatment because of the possibility of rupture of aneurysm, heart failure and infective endocarditis. A 47 years old male patient with dyspnea on exertion for 3 months was diagnosed as having a right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm according to the CT and coronary artery angiography. We resected the aneurysm and performed a coronary artery bypass graft.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.831-834
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• 1999

The Kawasaki disease has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The Kawasaki disease rarely affects adults and accordingly, there have been only a few cases reported in literatures. The present case describes a successful surgical treatment of a 43-year-old female patient with coronary artery aneurysm and stenosis, which resulted from an episode of the Kawasaki disease that occurred 20 years earlier. The patient was well at 5 months followup.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.743-746
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• 2010

Coronary artery aneurysm is an uncommon disease. The optimal medical or surgical treatment for this disease remains obscure. The causes of coronary artery aneurysms include atherosclerosis, Kawasaki disease, infectious vascular disease, connective tissue disorder and congenital malformation. A 50 year old man visit our institution for chest pain that had started 3 days previously. After coronary angiography, multiple coronary aneurysms were diagnosed and successful surgical intervention was performed.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.106-109
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• 2008

Multiple coronary aneurysms are rare in adults. The cause may be atherosclerosis, congenital malformations, post-traumatic or post-syphilitic vascular lesions, connective tissue diseases like Marfan and Ehler-Danlos syndromes or Kawasaki disease, all of which cause weakening of the media. Surgical intervention is indicated to prevent rupture, embolization or compression symptoms. The successful management of multiple coronary artery. aneurysms, associated with previous rupture and arrhythmia, originating from proximal potions of ramus intermedius and left circumflex artery are reported.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.851-854
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• 2007

A 76-year-old woman with a history of chest pain and palpitation, was diagnosed with bilateral coronary to pulmonary artery fistulae with a concomitant saccular aneurysm, which is quite rare. Suture closure of the fistular vessels around the pulmonary artery root, the removal of a saccular aneurysm, and the transpulmonary closure of coronary to pulmonary artery fistulae were performed. The patient was well at 4 months after surgery.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.228-231
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• 2007

Chest trauma can lead to various cardiac complications ranging from arrythmia to myocardial rupture. Coronary artery injury in patients with blunt chest trauma is rare, and traumatic aneurysm of the left coronary artery is even more unusual than right coronary artery. Injury to the coronary arteries, including intimal aneurysm, dissection, laceration, arteriovenous fistula and thrombosis, are sequelae that rarely occur after a blunt trauma. Occlusion of the coronary artery results is a serious complication for the patient via acute myocardial infarction, We report here on a case of acute myocardial infarction with coronary artery aneurysm that arose from blunt chest trauma in a 33-year-old male, and he was successfully managed by a coronary bypass graft without performing cardiopulmonary bypass.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.213-218
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• 2020

Coronary artery aneurysm is a rare disease. It occurs in the epicardial space, mostly along the course of major coronary arteries. Here, we report a case of a giant incidental aneurysm embedded in the basal posterior wall of the left ventricle. A 43-year-old woman was referred to our institution for the evaluation of cardiac palpitations that had been present from the previous 2 months. She reported no medical history (such as Kawasaki's disease or hypertension) or previous operative history. Echocardiogram and subsequent cardiac CT revealed a giant aneurysm in the left ventricle, with a direct fistulous connection to a dilated and tortuous left circumflex artery, which showed direct communication with the straight right coronary artery.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.787-791
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• 2001

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

• Journal of Chest Surgery
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• v.34 no.1
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• pp.45-50
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• 2001

배경: 관상동맥우회술은 허혈성 심질환 환자에서 증상을 완화하고 급사를 방지할 수 있는 효과적인 치료방법으로 확립되었다. 그러나 80년대에 들어와 지금까지 사용되었던 대복재정맥편에 비해 동맥이식편의 장기개통율이 월등함이 알려지면서 좌내유동맥과 함께 사용할 수 있는 동맥이식편에 대한 관심이 증가하였다. 본원에서는 1998년부터 다동맥이식편을 이용하여 관상동맥 우회술을 시행하고 있으며, 조기성적에 대해 대복재정맥을 사용한 경우와 비교하고자 하였다. 대상 및 방법: 1998년 6월부터 1999년 5월까지 본원에서 관상동맥우회술을 시행받았던 355명의 환자중 심정지액을 이용하여 시행했던 153명을 대상으로 하였다. 76명의 단일 동맥편을 사용한 환자를 I군, 두 개 이상의 다동맥편을 사용한 77명의 환자를 II군으로 분류하여 수술전후 임상기록, 심초음파 및 관상동맥 조영술 소견등을 후향적으로 분석하였다. 결과: 술전 양군간에는 II군의 환자가 I군의 환자에 비해 더 젊고 흡연자가 많다는 것 이외에는 통계학적으로 차이는 없었다. 술후 조기사망은 각 군에서 1례씩 있었고 환자당 문합갯수에 통계학적으로 차이가 있는 것 이외에는 수술과정 및 술후 결과에서 차이는 없었다. 결론: 다동맥편을 이용한 관상동맥우회술을 시행한 결과 본원에서 학습기(learning period)임에도 불구하고 조기성적에 있어 대복재정맥을 이용한 경우와 차이가 없었다. 물론 중기 및 장기성적에 대한 지속적인 추적관찰이 필요하겠으나 이러한 조기성적은 동맥이식편을 이용한 관상동맥우회술이 환자의 장기생존에 도움을 줄 수 있으리라 사료된다. 또한 이러한 결과를 토대로 완전 동맥이식편 관상동맥우회술로의 전환이 이루어질 수 있으리라 생각된다.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.225-227
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• 2007

The aortic inclusion technique is frequently used in the original Bentall's procedure for the control of excessive postoperative bleeding. Although this procedure has improved the outcome of patients with aortic root disease, there is a high incidence of both early and late complications, including coronary artery stenosis, kinking or pseudoaneurysm formation at the coronary suture lines. Pseudoaneurysm of the ascending aorta is a relatively rare, but fatal complication, which occurs after wrap-inclusion composite graft replacement. Herein, the case of a 45-year-old female, who developed a perigraft aortic pseudoaneurysm 10 years after a Bentall's procedure (wrap-inclusion technique), but was successfully managed using the Cabrol's method, is reported.