• Journal of Chest Surgery
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• v.36 no.10
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• pp.741-747
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• 2003

Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.7-12
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• 2014

Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD in this population. The literature has identified several traditional risk factors of CVD that originate from CKD, including hypertension, diabetes mellitus, dyslipidemia and obesity, in addition to new and non-traditional risk factors including anemia, secondary hyperparathyroidism, oxidative stress and inflammation. In cases of pediatric CKD, cardiovascular disease is usually restricted to subclinical manifestations such as left ventricular hypertrophy, thickening of intimal media on the carotid artery and calcification of the coronary artery. Therefore, risk factors of CVD in pediatric CKD patients should be closely monitored.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.762-767
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• 2004

With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method： From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p＜0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

• 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.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.754-758
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• 2006

Background: Surgical role for acute coronary syndrome has been reduced in recent years due to development of drug eluting stent. We evaluated the surgical results of acute coronary syndrome in our hospital. Material and Method: Between January 2001 and August 2005, 416 patients underwent coronary artery bypass grafting (CABG) under diagnosis of non-ST-elevation acute coronary syndrome (NSTE ACS). Mean age was $61.8{\pm}9.0$ years and 276 (66.3%) patients were male. 324 (77.9%) patients had triple vessel disease and 92 (22.1%) had left main disease at angiographic study. 236 (56.7%) patients had hypertension and 174 (41.8%) had diabetes mellitus. Conventional on-pump CABG was performed in 194 patients (46.6%) and off-pump CABG in 222 (53.4%). Total arterial revascularization with no touch technique was done in 97 patients (23.3%). The number of total distal anastomosis was 1,306 and the number per patient was $3.21{\pm}1.71$. Result: Surgical mortality rate was 1.0% (4 patients) and postoperative complication rate was 15.6% (65 patients). Graft patency was checked at mean $3.7{\pm}7.6$ months (from 1 to 37 months) postoperatively with multi-directional computed tomography in 152 patients. Left internal mammary artery was patent in 95.3%, right internal mammary artery in 98.1%, radial artery in 92.2% and saphenous vein in 89.0%. Conclusion: The surgical treatment of NSTE ACS showed relatively low mortality rate and good graft patency rate. Further study is needed to compare the long term results with drug eluting stent.

• Journal of Korean Academy of Nursing
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• v.28 no.1
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• pp.184-192
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• 1998

This study was done to examine the correlations between weight, BMI and risk factors of coronary heart disease in men and women in their forties and fifties. The subjects were 412 adults. who had regular health examinations between January and December of 1996 at S-Hospital in Seoul. The data were analyzed using ANOVA, Scheffe test, and Pearson correlation coefficient. The results are as follows : 1. The men between 50 and 59 years of age had higher levels for BMI, weight, systolic blood pressure, diastolic blood pressure, total cholesterol. LDL-cholesterol, triglyceride, fasting blood sugar, plasminogen activator-1, and hemoglobin A,C than the group of women in their forties. Yet. HDL-cholesterol was lower than in the former group. 2. In the group of men in their forties, weight was significantly correlated to diastolic blood pressure(r=.22), LDL-cholesterol(r=.20), plasminogen activator-inhibitor-1(r=.35) HDL-cholesterol(r=-.19). Their BMI was significantly correlted to systolic blood pressure(r=.27), diastolic blood pressure (r=.33), total cholesterol(r=.23), LDL-cholesterol (r=.26), plasminogen activator-1(r=.36) and HDL-cholesterol(r=-.25). 3. As for the group of women in their forties weight was significantly correlated to systolic blood pressure(r=.20), diastolic blood pressure(r=.22), triglyceride(r=.32) , plasminogen activator inhibitor-1 (r=.30) and HDL-cholesterol(r= -.37). Their BMI was significantly correlated to diastolic blood pressure (r=.25) triglyceride(r=.47), plasminogen activator-1 (r=.35), fibrinogen(r=.27) and HDL-cholesterol(r=-.47). 4. In the group of men in their fifties. weight was significantly correlated to total cholesterol (r=32), LDL-cholesterol(r=.29). plasminogen activator inhibitor-1(r=.26). Their BMI was significantly correlated to systolic blood pressure(r=.24), diastolic blood pressure (r=.22), total cholesterol (r=.34), LDL-cholesterol (r=.32), and plasminogen activator-1(r=.25). 5. In the group of women in their fifties, weight was significantly correlated to diastolic blood pressure(r=.33), total cholesterol(r=.21), LDL-cholesterol(r=.20), plasminogen activator inhibitor-1 (r=.43) and HDL-cholesterol(r=-.21). Their BMI was significantly correlated to systolic blood pressure(r=.25), diastolic blood pressure(r=.40), total cholesterol(r=.24), LDL-cholesterol(r=.24), triglyceride(r=22), and HDL-cholesterol (r=-.30). The above findings indicate that the BMI was more predictive than weight as a risk factor for coronary artery disease for men and women in their forties and fifties.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.22-27
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• 2009

Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

• Journal of Food Hygiene and Safety
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• v.13 no.2
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• pp.155-163
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• 1998

The purpose of this study was to determine the association between blood lipids, fibrinogen, fasting blood sugar, lifestyle-related factors and lipoprotein(a). This study was performed with 140 healthy adults (male:80, female:60) among the teachers in primary, middle, and high school in Seoul in November 1996. Lipoprotein(a) concentration was measured with an enzyme-linked-immunosorbents assay(ELISA), and the results showed that the distribution was highly skewed and the average concentrations of male and female were $16.94{\pm}12.70\;mg/dL\;and\;17.92{\pm}7.58\;mg/dL$, respectively. The percentage of subject with lipoprotein(a) concentrations higher than 30 mg/dL was 26.4%. Univariate analysis showed significant association between lipoprotein(a) and age, alcohol, meat, and NaCl consumption (p<0.05). In multivariate analysis, lipoprotein(a) correlated positively with age (p<0.05) and meat consumption (p<0.01). These data suggest that lifestyle-related factors may affect the lipoprotein(a) concentration regarded as a risk factor of atherosclerosis disease.

• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.567-574
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• 2022

Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.142-149
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• 2003

To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.