• Title/Summary/Keyword: 관상로

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Pathophysiology and Role of Coronary CT Angiography in Stable Angina (안정형 협심증의 병태생리 및 관상동맥 CT 혈관조영술의 역할)

  • Jong Eun Lee;Hye Mi Park;Yongwhan Lim;Won Gi Jeong;Yun-Hyeon Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.42-53
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    • 2022
  • The clinical concept of coronary artery disease (CAD) has seen a paradigm shift over the last decade. CAD is mostly a progressive disease, and patients with CAD can develop acute coronary syndromes at any point in disease progression. In this clinical context, a new term, "chronic coronary syndrome," was published in the 2019 European Society of Cardiology guidelines, reflecting the importance of early diagnosis and active management. Recent advances have been made in the evaluation of CAD using coronary CT angiography (CCTA). The clinical usefulness of CCTA in patients with stable angina or chronic coronary syndrome begins with the detection of early asymptomatic CAD. The characterization of atherosclerotic plaque and its role in determining treatment strategies for CAD have been demonstrated for all stages of the disease. This review describes the pathophysiology of stable angina to aid in the understanding of the clinical applications of CCTA.

Right Coronary Artery to Left Ventricular Fistula with a Giant Right Coronary Artery Aneurysm - A case report - (거대 우관상 동맥류를 동반한 우관상 동맥에서 좌심실로 유출되는 관상 동맥루 - 1예 보고 -)

  • Kang, Joon-Kyu;Huh, Jae-Hak;Chang, Ji-Min;Song, Cheol-Min
    • 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.

Axillocoronary Bypass as Coronary Reoperation via Minimally Invasive Procedure-A Report of One Case- (관상동맥 재수술로서의 최소 침습 수기를 통한 액와 -관상동맥 우회술 -1례 보고-)

  • 백완기;윤용한;김정택;김광호;임현경
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.399-402
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    • 2001
  • 최근 심폐기를 사용하지 않는 최소침습성 직접 관상동맥우회술(MIDCAB procedure)은 심장수술 분야에서 급속도로 발전을 거듭하고 있다. 금번 저자들은 전에 만들어 준 좌전하행지 이식편이 막혀 관상동맥 재수술을 필요로 하였으나 좌내 유동맥의 혈류량의 불충분하였다고 생각되었다. 1례에서 최소 침습 수기를 통한 액와-관상동맥 우회술을 시행하여 만족스러운 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.

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A Surgical case of Tetralogy of Fallot with Single Coronary Artery (단일관상동맥의 활로4징증 치험 1례)

  • 류재욱;서필원
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.251-253
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    • 1996
  • In the surgical repair of tetralogy of Fallot, the anomalous origin of the coronary artery has significant surgical implication. The coronary anomalies of concern are origin of the anterior descending coronary artery from the right coronary artery and certain variations of single coronary branching. We experienced a case of tetralogy of Falloff with single coronary artery from the left coronary sinus, from which the right coronary artery originated crossing the right ventricular outflow tract. This ty e of coronary anomaly in tetralogy of Fallot is known to be extremly rare.

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Comparison of Risk Factors for Men and Women According to Severity Classification in Patients with Coronary Artery Disease (관상동맥질환 중증도 분류에 따른 성별 위험요인 비교)

  • Kweon, Mi-Soo
    • Journal of Industrial Convergence
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    • v.20 no.8
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    • pp.85-96
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    • 2022
  • The aim of this retrospective study was to compare risk factors between men and women through secondary data of nursing information and medical records according to the severity classification in patients of 340 men and 221 women with coronary artery disease(CAD) who were admitted for the first time at a general hospital and underwent first coronary artery angiography. Consequently, men presented with risk factors such as age(p=.004), total cholesterol(p=.040), triglycerides(p=.049), HbA1c(p<.001), smoking(p<.001), alcohol consumption(p=.002) and comorbidities(p=.036) that showed statistically significant differences. Among women, age(p=.002) and comorbidities (p=.018) were the only factors that showed significant differences. Significant risk factors influencing the classification of CAD severity in men were total cholesterol (OR 0.97, 95% CI 0.96-1.00, p=.014) in 1VD, alcohol consumption (OR 52.47, 95% CI 2.99-91.95, p=.007)in 2VD, and total cholesterol in the 3VD(OR 0.98, 95% CI 0.95-0.98, p=.026). A significant risk factor affecting the classification of CAD severity in women was comorbidity (OR 0.30, 95% CI 0.11-0.82, p=.020) in the 3VD. This study identified the importance of nursing care for male CAD patients, such as smoking cessation and quitting drinking, blood sugar control, cholesterol, and accompanying disease management, and provided evidence of individually tailored nursing care.

Congenital Coronary Artery to Left Ventricular Fistula - A case report- (우관상동맥에서 좌심실로 유출되는 선천성 관상동맥루 -치험 1예-)

  • Kim Jin Sun;Yang Ji-Hyuk;Kim] Sung-Hye;Lee Heung Jae;Jun Tae-Gook
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.501-503
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    • 2005
  • Coronary artery fistula accounts for $0.27\~0.4\%$ of all congenital cardiac defects. In more than $50\%$ of the cases, right coronary artery is involved. The fistula drains into the right heart in $92\%$ of the cases. Left heart is the site of termination in only $8\%$ of the cases, especially less left ventricle $(3\%)$. We experienced a case of right coronary artery to left ventricular fistula in a 3-year-old boy who was diagnosed incidentally and underwent ligation of fistula.

Anormalous Origin of Left Coronary Artery from Pulmonary Artery (좌 관상동맥-폐동맥 이상 기시증 수술치험 1례)

  • 조광조;편승환
    • 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.

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Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results (심폐바이패스 없이 시행하는 관상동맥우회술과 경피적 관상동맥중재술의 병합요법 : 적응증 및 조기성적)

  • Hwang Ho Young;Kim Jin Hyun;Cho Kwang Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.733-738
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    • 2005
  • Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

영양교육이 고콜레스테롤혈증 환자의 식습관 및 혈청 지질 농도에 미치는 영향

  • 김소연;손정민;정우영
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.420-421
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    • 2004
  • 심혈관계 질환은 선진국에서 가장 중요한 사망원인이며, 특히 관상동맥 질환은 심혈관계 질환으로 인한 사망의 50% 이상을 차지하고 있다. 미국에서는 National Cholesterol Education Program(NCEP)을 통해 관상동맥질환의 예방 및 치료를 위한 식생활 지침을 마련하여 꾸준히 시행한 결과, 관상동맥질환으로 인한 사망률을 40% 가량 감소시키는 결과를 가져왔다. 그러나, 우리나라는 최근 10년간 관상동맥질환으로 인한 사망률이 1.8배 증가하는 양상을 보이고 있음에도 불구하고 관상동맥질환 예방을 위한 대국민적인 식생활 개선에 대한 기준이 미비한 실정이다.(중략)

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특집 - 당뇨인, 심장이 위험하다 '관상동맥질환'

  • Kim, Won
    • The Monthly Diabetes
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    • s.238
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    • pp.14-17
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    • 2009
  • 당뇨병환자들이 당뇨 자체보다 당뇨로 인한 합병증으로 목숨을 잃는다는 것은 잘 알려진 사실이며 이 중 가장 큰 사인은 관상동맥질환이다. 당뇨병환자는 같은 나이의 일반인에 비해 심근경색증을 포함한 관상동맥질환이 3$\sim$5배 정도 더 발생하는 것으로 알려져 있다. 그러나 당뇨병환자들의 심장병 가운데는 무증상인데다 검사로도 잘 나타나지 않는 사례가 적지 않기 때문에 관상동맥질환에 대한 정확한 이해와 치료, 그리고 예방이 무엇보다 중요하다고 하겠다.

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