• Title/Summary/Keyword: 관상심장질환

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Combined Repair of Coronary Artery Disease and Left Subclavian Artery Occlusion (관상동맥질환에 병발한 좌측쇄골하동맥폐색의 치험)

  • Kim, Sang-Ik;Kim, Byung-Hun;Noh, Jeong-Sup
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.773-776
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    • 2007
  • A 47-year-old male with hypertension, diabetes mellitus and heavy smoking, but no anginal symptoms, presented with claudication of the lower extremities. Extremity angiography with coronary angiography revealed peripheral arterial lesions including a left subclavian artery occlusion with coronary artery disease. The patient underwent an initial off-pump coronary artery bypass with an ascending aorto-axillary bypass. The right internal mammary artery was anastomosed to the left anterior descending coronary artery. The greater saphenous vein graft was connected from the ascending aorto-axillary bypass graft to the diagonal branch. At postoperative day 18, femorofemoral and bilateral femoropopliteal bypasses were performed. We report a case of the combined repair of coronary artery disease and a left subclavian artery occlusion.

Cor Triatriatum with Coronary Artery Disease in an Old Man -A case report- (고령환자에서 관상동맥 질환을 동반한 삼심방심의 수술치험 -1예 보고-)

  • 천종록;이응배;조용근;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.58-61
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    • 1999
  • Cor triatriatum is a rare anomaly in old age. This is a case report of a 66 year-old man who had been preoperatively diagnosed as coronary artery disease and cor triatriatum. The operative findings revealed that the left atrium had an intra-atrial septum with one small opening 10mm in diameter, the upper compartment received both pulmonary veins, and there were no other anomalies like anormalous pulmonary venous connection or atrial septal defect. The patient successfully underwent open heart surgery ; the anomalous septum was resected, the mitral valve was reconstructed using French technique with Carpentier-Edwards ring, and coronary artery bypass grafting was performed.

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Cognitive-behavioral Approach to Patients with Cardiovascular Diseases (심장혈관계 질환 환자들에 대한 인지행동적 접근)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.185-196
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    • 1995
  • The author reviewed cognitive-behavioral approach to A type behavior pattern and hypertension which are known to be risk factors for coronary heart diseases. Those cognitive distortions frequently found in persons with A type behavior include all-nothing thinking, selective attention, personalization, and attribution of causality. Cognitive-behavioral techniques were also described, which can be applied to management of each characteristic of A type behavior pattern such as time urgency, perfectionism, achievement striving, low self-esteem, excessive work involvement, hostility, and depression. Cognitive-behavioral intervention for hypertension might help the patients to recognize and monitor anger-engendering conflicts, identify characteristic styles of responding, and experiment with alternative ways of managing conflict and anger. Since different features predominate in different individuals, it is necessary to develop treatment plan on the basis of individual characteristics and problems.

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Use of Coronary CT Angiography as a Screening Tool for Coronary Artery Disease in Asymptomatic Healthy Individuals or Patients (무증상 정상인 또는 환자의 관상동맥 질환 선별 검사로서 관상동맥 전산화단층촬영 혈관조영술의 유용성)

  • Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.54-69
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    • 2022
  • Early detection of potential asymptomatic coronary artery disease is very important, as patients with sudden cardiac death often do not show symptoms such as chest pain or motor dyspnea. Coronary CT angiography (CCTA) has long been unjustified as a screening tool for asymptomatic patients because of the risks posed by radiation exposure. However, there are still various opinions regarding the usefulness of CCTA for screening for coronary artery disease (CAD) in asymptomatic healthy individuals or patients. This review investigated the usefulness of coronary artery calcium score and CCTA as screening tests for CAD in asymptomatic healthy individuals or patients through various literature reviews. With the development of CT technology, recent studies have been conducted in asymptomatic CAD patients with a reduced radiation dose of less than 1 mSv. A total of 2.6% of asymptomatic subjects on CCTA found significant CAD over 70%, and it was concluded that screening CCTA for CAD showed prognostic power in predicting the future occurrence of CAD in asymptomatic people. However, after the completion of the current NIH SCOT-HEART 2 study, it may be possible to determine whether CCTA is appropriate as a screening tool for CAD in asymptomatic healthy individuals.

Parametric Vessel Modeling for Simulation of Coronary Artery Bypass Graft (관상동맥우회시술 시뮬레이션을 위한 동적 혈관 매개변수모델링)

  • Song SooMin;Lee Yubu;Choi YooJoo;Kim MyoungHee
    • Proceedings of the Korea Society for Simulation Conference
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    • 2005.11a
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    • pp.130-137
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    • 2005
  • 본 논문은 심장이 수축$\cdot$이완함에 따라 그 형태와 위치가 변하는 관상동맥의 구조와 그 움직임을 사실적으로 표현하기 위한 매개변수적 모델링 기법을 제안한다. 완성된 모델은 관상동맥의 움직임을 관찰함으로써 심장질환 판단에 도움을 주고, 심장시술 시뮬레이션 및 시술계획수립에 사용될 수 있다. 매개변수적 기법으로 생성된 모델은 메쉬 정점의 인덱스만으로 모델간 매칭을 위한 대응점을 찾을 수 있으므로, 시간대별로 달라지는 정점의 위치를 쉽게 추적함으로써 모델의 움직임을 표현할 수 있다. 그러나 이러한 기법으로 생성된 모델은 분리, 접합 등의 변형조작이 어렵고, 트리형태 객체에 적용하기 힘든 단점이 있다. 본 논문에서는 이를 극복하기 위해 분할된 혈관영역의 골격데이타에서 찾아낸 분기점을 중심으로 Generalized Cylinder를 이용하여 실린더 형태의 각 혈관세그먼트를 모델링 한 후, 분기영역을 3개의 하프파이프(half pipe)와 2개의 삼각형 패치로 연결하여 모델링하였다. 완성된 모델은 다시점 관상동맥데이터에 적용하였고, 각 시점에서 구해진 정점의 위치를 선형보간함으로써 부드러운 혈관의 움직임을 나타내었다.

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Effect of Education and Counselling-based Cardiac Rehabilitation Program on Cardiovascular Risk, Health Behavior and Quality of Life in Elderly with Coronary Artery Disease (교육상담 기반 심장재활 프로그램이 노인 관상동맥질환자의 심혈관 위험도, 건강행위 및 삶의 질에 미치는 효과)

  • Won, Mi-Hwa
    • The Journal of the Korea Contents Association
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    • v.15 no.6
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    • pp.303-313
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    • 2015
  • Purpose: The purpose of this study was to investigate the effect of education and counselling-based cardiac rehabilitation program on cardiovascular risk, health behavior and quality of life in elderly with coronary artery disease. Methods: A quasi-experimental study used a non-equivalent control group pre-post test design. A five week education and counselling-based cardiac rehabilitation program for the elderly with coronary artery disease was developed and offered to the experimental group. Participants were drawn from hospital in Busan. Twenty two were selected for the experimental group while 22 were assigned to a control group. Cardiovascular risk, health behavior and quality of life were measured. Results: There was a statistically significant difference in the cardiovascular risk(U=118.5, p=.002), health behaviors(t=5.200, p=<.001) and quality of life(t=2.431, p=.001) between the experimental group and the control group. Conclusion: Education and counselling-based cardiac rehabilitation program can be not only an effective nursing intervention for old patients having coronary artery disease, but also the very basis of further research on aged people who have the same symptom.

Interaction Effect of Three Recumbent Postures and Heart Disease Severity on the Autonomic Nervous System (세 가지 누운 자세와 심장질환의 중증 정도가 교감-부교감 신경계의 균형에 미치는 상호작용 효과)

  • Bae Jang-Ho;Choi Hyoung-Min;Jang Eun-Hye;Kim Wuon-Shik
    • Science of Emotion and Sensibility
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    • v.8 no.1
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    • pp.29-36
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    • 2005
  • This study investigated which recumbent posture can give rise to the highest vagal modulation in patients with coronary artery disease(CAD), among three recumbent postures; namely, the supine, left lateral, and right lateral postures. For this purpose, 43 patients as CAD group and 31 patients as control group were studied. Heart rate variability(HRV) was measured on these patients for three recumbent postures in random order Normalized high-frequency power was the highest, whereas normalized low-frequency power was the lowest in the right lateral postures, among the three recumbent postures.

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CABG for Treating Unstable Angina with Multivessel Coronary Artery Aneurysms - A case report- (다혈관 관상동맥류가 동반된 불안정성 협심증 환자에서의 관상동맥 우회로술)

  • Kim, Jin-Sik;Chee, Hyun-Keun;Chung, Jin-Woo;Kim, Jun-Seok;Shin, Je-Kyoun;Song, Meong-Gun
    • 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.

Reference Standard of Korean Carotid Intima-Media Thickness (한국인 경동맥내중막두께 참조표준 개발 및 응용)

  • Kim, Won-Sik;Jang, Seung-Jin;Jang, Hak-Yeong;Choe, Hyeong-Min;Gang, Ji-Yun
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2009.05a
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    • pp.27-28
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    • 2009
  • 경동맥 내중막두께(intima media thickness: IMT)는 2000년 미국심장학회에서 관상동맥 질환이나 허혈성 뇌질환 위험도의 독립적인 인자임을 인정하여 일차 진단지표로 권장함에 따라 세계적으로 그 관심이 확산되고 있다. 최근 국내에서도 서구화되어 가는 식생활 패턴으로 인해 고혈압, 동맥경화, 뇌졸중, 관상동맥 질환 등의 심뇌혈관계 질환 발병률이 높아지고 있다. 서구의 연구결과에 의하면 경동맥 내중막 두께는 인종, 성별, 연령에 따라 많은 차이를 보이기 때문에 임상적 진단에 기초가 되는 한국형 경동맥 내숭막두께 정상치 확립이 요구된다. 경동맥의 내중막두께는 경동맥 팽대부에서 근위부 10 mm 부위의 far wall 총경동맥 부위에서 심혈관계 위험 인자와 가장 상관성이 많은 것으로 보고되고 있다.

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Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.