• Title/Summary/Keyword: Aortic disease

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Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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Aberrant Right Subclavian Artery with Dysphagia and Recurrent Pneumonia -A case report - (연하곤란 및 반복괵인 폐렴를 동반한 이상우쇄골하동맥 - 1예 보고 -)

  • 장원채;임영혁;임성철;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.282-285
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    • 2004
  • Aberrant right subclavian artery (ARSA) is an anomaly with a reported incidence of 0.5% to 2%. Most patients with an ARSA remain asymptomatic; however about to% of adult patients have compressive symptoms. A case is reported of a 64-year old female patient who had a few years of history of dysphagia and recurrent pneumonia. Angiography was performed, which demonstrated an ARSA with common origin of the right and left carotid arteries. Surgical correction was performed via right thoracotomy. The proximal aberrant artery was mobilized behind the esophagus. The distal, right subclavian artery was exposed, transected, and transposed with reimplantation into the aortic root by graft bypass.

Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience

  • Hyun, Myung Chul
    • Clinical and Experimental Pediatrics
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    • v.60 no.12
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    • pp.390-394
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    • 2017
  • Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

Novel Antioxidants and Atherosclerosis

  • Parthasarathy Sampath;Santanam Nalini
    • Proceedings of the Korean Society of Food Science and Nutrition Conference
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    • 2004.11a
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    • pp.265-270
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    • 2004
  • Coronary heart disease (CHD) has been the number one killer in western society for a long time, and CHD in most instances is due to atherosclerosis. One of the earliest events in atherogenesis is the intracellular accumulation of lipids, particularly cholesterol esters, in the aortic intima. The lipids presumably came from the uptake of plasma lipoproteins, particularly from LDL. These foam cells were identified as being predominantly as macrophages. Currently, it is believed that oxidation of low density lipoprotein (LDL) might contribute to the generation of foam cells. An outcome of the oxidation hypothesis is that the consumption of antioxidants would be beneficial. In this study, Boldine, an alkaloid of Peumus boldus was tested for their antioxidant potency both in, in vitro oxidation system and in mouse models. Boldine decreased the ex-vivo oxidation of Low-density lipoprotein (LDL). In vivo studies were performed to study the effect of these compounds on the atherosclerotic lesion formation in LDL r-/- mice. Three groups of LDL r-/- mice (N=12 each) were fed an atherogenic diet. Group 1 was given vehicle and group 2 and 3 were given 1 and 5 mg of Boldine/day in addition to the atherogenic diet. The results indicated that there was a decrease in lesion formation reaching a 40% reduction due to Boldine compared to controls. The in vivo tolerance of Boldine in humans (has been used as an herbal medicine in other diseases) should make it an attractive alternative to vitamin E.

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The Echocardiographic Assessment and clinical Application of Cardiac Disease in Korean Jin-do dog (진돗개에서 심장초음파 측정치의 평가와 임상적 응용 I. 심장초음파 측정치)

  • 박인철;강병규;손창호
    • Journal of Veterinary Clinics
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    • v.17 no.1
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    • pp.178-186
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    • 2000
  • Echocardiography was performed on 29 normal Korea Jin-do dogs(21 adults and 8 prematures) and the images were taken from chordae tendineae level short-axis view, left ventricular outflow tract long-axis view and 4-chamber long-axis view, respectively. The following cardiac parameters, in systole and diastole, were measured on the echoocardographic images: aortic dimension(AO), left atrial dimension(LA), left ventricular internal dimention at end-diastole (LVIDd), left ventricular internal dimention at end-systole(LVIDs), interventricular septal wall thickness at end-diastole(IVSd), interventricular septal wall thickness at end-systole(IVSs), left ventricular wall at end-diastole(LVWd), left ventricular wall at end-systole(LVWs). The cardiac parameters were not significantly different between sex and among imaging planes. The size of cardiac parameters increaed as regression lines according to body weights. These results suggest that the chordae tendineae level short-axis view, left ventricular outflow tract long-axis view and 4-chamber long-axis view can be utilized for the left cardiac examination, and these cardiac parameters can be used to basic dat for diagnosing the cardiac diseases in Korea Jin-do dog.

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Stress-induced Cardiomyopathy during Pulmonary Resection (Takotsubo Syndrome) - A case report -

  • Lee, Seok-Kee;Lim, Seung-Pyung;Yu, Jae-Hyeon;Na, Myung-Hoon;Kang, Shin-Kwang;Kang, Min-Woong;Oh, Hyun-Kong
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.294-297
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    • 2011
  • Stress-induced cardiomyopathy is caused by emotional or physical stressors and mimics acute myocardial infarction, though Stress-induced cardiomyopathy is characterized by reversible left ventricular (LV) apical ballooning in the absence of significant coronary artery disease. We describe a 51-year-old male who underwent left upper lobectomy for non-small cell lung cancer, and during which cardiogenic arrest occurred due to stress-induced cardiomyopathy, successfully managed by intra-aortic balloon pumping and extracorporeal membrane oxygenation.

Clinical experience of open heart surgery: report of 10 cases (개심술 치험 10례 보고)

  • 임승평
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.75-82
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    • 1983
  • This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

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Repair of Postinfarction Ventricular Septal Defect on a Beating Heart -One case report (심근경색 후 심실중격렬손의 심박동 상태에서의 교정술 -1예 보고-)

  • Kim, Hyuck;Lee, Hyung-Chang;Kim, Young-Hak;Chung, Won-Sang;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.543-545
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    • 2004
  • Postinfarction ventricular septal defect often induces cardiogenic shock and requires operative treatment early after myocardial infarction. Although the operative mortality of this disease has decreased during the past 3 decades, it is still relatively high. In this case, to prevent global myocardial ischemia, we used the technique of repair of postinfarction ventricular septal defect on a beating heart. This approach does not requir aortic cross-clamping and provides superior myocardial protection.

Technique of Coronary Transfer for TGA with Single Coronary Artery

  • Kim, Tae Ho;Jung, Jae Jun;Kim, Yong Han;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.529-532
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    • 2014
  • An eight-day-old neonate was diagnosed with dextro-transposition of the great arteries, atrial septal defect, patent ductus arteriosus, and a single sinus origin of the coronary arteries. The single coronary artery originated from the left sinus (sinus 2), had a proximal left circumflex arterial branch, and passed anteriorly to the right side of the aorta, further branching into the right coronary and left anterior descending arteries. We successfully performed an arterial switch operation and coronary transfer by tube graft reconstruction with autologous aortic tissue to treat the dextro-transposition of the great arteries and atrial septal defect with a single-sinus origin of the coronary arteries.

Intravenous administration of piceatannol, an arginase inhibitor, improves endothelial dysfunction in aged mice

  • Nguyen, Minh Cong;Ryoo, Sungwoo
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.1
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    • pp.83-90
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    • 2017
  • Advanced age is one of the risk factors for vascular diseases that are mainly caused by impaired nitric oxide (NO) production. It has been demonstrated that endothelial arginase constrains the activity of endothelial nitric oxide synthase (eNOS) and limits NO generation. Hence, arginase inhibition is suggested to be vasoprotective in aging. In this study, we examined the effects of intravenous injection of Piceatannol, an arginase inhibitor, on aged mice. Our results show that Piceatannol administration reduced the blood pressure in aged mice by inhibiting arginase activity, which was associated with NO production and reactive oxygen species generation. In addition, Piceatannol administration recovered $Ca^{2+}$/calmodulin-dependent protein kinase II phosphorylation, eNOS phosphorylation and eNOS dimer stability in the aged mice. The improved NO signaling was shown to be effective in attenuating the phenylephrine-dependent contractile response and in enhancing the acetylcholine-dependent vasorelaxation response in aortic rings from the aged mice. These data suggest Piceatannol as a potential treatment for vascular disease.