• Journal of Chest Surgery
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• 제42권4호
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• pp.528-531
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• 2009

경식도 초음파는 심장수술에서 비교적 안전하게 수술 중 심장의 기능 및 수술 결과를 평가할 수 있어 그 이용이 일반화되고 있으며, 경식도 초음파 관련 합병증은 드물지만 하인두 손상이나 식도 천공 등 위험한 합병증이 생길 수 있다. 폐부종을 동반한 심근경색으로 진단받은 77세 남자환자에서 심폐 바이패스를 사용하 않는 관상동맥우회술 시행 후, 수술 중 경식도 초음파 시술과 관련되어 발생한 것으로 추정되는 pyriform sinus 천공 및 이에 동반된 경부 심부감염을 경험하여 보고하는 바이다.

• Journal of Korean Biological Nursing Science
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• 제9권1호
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• pp.5-31
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• 2007

Purpose: The purpose of this study was to explore the knowledge and learning needs on cardiac rehabilitation of coronary artery bypass graft(CABG) patients. Method: The subjects consisted of 100 CABG patients at A hospital in Seoul. Data were collected by the two different kind of questionnaires which measure knowledge and learning needs on cardiac rehabilitation of CABG patients. The subjects responded the questionnaire on knowledge before CABG and that on learning needs before their discharge. Result: The mean score of knowledge on cardiac rehabilitation was 68.54. Knowledge on risk factor, nature of disease, diet, daily activity, medication, post operative care were great in order. The mean score of learning needs on cardiac rehabilitation was 4.28. Learning needs on diet, medication, nature of disease, post operative care, daily activity, risk factor were great in order. There were significant differences in knowledge according to occupation, economic status and family history(p=.021, p=.017, p=.023). There was a positive correlation between knowledge and learning needs(r=.3009, p=.002). Conclusion: Level of knowledge on cardiac rehabilitation of CABG patients is low and knowledge on postoperative care is the lowest, and learning needs are great in ail categories.

• Journal of Chest Surgery
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• 제49권5호
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• pp.383-386
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• 2016

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular arrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.

• Journal of Chest Surgery
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• 제33권2호
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• pp.190-192
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• 2000

A 53-year-old male patient who had suffered from acute myocardial infarction before a week was admitted due to postinfarction angina A mobile pedunculated left ventricular thrombus of 2.0-cm diameter which was overlooked in cardiac catheterization and ventriculographic study was diagnosed with transthoracic two-dimensional echocardiography. There was no exact clinical finding of left ventricular aneurysm and the thrombus was placed in the akinetic and hypokinetic apical portion. For preventing systemic embolism that was removed through a left ventriculotomy just prior to coronary artery bypass grafting.

• Journal of Chest Surgery
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• 제52권3호
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• pp.189-189
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• 2019

• Journal of Chest Surgery
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• 제33권2호
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• pp.167-172
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• 2000

Background: As the internal mammary artery is far superior to the vein in the patency rate recently there has been a tendency to use the arterial graft as much as possible in coronary artery bypass grafts with the expectation of better the short- and long-term patency rate. Material and Method: We sequentially grafted the diagonal and the left anterior descending artery significantly influencing the cardiac function with the internal mammary artery. There were 32 cases of sequential grafts from July 1993 to December 1998: 21 men and 11 women. The age range was from 43 to 69 years with a mean age of 56.64$\pm$6.41 years. There were 22 unstable angina 7 stable angina and 3 acute myocardial infarction. 8 cases of them were accompanied by stenosis of the left main coronary artery. The grafts for coronary artery bypass surgery included the great saphenous vein at 60 the right gastroepiploci artery at 5 and the left internal mammary artery at 64 coronary arteries. Result: One patient died from sepsis and multiorgan failure. Complications included wound infections in two cases and gastrointestinal bleeding in one patient. All patients showed decrease or disappearance of angina after operation. The postoperative coronary angiogram performed in 9 patients showed neither occlusion nor stenosis of the grafts. Conclusion: This study suggests that sequential anastomosis of the internal mammary artery to the diagonal and the left anterior descending artery may result in excellent short-term patency diagonal and the left anterior descending artery may result in excellent short-term patency rate and be useful for the coronary artery bypass graft using only arterial grafts

• Journal of Chest Surgery
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• 제40권1호
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• pp.56-59
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• 2007

흉통을 주소로 입원한 65세 남자 환자가 불안정형 협심증으로 관상동맥우회수술이 필요한 상태였다. 이학적 검사상 심한 빈혈소견이 동반되었고 혈색소는 5.7 g/dL이었다. 빈혈에 대한 검사 중에 위내시경검사상 출혈을 동반하고 있는 4 cm크기의 종괴가 위소만부에서 관찰되었다. 조직학적 검사상 선암으로 진단되었고, 종양의 출혈로 인해 관상동맥우회수술과 위전절제술이 동시에 계획되었다. 환자는 체외순환 없이 관상동맥우회수술을 시행 받은 후에 동시에 이어서 위전절제술을 시행 받았다 수술 후 경과는 순조로웠다. 환자는 술 후 12일째 퇴원하여 9개월째 추적관찰 중이다. 이에 저자들은 협심증과 위암을 동시에 수술하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제32권10호
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• pp.883-890
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• 1999

Long term patency of arterial graft has been better than venous graft and redo coronary artery bypass grafting has been increasing, therefore, there has been an increasing need for alternative arterial grafts except internal thoracic artery(ITA). Material and Method: Right gastroepiploic arteries(RGEA) were harvested from 100 patients who had received gastrectomy for gastric cancer or ulcer. ITAs were obtained from 10 patients undergoing coronary artery bypass grafting. The length of RGEA was measured from the pyloric ring. Items of the morphometric and histologic study at the pyloric ring and sites of the 10cm and 20cm RGEA from the pyloric ring were luminal diameter, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness, medial thickness, wall thickness, degree of intimal hyperplasia, intimal thickness index, medial thickness index, and the number of discontinuities of the internal elastic lamina. Similar items were applied to the proximal site of ITAs. Result: The length of RGEA was 23${\pm}$2.7cm(range 17∼31cm). Comparing the 20cm RGEA with ITA, intimal thickness, medial thickness, wall thickness, and degree of intimal hyperplasia did not show any difference(p>0.05). However, 20cm RGEA was greater than ITA at the luminal diameter, intimal thickness index, and the number thickness and wall thickness in each site of the RGEA(pyloric ring, 10cm, 20cm) decreased from the pyloric ring to the distal sites(p<0.05). The degree of intimal hyperplasia and the number of discontinuities of the internal elastic lamina did not show any difference between the pyloric ring and 10cm, however, those of 20cm were smaller than these sites(p<0.05). RGEA had more number of discontinuities of the internal elastic lamina and rich smooth muscle cells in the media than ITA. Conclusion: The length and diameter of RGEA is good enough to reach most of the coronary arteries. Moreover, long term patency of RGEA may be improved, if anastomosed in the distal site.

• Journal of Chest Surgery
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• 제38권3호
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• pp.253-257
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• 2005

원발성 폐암의 환자에서 협심증을 동반하고 있는 경우 그 동안 관상동맥우회술을 폐수술 전에 먼저 시행하여 교정하는 단계적인 방법이 주로 이용되었다. 그러나 최근 관상동맥우회술과 폐절제를 동시에 시행하여 단계적 수술 방법의 단점으로 지적되고 있는 두 번의 전신마취, 두 개의 수술상처, 폐 절제의 지연 등을 감소시키려는 경향이 늘고 있고, 좋은 성적을 보고하고 있다. 본원에서도 국내 최초로 폐절제와 관상동맥우회술을 동시에 시행하여 수술 후 양호한 경과를 보이면서 현재까지 추적 관찰하는 중에 암과 협심증의 재발이 없음을 관찰하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제41권5호
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• pp.636-639
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• 2008

우관상동맥 이상기시는 급사, 심근경색, 부정맥이나 실신을 일으킬 수 있으며, 관상동맥경화를 진행시키는 요인으로 여겨진다. 우관상동맥 이상기시에서의 심근 허혈의 기전은 확실하지 않으며, 여러 가지 수술적 치료방법이 보고되고 있다. 다절편 전산화흉부단층촬영은 비정상적인 관상동맥의 경로와 심근 허혈의 기전을 밝혀 적절한 수술적 치료를 결정하는데 도움이 된다. 저자들은 우관상동맥 이상기시와 함께 급성 심근 경색이 있었던 환자에 있어서 관상동맥우회술로 치료한 증례를 보고하는 바이다.