• Title/Summary/Keyword: Bypass surgery

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"Off-Pump" Coronary rtery bypass Grafting in Multi-vessel Coronary Disease -Two Cases- (다중 혈관질환에서 심폐바이패스를 이용하지 않은 관상동맥 우회술)

  • 유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1123-1126
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    • 1999
  • Coronary artery bypass grafting (CABG) technique has been much developed but CABG under cardiopulmonary bypass has the unavoidable deficits such as generalized inflammatory reaction from cardiopulmonary bypass and myocardial ischemia from aortic-cross clamp. There has been remarkable advancement of CABG without cadiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass. We performed CABG successfully without cardiopulmonary bypass in two patients with multivessel coronary disease who were failed to intervene with percutaneous transluminal coronary angioplasty. We herein report the two cases.

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Coronary Artery Bypass Grafting without Cardiopulmonary Bypass -one case report- (임공심폐기를 사용하지않는 관상동맥우회술 -1례 보고-)

  • Na, Chan-Young;Lee, Young-Tak;Kim, Woong-Han;Chung, Chul-Hyun;Jung, Yoon-Seop;Bang, Jeong-Hyin;Kim, Wook-Seong;Lee, Sub;Han, Jae-Jin;Chung, Do-Hyun;Chung, Ill-Sang;Park, Jung-Won;Park, Young-Kwan;Hong, Sung-Nok;Moon, Hyun-Soo
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1267-1269
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    • 1996
  • Coronary artery bypass grafting without cardiopulmonary bypass is now one of accepted technique of myocardial revascularization. This technique is an alternative method for patients with lesions in the left anterior descending coronary artery and right coronary artery. We report a case of coronary artery bypass grafting without cardiopulmonary bypass or cardiac arrest.

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The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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Wrapping of an Ascending Aortic Aneurysm with the Multiple Boot-Straps Technique in a Patient Undergoing Off-Pump Coronary Artery Bypass Grafting

  • Na, Kwon Joong;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.206-209
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    • 2015
  • Ascending aortic aneurysms are usually treated with graft replacement under cardiopulmonary bypass. However, if a candidate for off-pump coronary artery bypass grafting has an enlarged ascending aorta, surgeons may consider wrapping it without cardiopulmonary bypass. Here, we report a 78-year-old female who underwent successful wrapping of the ascending aorta concomitant with off-pump coronary artery bypass grafting, using a new wrapping technique that involves multiple bootstraps.

Partial Left Heart Bypass for Perioperative Left Ventricular Failure [A Report of 2 Clinical Cases] (개심술시 병발한 좌심실 기능부전에 대한 Partial Left Heart Bypass 치험)

  • 이종국
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.193-204
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    • 1985
  • During the period from February to March, 1984, we employed a partial left heart bypass [left atrium to ascending aorta] in 2 patients who could not weaned from cardiopulmonary bypass with inotropic agents and cardiac pacing after coronary bypass surgery. These two patients showed significant improvement in ventricular function 18 to 47 hours after inserting the left heart bypass and were able to wean from the left heart bypass under using inotropic agents. Two patients died of multiple organ failures 11 days and 15 days postoperatively. These results indicate that early institution of left heart bypass in ventricular failure patients after open heart surgery can provide satisfactory long-term result.

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An Unusual Delayed Pseudoaneurysm That Originated from a Bypass Suture Site and It Was Revealed to Be an Organizing Thrombus 7 Years an Extraanatomic Bypass - A case report - (외해부학적 우회술 7년 뒤에 발생되어 기질성 혈전으로 밝혀진 우회술 봉합 부위에서 야기된 드문 양상의 지연성 가성동맥류 - 1예 보고 -)

  • Lee, Woo-Surng;Kim, Yo-Han;Chee, Hyun-Keun;Hwang, Jae-Joon;Kim, Jun-Seok;Lee, Song-Am
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.532-536
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    • 2009
  • Bypass surgery is performed for insuring continuity of a blood supply that is restricted due to obstruction of the native blood supply. Two types of surgery are commonly carried out: one is anatomic bypass and the other is extraanatomic bypass. Especially, extraanatomic bypass surgery is performed in patients who are a high risk for performing anatomical bypass surgery. The risk factors for anatomical bypass surgery are old age, infection, previous surgery and trauma. A 96-year-old patient underwent extraanatomic bypass surgery from the right femoral artery to the left femoral artery due to total occlusion of the left iliac artery, and 7 years after that operation, a pseudoaneurysm abruptly and spontaneously appeared from the bypass suture site without any predisposing factor. The lesion was revealed to be an organizing thrombus.

Efficacy and patient satisfaction regarding lymphovenous bypass with sleeve-in anastomosis for extremity lymphedema

  • Chung, Jae-Ho;Baek, Si-Ook;Park, Ho-Jin;Lee, Byung-Il;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.46-56
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    • 2019
  • Background When performing lymphovenous anastomosis, it is sometimes difficult to find venules in the proximity of an ideal lymphatic vessel that have a similar diameter to that of the lymphatic vessel. In this situation, larger venules can be used. Methods The authors evaluated the efficacy of and patient satisfaction with lymphovenous bypass with sleeve-in anastomosis. Between January 2014 and December 2016, we performed this procedure in 18 patients (eight upper extremities and 10 lower extremities) with secondary lymphedema. Lymphovenous bypass with sleeve-in anastomosis was performed under microscopy after injecting indocyanine green dye. The circumferential diameter was measured before lymphovenous bypass and at 1, 2, and 6 months after the procedure. An outcomes survey that included patients' qualitative satisfaction with lymphovenous bypass was conducted at 6 months postoperatively. Results Almost all patients showed quantitative improvements after surgery. The circumferential reduction rate in patients with stage II lymphedema of both the upper and lower extremities was significantly greater than in their counterparts with stage III/IV lymphedema. The circumferential reduction rate was lower in lower-extremity patients than in upper-extremity patients. Conclusions Lymphovenous bypass surgery with sleeve-in anastomosis in lymphedema patients is beneficial, and appears to be effective, when adequately-sized venules cannot be found in the proximity of an ideal lymphatic vessel.

The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Management of Infected Axillo-bifemoral Graft; A Case Report (액와동맥-양측대퇴동맥우회술후 발생한 인조혈관 감염의 치료)

  • 정철하
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.552-556
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    • 1993
  • Infection after reconstructive surgery is one of the most catastrophic postoperative complication in vascular surgery. Mortality rates reported from a world-wide experience range between 25 and 88 percent. The surgeon faced with such a complication must choose among many diagnostic and management options to maximize limb salvage and survival based on the presentation and site of the infectiota the degree of ischemia of the lower extremities, and the overall medical condition of the patient. We successfully managed with descending thoracic aorta-to-bifemoral arteries bypass after the entire removal of the infected axillo-bifemoral graft because of bypass graft infection.

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Simple Anastomotic Techniques for Coronary Artery Bypass Surgery in Patients with Small Coronary Arteries or a Marked Size Discrepancy Between the Coronary Artery and Graft

  • Lee, Mi Kyung;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.485-488
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    • 2016
  • Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%.