• Title/Summary/Keyword: Coronary

Search Result 2,243, Processing Time 0.025 seconds

Spontaneous resolution of new coronary artery aneurysm following guideline-directed medical therapy after drug-eluting stent implantation

  • Jae-Geun Lee;Ki Yung Boo
    • Journal of Medicine and Life Science
    • /
    • v.20 no.3
    • /
    • pp.131-134
    • /
    • 2023
  • Here, we present a case of a 56-year-old man with acute myocardial infarction. The patient underwent percutaneous coronary intervention (PCI) at the left main bifurcation and mid-left anterior descending artery using drugeluting stents. Four months after the PCI, the patient was readmitted for cardiac arrest. Coronary angiography (CAG) revealed stent thrombosis in the left main-to-proximal left anterior descending artery and in-stent restenosis in the left main-to-proximal left circumflex artery. We performed balloon angioplasty at the left main to mid-left anterior descending artery and left main to proximal left circumflex artery stents; subsequently, blood flow was fully restored. However, contrast agent extravasation was observed outside the mid-portion of the left main artery to the proximal left anterior descending artery stent, indicating the presence of a coronary artery aneurysm (CAA) outside the stent. After guideline-directed medical therapy with dual antiplatelet agents and high-intensity statins, follow-up CAG revealed near-resolution of the CAA, absence of stenotic lesions, and good blood flow.

Difference in Knowledge and Learning Needs of the Coronary Artery Disease according to the General Characteristics of the Patients with Type 2 Diabetes Mellitus (제 2형 당뇨병 환자 특성에 따른 관상동맥질환 지식과 교육요구도 차이)

  • Song, Min-Sun;Kim, Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.14 no.3
    • /
    • pp.323-330
    • /
    • 2007
  • Purpose: The purpose of this study was to assess the difference in knowledge and learning needs of the coronary artery disease according to the general characteristics of the patients with type 2 diabetes mellitus. Method: The participants were 188 patients who had diabetes mellitus. Data were obtained between January and April 2006 by asking the knowledge and learning needs of the coronary artery disease. Data were analyzed using SAS program. Results: Participants' knowledge level was high in the cause and prevention, but the level was low in the symptom and occurrence of pain. Learning need for "Influence of smoking on heart disease" and "The structure and functions of the heart" was great, but learning need for "Complete diagnosis" and "Management of pain and pressure on the sternum" was little. No significant differences were found in the knowledge level of the coronary artery disease according to the general characteristics. Learning needs were greater in participants under 60 years of age (p=0.011) and in those with low education level (p=0.049). There was a significant correlation between knowledge and learning needs of the coronary artery disease (p=0.003). Conclusion: In planing the education programs, the general characteristics of the patients should be considered.

  • PDF

Management of Coronary Sinus Ostial Atresia during a Staged Operation of a Functional Single Ventricle

  • Kang, Seung Ri;Park, Won Kyoun;Kwon, Bo Sang;Ko, Jae Kon;Goo, Hyun Woo;Park, Jeong-Jun
    • Journal of Chest Surgery
    • /
    • v.51 no.2
    • /
    • pp.130-132
    • /
    • 2018
  • Coronary sinus ostial atresia (CSOA) with persistent left superior vena cava (LSVC) in the absence of an unroofed coronary sinus is a benign and rare anomaly that may be taken lightly in most instances. However, if overlooked in patients undergoing univentricular heart repair such as bidirectional Glenn or Fontan-type surgery, fatal surgical outcomes may occur due to coronary venous drainage failure. We report a case of CSOA with a persistent LSVC that was managed through coronary sinus rerouting during a total cavopulmonary connection, and provide a review of the literature regarding this rare anomaly.

Effects of Stenting Shapes on the Wall Shear Stress in the Angulated Coronary Stenosis (협착된 관상동맥에 시술된 스텐트형상이 벽면 전단응력에 미치는 영향)

  • Cho, Min-Tae;Suh, Sang-Ho;Yoo, Sang-Sin;Keun, Huk-Moon
    • Proceedings of the KSME Conference
    • /
    • 2001.06e
    • /
    • pp.219-222
    • /
    • 2001
  • The objective of the present study is to evaluate the effects of the stenting shapes on flow velocity and wall shear stress in angulated coronary stenosis by computer simulation. Coronary angiogram and Doppler ultrasound measurement in the patients with angulated coronary stenosis were obtained. Inlet wave velocity distribution obtained from in vivo intracoronary Doppler data was used for the numerical simulation. Spatial pattern of blood flow velocity and recirculation area were drawn through out the selected segment of coronary models. Wall shear stresses in the intracoronary stent models were calculated from three-dimensional computer simulation. A negative shear stress region, which is consistent with re-circulation area on flow pattern, was noted on the inner wall of post-stenotic area of pre-stenting model. The negative shear stress was disappeared after stenting. Shear stress in the post-stenting model was markedly reduced up to about two orders of magnitude compared to that of the pre-stenting model.

  • PDF

Predictors of Intention to Quit Smoking among Patient with Coronary Heart Disease (관상동맥질환자의 금연의도에 영향을 미치는 요인)

  • 김은경;김매자;송미령
    • Journal of Korean Academy of Nursing
    • /
    • v.32 no.3
    • /
    • pp.355-363
    • /
    • 2002
  • The purpose of this study was to examine the level of intention to quit smoking and to identify factors influencing intention to quit among patients with coronary heart disease. Method: The subjects consisted of 80 male patients with coronary heart disease (angina pectoris, myocardial infarction) at three hospitals in Seoul. The data were collected with self reporting in a structured questionnaire. Stepwise multiple regression was used to identify predictors of intention to quit. Included variables were attitudes toward smoking cessation, subjective norms, perceived behavioral control, usefulness of smoking cessation, and previous attempts to quit. Result: 1. The mean score for intention to quit was 11.1($\pm$6.1) which was lower than median score of the scale. 2. There were significant correlations between the all predictive variables and the intention to quit(r=.24-.48, p<.05). 3. usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit explained 34.6% of the variance for intention to quit. Conclusion: usefulness of smoking cessation, perceived behavioral control, and previous attempts to quit were identified as important variables in explaining the intention to quit smoking among patients with coronary heart disease. Thus, it is necessary to try to enhance this factors for increasing intention to quit among patients with coronary heart disease.

Thoracodorsal Artery as an Alternative in Complete Arterial Coronary Revascularization -3 Cases- (완전동맥도관 관상동맥 우회술에서 대체동맥편으로 사용한 흉배동맥 -3례보고-)

  • 정철현;허재학;장지민;김욱성;장우익;이윤석
    • Journal of Chest Surgery
    • /
    • v.35 no.12
    • /
    • pp.898-901
    • /
    • 2002
  • It is now widely accepted that the complete arterial coronary revascularization has better short and long term results compared to coronary bypass surgery using arterial graft mixed with vein graft mainly due to its superior patency rate. However, sometimes the internal thoracic artery and other conventionally used grafts might be unavailable or it may require caution in using bilateral internal thoracic artery especially in diabetic patient because of the possible risk of the mediastinitis or other associated morbidities. Moreover, there could also be a shortage for arterial graft in case of coronary reoperation. We report our first three cases using thoracodorsal artery(TDA) as an alternative graft in complete arterial coronary revascularization.

Flow Visualization in Realistic Arterial Bypass Graft Model

  • Singh, Megha;Shin, Se-Hyun
    • International Journal of Vascular Biomedical Engineering
    • /
    • v.3 no.1
    • /
    • pp.1-5
    • /
    • 2005
  • Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.

  • PDF

A Case of Successful Recovery from High Dose Intravenous Nicorandil Infusion in Refractory Coronary Vasospasm with Hemodynamic Collapse

  • Koh, Won-Jun;Cho, Jeong-Hyeon;Lee, Ji-Hyun;Kang, Won-Sik;Lee, Min-Kyung;Kim, Jun-Hyoung;Cho, Deok-Kyu
    • Journal of Yeungnam Medical Science
    • /
    • v.29 no.2
    • /
    • pp.129-131
    • /
    • 2012
  • A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

  • PDF

Long Segmental Reconstruction of Diffusely Diseased Left Anterior Descending Coronary Artery Using Left Internal Thoracic Artery with Extensive Endarterectomy

  • Heo, Woon;Min, Ho-Ki;Kang, Do Kyun;Lee, Sung Kwang;Jun, Hee Jae;Hwang, Youn-Ho
    • Journal of Chest Surgery
    • /
    • v.48 no.4
    • /
    • pp.285-288
    • /
    • 2015
  • In coronary artery bypass grafting, a diffusely diseased left anterior descending coronary artery (LAD) is an obstacle to achieving complete revascularization, consequently leading to the possibility of a poor prognosis. Long segmental reconstruction with or without endarterectomy is a revascularization method for treating diffusely diseased coronary arteries. Herein, we report a successful case of long segmental reconstruction of a diffusely diseased LAD using a left internal thoracic artery onlay patch after endarterectomy.

Transvenous proximal closure of large congenital coronary arteriovenous fistula using the single Amplatzer vascular plug in a 3-year-old girl

  • Jang, Hae In;Choi, Young Earl;Cho, Hwa Jin;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
    • /
    • v.56 no.2
    • /
    • pp.90-93
    • /
    • 2013
  • Congenital coronary arteriovenous fistulas (CCAFs) are rare coronary artery abnormalities in which blood is shunted into a cardiac chamber or great vessel. If the fistula itself is large and tortuous, it is generally recommended to occlude the fistula to prevent several complications. In approaches of transcatheter occlusion, the transvenous approach is preferred over the transarterial approach. The transvenous approach would enable the cannulation of a relatively larger catheter or sheath without potential damage to the femoral vessels or normal coronary arteries, which can occur in the transarterial approach. The transvenous approach may also minimize the blind pouch after releasing the devices. Herein, we report the success of transvenous proximal closure of a CCAF using an Amplatzer vascular plug (AVP) in a 3-year-old patient with cardiomegaly. Complete occlusion was achieved by a single AVP and thrombus formation of the distal aneurysmal portion of the fistula. We suggest that this strategy of closing the proximal end with a dilated fistula using a single AVP by the transvenous approach may be a good option in treating CCAFs in a young child.