• Title/Summary/Keyword: Coronary

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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
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    • v.35 no.12
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    • pp.898-901
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    • 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
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    • v.3 no.1
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    • pp.1-5
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    • 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.

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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
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    • v.29 no.2
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    • pp.129-131
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    • 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.

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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
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    • v.48 no.4
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    • pp.285-288
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    • 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
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    • v.56 no.2
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    • pp.90-93
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    • 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.

Predicting Factors on Eating Behavior in Coronary Artery Disease Patients (관상동맥질환의 식이이행 예측 요인)

  • Han, Sang-Sook;Lee, Ju-Im;Kim, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1193-1201
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    • 2007
  • Purpose: This study was aimed to identify the factors that influence eating behaviors in coronary artery disease patients and to create data for nursing which is thought to improve the eating behavior. Method: The study population was coronary artery disease patients who were treated on an outpatient basis. The measurements were eating behavior, diet self-efficacy, perceived-benefits, perceived-seriousness, family support and medical team support. All of the measurement tools above were thoroughly modified to verify validity and reliability. Statistical analysis was done by the SPSS PC 12.0 program. Results: The influencing factors for the eating behavior was diet self-efficacy (${\beta}=0.476$), social support (${\beta}=0.253$), chest pain (${\beta}=0.177$), smoking (${\beta}=-0.173$) and regular exercise (${\beta}=.169$), which explained 46.2%. Conclusion: Eating behaviors of coronary artery disease patients were influenced by diet self-efficacy, family support and the presence of chest pain. Therefore, the development of a program for efficient dietary education that prevents the progression of coronary artery disease is needed.

Fibrocalcific Embolism of Right Coronary Artery Combined with Aortic Valvular Stenosis (대동맥판협착증에 동반된 우관상동맥의 석회성 색전증)

  • 장성욱;박정옥;김영권;이명용;류재욱;박성식;서필원;김삼현
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.858-861
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    • 2003
  • The main cause of ischemic heart disease combined with aortic valve disease is the systemic atherosclerotic process. Coronary artery embolism by a particle from the calcified aortic valvular tissue is very rare. A 73-year-old female patient was admitted due to chest tightness of recent onset. Two dimensional echocardiogram showed severe calcific aortic valve stenosis. Preoperative coronary angiogram exhibited a stenotic lesion at the distal right coronary artery, which seemed to be embolic in origin. The coronary embolus was removed through the coronary arteriotomy and then the arteriotomy site was repaired by onlay patch angioplasty technique. Aortic valve was replaced by a bioprosthetic valve. The embolus was reported as a fibrocalcified particle of diseased valve.

Anger Expression and Health Behavior in Patients with Coronary Arteries Disease (관상동맥질환자의 분노표현유형과 건강행위)

  • Hong, Eun-Mi;Park, Jin-Hee
    • Journal of Home Health Care Nursing
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    • v.21 no.2
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    • pp.101-109
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    • 2014
  • Purpose: The purpose of this study was to identify the difference in health behavior according to the anger expression styles in patients with coronary arteries disease. Methods: Participants included 99 patients with coronary artery disease who were treated with a percutaneous coronary intervention in K University Hospital in Seoul, from January to March 2012. The survey data were collected using the Anger Expression Inventory Korea Version and the Health Promoting Lifestyle Profile Version 2. The data were analyzed using descriptive statistics, acluster analysis, chi-square test,and ANOVA with the PASW 19.0program. Results: The anger expression styles identified from the cluster analysis were anger-control type(43.3%), anger-in/out type(42.4%), and high anger expression type(14.4%). The total score of the Health Promoting Life style Profile for the anger-control type was significantly higher than the other two types. Additionally, anger-control type showed significantly higher scores than the other two types in all domains of the Health Promoting Life style Profile. Conclusion: These results indicated that higher levels of anger-in and anger-out increased the risk of adverse health behavior and that anger control strategies could have some benefit in reinforcing healthy behavior in patients with coronary artery disease.

Differential Vasorelaxant Effects of KR-30075, a New Cyclic AMP-phosphodiesterase Inhibitor, on Guinea-pig Pulmonary, Bovine Coronary and Renal Arteries

  • Jung, Yee-Suk;Kwon, Kwang-Il;Zee, Ok-Pyo
    • Archives of Pharmacal Research
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    • v.13 no.2
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    • pp.136-141
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    • 1990
  • The vasorelaxant effects of KR-30075 in guinea-pig pulmonary, bovine coronary and renal arterial strips contracted by either$K^+$depolarization, phenylephrine, or prostaglandin $F_{2a}$($PGF_{2a}$) were evaluated. KR-30075 was more potent than imazodan as a vasorelaxant against $PGF_{2a}$-induced contractions in bovine coronary and renal arteries, whereas against$K^+$induced contractions KR-30075 was less potent than imazodan in guieapig pulmonary arteries and more potent in bovine coronary arteries. KR-30075 was more potent against contractions induced by phenylephrine or $PGF_{2a}$ than the contractions induced by $K^+$ This profile of activity for KR-30075 was similar to that of imazodan and dissimilar from the calcium entry blocking agent nifedipine. There was no vascular selectivity of KR-30075 between bovine coronary and renal arterial strip preparations. In conclusion, this study shows that KR-30075 represents the vasorelaxant effects on guinea-pig pulmonary, bovine coronary and renal arteries without specific vascular selectivity. The vasorelaxant profile of KR-30075, with different sources of vascular smooth muscle, is unlike that of calcium entry blocking agent and more similar to the profile of the agent that inhibit cyclic nucleotide phosphodiesterase.

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The Analysis of Risk Factor Management Programs for Patients with Coronary Artery Disease (관상동맥질환자를 위한 위험요인관리 프로그램 분석)

  • Bang, So-Youn;Park, Mi-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.16 no.1
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    • pp.27-36
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    • 2013
  • Purpose: This study was performed to analyse the trends of risk factor management programs for patients with coronary artery disease. Methods: Using PubMed, 35 intervention studies related to risk factor management programs among randomized controlled trials searched with the key words of coronary artery disease and coronary heart disease. Collected studies were analysed according to the characteristics of studies and participants, method and content of intervention, and outcome indicator and its effects. Results: The mean period of intervention was $28.7{\pm}26.8$ weeks, the mean frequency was $3.0{\pm}2.0$ times per week, and the duration of one session was below 60 minuets in 65.8% of the reviewed studies. The interventions were counselling, exercise, education, and cognitive behavior therapy. Counselling was applied most frequently in previous studies. The outcomes of intervention had been measured with anthropometric, physical, physiological, psychological, behavioral, and cognitive aspects, but the effect of the intervention was inconsistent among the studies. Conclusion: Based on the results of this study, systematic and comprehensive cardiac rehabilitation program consisted of counselling, exercise, and education should be developed and performed for health management and relapse prevention of patients with coronary artery disease.