• Journal of Chest Surgery
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• v.33 no.6
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• pp.512-517
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• 2000

Background: Onlay vein patch coronary angioplasty has been known to be an option for coronary artery stenosis in the selective iesions Material and method: During the period between July 1997 and August 1999, coronary angioplasty using autologous saphenous vein was done on 16 sites in 14 cases for the stenotic lesion at the bifurcation area and significantly stenosis distal to anastomosis. Result: Early patency of the angioplasty site was 85.7% at postoperative day 7. There was no statistically difference in graft patency, operative parameters, and complications compared to conventional anatomosis(p>0.05). Conclusion: Despite the small number of cases, the patency rate of the coronary patch angioplasty was comparable to the conventional CABG. Coronary artery only patch angioplasty could be performed in highly selected coronary arteries.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.708-712
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• 1995

We report two cases of angioplasty of the left main coronary artery for isolated left main coronary artery disease. One was 63-years old male with 90% occlusion of the left main coronary artery and the other was 64-years old male with 80% occlusion of the left main coronary artery. We have performed left main coronary artery angioplasty with pericardium. The postoperative courses were uneventful and good without specific complications.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.247-252
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• 1995

The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

• Journal of Chest Surgery
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• v.27 no.2
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• pp.170-173
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• 1994

Isolated stenotic lesion located at the ostium of the left main coronary artery associated with Takayasu`s aortitis is quite rare. This report herein described a case of 25 year old woman with isolated ostial stenosis of the left main coronary artery underwent pericardial patch [fixed with 0.6 % glutaraldehyde] angioplasty. An anterior approach was used and postoperative coronary angiogram of the patient showed normal coronary ostial contour with normal runoff.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.433-437
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• 1999

Background: Left main coronary artery (LMCA) angioplasty is another option in the surgical treatment for LMCA disease because of its advantages over the conventional coronary artery bypass grafting (CABG). Material and Method: Between July 1994 and December 1997, 15 patients underwent left main coronary angioplasty for the stenoses of LMCA. There were 8 males and 7 females with the mean age of 53.3${\pm}$8.8 years. The locations of the LMCA stenoses were proximal one-third of the LMCA in 9, middle one-third in 1, distal one-third in 3, and the whole length of the LMCA in 2 cases. Nine patients had peripheral coronary lesions in addition to the LMCA stenosis. The LMCA was approached anteriorly with or without transsection of the main pulmonary artery. The angioplasty was performed with onlay patch widening using an autologous pericardium (14 cases) or saphenous vein (1 case). Additional graftings were required in 9 cases, and both LMCA angioplasty and right coronary ostial angioplasty were done in 1 case. Result: There was no operative mortality. One case needed redo CABG due to the stenosis of the angioplasty site which developed 4 months postoperatively. Coronary angiography was performed in 8 cases one year postoperatively, and revealed good patency of the angioplasty site except for one who showed 50% stenosis at the angioplasty site. No patient complained of angina with a mean follow up of 23${\pm}$11 months. Conclusion: Surgical angioplasty of the LMCA stenosis can be performed in selected cases with safety and good mid-term results.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.409-411
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• 1995

One patient developing left main coronary stenosis following double valve replacement is reviewed. Angina pectoris developed 5 months postoperatively. Coronary perfusion with a balloon tip perfusion catheter was performed during previous operation and was considered technically satisfactory. Coronary angiography confirmed stenosis of the left main coronary artery. There was no further coronary arterial disease. An anterior approach between the aorta and pulmonary artery to expose the left main coronary artery was used and patch angioplasty was done. Repeat coronary angiography showed a widely patent left main coronary artery with excellent runoff. A careful search for coronary arterial injury should be made in all symptomatic patients following aortic valve replacement.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1127-1130
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• 1999

Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.73-78
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• 1992

From Octorber 1984 through September 1991, 480 patients underwent percutaneous tra-nsluminal coronary angioplasty and 7 of these[1.4%] required coronary artery bypass surgeries in the emergency base. The principal indications for surgery were coronary dis-sections[n=2], acute coronary occlusions[n=3], and ventricular arrhythmias[n=2]. There were two early deaths and one late death. No patient who developed cardiac arrest and had not been resuscitated before surgery survived the operation. The outcome of surgery was related to the preoperative clinical status of patients.

• International Journal of Vascular Biomedical Engineering
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• v.2 no.1
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• pp.25-30
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• 2004

Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Uses of catheters during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. Catheters in blood vessels cause pressure gradient rise and blood flow drop during the measurements. In this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter obstructions during the coronary angioplasty. The computer simulation models are generated by the data, which are measured by coronary angiogram, and the blood is treated as non-Newtonian fluid. The velocity, pressure, and wall shear stress variations are observed for the estimate of damages of blood vessel. This study is also extended to investigate the effects of stenotic vessel size, and shape and catheter size and location.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.861-866
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• 1996

Surgical angioplasty of isolated stenosis of the left main coronary artery(LMCA) restores a more physiologic flow to the myocardium, allows percutdneous transluminal coronary angioplasty (PTCA) of distal coronary stenoses at a later stage, and is a less time consuming and convenient procedure than the conventional coronary artery bypass grafting(CABG) . Between Jul. 1994 and Dec. 1995, 7 surgical angioplasty had been performed. LMCA stenoses involved ostium in 2 patients, middle third in 3, and dis- tal third in 2. In 2 patients, the origin of left anterior descending coronary artery was involved in conjunction with LMCA. T e additional coronary artery stenoses were found in 2 cases. One patient was emergently operated after coronary angiography following his cardiac arrest. LMCA was approached anteriorly in all patients. The pulmonary artery was transected in 3 patients for a better exposure. The onlay patch consisted or autologous or bovine pericardium. There was no postoperative myocardial infarction or mortality. Left ventricular functions were well preserved in all patients. Postoperative coronary angiography revealed widely patent LMCA in 5 cases, and mild narrowing of distal anastomotic sites in 2 cases. Provided that well defined indications are followed correctly, surgical angioplasty can be a safe alternative to conventional CABG.