• Journal of Chest Surgery
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• 제20권2호
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• pp.384-392
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• 1987

The occlusive coronary artery disease presents a potential threat to a significant population in the United State. According to many case reports, the increasing incidence of coronary artery disease due to atherosclerosis is noted in Korean, recently. We experienced one case of coronary artery disease. He was a 68 year old male who had been suffered from hypertension since 1 5 years ago, and had intermittent conservative treatment at local clinic. He had been afflicted with severe chest pain on exertion, but this symptom was relieved on rest. Pre-operative EKG finding revealed no any other ischemic sign. Significant S-T segment depression was noted at lead II, aVF, V3, V4, and V5, and inverted T wave in V5 and V6 after Master`s test. Simple chest X-ray finding showed emphysematous field, bilaterally. Final pre-operative diagnosis was made by coronary angiogram, which showed almost 90% degree of occlusive lesion in the proximal part of left main coronary artery above the origin LAD artery. He was treated successfully by aorta-coronary saphenous vein graft under extra-corporeal circulation in May, 1987. He has been followed up with uneventful course.

• Journal of Chest Surgery
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• 제28권4호
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• pp.401-403
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• 1995

Recently we experienced coronary artery bypass graft in two patients over 70years of age. Among them, one case was 74 old year male and the other case was 73 old year male. The coronary artery diseases of them were angiographically diagnosed to triple vessel diseases. We only used great saphenous vein as graft vessel in two patients. The postoperative courses were good except mediastinal bleeding in 1 case. They were discharged with good results. They were still healthy 40 months in one and 30 months in the other after coronary artery bypass grafting.

• Journal of Chest Surgery
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• 제45권4호
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• pp.251-253
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• 2012

We report a redo coronary artery bypass grafting (CABG) in a 55-year-old man. Angina recurred 7 years after the initial surgery. Coronary angiography showed all patent grafts except a faint visualization of the in situ right gastroepiploic artery (RGEA) graft, which was anastomosed to the posterior descending coronary artery, associated with celiac axis stenosis. Redo-CABG was performed at postoperative 10 years because of aggravated angina and decreased perfusion of the inferior wall in the myocardial single photon emission computed tomography. The saphenous vein graft was interposed between the 2 in situ grafts used previously; the right internal thoracic artery and RGEA grafts. Angina was relieved and myocardial perfusion was improved.

• Knee surgery & related research
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• 제30권4호
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• pp.364-368
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• 2018

We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

• Journal of Chest Surgery
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• 제43권5호
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• pp.534-537
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• 2010

5세 때에 교통사고 후 지혈목적으로 대퇴정맥 결찰을 받은 26세 남자 환자가 입원 5일 전 축구하다 생긴 좌측 하지의 정맥궤양에서 나타난 출혈을 주소로 입원하였다. 환자는 좌측 하지에 하지 정맥류의 발생과 정체성 피부염과 정맥 궤양이 있었다. 좌측 대퇴정맥 혈류를 우측 대퇴정맥으로 환류시키려고 우측 대복재정맥을 이용하여 동정맥루가 있는 우회로 조성술을 시행하였다. 우회로의 원활한 개통을 위해 만든 동정맥루는 처음 수술 6주 후에 폐쇄하였다. 환자는 수술 후 6개월 간 좌측 하지 둘레가 비교적 일정하게 유지되고 있다. 이와 같이 만성 대퇴정맥 결찰 환자에 대한 정맥 crossover 우회로 조성술 1예를 치험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제26권7호
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• pp.526-531
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• 1993

Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

• Journal of Chest Surgery
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• 제19권4호
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• pp.606-617
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• 1986

During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.

• 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

• 대한골관절종양학회지
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• 제12권1호
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• pp.83-88
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• 2006

골연골종은 가장 흔한 양성 골 종양으로, 주변 골단판 연골의 골막하 전위에 의한 과증식성 골 병변이며, 대개 골단판이 닫히면서 성장이 끝나는 것으로 알려져 있다. 이러한 골연골종이 혈관계 합병증을 유발하는 경우는 드물지만, 종괴 효과로 주변의 동맥이나 정맥을 눌러 허혈이나 정맥염이 생기거나, 연골모가 골화되면서 생기는 날카로운 말단에 의해 동맥벽의 천공이 생길 수 있다. 이러한 혈관계 합병증은 대부분 젊은 남자의 동맥에서 발생하며, 정맥에 생기는 경우는 드문 것으로 알려져 있다. 저자들은 원위 대퇴골 골연골종으로 인해 심부 정맥 혈전증이 발생한 21세 남자 환자에서 골연골종의 제거 후 정맥 절제술 및 복재 정맥 이식술로 치료한 경험을 보고하고자 한다.

• Journal of Chest Surgery
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• 제29권8호
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• pp.927-930
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• 1996

인제의대 서울백병원에서는 1986년부터 1994년까지 말초동맥에 발생한가성동맥류환자 6례를 수술 치험하였다. 발생원인은 자상의 일차 봉합술 후 3례, 혈관에 도관삽입 후 2례, 골절상 후 고정 핀을 제거하기 위한 수술 후 1례였다. 발생부위는심부 대퇴동맥 2례, 총대퇴동맥 2례, 쇄골하동맥과 액와동맥에 각각 1례였다. 증상은 박동성 종괴가 4례에서 촉지되었고, 청진시 잡음은 3례, 동통과 종창이 2례, 압통이 1례에서 있었다. 이 중 5례에서 수술을 시행하였다. 수술은 2례에서 심부 대퇴동맥을 결찰하여 가성동맥류를 제거하였다. 단순 가성동맥류의 절제, 요피정맥을 연결하여 성형술, 복재정맥의 첩제를 이용한 성형술을 각각 1례에서 시행하여 가성동맥류를 제거하였다. 1례는 자연 치유되었다.