• Title/Summary/Keyword: Vein graft

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Clinical Analysis of Cardiovascular Surgery -Report of 2094 Cases- (심혈관질환수술에 대한 임상적 고찰 -2094례 보고-)

  • 김병열
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1030-1039
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    • 1988
  • From 1985 through Oct. 1988, we have experienced 5 cases of Aorto-Coronary Bypass Surgery [ACBS] and 3 cases of Percutaneous Transluminal Coronary Anogioplasty [PTCA]under the diagnosis of unstable angina. There were 6 males and 2 females who ranged from 48 to 70 years old. Almost all patients had a evidence of hypertension & hyperlipidemia. Two patients showed old myocardial infarction and remaining patients showed myocardial ischemia on resting state. The patterns of involvement of coronary artery disease were single vessel disease [4 cases], double vessel disease [3 cases], Triple vessel disease [1 case]. Among 5 cases of ACBS, double bypass graft was in 3 cases and single bypass graft was in 2 cases. Mode of anastomosis were all individual anastomosis, using Saphenous vein graft. Postoperative complications were perioperative myocardial infarction [2 cases], postoperative bleeding [1 case], leg wound disruption [1 case]. Perioperative myocardial infarction cases didn*t survive. In cases of PTCA, there were no complications. Follow up periods were ranged from 1 month to 25 months. All survived cases were asymptomatic except one case, who showed Functional Class II.

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One Sage Operation for Bilateral Carotid Arterial Obstruction and Right Coronary Artery Ostial Stenosis in Takayasu's Arteritis -Report of One Case- (Takayasu씨 대동맥염에 의한 양경동맥협착과 우관상동맥개구협착의 동시수술치험 -1례 보고-)

  • 정일영
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.320-323
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    • 1995
  • We report a case of recurred Takayasu,s arteritis.The patient was 28-year-old female underwent aorto-left common carotid and aorto-left subclavian bypass graft replacement 1 year ago.Unfortunately, she was readmitted because of newly developing angina and both eye claudication severe headache. Aorto-coronary angiogram showed complete obstruction of left common carotid artery ,stenosis of right carotid artery bifurcation and ostial stenosis of right coronary artery.Bilateral carotid arteries bypass graft with great saphenous vein and right coronary artery bypass graft with right internal mammary artery were done at same the time and she discharged after 21 days without any problem.

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Pseudoaneurysm Involving Proximal Ascending Aorta and Proximal Descending Thoracic Aorta (상행 대동맥과 하행 흉부 대동맥에 동시에 발생한 가성 대동맥류 치험 1례)

  • 이호철;류한영
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.337-341
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    • 1996
  • A 40-year-old male patient who had ascending aortic pseudoaneurysm Involving right coronary artery obstruction and thoracic descending aortic pseudoaneurysm was successfully managed by two-stage operation. Repair of intimal tear of ascending aortic pseudoaneurysm with a patch of woven dacron vascular graft and right coronary artery bypass graft with great saphenous vein were performed in first stage operation. On 28 days postoperatively, Repair of intimal tear of descending aortic pseudoaneurysm with a patch of woven dacron vascular graft was done under the femorofemoral partial cardiopulri!onary bypass in second stage operation. The patient was discharged at postoperative 13th days without any evident.

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Coronary Artery Bypass Rrafts in Two Renal Transplanted Patients (신장이식환자의 관상동맥우회로술 -2례 보고-)

  • Jin, Ung;Yoon, Jeong-Seob;Jo, Keon-Hyon;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.48-51
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    • 1994
  • Doing CABG in patient with renal transplantation requires special concern to keep and preserve renal function safely during and after operation. We experienced two cases of CABG for treatment of myocardial ischemia. who underwent renal transplantation 2 and 3 years ago respectively. The first patient received single reversed saphenous vein graft at LAD and second one received double saphenous vein graft at LAD and OMI. Peri & postoperative urinary volume and renal function test were comparable with preoperative status in both cases. Although abnormal lipid metabolism due to long term use of immunosuppressive regimen act a causative role in development and progression of coronary artherosclerosis in renal transplantation patient, CABG can be done safely with some precaution including maintenance of adequate mean blood pressure and blood level of immunosupressive regimen during cardiopulmonary bypass.

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Restoring blood flow to the lateral plantar artery after elevation of an instep flap or medialis pedis flap

  • Velazquez-Mujica, Jonathan;Amendola, Francesco;Spadoni, Davide;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.80-85
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    • 2022
  • The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

A Case of Bilateral Subclavian Venous Thrombosis Associated with Sternocostoclavicular Hyperostosis (흉쇄늑골과골증에 동반된 양측성 쇄골하정맥혈전 1예)

  • Jeong, Hoon;Sim, Young-Mog;Yoo, Bin;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Dong-Soon;Kim, Won-Dong;Kim, Woo-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.379-385
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    • 2001
  • Sternocostoclavicular hyperostosis is an uncommon disease, characterized by an inflammatory arthrosteitis of the sternocostoclavicular region. Clinically, it manifests as a painful swelling of the upper anterior chest wall, which is associated with occasional pustulosis palmaris and plantaris. A 48-year-old man had suffered from pain in both shoulders and the upper anterior part of the chest for 6 months. On examination, a venous engorgement in the neck with dilated collateral veins in the upper chest and shoulders was observed. Swelling was noticed in his face, neck and both arms. Radiologically, the clavicles, the sternum and the first ribs were enlarged with complete fusion between them. 99Tc scintigraphy showed increased uptake in the clavicles and the sternum. Selective venography resulted in a bilateral subclavian and brachiocephalic vein occlusion, which resulted from a subclavian vein thrombosis. All the above suggested a sternocostoclavicular hyperostosis. He underwent a vascular graft interposition between the right jugular vein and the left innomianate vein (using 8mm ringed Gore-Tex graft) and a resection of the bilateral medial half of clavicle and 1st rib. Here, we present a case on sternoclavicular hyperostosis with subclavian and brachiocephalic vein thrombosis, and report this case study with a review of the appropriate literature.

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Subclavian Vein Thrombotic Occlusion Secondary to Hemodialysis Catheterization (혈액투석 카테터에 의한 쇄골하정맥 혈전성 폐쇄증의 수술치험 1례)

  • Kim, Kwan-Mien;Chee, Hyun-Keun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.73-77
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    • 1995
  • We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

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Aortocoronary bypass surgery in the management of coronary artery disease (관상동맥협측증의 외과적 요법)

  • 이재원
    • Journal of Chest Surgery
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    • v.19 no.4
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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.

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Coronary Artery Bypass Grafting Using Sequential Graft of the Left Internal Mammary Artery (내유동맥 연쇄문합술을 이용한 관동맥우회로 이식술)

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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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

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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.