• Title/Summary/Keyword: left coronary artery

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Evaluation of Regional Wall Motion by Phase Analysis of Radionuclide Cardiac Blood Pool Scintigrams in Coronary Artery Disease Patients (관상동맥질환 환자에서 방사성동위원소 위상분석에 의한 심근 국소 운동 평가)

  • Yi, Gang-Wook;Chung, June-Key;Oh, Byeong-Hui;Park, Young-Bae;Lee, Myung-Chul;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.167-174
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    • 1987
  • Among noninvasive approaches for the evaluation of left ventricular performance, radionuclide ventriculography (RVG) has been shown to be of particular values. Phase analysis, recently introduced as more objective means for evaluating the temporal sequence of systolic ventricular wall motion than cine image of RVG comprises a pixel by pixel Fourier transformation of the time activity curve of a multiple gated acquisition equilibrium blood pool study. To examine the regional wall motion of ventricles in myocardial infarctions, we evaluated the phase image and histogram constructed for each ventricle by total phase angle range and full width of half maximum (FWHM). This study consisted of 7 normal subjects and 23 subjects with acute myocardial infarction. Contrast ventriculography and coronary angiography was performed in all partients with myocardial infarction. And we compared the result of phase analysis with cine image of RVG and examined the interrelationship between phase analysis and contrast ventriculography with coronary angiography. The results were as follows; 1) The total phase angle range and FWHM of LV phase histogram in myocardial infarction ($86^{\circ}\;and\;32^{\circ}$, repectively) were wider than those in normal control ($38^{\circ}\;and\;18^{\circ}$, respectively p<0.01). 2) RV phase angle range and FWHM in patients with right coronary artery (RCA) occlusion ($79^{\circ}\;and\;37^{\circ}$, respectively) were wider than those in normal control ($39^{\circ}\;and\;18^{\circ}$, respectively p<0.001) and the patients without RCA occlusion ($52^{\circ}\;and\;19^{\circ}$, respectively p<0.01). 3) Phase analysis was more sensitive (95%) than cine image of RVG (70%) for the detection of regional wall motion abnormality of LV.

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승모판 협착증의 외과적 요법

  • 이영균
    • Journal of Chest Surgery
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    • v.4 no.1
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    • pp.11-24
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    • 1971
  • Eighty-four cases of mitral commissurotomy were done in this department between October 1958 and September 1970. Therc wcre 54 males and 30 females. Six cases were under the age of 20 years. Prcoperativc embolization occurred in 9. 5% of the cases. consisting of 8. 3% cerebral and 1.2% peripheral embolization. Intraoperative and postoperative cmbolization occurred in 4.7% of the cases, with 1. 2% cerebral and 3.5% peripheral embolism. Two out of three postopeative embolism cases expired, one of which was caused by septic cerebral embolism due to valve vegetation nnd the other by mesenteric embolism. Atrial fibrillation was 1loted ill 43% of the case. Seventy closed mitral commissurotomy was done by left appendegeal approach with finger fracture method or Bailey's guillotine valvotome. Fourteen open mitral commissurotomy cases were done either by right side approach or median sternotomy, three of which were reoperation cases after blind mitral commissurotomy. One out of 14 cases were operated on with open mitral commissurotomy and concomitant open aortic valve bicuspidalization, This case expired due to severe serum hepatitis ten days after operation. Thirty-two per cent of valve calcification was noted during operation and one of which had marked vegetation on the valve cusps too. Operative mortality was 1.4% in blind mitral commissurotomy and 14% in open mitral commissurotomy. Over-all mortality in the entire series was 3.5%. One case among the blind commissurotomy cases expired during operation due to left inferior pulmonary vein laceration and death was caused in two open mitral commissurotomy cases by coronary artery airembolism. Three hospital death occurred in blind operation group, one due to coronary embolism, and two by hepatic failures. Three hospital death among open heart surgery cases were caused by hepatic failure in two and cerebral embolism in one cases. ln most of the survivors improved functional capacity and exercise lolerance were noted.

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Study on the interrelationship between the PWV and the temperature difference (맥파전달속도(PWV)와 말초체열분포(DITI)와의 관계 연구)

  • Lee, Yoon-Jae;Cho, Jung-Hoon;Lee, Chang-Hoon;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.6 no.1
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    • pp.23-31
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    • 2008
  • Objective: The purpose of this study is to identify relationship between the PWV and the temperature difference. Methods: When it comes to senile patients who suffer from cold limbs, there is need to see whether or not the patient's low temperature of the limbs is do to arteriosclerosis. The Pulse Wave Velocity(PWV) is a non-invasive method measuring the artery's rigidness. And the Digital Infrared Thermal Imaging(D.I.T.I) is a non-invasive method to see the body's thermal change. Research on the interrelationship of the artery's rigidness and body's thermal distribution was done by using these two tests. The subjects of this research were patients between the age 40~65 who have done both the D.I.T.I and PWV in March 2005~ September 2005. They had to have no history of diabetes, coronary illnesses or cerebrovascular diseases which are diseases that can effect the outcome of the PVW, nor history of spondylopathy or dermatosis which can effect the outcome of the D.I.T.I. Results: The results were as follows. 1. There was a significant interrelationship between the right wrist-ankle PWV and the temperature difference of the right wrist-palm. 2. There was a significant interrelationship between the left wrist-ankle PWV and the temperature difference of the left wrist-palm. 3. There was no significant interrelationship between the right wrist-ankle PWV and the temperature difference of the right thigh-dorsum of foot. 4. There was no significant interrelationship between the left wrist-ankle PWV and the temperature difference of the left thigh-dorsum of foot. 5. The right ABI showed no significant interrelationship between the temperature difference of the right wrist-palm and the right thigh-dorsum of foot. 6. The left ABI showed no significant interrelationship between the temperature difference of the left wrist-palm and the left thigh-dorsum of foot. Conclusion: The study shows that there was a significant interrelationship between wrist-ankle PWV and the temperature difference of wrist-palm.

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Early Results of Coronary Bypass Surgery in Patients with Severe Left Ventricular Dysfunction (심한 좌심실 기능저하를 동반한 환자에서의 관상동맥 우회로 조성수술의 조기성적)

  • 정윤섭;김욱성
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.383-389
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    • 1997
  • From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

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The Unusual Suspect: Anemia-induced Systolic Anterior Motion of the Mitral Valve and Intraventricular Dynamic Obstruction in a Hyperdynamic Heart as Unexpected Causes of Exertional Dyspnea after Cardiac Surgery

  • Mun, Jeong-Beom;Oh, Ah-Reum;Park, Hwa-Sun;Park, Chul-Hyun;Park, Kook-Yang;Moon, Jeonggeun
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.457-460
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    • 2013
  • Dynamic left ventricular (LV) outflow tract obstruction is a characteristic feature of hypertrophic cardiomyopathy; however, it can also occur in association with hyperdynamic LV contraction and/or changes in the cardiac loading condition, even in a structurally normal or near-normal heart. Here, we report a case of anemia-induced systolic anterior motion of the mitral valve and the resultant intraventricular obstruction in a patient who underwent coronary artery bypass grafting and suffered from anemia associated with recurrent gastrointestinal bleeding.

Surgical Treatment of Supravalvular Aortic Stenosis - Report of a case - (대동맥 판상부 협착증 치험 1례)

  • 조영철
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.680-686
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    • 1989
  • Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origin of the coronary arteries. It may occur in several different anatomical form. Three type have been described; the hourglass, the hypoplastic and the membranous type, each term identifying the gross characteristic of the lesion causing by the aortic obstruction. Non cardiovascular condition commonly associated with supravalvular aortic stenosis are mental retardation, facial anomalies, hypercalcemia, etc. The diagnosis can be established preoperatively by left heart catheterization and selective angiography. Recently, we experienced a case of multiple localized supravalvular aortic stenosis involving, just above the sinus Valsalva and just proximal of the innominate artery. The surgical correction which was performed by a vertical incision across the each narrowing of aorta with replacement of diamond shaped double velour Woven Dacron patch under the CPB. He was discharged without any event.

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Repair of Acute Post Infarction Mitral Regurgitation with Papillary Muscle Reimplantation - A case report -

  • Park, Won-Kyoun;Kim, Joon-Bum;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.285-287
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    • 2011
  • A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

Clinical Analysis of Open Heart Surgery - Review of 477 cases - (개심술 477예에 대한 임상적 고찰)

  • 이필수
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.741-750
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    • 1991
  • Between April, 1986 and July, 1991, 477 patients underwent open heart surgery with hypothermic cardiopulmonary bypass. There were 242 patients [50.7%] of acyanotic congenital anomalies, 34 patients [7.1%] of cyanotic congenital anomalies, and 187 patients [39.2%] of acquired heart diseases, 8 patients [1.7%] of coronary artery diseases, and 6 patients [1.3%] of mixed anomalies. Among the 276 congenital cardiac anomalies, 147 patients [53.3%] were male and 129 patients [46.7%] were female, ranged in age from 2 years to 58 years. Among the 187 acquired heart diseases, 72 patients [38.5%] were male and 115 patients [61.5%] were female, ranged in age from 10 years to 68 years. The common congenital defect were VSD and ASD in acyanotic cardiac patients, and TOF in cyanotic cardiac patients. Among the 187 acquired heart diseases, 180 patients underwent operation for cardiac valvular diseases, 4 patients were resected left atrial myxoma, and 3 patients underwent operation for aortic regurgitation with ascending aortic aneurysm. The operative mortality rate was 1.2% in acyanotic cardiac patients, 11.8% in cyanotic cardiac patients, and 6.9% in acquired cardiac patients, with overall mortality rate 4.2%.

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A Comparative Study of the Hemodynamic Hypotheses for the Generation of Atherosclerosis (동맥경화증의 발생에 관한 혈류역학적 가설들에 대한 비교연구)

  • Suh, Sang-Ho;Cho, Min-Tae;Roh, Hyung-Woon;Kwon, Hyuck-Moon
    • Proceedings of the KSME Conference
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    • 2003.04a
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    • pp.1915-1918
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    • 2003
  • Atherosclerosis, which is a degenerate disease, is believed to occur in the vascular system due to deposition of cholesterol and low density lipoprotein(LDL) or thrombosis on the blood vessel. Atherosclerosis narrows arterial lumen, which is known as stenosis phenomenon of blood vessel. Pathogenesis of atherosclerosis is thought to occur mainly by aging. Restenosis phenomenon is observed in the same site of insertion of a stent and balloon angioplasty after treatment of interventional theraphy. Several hypothetical theories related to the generation of atherosclerosis have been reported: high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory and high pressure theory. However, no one theory clearly explains the causes of atherosclerosis. In the present study the generation of atherosclerosis in the left coronary artery is investigated. The hypotheses are verified by using the computer simulation.

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New Imaging Techniques in Myocardial Perfusion SPECT (심근 관류 SOECT의 새로운 방법)

  • Lee, Dong Soo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.1-9
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    • 1998
  • Gated myocardial SPECT and attenuation correction gave birth to new insights into the pathophysiology of ischemic myocardial perfusion and function in clinical routine practice. Gated myocardial Tc-99m-compound SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls as well as myocardial perfusion at the same time. Quantitative and qualitative assessment of myocardial performance and perfusion let us to understand the myocardial physiology in ischemia and infarction. In every patient who underwent gated perfusion SPECT, we will find ejection fraction, left ventricular volumes and regional wall motion. There are hopes to use gated TI-201 SPECT for the same purpose and to use gated SPECT for evaluation of wall motion and thickening at stress or immediate post-stress. Attenuation correction could improve diagnostic accuracy mainly by increasing normalcy ratio or performance of non-expert physicians. Both gated methods and attenuation correction improved specificity of non-expert physicians in diagnosing patients with moderate pretest likelihood. New imaging techniques will fill the desire of cardiologists to examine function and perfusion, and possibly metabolism in their clinical routine practice.

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