• Journal of Chest Surgery
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• 제44권4호
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• pp.298-300
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• 2011

A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm.

• Journal of Chest Surgery
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• 제26권5호
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• pp.349-354
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• 1993

From July 1992 through January 1993, 11 patients with unstable angina received aorto-coronary bypass surgery at Dong-A University Hospital. There were 5 males and 6 females whose age ranged from 36 to 76 years old. Of the 11 patients, 3 were Functional class IL 5 were Functional class 111.3 were Functional class IV. Preoperative coronary angiography showed a significant stenosis of the left anterior descending artery in 9 cases, of its diagonal branch in I case, of the circumfiex artery in 3 cases, and of its obtuse marginal branch in 2 cases, of the right coronary artery in 4 cases, and of left main coronary artery in 3 cases. There were 4 cases of single vessel disease, 1 double vessel disease, 3 triple vessel disease and 3 left main disease. A single graft was placed in 1 patient, a double graft in 5, a triple graft in 2, and a quadriple graft in 3 patients. Left internal mammary artery plus saphenous vein graft were used in 4 patients. Postoperative complications were mediastinitis in 1, sternal instability in 2, pneumonia in 1, arrythmia in I case.

• Journal of Chest Surgery
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• 제26권3호
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• pp.228-233
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• 1993

Patients with anomalous connection of the left coronary artery to the pulmonary artery are at risk for myocardial infarction, and early or sudden death. Between 1986 to 1992, a total of 4 of these patients underwent surgical intervention with various operative techniques at our institution. Age at operation ranged from 2 months to 43 years. Three infant patients had congestive heart failure, 2 of them had mitral regurgitaion, and 1 had ST-T change on elctrocardiogram. Operative techniques included direct coronary artery transfer to the aorta[n=2], intrapulmonary tunnel from the aortopulmonary window[n=1], coronary artery bypass using saphenous vein[n=1]. One deaths occured at 2 weeks after direct coronary arterial transfer due to respiratory failure caused by Respiratory Syncitial virus pneumonia. Supravalvar pulmoanry stenosis occured after intrapulmoanry tunnel. We recommend direct aortic implatation of the anomalous coronary artery at the time of diagnosis. Intrapulmonary tunnel from aortopulmonary window or subclavian-coronary anastomosis could be alternatives in whom aortic implantation is not feasible anatomically.

• 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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• 제20권2호
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• pp.393-398
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• 1987

Unstable angina pectoris is often premonitory to an acute myocardial infarction. Surgical revascularization in this syndrome is of great potential benefit and relatively low mortality. A patient with unstable angina pectoris is reported. A 65-year-old man complained of dyspnea and pain in the left anterior chest. The pain was brought on by mild exercise, occurred at rest and sleeping time. The pain worsened over a month period and more aggravated in intensity and duration. Physical examination showed no abnormalities except hypertension and laboratory data were within normal limits. His anginal pain was not relived by nitroglycerin ingestion. Preoperative coronary angiograms revealed significant obstruction [>90%] of left anterior descending coronary artery. Aorto-left anterior descending coronary bypass with autogenous saphenous vein used as conduit was performed. The postoperative course was uneventful and he was discharged on 16th postoperative day in a healthy condition.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1048-1054
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• 1992

With use of a simple, inexpensive and nonpharmacological program for blood conservation, 24 consecutive patients underwent elective or urgent coronary artery bypass grafting without need of homologous red cell transfusions and /or fresh frozen plasma transfusions in 16 patients[66.7%]. Left internal mammary artery graftings were done in 18 patients[75%], with supplemental saphenous vein grafts in all. Intraoperatively, autologous heparinized blood was removed before bypass and retransfused at the conclusion of ext-racorporeal circulation. The volume remaining in the oxygenator and tubing set was returned without cell processing or hemofiltration. Using the hard-shell cardiotomy reservoir from the oxygenator, autotransfusion of the shed mediastinal blood was continued hourly by the next early;norning. The mean postoperative mediastinal blood loss was 364$\pm$234ml, whereas 553$\pm$383ml was autotransfused. 4 patients [16.7%] received homologous blood and an additional 4 patients[16.7%] fresh frozen plasma. Thus, in total, 16 patients[66.7%] were not exposed to any homologous blood products during the hospital stay. At discharge, the mean hemoglobin concentration was 10.3$\pm$1.6g /dl. Postoperative complications were few and there was no hospital death.

• 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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• 제29권3호
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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.

• Journal of Chest Surgery
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• 제46권3호
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• pp.165-177
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• 2013

This is the third in a series on coronary artery bypass which reviews three alternative arterial conduits. The radial artery has become the most widely used of the three and accumulating experience demonstrates better patency at 10 years versus saphenous vein. Drawbacks are a long incision on the forearm, the propensity for spasm and persistent sensory disturbance in about 10%. The first is answered by endoscopic harvest which may yield a shorter conduit but reduces sensory nerve injury. Spasm is managed pharmacologically and by less harvest trauma. The gastroepiploic artery is used in situ and free and although the abdominal cavity is entered complications are minimal and patency compares favorably with the radial artery. Use of the inferior epigastric artery remains minimal and its similar length often requires composite use but limited patency data are supportive. Other arteries have had rare use and this is unlikely to change because the three presented here have significant advantages and acceptance.

• Journal of Chest Surgery
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• 제24권1호
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• pp.106-112
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• 1991

A 37-year old man was admitted due to the left subauricular mass of 6 month duration which was 3 x 4cm sized, pulsatile and slowly growing He was suffered from the intermittent left facial and auricular pain radiating to the occipital area. The carotid angiography revealed 3x4cm sized saccular aneurysm of the left internal carotid artery just above the carotid bifurcation, extending to the mandibular angle level. He was planned to be operated under the direct clamp of internal carotid artery or shunting procedure. But, the back pressure of the internal carotid was 35mmHg, which suggested adequate cerebral collateral. Thereby, aneurysmectomy and restoration of cerebral blood flow with saphenous vein graft was done under the direct clamp of internal carotid artery for 25 minutes. Although mild transient neurologic sequelae such as mydriasis, tongue deviation for 10 days, he recovered completely without any complication. The aneurysmal sac had no thrombus and pathologic finding was compatible with congenital origin.