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1.
Yonsei Medical Journal ; : 602-610, 2018.
Artículo en Inglés | WPRIM | ID: wpr-715902

RESUMEN

PURPOSE: Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population. MATERIALS AND METHODS: A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years. RESULTS: After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, p=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, p=0.028), compared with the MT group up to 5 years. CONCLUSION: In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI.


Asunto(s)
Humanos , Angiografía Coronaria , Stents Liberadores de Fármacos , Incidencia , Modelos Logísticos , Infarto del Miocardio , Intervención Coronaria Percutánea , Puntaje de Propensión , Accidente Cerebrovascular
2.
Korean Journal of Critical Care Medicine ; : 156-161, 2016.
Artículo en Inglés | WPRIM | ID: wpr-42554

RESUMEN

A patient had undergone left pneumonectomy for lung cancer and had an increased risk of fatal complications such as pneumonia, including acute respiratory distress syndrome (ARDS). The treatment effects of veno-venous extracorporeal membrane oxygenation (VV-ECMO) for ARDS of postpneumonectomy patient are uncertain. A 74-year-old man with one lung experienced aspiration pneumonia while swallowing pills after the operation, and his condition progressed to ARDS within a day. He was successfully treated with VV-ECMO support and intensive care unit care.


Asunto(s)
Anciano , Humanos , Deglución , Oxigenación por Membrana Extracorpórea , Unidades de Cuidados Intensivos , Neoplasias Pulmonares , Pulmón , Neumonectomía , Neumonía , Neumonía por Aspiración , Síndrome de Dificultad Respiratoria
3.
The Korean Journal of Critical Care Medicine ; : 156-161, 2016.
Artículo en Inglés | WPRIM | ID: wpr-770930

RESUMEN

A patient had undergone left pneumonectomy for lung cancer and had an increased risk of fatal complications such as pneumonia, including acute respiratory distress syndrome (ARDS). The treatment effects of veno-venous extracorporeal membrane oxygenation (VV-ECMO) for ARDS of postpneumonectomy patient are uncertain. A 74-year-old man with one lung experienced aspiration pneumonia while swallowing pills after the operation, and his condition progressed to ARDS within a day. He was successfully treated with VV-ECMO support and intensive care unit care.


Asunto(s)
Anciano , Humanos , Deglución , Oxigenación por Membrana Extracorpórea , Unidades de Cuidados Intensivos , Neoplasias Pulmonares , Pulmón , Neumonectomía , Neumonía , Neumonía por Aspiración , Síndrome de Dificultad Respiratoria
4.
Journal of Cardiovascular Ultrasound ; : 103-106, 2015.
Artículo en Inglés | WPRIM | ID: wpr-30146

RESUMEN

Although stress-induced cardiomyopathy (SCMP) is a reversible disease and the prognosis is usually excellent, several complications can occur and can result in fatal adverse events. The formation of left ventricular (LV) thrombus is one of these critical complications of SCMP. This report describes a case of SCMP complicated by formation of a LV thrombus that became increasingly mobile as LV contractility recovered, and for which surgical removal was performed. Here, we report a case of SCMP complicated by LV thrombus and review the literature regarding this topic.


Asunto(s)
Humanos , Cardiomiopatías , Ecocardiografía , Pronóstico , Cardiomiopatía de Takotsubo , Trombosis
5.
Journal of Korean Medical Science ; : 142-144, 2010.
Artículo en Inglés | WPRIM | ID: wpr-64128

RESUMEN

Emergency surgical repair for acute traumatic aortic ruptures has been associated with a high peri-procedural mortality rate. Endovascular stent-grafting, as a less invasive procedure, has shown encouraging results. This report describes a patient with a short landing zone, who was treated by transposing the supra-aortic branch without sternotomy, followed by covered stent-grafting with an extended proximal bare portion to enhance fixation.


Asunto(s)
Anciano , Femenino , Humanos , Enfermedad Aguda , Rotura de la Aorta/diagnóstico , Stents , Esternotomía , Arteria Subclavia , Procedimientos Quirúrgicos Mínimamente Invasivos , Tomografía Computarizada por Rayos X
6.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 256-258, 2009.
Artículo en Coreano | WPRIM | ID: wpr-151345

RESUMEN

A 63-year-old man who had a permanent pacemaker placed 17 years ago presented to us with local inflammatory signs on his chest. The skin was opened to remove the permanent pacemaker. However, the pacing wire was not easily removed. So, the permanent pacemaker was removed from the chest with leaving the remnant wire inside. However, the local infection recurred because of the remnant wire. Right thoracotomy was performed and cardiopulmonary bypass was started. After total circulatory arrest, the right atrium was opened and the wire was completely removed.


Asunto(s)
Humanos , Persona de Mediana Edad , Puente Cardiopulmonar , Atrios Cardíacos , Piel , Cirugía Torácica , Toracotomía , Tórax
7.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 149-159, 2008.
Artículo en Coreano | WPRIM | ID: wpr-159173

RESUMEN

BACKGROUND: With increasing coronary bypass and peripheral vascular surgeries, the demand for homologous vascular or synthetic conduits has continued to grow, but wide-spread application has been limited by dismal patency rates. Although cryopreserved allograft valves may provide a suitable alternative, current viability or patency of implanted allograft vascular conduits has been unsatisfactory. MATERIAL AND METHOD: We serially analyzed the outcomes of canine femoral artery and saphenous vein allograft implants after storage in either 4degrees C or -170degrees C. RESULT: There were no differences in graft flow rate (patency) (p=0.264), rate of thrombosis (p=0.264), presence of endothelium (p=0.587), or immunohistochemical staining for thrombomodulin (p=0.657) were detected between grafts stored in 4degrees C and -170degrees C. Greater flow occurred in the arterial grafts versus the venous grafts (p=0.030), irrespective of the preservation method, with a significantly lower incidence of thrombosis (p=0.030) in arterial allografts. There was a correlation coefficient of -0.654 between thrombosis and positive immunohistochemical staining for thrombomodulin (p=0.006) and a correlation coefficient of 0.520 (p=0.0049) between the endothelial presence and positive immunohistochemical staining for thrombomodulin. The relationship between the presence of endothelium and thrombomodulin expression failed to show any correlation within the first 2 weeks (p=0.306). However, a strong correlation was seen after 1 month (p=0.0008). CONCLUSION: Tissue storage in either 4degrees C or -170degrees C in 10% DMSO/RPMI-1640 preservation solution preserved grafts equally well. In terms of thrombosis and graft patency, arterial grafts were superior to venous grafts. Considering the poor correlation between thrombomodulin expression and the presence of an endothelium in the implanted graft within the first two weeks, grafts in this period would not be thromboresistant.


Asunto(s)
Animales , Perros , Prótesis Vascular , Criopreservación , Endotelio , Arteria Femoral , Incidencia , Vena Safena , Trombomodulina , Trombosis , Trasplante Homólogo , Trasplantes
8.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 508-511, 2007.
Artículo en Coreano | WPRIM | ID: wpr-146273

RESUMEN

The causes of aortic dissection are usually hypertension, connective tissue disease such as Marfan syndrome, congenital valvular abnormality such as bicuspid aortic valve, iatrogenic injury, pregnancy and drugs. Previous studies have shown that 50% of all dissections in women less than 40 years age were associated with pregnancy. Almost all aortic dissections during pregnancy occur during the third trimester or during labor and delivery. Marfan's syndrome is a particularly important predisposing factor for aortic dissection during pregnancy. We report here on a case of surgical treatment for acute type II aortic dissection in a Marfan syndrome patient who was 24 weeks pregnant, and we include a review of literature.


Asunto(s)
Femenino , Humanos , Embarazo , Válvula Aórtica , Diente Premolar , Causalidad , Enfermedades del Tejido Conjuntivo , Hipertensión , Síndrome de Marfan , Tercer Trimestre del Embarazo
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