Jae-Min Shim

Yonsei University, Sŏul, Seoul, South Korea

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Publications (6)21.36 Total impact

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    ABSTRACT: Background: Atrial fibrillation (AF) is common among adult patients with an atrial septal defect (ASD). Catheter ablation or the Maze procedure can be considered for AF before or concurrently with ASD closure. However, the fate of preoperative AF is not well established. This study examined the postoperative course of patients with AF before undergoing ASD correction. Methods and results: The 471 patients (131 men, 42 ± 14 years) underwent transcatheter closure (n=237, 50%) or surgical repair (n=234, 50%) of an ASD. ECG and Holter monitoring were used to document preoperative and postoperative AF. Forty patients had AF before transcatheter closure (n=10) or surgical repair (n=30) of the ASD. During the follow-up period of 44 ± 28 months, excluding 15 patients who had undergone surgical repair with the Maze procedure, sinus rhythm (SR) was maintained in 7 (88%) of 8 patients with paroxysmal AF. However, only 3 (18%) of 17 patients with persistent AF maintained SR. Among the 15 patients treated with the Maze procedure, 12 (80%) maintained SR. Conclusions: Hemodynamic correction of ASD was effective in conversion to SR in most patients with preoperative paroxysmal AF. However, the Maze procedure or transcatheter ablation before ASD correction needs to be considered for the treatment of AF in patients with persistent AF.
    No preview · Article · Oct 2012 · Circulation Journal
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    ABSTRACT: Morphologic changes of small-sized post-stent malapposition have not been sufficiently evaluated. We investigated serial changes of minimal post-stent malapposition with a follow-up optical coherence tomography (OCT) study. Post-stent OCT and intravascular ultrasound (IVUS) and follow-up OCT were performed in 26 patients with minimal post-stent malapposition. Serial changes of number and percent of malapposition struts, and mean extra-stent malapposition area were measured in OCT analysis. Zotarolimus-eluting stent (ZES), sirolimus-eluting stent (SES), and paclitaxel-eluting stent (PES) were deployed in 17, 7 and 2 patients, respectively. Mean durations of the follow-up OCT study were 5.7 ± 3.0 months. The minimal post-stent malapposition cannot be detected by the IVUS, but be visualized with an OCT examination. According to different drug-eluting stents, malapposed stent struts were defined as the struts with detachment from the vessel wall ≥160 μm for SES, ≥130 μm for PES, and ≥110 μm for ZES. The percent of malapposition struts significantly decreased from 12.2 ± 11.0% post-stent to 1.0 ± 2.2% follow-up (P < 0.001). There was a significant decrease in the mean extra-stent malapposition area from 0.35 ± 0.16 mm(2) post-stent to 0.04 ± 0.11 mm(2) follow-up (P < 0.001). Complete disappearance of stent malapposition was also observed in 22 (85%) patients. In conclusion, minimal stent malapposition which is not detectable by IVUS may disappear or decrease in follow-up OCT evaluation.
    Preview · Article · Oct 2010 · Clinical Research in Cardiology
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    ABSTRACT: The status of neointimal coverage on the drug-eluting stent (DES) struts, which are placed across the side-branch vessels, remains unclear. The degree of neointimal coverage of stent struts crossing the side-branch vessel was evaluated according to the different types of DESs. Follow-up optical coherence tomography images at 9.3 months after the index procedure were identified in 51 patients who had undergone DES (sirolimus-eluting stents [SESs] in 22 patients, paclitaxel-eluting stents [PESs] in 15, and zotarolimus-eluting stents [ZESs] in 14) implantation with crossover of the side-branch vessels (size >2.0 mm). The enrolled patients were classified as a covered group if every unapposed strut showed neointimal coverage or an uncovered group if any struts lacked neointimal coverage. The neointimal hyperplasia thickness was also measured. The number of patients in the covered group was 15 (29%), with 36 patients in the uncovered group. Significant differences were found in the proportion of the covered group among the 3 DES types (6 [27%] of 22 with SESs, 1 [7%] of 15 with PESs, and 8 [57%] of 14 with ZESs; p = 0.011). The percentage of neointimal coverage in the overall stent struts was also significantly different among the 3 DES types (65% of 356 struts, 20% of 165 struts, and 83% of 143 struts for the SESs, PESs, and ZESs, respectively; p<0.001). The neointimal hyperplasia thickness in the PES group was significantly smaller than those of the ZES and SES groups (0.02 +/- 0.02 mm vs 0.08 +/- 0.06 mm and 0.04 +/- 0.03 mm, respectively; p = 0.002). In conclusion, different patterns of neointimal coverage of the stent struts crossing the side branch vessels were observed according to the type of DES.
    No preview · Article · Jun 2010 · The American journal of cardiology
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    ABSTRACT: There has been much debate for the adequate treatment strategies for true bifurcation lesions. The purpose of this study is to introduce and test a novel stent design for the treatment of true bifurcation lesions. This side branch stent is composed of three parts: proximal, connecting, and distal parts. The distal part for the side branch vessel has a slope-side stent margin for circumferential coverage of the ostium and one radio-opaque marker for targeting the carina. The proximal part with two radio-opaque markers operates for safe stent delivery and useful guidance for a more precise placement of the distal part on the side branch ostium. Results of the in vitro test in the acrylic resin-made bifurcation phantom model were evaluated with microcomputer tomography. Animal experiments with this new stent platform were also performed in five pigs. In vitro test and microcomputer tomography showed complete coverage of the side branch ostium circumferentially with stent struts, and the absence of stent struts in the main vessel above the side branch ostium level. This side branch stents were successfully deployed in all 5 pigs. The results of animal experiments were also similar to those of in vitro tests. In vivo and vitro tests demonstrated the effective modality of this side branch stent for the treatment of true bifurcation lesions.
    No preview · Article · Feb 2010 · Journal of Interventional Cardiology
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    ABSTRACT: Intracoronary thrombus formation after drug-eluting stent (DES) implantation is not sufficiently evaluated. Optical coherence tomography (OCT) was performed in 226 patients (total DES n = 244, sirolimus-eluting stent [SES] n = 95, paclitaxel-eluting stent [PES] n = 62, zotarolimus-eluting stent [ZES] n = 87) after implantation (mean 11 months, range 3-66 months). Using OCT, we investigated the incidence and determinants of intracoronary thrombus. Intracoronary thrombus was detected in 35 (14%) cases (27 SES [28%], 7 PES [11%], and 1 ZES [1%], P < .001) and was associated with longer stent, smaller stent diameter, and stents at bifurcation lesions. More uncovered stent struts (26 +/- 23 vs 8 +/- 17, P < .001) and malapposed stent struts (6 +/- 14 vs 2 +/- 6, P < .001) were also associated with intracoronary thrombus. Multiple logistic regression analysis found the following determinants of intracoronary thrombus: stent length > or =28 mm (odds ratio [OR] 7.31, 95% CI 1.79-29.86, P = .01), stent diameter <3.0 mm (OR 4.38, 95% CI 1.38-13.97, P = .01), and > or =8 uncovered struts in each stent (OR 3.29, 95% CI 1.07-10.17, P = .04). Length, size, and types of DES may be more important than clinical factors in intracoronary thrombus formation after DES implantations.
    No preview · Article · Feb 2010 · American heart journal
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    ABSTRACT: The relationship between plasma biomarkers and vulnerable plaque is not well understood. The 188 patients who underwent 3-vessel virtual histology (VH) intravascular ultrasound (IVUS) with peripheral blood sampling were enrolled. Plasma levels of matrix metalloproteinase 2 and 9 (MMP-2, -9), tissue inhibitor of metalloproteinase-1, adiponectin, and macrophage migration inhibitory factor were measured. VH-IVUS-derived thin cap fibroatheroma (VH-TCFA) was defined as a necrotic core >10% of plaque area in the presence of >40% plaque burden. There were 38 patients with ruptured plaque and 150 patients without (107 patients with VH-TCFA, 43 patients without VH-TCFA) in culprit/target lesions. Among the biomarkers, only the MMP-9 level was significantly higher in patients with ruptured plaque (P=0.002). In the subgroup without ruptured plaque, significant differences in the levels of several biomarkers were not observed between patients with and without VH-TCFA. In both culprit/target and nonculprit/non-target vessels, the MMP-9 level showed a weak correlation with the total number of ruptured plaques (r=0.231, P=0.002). Among the biomarkers tested in this study, the MMP-9 level was significantly higher in patients with ruptured plaque. However, measurement of several biomarkers, including MMP-9, was incapable of predicting the presence of VH-TCFA.
    No preview · Article · Dec 2009 · Circulation Journal

Publication Stats

89 Citations
21.36 Total Impact Points


  • 2009-2012
    • Yonsei University
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2010
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea