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Congenital Aortic Valvular Insufficiency Caused by Abnormal Valvular Structures in a Labrador Retriever Dog (래브라도 리트리버종 개의 비정상 판막 구조에 의한 선천성 대동맥 판막 부전)

  • Moon, Hyeong-Sun;Lee, Seung-Gon;Lee, Sang-Eun;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.233-237
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    • 2007
  • A 10-month-old intact male Labrador Retriever dog was referred with the primary complaint of exercise intolerance, especially after vigorous exercise. Physical examination revealed split S1 and grade III/VI diastolic regurgitant murmur at the left apex and base, respectively. ECG finding was normal sinus rhythm at rest, but supraventricular tachycardia with bundle branch blocks after exercise. Thoracic radiography revealed dilated ascending aorta with normal range of cardiac silhouette (VHS 10.2). Echocardiography revealed abnormal valvular structures just above the aortic valvular cusps causing aortic regurgitation with a reduction of left ventricular ejection fraction (LVEF). Based on those findings, the case was diagnosed as congenital aortic regurgitation caused by abnormal valvular structures. The dog was managed with diltiazem and exercise restriction. This is a rare case of aortic deformity in dogs.

Design of Arrhythmia Classification System Based on 1-D Convolutional Neural Networks (1차원 합성곱 신경망에 기반한 부정맥 분류 시스템의 설계)

  • Kim, Seong-Woo;Kim, In-Ju;Shin, Seung-Cheol
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.1
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    • pp.37-43
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    • 2020
  • Recently, many researches have been actively to diagnose symptoms of heart disease using ECG signal, which is an electrical signal measuring heart status. In particular, the electrocardiogram signal can be used to monitor and diagnose arrhythmias that indicates an abnormal heart status. In this paper, we proposed 1-D convolutional neural network for arrhythmias classification systems. The proposed model consists of deep 11 layers which can learn to extract features and classify 5 types of arrhythmias. The simulation results over MIT-BIH arrhythmia database show that the learned neural network has more than 99% classification accuracy. It is analyzed that the more the number of convolutional kernels the network has, the more detailed characteristics of ECG signal resulted in better performance. Moreover, we implemented a practical application based on the proposed one to classify arrythmias in real-time.

A Case of Ascending Aortic Dissection with Severe Aortic Regurgitation Diagnosed by Echocardiography (심장초음파검사로 진단된 중증 대동맥판역류를 동반한 상행대동맥박리증 1예)

  • Kim, Sung-Hee;Lee, Ok-Kyoung
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.4
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    • pp.425-429
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    • 2020
  • Aortic dissection refers to the separation of the aorta into a true and false lumen as the medial membrane of the aorta is torn along the long axis due to a high aortic pressure when a minute rupture occurs in the aortic lining. The mortality rate is very high, and aortic dissection occurs 2~5 times more in men than women. The prevalent age range is 50~70 years old. In this case, the authors experienced a diagnosis of aortic dissection that occurred in a young woman in her 30s, which does not occur frequently. In the process of tracking severe aortic regurgitation, aortic valve prolapse was initially suspected. We report this case because aortic dissection could be diagnosed by observing the intimal flap of the ascending aorta in the process of confirming this suspected part.

Arrhythmia Classification using Hybrid Combination Model of CNN-LSTM (합성곱-장단기 기억 신경망의 하이브리드 결합 모델을 이용한 부정맥 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.1
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    • pp.76-84
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    • 2022
  • Arrhythmia is a condition in which the heart beats abnormally or irregularly, early detection is very important because it can cause dangerous situations such as fainting or sudden cardiac death. However, performance degradation occurs due to personalized differences in ECG signals. In this paper, we propose arrhythmia classification using hybrid combination model of CNN-LSTM. For this purpose, the R wave is detected from noise removed signal and a single bit segment was extracted. It consisted of eight convolutional layers to extract the features of the arrhythmia in detail, used them as the input of the LSTM. The weights were learned through deep learning and the model was evaluated by the verification data. The performance was compared in terms of the accuracy, precision, recall, F1 score through MIT-BIH arrhythmia database. The achieved scores indicate 92.3%, 90.98%, 92.20%, 90.72% in terms of the accuracy, precision, recall, F1 score, respectively.

Arrhythmia Classification using GAN-based Over-Sampling Method and Combination Model of CNN-BLSTM (GAN 오버샘플링 기법과 CNN-BLSTM 결합 모델을 이용한 부정맥 분류)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.26 no.10
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    • pp.1490-1499
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    • 2022
  • Arrhythmia is a condition in which the heart has an irregular rhythm or abnormal heart rate, early diagnosis and management is very important because it can cause stroke, cardiac arrest, or even death. In this paper, we propose arrhythmia classification using hybrid combination model of CNN-BLSTM. For this purpose, the QRS features are detected from noise removed signal through pre-processing and a single bit segment was extracted. In this case, the GAN oversampling technique is applied to solve the data imbalance problem. It consisted of CNN layers to extract the patterns of the arrhythmia precisely, used them as the input of the BLSTM. The weights were learned through deep learning and the learning model was evaluated by the validation data. To evaluate the performance of the proposed method, classification accuracy, precision, recall, and F1-score were compared by using the MIT-BIH arrhythmia database. The achieved scores indicate 99.30%, 98.70%, 97.50%, 98.06% in terms of the accuracy, precision, recall, F1 score, respectively.

Anatomical Structures of the Aortic Root in Koreans (한국인 대동맥 근부의 해부학적 구조)

  • Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Kim, Si-Wook;Kim, Su-Il;Chung, In-Hyuk;Na, Myung-Hoon
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.321-328
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    • 2007
  • Background: It is very important to determine the surgical anatomy of the aortic root when performing spreading aortic root preserving heart surgery. This study focuses on the surgical aspect of the aortic root anatomy by performing dissection of Korean cadavers. Material and Method: The subjects were 62 cadavers. We measured the intercommissural distances, heights of the sinuses and the circumference of the sinotubular junction and the aortic annulus. Result: The mean age of death was 61.3 years. The intercommissural distance for the right coronary sinus was $0.73{\pm}2.23mm$, that for the non coronary sinus was $19.34{\pm}2.03mm$, and that for the left coronary sinus was $18.58{\pm}2.15mm$. The height of sinus was $20.59{\pm}2.48mm$ for the right coronary sinus, $18.61{\pm}2.26mm$ for the non coronary sinus and $17.95{\pm}19mm$ for the left coronary sinus. The circumference of the sinotubular junction was $70.73{\pm}5.94mm$ and that of the aortic annulus was $77.94{\pm}5.63mm$. There is no correlation between age and STJ, aortic annulus and the ratio of STJ of aortic annulus respectively (p=0.920, p=0.111, p=0.073). The tilting angle of the sinotubular junction and aortic annulus is from $2.03^{\circ}$ to $7.77^{\circ}$ $(mean=4.90^{\circ})$. Conclusion: The intercommissural distance and the height of the sinus were largest in the right coronary sinus, and the position of the sinotubular junction to the aortic annulus is obliquely tilted levo-posteriorly.

Composite valve graft Replacement of the Aortic Root (Composite valve graft를 이용한 대동맥근부 치환술)

  • 백만종;나찬영;김웅한;오삼세;김수철
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.102-112
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    • 2002
  • This study was undertaken to analyze the outcome of composite valve graftreplacement(CVGR) for the treatment of aneurysms of the ascending aorta involving the aortic root. Material and Method: Between April 1995 and June 2001, 56 patients had replacement of the ascending aorta and aortic root with a composite graft valve and were reviewed retrospectively. Aortic regurgitation was present in 50 patients(89%), Marfan's syndrome in 18 patients(32%), and bicuspid aortic valve in 7(12.5%). The indications for operation were annuloaortic ectasia(AAE) in 30 patients(53.6%), aortic dissection in 13(23.2%), aneurysms of the ascending aorta involving aortic root in 11(19.6%), and aortitis in 2(3.6%). Cardiogenic shock due to the aortic rupture was present in 2 patients. Nine patients(16%) had previous operations on the ascending aorta or open heart surgery. The operative techniques used for CVGR were the aortic button technique in 51 patients(91%), the modified Cabrol technique in 4, and the classic Bentall technique in 1. The concomitant procedures were aortic arch replacement in 24 patients(43%), coronary artery bypass graft in 8(14.3%), mitral valve repair in 2, redo mitral valve replacement in 1, and the others in 7 The mean time of circulatory arrest, total bypass, and aortic crossclamp were 21$\pm$14 minutes, 186$\pm$68 minutes, and 132$\pm$42 minutes, respectively. Result: Early mortality was 1.8%(1/56). The postoperative complications were left ventricular dysfunction in 16 patients(28.6%), reoperation for bleeding in 7(12.5%), pericardial effusion in 2, and the others in 7. Fifty-three patients out of 55 hospital survivors were followed up for a mean of 23.2 $\pm$ 18.7 months(1-75 months). There were two late deaths(3.8%) including one death due to the traumatic cerebral hemorrhage, and CVGR-related late mortality was 1.9%. The 1- and 6-year actuarial survival was 98.1$\pm$1.9% and 93.2$\pm$5.1%, respectively. Two patients required reoperation for complication of CYGR(3.8%) and two other patients required subsequent operations for dissection of the remaining thoracoabdominal aorta. The 1- and 6-year actuarial freedom from reoperation was 97.8$\pm$2.0% and 65.3$\pm$26.7%, respectively.

Arrhythmia Surgery in Fontan Operation (폰탄 수술에서의 부정맥수술)

  • 임홍국;한국남;김웅한;이정렬;노준량;김용진
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.644-651
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    • 2004
  • Background: Refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with arrhythmia surgery in patients who had Fontan operation. Material and Method: Between July 1986 and December 2003, 275 early survivors after Fontan operation were reviewed. Fourteen patients underwent. arrhythmia surgery at reoperation after Fontan operation, and mean age at reoperation was 16.8$\pm$7.1 (range: 4.5 ∼ 30.6) years. Mechanisms of arrhythmia included atrial flutter in 8 patients, and atrial fibrillation in 2. Arrhythmia surgery has evolved from isthmus cryoablation in 12 patients to right-sided maze in 2 patients. Thirty-two patients. underwent prophylactic isthmus cryoablation concomitantly at initial Fontan operation. Result: Postoperative arrhythmias occurred in 68 patients (24.7%) among 275. There was no early and late mortality after the arrhythmia surgery. After redo Fontan operation, all patients maintained normal sinus rhythm. Atrial flutter recurred in 3 patients who had sinus conversion with medication and 7 required permanent pacemakers with a mean follow-up of 26.5$\pm$29.1 (range: 2 ∼ 73) months. All patients have improved to NYHA class I or II. After prophylactic cryoablation at initial Fontan operation, 29 patients (90.6%) had sinus rhythm, 1 patient had junctional tachycardia, 1 patient had sinus nodal dysfunction, and 1 patient had AV block with a mean follow-up of 51.3$\pm$19.8 (range: 4∼80) months. Conclusion: Redo Fontan operation, and concomitant arrhythmia surgery reduced atrial arrhythmias and improved NYHA functional classification.