• Title/Summary/Keyword: 심실수

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Development of the Control Algorithm for Counterpulsation between a Moving-actuator type Bi-Ventricular Assist Device (AnyHeart) and a Natural Heart (한국형 심실 보조 인공심장과 자연심장 간의 counterpulsation 제어 알고리즘의 개발)

  • Nam, Kyoung Won;Choi, Seong Wook;Chung, Jinhan;Kim, Wook Eun;Min, Byoung Goo
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.33-38
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    • 2002
  • A Ventricular Assist Device(YAD) is used to support the injured natural heart So. when considering a control algorithm for YAD. it is important to reduce a natural heart's load to enhance its recovery condition. To reduce natural heart's load, a counterpulsation algorithm is used commonly. In this study, we developed a counterpulsation control algorithm for moving-actuator type VAD and tested its usefulness using in vitro MOCK circulatory system. To notice a natural heart's Pumping status, electrocardiogram(ECG) signal was used and as a result of test. the counterpulsation effect between YAD and a natural heart was occurred and Automatic Control Mode Transition was occurred properly.

Surgical and Long Term Results for Double Outlet Right Ventricle by the Type of Ventricular Septal Defect (심실중격결손의 형태에 따른 양대혈관 우심실기시증의 수술 및 장기 결과)

  • Yu Song Hyeon;Park Han Ki;Cho Bum Koo;Park Young Hwan
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.181-190
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    • 2005
  • The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

체적변화에 따른 3차원 가상 심실 모델 시뮬레이션

  • Lee, Jong-Ho;Kim, Gi-Tae;Sin, Seong-Ung;Bang, Hyeon-Gi;Lee, Gyeong-Eun;Sim, Eun-Bo
    • Proceeding of EDISON Challenge
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    • 2017.03a
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    • pp.662-664
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    • 2017
  • 심실 내부에 가해지는 수축력에 의해 심실 내부 벽에는 큰 무리가 될 수 있다. 이로 인해 다양한 심장질환인 부정맥, 심실 세동 등을 유발한다. 따라서 본 연구에서는 가상 심장모델을 구축하여 컴퓨터 시뮬레이션을 통한 수축이완시의 심장 상태를 살펴보고자 하였다. 이를 위해서 개 심장 모델을 활용하여 3차원으로 이뤄진 심장모델을 구현하였다. 심장모델의 전기생리학 기전에 기초한 전기전도 해석을 수행하고, 전기전도 해석 시 발생되는 칼슘이온의 농도변화를 활용하였다. 시간에 따른 칼슘 이온의 심장 수축 영향을 바탕으로 비선형 유한요소법을 이용, 3차원 심장의 수축역학을 해석하였다. 이러한 기전으로 심장 근육에 부하되는 응력(tension)를 계산하고, 이렇게 계산된 심근의 응력분포에 대해 관측 및 분석을 진행하였다.

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Assessment of PVC-RUNs Arrhythmia by R-R Interval (R-R 간격을 이용한 PVC-RUNs 부정맥 검출)

  • Lee, Sun-Ju;Yoon, Tae-Ho;Kim, Kyeong-Seop;Lee, Jeong-Whan;Kim, Dong-Jun
    • Proceedings of the IEEK Conference
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    • 2009.05a
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    • pp.393-395
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    • 2009
  • 심장의 활성 근육의 움직임에 의하여 발생되는 전기적 변화량을 나타내는 심전도는 부정맥 또는 허혈성 심장질환을 진단하는데 널리 활용되고 있다. 특히 심실빈맥(Ventricular Tachycardia) 또는 심실세동(Ventricular Fibrillation)과 같이 치명적인 심장리듬이 발생하기 이전에, 심실조기수축(Ventricular Premature Contraction)을 검출하여 생명을 위협할 수 있는 부정맥을 조기에 진단할 수 있는 연구들이 일부 진행되고 있다. 이에 따라서 본 연구에서는 심전도 신호의 R-R 간격 정보와 R-peak 정보의 진위성을 판단하여 PVC 부정맥 패턴뿐만 아니라 PVC 파형이 연속적으로 진행되는 PVC-RUNs을 효율적으로 검출할 수 있는 부정맥 진단 알고리즘을 제안하고자 하였다.

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Inherited Malignant Ventricular Tachyarrhythmia in a German Shepherd (져먼 셰퍼드종 개에서 발생한 유전성 악성 심실성 부정맥증)

  • Lee, Joon-Seok;Lee, Seung-Gon;Park, In-Chul;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.329-333
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    • 2006
  • A 9-month-old neutered male German Shepherd dog was referred with the primary complaint of episodic collapse. Apparent abnormal findings were not observed in physical examination, routine biochemistry, and diagnostic imaging studies. In the 12-lead surface ECG after collapse, the dog showed frequent ventricular premature contractions (VPCs) with torsade de pointes. The frequency of VPCs was reduced after lidocaine infusion. Based on the history, findings in event recordings oi the ECG and lidocaine response test, the dog was diagnosed as inherited malignant ventricular tachyarrhythmia. Although the dog was initially responded to oral sotalol therapy, the dog was died suddenly. This report described the first case of malignant ventricular tachyarrhythmia of German Sheperd in Korea.

Modified Starnes Operation for Neonatal Stenotic Ebstein Anomaly (신생아 폐쇄성 엡스타인 기형에 대한 변형 Starnes 술식)

  • Lee Seung Hyun;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.633-636
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    • 2005
  • Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.

Surgical Treatment of a Submitral Left Ventricular Aneurysm and the Patient Present with Recurrent Ventricular Tachycardia (재발성 심실성 빈맥이 동반된 승모판하 좌심실류의 외과적 치료)

  • Kim, Young-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Baek, Wan-Ki;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.180-183
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    • 2010
  • Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.

PVC Classification by Personalized Abnormal Signal Detection and QRS Pattern Variability (개인별 이상신호 검출과 QRS 패턴 변화에 따른 조기심실수축 분류)

  • Cho, Ik-Sung;Yoon, Jeong-Oh;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.7
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    • pp.1531-1539
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    • 2014
  • Premature ventricular contraction(PVC) is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Nevertheless personalized difference of ECG signal exist, performance degradation occurs because of carrying out diagnosis by general classification rule. In other words, the design of algorithm that exactly detects abnormal signal and classifies PVC by analyzing the persons's physical condition and/or environment and variable QRS pattern is needed. Thus, PVC classification by personalized abnormal signal detection and QRS pattern variability is presented in this paper. For this purpose, we detected R wave through the preprocessing method and subtractive operation method and selected abnormal signal sets. Also, we classified PVC in realtime through QS interval and R wave amplitude. The performance of abnormal beat detection and PVC classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 98.33% in abnormal beat classification error and 94.46% in PVC classification.

Acute Heart Failure after Relief of Massive Pericardial Effusion (대량의 심낭삼출액 제거 후 발생한 급성 심부전)

  • Jung Tae-Eun;Lee Dong-Hyup
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.702-705
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    • 2006
  • Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

Prediction of Improvement of Hibernating Myocardium after Coronary Artery Bypass Grafting -The role of dobutamine stress echocardiography- (동면심근을 가진 관상동맥 환자의 수술 후 기능회복의 예측에 대한 임상적 고찰 - Dobutamine 심초음파의 역할 -)

  • 유경종;강면식;이교준;김대준;임세중;정남식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.776-780
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    • 1998
  • Background: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular(LV) function after surgical revascularization. Materials and methods: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography(DSE) (dobutamine: baseline, 5, 10, 20$\mu$g/kg/min) before coronary artery bypass grafting(CABG) and underwent echocardiography at least 2 months after CABG. Results: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8(50%) of 16 patients in DSE. Among them, 6 patients(75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients(38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments(74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments(23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.

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