• 제목/요약/키워드: 3 Valve

검색결과 2,045건 처리시간 0.023초

Surgical Management of Aortic Root Dilatation with Advanced Aortic Regurgitation: Bentall Operation versus Valve-sparing Procedure

  • Lim, Ju-Yong;Kim, Joon-Bum;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • 제45권3호
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    • pp.141-147
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    • 2012
  • Background: Although the aortic valve-sparing procedure has gained popularity in recent years, it still remains challenging in patients with advanced aortic regurgitation (AR). We compared the long-term outcomes of the aortic valve-sparing procedure with the Bentall operation in patients with advanced aortic regurgitation secondary to aortic root dilatation. Materials and Methods: A retrospective review of 120 patients who underwent surgery for aortic root dilatation with moderate to severe AR between January 1999 and June 2009 was performed. Forty-eight patients underwent valve-sparing procedures (valve-sparing group), and 72 patients underwent the Bentall procedure (Bentall group). The two groups' overall survival, valve-related complications, and aortic valve function were compared. Results: The mean follow-up duration was $4.9{\pm}3.1$ years. After adjustment, the valve-sparing group had similar risks of death (hazard ratio [HR], 0.61; p=0.45), and valve related complications (HR, 1.27; p=0.66). However, a significant number of patients developed moderate to severe AR in the valve-sparing group at a mean of $4.4{\pm}2.5$ years of echocardiographic follow-up (p<0.001). Conclusion: Both the Bentall operation and aortic valve-sparing procedure showed comparable long-term clinical results in patients with advanced aortic regurgitation with aortic root dilatation. However, recurrent advanced aortic regurgitation was more frequently observed following valve-sparing procedures.

16세 미만에서의 심장판막치환술 (Cardiac valve replacement in patient less than 16 years of age)

  • 김응중;서경필;이영균
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.108-115
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    • 1986
  • During 12 years period from 1974 to 1985, 76 valve replacement procedures were performed at Seoul National University Hospital in 67 pediatric patients aging up to 15 years [mean 12.3 years] and it was 7.3% of total valve replacement procedures in same period. Sixty seven patients were composed of 44 males and 23 females. Of the 67 patients, 43 patients had acquired valve lesions and 24 patients congenital valve lesions. Sixty cases received single valve replacement, 7 cases double or triple valve replacement and 9 cases redo-valve replacement. Sixty seven patients received 84 valves [65 bioprosthetic valves and 19 prosthetic valves by] 76 operations, Sixty three of 65 bioprosthetic valves had been replaced before 1983 and 15 of 19 prosthetic valves in recent 2 years. Eleven patients [14.6%] died within one month post-operatively and 8 patients [10.5%] during the follow-up period with the overall mortality rate of 25.1%. There were early post-operative complication of 23 cases [30.3%] and late post-operative complication of 27 cases [35.3%] with the total complication rate of 65.8%. In 58 patients received bioprosthetic valves, there were 14 cases of restenosis of replaced valves. Of the 14 cases of bioprosthetic valve restenosis, 8 cases received redo-valve replacement procedures without mortality in 1 5/12-5 years after initial operation but 4 cases died without reoperation and 2 cases lost during follow-up. The overall mortality and complication rate were still high but they markedly decreased during recent 2 years. So, in spite of its containing many problems, valve replacement in children is becoming safe and useful procedure in whom valve reconstructive procedures are impossible.

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머신비전을 이용한 밸브어셈블리의 3차원 마멸특성 분석 (3D Wear Analysis of Valve Assemblies by Using the Machine Vision)

  • 박창우;정성종
    • 대한기계학회논문집A
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    • 제30권5호
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    • pp.496-504
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    • 2006
  • Wear of engine valves and seat inserts is a major factor affecting engine performance. In order to improve quality and life of valve assemblies, wear mechanism and 3-D surface topography should be analyzed according to operating conditions of the engine. After developing an engine simulator that generates valve speed up to 90Hz and temperature up to $900^{\circ}C$ as well as controls test load, wear experiments have been conducted for two different engine speeds as 10Hz and 25Hz. In order to observe the wear characteristics and monitor surface conditions of the valve assemblies, a cost-effective 3-D wear analysis system based on the shape from focus(SFF) and machine vision has been fabricated in this paper. 3-D surface topography of the valve assemblies has been analyzed to understand the wear behavior according to operating conditions of the engine. Consequently, wear volume of the valve assemblies is quantized by using the developed 3-D wear analysis system.

고차압 제어용 글로브 밸브 트림 내부의 3차원 유동장 해석 (Numerical Analysis of the 3-D Flow Field in a Globe Valve Trim under High Pressure Drop)

  • 윤준용;변성준;양재모;이도형
    • 한국유체기계학회 논문집
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    • 제4권3호
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    • pp.14-20
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    • 2001
  • Numerical analysis of the three dimensional turbulent flow field in a complex valve trim is carried out to confirm the possibility whether this simulation tool can be used as a design tool or not. The simulation of the incompressible flow in a glove valve is performed by using the commercial code. CFD-ACEA utilizes the finite volume approach as a discretization scheme, and the pressure-velocity coupling is made from SIMPLEC algorithm in it. Four flow cases of the control valve are investigated, and the valve flow coefficient for each case is compared with the experimental data. Simulation results show a good agreement with the experiments, and it is observed that the cavitation model improves the simulation results.

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인공심장판막의 재치환술 (Redo Operation of the Artifitial Heart Valves)

  • 조상록
    • Journal of Chest Surgery
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    • 제25권2호
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    • pp.158-166
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    • 1992
  • From 1985 to 1990, a total of 160 new valves were implanted for 125 adult patients to whom prosthetic valve replacement had been performed [One patient had consecutive 2 reoperations]. Following data are the results from the follow-up study from January 1985 to February 1991. Mean age of the patients was 37.9$\pm$12.1 years. Mean follow-up period was 25.8$\pm$18.8 months. In bioprosthesis, mean interval between the previous operation and reoperation was 85.6$\pm$36.4 months in aortic valve, and 87.3$\pm$30.0 months in mitral valve. The causes of reoperation were prosthetic valve failure[103 patients, 81.7%], prosthetic valve endocarditis[17 patients, 13.5%], periprosthetic leakage[5 patients, 4.0%], and aneurysm of ascending aorta[1 patient, 0.8%]. Fourteen patients[11.1%] died in hospital; 5 in 22 replacement of aortic valve[22.7%], 6 in 73 rereplacement of mitral valve[8.2%], and 3 in 31 replacement of multiple valves [9.7%] Except for 3 intraoperative deaths, postoperative, major and minor complications occurred in 39 patients[31.0%]. And the actuarial 5-year survival rate of operative survivors was 95.5$\pm$8.6%.

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고속 온.오프 전자밸브를 사용한 유압실린더 힘 제어계의 응답성 개선 (Response Improvement in Hydraulic Cylinder Force Control System by Using a High Speed On-Off Electro-Magnetic Valve)

  • 이일영;권정호;박정환
    • 유공압시스템학회논문집
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    • 제1권4호
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    • pp.15-21
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    • 2004
  • High speed on-off electro-magnetic valves have been used for pressure control or flow control in automotive or construction machine servomechanisms. These systems require quicker valve switching speed to improve control preciseness. The authors designed and manufactured an electric valve driver with quick response characteristics by using 3 power source type valve driver concept. In experiments by using a hydraulic system incorporating the new valve driver, the new driver shortened the switching lag time from 5 ms to 1.3 ms. And also the new driver showed excellent position tracking control performances.

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Ionescue-Shiley 인조판막을 이용한 판막대치술의 혈류역학적 성적 (Hemodynamic evaluation of the Ionescu-Shiley pericardial xenograft heart valve)

  • 정원상;김근호
    • Journal of Chest Surgery
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    • 제17권2호
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    • pp.223-230
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    • 1984
  • Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.

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이색 PIV 기술을 이용한 5밸브 가솔린엔진 연소실 내의 유동특성 분석 (Investigation on the In-Cylinder Flow of 5-Valve Gasoline Engine by Using Two Color PIV Method)

  • 이기형;우영완;박상찬;이창식
    • 대한기계학회논문집B
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    • 제26권2호
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    • pp.238-244
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    • 2002
  • A 5-valve(intake 3-valve) engine has been developed to increase engine performance. These engines have a high power caused by the decrease of inertia mass of an intake valve and the increase of intake effective area. In this study, in-cylinder flow patterns were visualized with laser sheet method and velocity profiles at near intake valves were inspected by using a two-color PIV. In addition, steady flow tests were performed to quantify tumble ratio of flow-fields generated by a tumble control valve(TCV). Experimental results of steady flow test show that the cure of tumble ratio in intake 3-valve engine farmed as a S shape with valve lift changes. This tendency is different from the one in intake 2-valve engine. Using laser sheet method and two color PIV method, we can find that the intake flow through upper valve increases and the velocity gradient also slightly increases as valve lift increases. From this study, the in-cylinder flow characteristics around intake valves were made clearly.

2기통 소형 터보가솔린엔진에서 배기 밸브 타이밍 제어에 따른 LIVC, EIVC 상태에서의 엔진 효율 영향 (Effect of Controlling Exhaust Valve Timing on Engine Efficiency in LIVC and EIVC States in a 2-Cylinder Small Turbo Gasoline Engine)

  • 장진영;우영민;신영진;고아현;정용진;조종표;김강출;표영덕;한명훈
    • 한국분무공학회지
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    • 제27권3호
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    • pp.117-125
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    • 2022
  • This study examines whether engine fuel efficiency is improved by optimization of the exhaust valve timing in a state where the intake valve timing has been optimized in a small turbo gasoline engine that has intake cams and exhaust cams with fixed valve opening periods. When the exhaust valve is opened late, the expansion stroke is longer, and the efficiency can be improved. A 2-cylinder turbo gasoline engine with 0.8 liters of displacement and an MPI (Multi Point Injection) fuel system was used. The engine was operated at 1,500 and 3,000 rpm, and the load conditions included a partial load of 50 N·m and a high load of 70 N·m. Data was recorded as the exhaust valve timing was controlled, and this was used to calculate the efficiency of combustion using a heat release, the fuel conversion efficiency, and the pumping loss. Results and the hydrocarbon concentrations in the exhaust gas were compared for each condition. Experiment results confirmed that additional fuel efficiency improvements are possible through exhaust valve timing control at 1,500 rpm and 50 N·m. However, in other operating conditions, fuel efficiency improvements could not be obtained through exhaust valve timing control because cases where the pumping loss and fuel/air mixture slip increased when the exhaust valve timing changed and the fuel efficiency declined.

CarboMedics 기계판막의 임상경험 (Mid term experience with CarboMedics Medical Valve)

  • 김기출
    • Journal of Chest Surgery
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    • 제26권10호
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    • pp.753-760
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    • 1993
  • The CarboMedics valve is a bileaflet prosthesis with excellent hemodynamic characteristics, but the long term surgical experience with this valve, its durability and its biocompatibility are unknown. During a 5 year period from october 1988 to July 1993, 748 prostheses [402 mitral, 261 aortic, 58 tricuspid, 27 pulmonic] were inserted in 552 patients [mean age 40.2 years]. The operative mortality was 6.6% [37/560, 13.2% in age group below 15 years and 5.7% above 15 years]. and the main causes of death were complex congenital malformation and left ventricular failure. Follow up was totaled 1182 patient- years and mean follow up was 28.3 months/patient. No structural failure has been observed. Hemorrhage was the most frequent valve related complication[1.78% / Patient-year]. Embolism occurred at a rate of 0.93% / Patient-year. There were 5 cases of valve thrombosis [0.42% / Patient-year, two fatal]. There occurred 11 late deaths[6 valve related] and 42 valve related complications. Actuarial survival at 5 years is 97.18 0.94% and actuarial complication free survival at 5 years is 89.07 1.54%. In summary, the CarboMedics valve stands for a durable valve substitute, with low valve related complications.

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