• 대한의용생체공학회:의공학회지
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• 제28권4호
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• pp.569-576
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• 2007

Ventricular Assist Device(VAD) has switched its goal from a short-tenn use for bridge-to-transplantation to a long-tenn use for destination therapy, With this goal, the importance of long-tenn reliability gets more interests and importances, H-VAD is an portable extracorporeal biventricular assist device, and adopts an electro-pneumatic driving mechanism. The pneumatic pressure to pump out blood is generated with compression of bellows, and is transmitted in a closed pneumatic circuit through a pneumatic line. The existing pneumatic VAD adopts a air compressor which can generate stable pressures but has defects such as a noise and a size problem. Thus, it is not suitable for being used as a portable device, These problems are covered with adopting a closed pneumatic circuit mechanism with a bellows which has a small size and small noise generation, but it has defects that improper pneumatic setting causes a failure of adequate flow generation. In this study, the pneumatic pressure regulation system is developed to cover these defects of a bellows-type pneumatic VAD. The optimal pneumatic pressure conditions according to various afterload conditions for an optimal flow rate were investigated and the afterload estimation algorithm was developed, The final pneumatic regulation system estimates a current afterload and regulate the pneumatic pressure to the optimal point at a given afterload condition. The afterload estimation algorithm showed a sufficient performance that the standard deviation of error is 8.8 mmHg, The pneumatic pressure regulation system showed a sufficient performance that the flow rate was stably governed to various afterload conditions. In a further study, if a additional sensor such as ultrasonic sensor is developed to monitor the direct movement of diaphragm in a blood pump part, the reliability would be greatly increased. Moreover, if the afterload estimation algorithm gets more accuracy, it would be also helpful to monitor the hemodynamic condition of patients.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 1996년도 춘계학술대회 논문집
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• pp.346-350
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• 1996

This paper presents a Neural Network Identification (NNI) method for modeling of highly complicated nonlinear and time varing human system with a pneumatically driven mock circulation system of Left Ventricular Assist Device(LVD). This system consists of electronic circuits and pneumatic driving circuits. The initation of systole and the pumping duration can be determined by the computer program. The line pressure from a pressure transducer inserted in the pneumatic line was recorded. System modeling is completed using the adaptively trained backpropagation learning algorithms with input variables, Heart Rate(HR), Systole-Diastole Rate(SDR), which can vary state of system, and preload, afterload, which indicate the systemic dynamic characteristics and output parameters are preload, afterload.

• Journal of Chest Surgery
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• 제34권2호
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• pp.111-117
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• 2001

배경: 심근 수축력과 더불어 전신저항은 개심술 후 적절한 심박출량을 유지하기 위한 매우 중요한 요인이다. 후부하의 변화를 비관혈적으로 평가할 수 있는지 알아 보고자 대동맥 혈류파형의 변화를 관찰하였다. 대상 및 방법: 개흉한 8마리의 잡견에서 연속파형 Doppler 심초음파를 이용하여 nitroprusside 단독 또는 epinephrine과의 병합투여 잔후로 상행 대동맥 혈류를 측정하였다. 결과: Nitroprusside의 투여로 동맥압과 전신저항은 약물의 투여량에 비례하여 감소함으로써(p<0.05 vs 기준치), 대동맥 혈류파형의 최고속도, 평균가속 및 분거리(속도시간적분$\times$심박동수)는 증가하였고, 가속시간은 짧아졌으며(p<0.05 vs 기준치), 가속시간/박출시간의 비는 변화가 없었다. Nitroprusside 투여로 인한 전신저항의 변화는 속도시간적분이나 Doppler 시간간격 지표보다는 최고속도(r=0.60, p=0.001)와 평균가속(r=0.52, p=0.003)과 상관관계가 있었다. Epinephrine과의 병합투여로 전신저항이 증가하지 않는 한 nitroprusside 단독투여에 비해서 최고속도, 평균가속 및 속도시간적분이 더 크게 증가했으나, 전신저항이 증가되면 이 Doppler 지표들은 감소하는 경향을 보였다. 결론: Doppler 심초음파를 이용하여 상행 대동맥 혈류파형의 최고속도와 평균가속을 연속적으로 측정함으로써 후부하의 변화를 비관혈적으로 평가할 수 있으리라 생각된다.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1192-1202
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• 1992

Postoperative cardiac outputs and other hernoaynamic values were serially measured in fifteen patients of cyanotic congenital heart disease, after use of blood cardioplegic solution. Cardiac indices showed no change untill eight postoparative hours, then it began to decline to reach as low as 3.22$\pm$0.7L/min/m2 at 12 hours. After then gradual increse occ-ured to recover upto immediate postoperative value at 20 hours. Sharp decrese of heart rate and increse of systemic vascular resistance during 8~16 hours and steady increase of stroke indices during the whole study periods were observed. These observations suggested that the myocardium recovered gradually after open heart surgery, and that the decrease of cardiac indices during 8~16 hours could be a result of decrease of heart rates and increase of afterload. The changes of cardiac indices correlated with the changes of heart rate, postoperative time and mixed venous oxygen saturation [p<0.05]. No other hemodynamic values found to be in statistically significant correlation with the changes of cardiac indices. Left ventricular dysfunction seemed to occur more frequently during 8~12 hours, but it was not statistically significant. [p=0.73] In conclusion, great care must be taken during 2~3 days after the operation of cyanotic congenital heart disease, not to fall into a low cardiac output state, by maintaing adequate heart rates and reducing afterload especially when the systemic vascular resistance increases.

• Journal of Chest Surgery
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• 제27권4호
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• pp.318-324
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• 1994

Cross-clamping of the descending thoracic aorta results in proximal hypertension,increase in left ventricular afterload,and impairment of distal organ perfusion. Bypass of the descending thoracic aorta is frequently advocated as an adjunct for repair of traumatic tears and degenerative aneurysms. Many methods of bypass have been proposed to provide distal perfusion and reduce left ventricular afterload during cross-clamping of the thoracic aorta. At Seoul National University Hospital, 7 patients were treated for the thoracic or thoracoabdominal aortic aneurysm using left atrium-femoral artery bypass with Bio-medicus centrifugal pump between October,1989, and January,1993. There were atherosclerotic thoracic aneurysm in 3 cases, thoracoabdominal aortic aneurysm due to chronic aortic dissection in 3 cases,aortic rupture due to trauma in 1 case. Total of 7 patients were operated by graft replacement with reimplantation of important branches. None of these cases developed severe complications and hospital death. We believe that the Bio-Medicus centrifugal pump is a simple and safe means of perfusing the lower body, kidneys, and spinal cord without necessitating heparinization.

• Journal of Chest Surgery
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• 제28권6호
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• pp.542-548
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• 1995

The goal of this study is to develop an effective control system for cardiac output regulation based upon the preload and afterload conditions without any transducers and compliance chambers in the moving actuator type total artificial heart. Motor current waveforms during the actuator movement are used as an input to the automatic control algorithm. While the current waveform analysis is performed, the stroke length and velocity of the actuator are gradually increased up to the maximum pump output level. If the diastolic filling rate of either right or left pump begins to exceed the venous return, atrial collapse will occur. Since the diastolic suction acts as a load to the motor, this critical condition can be detected by analyzing the motor current waveforms. Every time this detection criterion is met, the control algorithm decreases the stroke velocity and length of the actuator step by step just below the critical detection level. Then, they start to increase. In this way the maximum pump output under given venous return can be achieved. Additionally the control algorithm provides some degree of afterload sensitivity. If the aortic pressure is detected to exceed 120 mmHg, the stroke length and velocity decrease in the same way as the response to the preload. Left-right pump output balance is maintained by proper adjustment of the asymmetry of the stroke angle. In the mock circulatory test, this control system worked well and there was a considerable range of stroke volume difference with adjustment of the asymmetry value. Two ovine experiments were performed. It was confirmed that the required cardiac output regulation according to the venous return could be achieved with adequate detection of diastolic function, at least in the in vivo short-term survival cases[2-3 days . We conclude that this control algorithm is a promising method to regulate cardiac output in the moving actuator type total artificial heart.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권1호
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• pp.11-18
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• 2022

Background: The vasoconstrictive effect of epinephrine in local anesthetics affects the heart, which leads to hesitation among dentists in injecting local anesthetics into patients with cardiovascular disease. Due to its vasoconstrictive effects, the present study investigated the effects of vasopressin administration on cardiac function in rats. Methods: Experiment 1 aimed to determine the vasopressin concentration that could affect cardiac function. An arterial catheter was inserted into the male Wistar rats. Next, 0.03, 0.3, and 3.0 U/mL arginine vasopressin (AVP) (0.03V, 0.3V, and 3.0V) was injected into the tongue, and the blood pressure was measured. The control group received normal saline only. In Experiment 2, following anesthesia infiltration, a pressure-volume catheter was placed in the left ventricle. Baseline values of end-systolic elastance, end-diastolic volume, end-systolic pressure, stroke work, stroke volume, and end-systolic elastance were recorded. Next, normal saline and 3.0V AVP were injected into the tongue to measure their effect on hemodynamic and cardiac function. Results: After 3.0V administration, systolic blood pressures at 10 and 15 min were higher than those of the control group; they increased at 10 min compared with those at baseline. The diastolic blood pressures at 5-15 min were higher than those of the control group; they increased at 5 and 10 min compared with those at baseline. The preload decreased at 5 and 10 min compared to that at baseline. However, the afterload increased from 5 to 15 min compared with that of the control group; it increased at 10 min compared with that at baseline. Stroke volume decreased at 10 and 15 min compared with that of the control group; it decreased from 5 to 15 min compared with that at baseline. Stroke work decreased from 5 to 15 min compared with that of the control group; it decreased from 5 to 15 min compared with that at baseline. Conclusion: Our results showed that 3.0 U/mL concentration of vasopressin resulted in increased blood pressure, decreased stroke volume and stoke work, decreased preload and increased afterload, without any effect on myocardial contractility.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2007년도 춘계학술대회B
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• pp.2941-2946
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• 2007

A model of the cardiovascular system coupling cell, hemodynamics and autonomic nervecontrol function is proposed for analyzing heart mechanics. We developed a comprehensive cardiovascular model with multi-physics and multi-scale characteristics that simulates the physiological events from membrane excitation of a cardiac cell to contraction of the human heart and systemic blood circulation and ultimately to autonomic nerve control. Using this model, we delineatedthe cellular mechanism of heart contractility mediated by nerve control function. To verify the integrated method, we simulated a 10% hemorrhage, which involves cardiac cell mechanics, circulatory hemodynamics, and nerve control function. The computed and experimental results were compared. Using this methodology, the state of cardiac contractility, influenced by diverse properties such as the afterload and nerve control systems, is easily assessed in an integrated manner.

• 전자공학회논문지B
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• 제32B권3호
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• pp.38-47
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• 1995

A new automatic cardiac output control algorithm for the motor-driven electromechanical total artificial heart(TAH) was developed based on the motor current waveform analysis without using any extra transducer. The basic control requirements of artificial heart can be described in terms of three features : preload sensitivity, afterload insensitivity, and balanced ventricular outputs. In the previous studies, many transducers were utilized to obtain informations of hemodynamic states for the automatic cardiac output control, But such automatic control systems with sensors have had reliability problems. We proposed a new sensorless automatic cardiac output control algorithm providing adequate cardiac output to the time-varying physiological demand without causing right atrial collapse, which is one of the critical problem in an active-filling type device. In-vitro tests were performed on a mock circulation system to evaluate the performance of the developed algorithm and the results show that the new algorithm satisfied the basic control requirements on the cardiac output response and the possibility of application of the developed algorithm to in vivo experiments.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.122-125
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• 1997

It is needless to say that the hemodynamic variables estimation is a very important study or the artificial heart. Even though its importance there have not been satisfactory results which can be applied to the real-world situations. In this paper, we propose a practical afterload model ( AoP, PAP) which can be applied to the real-world situation.