• Journal of Chest Surgery
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• 제13권4호
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• pp.375-384
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• 1980

Since 1958 up to the end of October 31, 1980, 2032 cases of cardiovascular lesions were operated, including 1225 open heart surgery and 354 valve replacement patients. There were 1271 Congenital anomaly cases and 761 acquired lesions including 149 vascular lesions. Among 1~271 congenital malformations 819 cases belong to acyanotic and 452 to cyanotic group. Over all mortality was 11.1 %, consisting of 12.4% for congenital and 8.9% for acquired lesions. Mortality for 1225 open heart surgery cases was 15% and 13.8% for various 354 valve replacement cases. In most of the open heart surgery cases Shiley oxygenator was utilized and Ionescu-Shiley bovine pericardial xenograft bioprosthesis**** valves were used mainly for valve replacement.

• 대한의용생체공학회:의공학회지
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• 제10권2호
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• pp.91-93
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• 1989

We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate.

• 대한의용생체공학회:의공학회지
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• 제16권1호
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• pp.61-66
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• 1995

We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane. To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medicals prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volllme and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate.

• Journal of Chest Surgery
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• 제33권2호
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• pp.160-166
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• 2000

Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

• 한국멀티미디어학회논문지
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• 제15권11호
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• pp.1330-1340
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• 2012

본 논문에서는 심음신호를 이용해 강한 심 잡음이 나타나는 심장판막협착 영역을 검출하는 새로운 알고리듬을 제안하였다. 심음의 주성분을 찾거나 심 잡음을 제거하기 위한 지금까지의 많은 연구들은 대동맥판막협착증이나 승모판막협착증과 같이 강한 심 잡음이 나타나는 비정상 심음의 경우, 강한 심 잡음으로 인해 좋은 결과를 보이지 못하였다. 본 논문에서는 구간 잡음강도함수를 이용한 잡음 검출 알고리듬을 제안하였다. 제안한 구간 잡음 강도 함수는 심음 신호에서 제 1심음과 제 2심음을 검출하여, 이를 이용한 심음 구간을 설정한 후 구간 자기상관변화량을 이용하여 도출할 수 있다. 제안한 구간 잡음강도함수를 이용하여 심 잡음의 강도를 판단하고 심 잡음 유무를 검출하였다. 제안한 알고리듬으로 실험한 결과, 심장판막협착 영역 검출에서 기존의 연구보다 뛰어난 성능을 가지는 것을 확인하였다.

• Journal of Chest Surgery
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• 제30권8호
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• pp.770-779
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• 1997

본원에서는 1985년 2월 부터 1996년 8월까지 450례의 개심술을 시행하였다. 450례중 선천성 심질환은 222례(49.3%), 후천성 심질환은 228례(50.7%)로 거의 비슷한 비율이었으며, 후반 기 5년간은 후천성 심질환이 더 많았다. 선천성 심질환은 비청색증심질환이 201례, 청색증 심질환이 21례를 차지 하였으며, 수술 사망율은 각각 5.5%와 38.1%를 차지하였다. 청색증 심질환은 대부분 활롯 4징증 이었다. 후천성 심질환 228례중 판막질환은 17례, 허혈성 심질환은 32례, 대동맥 질환은 12례, 심장종양은 6례 있었다. 판막질환은 승모판치환술이 87fll, 대동맥판막 치환술이 45례, 이중판막 치환술이 35례를 차지하였다. 허혈성 심장병의 평균문합순는 2.37개소 였으며, 사망율은 6.3%였다. 판막질환의 사망율은 10.8%, 대동맥질 환의 사망율은 16.7%였다. 전체 사망율은 9.6%이며, 선천성 심질환은 9.0%, 후천성 심질환은 10.1%였다.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1038-1044
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• 1995

We have been used cryopreserved homograft valves for right ventricular outflow tract[RVOT reconstruction since November 1993. The homograft valves were harvested from the hearts of brain dead patients or hearts of transplant recipients. There were 12 male and 10 female patients. Their ages ranged from 5 months to 13 years[mean age,39.2 $\pm$ 37.4 months and the weight ranged from 5 to 48kg [mean weight, 13.7$\pm$ 9. l kg . The diagnoses included pulmonary atresia with ventricular septal defect [n=14 , tetralogy of Fallot[n=4 , truncus arteriosus[n=3 , and double outlet right ventricle with pulmonic stenosis[n=l .Monocuspid homograft patches were used for RVOT widening or REV[reparation l`etage ventriculaire operations in 4 patients. We also used homograft as valved conduits for RVOT reconstruction in 17 patients and left ventricular outflow tract reconstruction in anatomically corrected transposition in 1 patient. Among them size-reducing technique [converting a tricuspid valved conduit into a bicuspid valved conduit were applied to six patients for the correction of size mismatching. The mean follow-up period was 10.6 $\pm$ 5.4 months. There was one operative death[4.5% due to bleeding and one reoperation for removal of vegetation on the homograft leaflet. Postoperative echocardiography documented no significant homograft insufficiency and RVOT obstructions.In short-term, the homograft valves provide excellent hemodynamic characteristics, even though further studies are necessary to evaluate the long-term results.

• 한국유체기계학회 논문집
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• 제7권3호
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• pp.14-22
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• 2004

Bileaflet mechanical valves have the complications such as hemolysis and thromboembolism, leaflet damage, and leaflet break. These complications are related with the fluid velocity and shear stress characteristics of mechanical heart valves. The first aim of the current study is to introduce fluid-structure interaction method for calculation of unsteady and three-dimensional blood flow through bileaflet valve and leaflet behavior interacted with its flow, and to overcome the shortness of the previous studies, where the leaflet motion has been ignored or simplified, by using FSI method. A finite volume computational fluid dynamics code and a finite element structure dynamics code have been used concurrently to solve the flow and structure equations, respectively, to investigate the interaction between the blood flow and leaflet. As a result, it is observed that the leaflet is closing very slowly at the first stage of processing but it goes too fast at the last stage. And the results noted that the low pressure is formed behind leaflet to make the cavitation because of closing velocity three times faster than opening velocity. Also it is observed some fluttering phenomenon when the leaflet is completely opened. And the rebounce phenomenon due to the sudden pressure change of before and after the leaflet just before closing completely. The some of time-delay is presented between the inversion point of ventricle and aorta pressure and closing point of leaflet. The shear stress is bigger and the time of exposure is longer when the flow rate is maximum. So it is concluded that the distribution of shear stress at complete opening stage has big effect on the blood damage, and that the low-pressure region appeared behind leaflet at complete closing stage has also effect on the blood damage.

• Journal of Chest Surgery
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• 제37권4호
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• pp.297-306
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• 2004

기존의 인공 심장 판막은 혈전 형성, 내구성, 세균 감염에 대한 저항력, 성장성 등에서 문제점을 가지고 있다 최근 이상적인 심장 판막을 개발하기 위한 노력으로 조직공학 기법을 이용하고 있다. 본 연구는 이종 판막을 지지체로 하여 이종 세포 제거 후 자가 세포를 파종한 조직공학 심장 판막을 개발하기 위하여 이종 세포 제거와 자가 세포 파종 방법을 비교하였고, 얻어진 심장 판막첨의 생체 적합성을 살펴보았다. 대상 및 방법: 이종 지지체로 두 마리의 돼지에서 각각 3개의 폐동맥 판막첨을 채취하여, Triton-X, freeze-thawing, NaCl-SDS 등 세 방법 중 하나로, 각각 두 개의 판막첨을 처리하고, 세포 제거 정도를 비교하였다. 염소의 경정맥에서 분리한 내피 세포를 배양하여, 상기한 방법 중 하나로 이종 세포가 제거된 돼지 판막첨에 파종한 후, 내피 세포의 보존 상해를 비교하였다. 생체 실험을 위해, 6마리 돼지에서 각각 2개의 폐동맥 판막첨을 채취해 이종 세포를 제거하였고, 6개의 판막첨은 염소의 내피 세포를 파종하고(이종-자가 이식편),다른 6개의 판막첨은 내피 세포를 파종않고(이종 이식편) 6마리 염소의 폐동맥 판막첨 두 개와 치환하였다. 치환되지 않은 하나의 판막첨을 대조군으로 비교하였다. 염소는 수술 6시간, 24시간, 1주일, 1개월, 3개월, 그리고 6개월 후 희생시키고 폐동맥 판막첨을 채취하여 분석하였다 걸과: Triton-X와 freeze-thawing 처리한 판막첨에서는 이종세포가 남아 있었으나, NaCl-SDS 처리한 판막첨에서는 세포가 완전히 제거되었고, 이종 세포 제거 후 파종한 자가 내피 세포도 NaCl-SDS 처리한 판막첨에서 다른 두 방법으로 처리한 판막첨에 비해 잘 보존되어 있었다. 6마리 염소는 혈색전증의 소견 없이 예정된 기간 동안 모두 생존하였으며, 희생 후 적출한 이종 이식편과 이종-자가 이식편 모두 대조군 보다 두꺼워져 있었다. 두 이식편 모두 24시간 후부터 섬유아세포의 증식이 관찰되었고, 1개월 후 세포의 개형(remodeling)과정을 볼 수 있었고, 3개월 후 세포 기능을 수행하였고, 6개월 후 대조군보다 세포수가 더 많이 증가하였다. 파종한 내피 세포는 잘 보존되어 있었고, 이종 이식편도 6개월 후에는 내피 세포가 피복 되어 있었다. 걸론: 이종 세포의 제거와 자가 세포의 파종에 가장 적합한 방법은 NaCl-SDS 처리였다 동물 실험에서 이종 이식편과 이종-자가 이식편 모두 6개월 간 지지체의 역할을 수행하면서, 자가 세포의 증식을 가능하게 하였고, 자가 조직으로 발전할 가능성을 보여 주었다.

• Journal of Chest Surgery
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• 제24권2호
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• pp.171-181
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• 1991

Result of St. Jude Medical valve replacement are presented in 106 patients who underwent operation from January 1985 through July 1989. The patient were 52 males and 56 females. Total 136 of St. Jude Medical valves were implanted; 91 in mitral position, 45 in aortic position. The hospital mortality rate was 5.7%o[6 patients] and the late mortality rate was 2.0%[2 patients]. The causes of death were low cardiac output in 5, iatrogenic right ventricular rupture in 1, heart failure in 1, ventricular arrhythmia in l. And, the causes of valve related complication were anticoagulant related hemorrhage in 5 patients[0.03% /patient-year] and thromboembolism[0.01% /patient-year] in 2 patients. In conclusion, the performance of the St. Jude Medical valve compare most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.