• Journal of Sensor Science and Technology
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• v.20 no.2
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• pp.118-123
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• 2011

Heart related diseases mainly caused by heavy work load and increasing stress in human daily life. Therefore, researches on mobile healthcare monitoring for daily life has been carried out. Notably, wearable healthcare monitoring system which has least restriction has been tried to provide an emergency alert of abnormal heart rate. In this study, we developed chair type unconstrained BCG measurement system which able to perform continuous heart status monitoring at the office and daily life in the unconstrained way. Furthermore, adaptive threshold is used to detect the heart rate from BCG signals. The HRV(heart rate variability) is calculated from heart rate interval. ECG signal measured using conventional method and BCG signal measured using unconstraint system are carried out simultaneously for the purpose of performance evaluation. From the comparison result, BCG signal shows a similar heart beat characteristic as ECG signal. This proves the possibility of practical implementation of unconstraint healthcare monitoring system. In addition, medical examination like valsalva maneuver is performed to observe the changes in HRV due to stress. By performing valsalva maneuver, heart is said to be placed under an artificial physical stress condition. Under this artificial physical stress condition, the time and frequency domain of HRV parameters are evaluated.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2009.05a
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• pp.349-352
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• 2009

최근 유비쿼터스 헬스케어가 부각됨에 따라 심장의 활동상태를 보다 편리하게 측정하기 위하여 이동성 및 휴대성을 강조한 심전도 계측 시스템 및 스트레스 상태를 분석하기 위한 연구들이 수행되고 있다. 하지만 기존 심전도 계측은 전극의 부착 및 계측시스템과의 연결을 위한 리드선의 사용으로 인해 활동의 불편함을 유발한다. 본 연구에서는 기 연구 수행된 가정 또는 사무실에서 무구속적인(unconstrained) 방법으로 지속적인 심장의 활동상태의 모니터링이 가능한 무구속 의자형 심탄도 계측 시스템을 구현하였다. 무구속적인 방법으로 심탄도 신호를 계측하고 심탄도신호로부터 심박동변이율을 추출함으로써 일상생활 중 스트레스를 모니터링 하고자 하였다. 구현된 시스템을 통한 스트레스 모니터링의 가능성을 평가하기위하여 안정상태의 심박동변이율과 인위적인 신체적 스트레스인 Valsalva 조작를 유도한 후 심박동 변이율을 비교평가 하였다. 건강한 대학생 10명을 대상으로 비교분석을 수행한 결과 안정 상태와 육체적 스트레스 인가 후 심박동 변이율의 변화 양상을 관찰할 수 있었으며, 무구속적인 방법에 의해 스트레스의 모니터링이 가능함을 확인 할 수 있었다.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.243-245
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• 2022

True aneurysms of the coronary artery after aortic root replacement in Marfan syndrome patients are very rare. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva adds complexity during aortic root surgery. We present a case of a 37-year-old male patient with Marfan syndrome who had an RCA anomaly and a 4.5-cm true aneurysm of the common coronary button 14 years after a previous Bentall procedure. A redo Bentall operation and hemi-arch replacement were successfully performed. The anomalous origin of the RCA from the left sinus of Valsalva was safely divided and anastomosed as separate coronary buttons to the prosthetic composite valve graft. To prevent coronary button aneurysms after aortic root surgery in Marfan patients, the coronary buttons and the corresponding side holes on the prosthetic graft must be reduced to the maximum possible extent.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.776-779
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• 2005

Anomalous origin of right coronary artery from left sinus of valsalva is associated with sudden unexpected death, syncope, arrhythmia and myocardial ischemia. The mechanism that explains the restriction of coronary flow in the anomalous coronary artery is unclear but several surgical methods have been proposed, such as coronary artery bypass graft, coronary reimplantation, translocation of pulmonary artery, and unroofing procedure. We reported the surgical correction of the anomalous origin of right coronary artery from left sinus of valsalva between the aorta and pulmonary trunk using the unroofing procedure.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.33-42
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• 1979

The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.585-590
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• 2003

Purpose : This study is designed to determine the prevalence of cardiovascular autonomic neuropathy and its relationship to risk factors in adolescents with diabetes mellitus(DM). Methods : Ninety-two diabetic patients(80 with type 1 DM and 12 with type 2 DM), ranging from eight to 26 years of age, were studied for cardiovascular autonomic function, and the relationship to age, duration of diabetes, glycated hemoglobin(HbA1c), urinary albumin excretion, and the presence of diabetic retinopathy and abnormal nerve conduction velocities(NCV) were analysed. Autonomic function was assessed by measuring heart rate variation during valsalva manoeuvre, deep breathing and standing from a lying position(30 : 15 ratio), and postural hypotension. Results : Among patients with type 1 DM, 22.5% had early, 8.7% had definite, and 1.3% had severe autonomic dysfunction, and among patients with type 2 DM, 16.7% had early, 8.3% had definite, and 8.3% had severe autonomic dysfunction. On logistic regression analysis including both type 1 and type 2 diabetic patients, the age of the patient(OR=1.133(1.003-1.279), P<0.05) and duration of diabetes(OR=1.148(1.009-1.307), P<0.05) significantly predicted cardiovascular autonomic dysfunction while HbA1c, blood pressure, urinary albumin excretion, and presence of diabetic retinopathy and abnormal NCV did not. The valsalva ratio was borderline or abnormal in 31.5% of patients, the heart rate variation on deep breathing in 41.3%, the 30 : 15 ratio in 14.1%, and postural hypotension in 9.8% of patients. The valsalva ratio and the heart rate variation on deep breathing significantly predicted cardiovascular autonomic dysfunction, but the 30 : 15 ratio and postural hypotension did not. Conclusion : Cardiovascular autonomic dysfunction was found in 32.6% of diabetic patients and 10.8 % of patients had definite or severe involvement. The risk of cardiovascular autonomic dysfunction increased with the patient's age and the duration of DM. This study suggests that the valsalva ratio and the heart rate variation on deep breathing are the most useful tests in evaluating the cardiovascular autonomic function in children and adolescents with DM.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.680-686
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• 1989

Supravalvular aortic stenosis may be defined as an obstructive congenital deformity of the ascending aorta which originates just distal to the level of the origin of the coronary arteries. It may occur in several different anatomical form. Three type have been described; the hourglass, the hypoplastic and the membranous type, each term identifying the gross characteristic of the lesion causing by the aortic obstruction. Non cardiovascular condition commonly associated with supravalvular aortic stenosis are mental retardation, facial anomalies, hypercalcemia, etc. The diagnosis can be established preoperatively by left heart catheterization and selective angiography. Recently, we experienced a case of multiple localized supravalvular aortic stenosis involving, just above the sinus Valsalva and just proximal of the innominate artery. The surgical correction which was performed by a vertical incision across the each narrowing of aorta with replacement of diamond shaped double velour Woven Dacron patch under the CPB. He was discharged without any event.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.882-888
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• 1988

A case of Annuloaortic Ectasia associated with Marfan syndrome and mitral regurgitation is treated surgically by Bentall`s method and mitral annuloplasty. The Annuloaortic Ectasia is frequently accompanied with Marfan syndrome, its definition is simply explained as the following; the marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. As the operative finding, the intimal tearing was shown as circular and the both coronary ostia were changed the position into high up. The patient was taken a corrective operation replacing the ascending aorta and aortic valve with a composite graft[St. Jude medical valve 29mm, woven Dacron tubular graft 31mm]. The both coronary ostia were reimplanted on the graft with 4-0 prolene by continuous suture. Mitral annuloplasty was performed. After the operation, the patient developed both spontaneous pneumothorax, he improved state by the closed thoracostomy. He has been doing well, postoperatively.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.456-460
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• 1985

A case of Annuloaortic Ectasia associated with Marfan syndrome was treated by replacement of aorta and aortic valve with a valved conduit. A 26 years old man had suffered from palpitation and precordial pain. He had stigmata of Marfan`s syndrome. Aortogram and 2-D echocardiogram confirmed aneurysm of the ascending aorta with aortic insufficiency. Surgery was performed under the moderate hypothermia to 28oC. There was marked dilatation of the aortic annulus as well as sinus of Valsalva, with displacement of the coronary ostia. Aortic valve and aneurysm was replacement with 25mm, woven Dacron tubular graft, to which a 25mm, S.T. Jude Medical valve had been previously sutured. Right & left coronary ostia were anastomosed to the graft with the use of 3O Nylon pledget suture. The patient had a satisfactory post operation period with out specific complication.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1230-1233
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• 1998

The Cox-Maze procedure was developed as a cure for atrial fibrillation. The recovery rate of both atrial contractility is reported low in the atrial fibrillation associated with mitral valvular heart disease than that of loan atrial fibrillation. We performed the Cox-Maze procedure (Maze III) in three cases who suffered from non-mitral heart diseases associated with atrial fibrillation: A ruptured sinus of Valsalva aneurysm, a ventricular septal defect, and an aortic stenoinsufficiency. The Cox-Maze procedure was performed concomitantly with correction of the underlying heart disease. Conversion to sinus rhythm was achieved in all three patients, and both right and left atrial mechanical activities could be identified echocardiographically after three postoperative months.