• Journal of Chest Surgery
• /
• 제18권2호
• /
• pp.193-204
• /
• 1985

During the period from February to March, 1984, we employed a partial left heart bypass [left atrium to ascending aorta] in 2 patients who could not weaned from cardiopulmonary bypass with inotropic agents and cardiac pacing after coronary bypass surgery. These two patients showed significant improvement in ventricular function 18 to 47 hours after inserting the left heart bypass and were able to wean from the left heart bypass under using inotropic agents. Two patients died of multiple organ failures 11 days and 15 days postoperatively. These results indicate that early institution of left heart bypass in ventricular failure patients after open heart surgery can provide satisfactory long-term result.

• Journal of Chest Surgery
• /
• 제48권6호
• /
• pp.407-410
• /
• 2015

A two-month-old infant presented with coarctation of the aorta, severe left ventricular dysfunction, and moderate to severe mitral regurgitation. Through median sternotomy, the aortic arch was repaired under cardiopulmonary bypass and regional cerebral perfusion. The patient was postoperatively supported with a left ventricular assist device for five days. Left ventricular function gradually improved, eventually recovering with the concomitant regression of mitral regurgitation. Prompt surgical repair of coarctation of the aorta is indicated for patients with severe left ventricular dysfunction. A central approach for surgical repair with a back-up left ventricular assist device is a safe and effective treatment strategy for these patients.

• 대한의용생체공학회:의공학회지
• /
• 제17권1호
• /
• pp.109-120
• /
• 1996

Cardiac function is evaluated quantitatively using angiographic images via the analysis of the shape change or the heart wall boundaries. To kin with, boundary defection or ESLV(End Systolic Lert Ventricular) and EDLV(End Diastolic Left Ventricular) is essential for the quantitative analysis of cardiac function. The boundary detection methods proposed in the past were almost semi-automatic. Intervention by a knowledgeable human operator was still required Of con, manual tracing of the boundaries is currently used for subsequent analysis and diagnosis. This method would not cut excessive time, labor, and subjectivity associated with manual intervention by a human operator. EDLV images have noncontiguous and ambiguous edge signal on some boundary regions. In this paper, we propose a new method for automated detection of boundaries in noncontiguous and ambiguous EDLV images. The boundary detection scheme which based on a priori knowledge information is divided into two steps. The first step is to detect the candidate edge points of EDLV using ESLV boundaries. The second step is to correct detected boundaries of EDLV using the LV shape. We developed the algorithm of modifying EDLV boundaries defined adaptive modifier. We experimented the method proposed in this paper and compared our proposed method with the manual method in detecting boundaries of EDLV. In the areas within estimated boundaries of EDLV, the percentage of error was about 1.4%. We verified the useflilness and obtained the satisfying results througll the experiments of the proposed method.

• Journal of Chest Surgery
• /
• 제21권2호
• /
• pp.211-222
• /
• 1988

Tetralogy of Fallot is a cyanotic congenital heart disease characterized by large ventricular septal defect[VSD] and stenosis of right ventricular outflow tract[RVOT] and the degree of RVOT stenosis and the state of pulmonary arteries are the major determinant of prognosis of this anomaly after operation. The sum of blood flow through RVOT and collateral flow from systemic arteries determine the total pulmonary blood flow and it is drained to left atrium and left ventricle. Therefore the degree of development of left ventricle not only reflects pulmonary blood flow and the status of peripheral pulmonary arteries but also affects postoperative prognosis as a systemic ventricle. In this article, left ventricular volume and its influence on postoperative cardiac function in tetralogy of Fallot were studied in 34 patients operated on at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital in 1985. Mean age of the patients was 5 1/12*3 9/12 years[range 9/12 - 14 8/12 years], mean body surface area[BSA] 0.65*0.20m2[range 0.38 - 1.22m2], mean body weight 15.6k6.48kg[range 7.0 - 36kg]and mean hematocrit 50.6*9.77%[range 32.0 - 73.5%]. Left ventricular end-diastolic volume[LVEDV] of them were from 11.2 to 113cc and there was a good linear correlation between BSA[m2, X]and LVEDV[cc, Y][Y= - 20.0+923x, r= 0.84, p < 0.005]. Mean LVEDV/m2 was [57.6 * 18.3 cc / m2[range 28.7 - 95.8 cc / m2] and there was a significant reduction of volume compared with normal value. As body surface increases, there was a increasing tendency in LVEDV/m2 but there was no statistical significance. Mean total amount of postoperatively infused dopamine in these 33 patients[except one who expired postoperatively] was 65.6*74.5mg / kg and it was 40.6*44.0mg / kg in routine RVOT widening group [Group I] and 205*49.3mg / kg in transannular RVOT widening group[Group II]. There was a statistically significant difference between two groups. In group I patients there was a good linear inverse correlation between dopamine total amount[mg / kg, Y] and LV volume[cc / m2, X] [Y = 150 - 1.89 X, r = - 0. 77, p < 0.005]. But there were no correlations between dopamine total amount and Hct, cardiopulmonary bypass time and aorta cross clamp time. In conclusion, the patient with small preoperative left ventricular volume required more amount of dopamine as an inotropic agent for the maintenance of a cardiac function in postoperative period. But this is a result of immediate postoperative period and does not reflect the long term effect of left ventricular volume in tetralogy of Fallot. There must be more study for the evaluation of its long term effect.

• Journal of Cardiovascular Imaging
• /
• 제31권1호
• /
• pp.41-48
• /
• 2023

BACKGROUND: The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging (VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls. METHODS: Fourteen patients with HCMP (72% male, mean age of 52.6 ± 9.8), 15 hypertensive patients with LVH (88% male, mean age of 54.0 ± 15.3), and 10 age-matched controls (83% male, mean age of 50.0 ± 4.6) were prospectively studied. Echocardiographic images of the LA were analyzed with VVI, and strain rate (SR) was compared among the 3 groups. RESULTS: The e' velocity (7.7 ± 1.1; 5.1 ± 0.8; 4.5 ± 1.3 cm/sec, p = 0.013), E/e' (6.8 ± 1.6; 12.4 ± 3.3; 14.7 ± 4.2, p = 0.035), and late diastolic SR at mid LA (-1.65 ± 0.51; -0.97 ± 0.55; -0.82 ± 0.32, p = 0.002) were significantly different among the groups (normal; LVH; HCMP, respectively). The e' velocity, E/e', and late diastolic SR at mid LA were significantly different between normal and LVH (p = 0.001; 0.022; 0.018), whereas LA size was similar between normal and LVH (p = 0.592). The mean late diastolic peak SR of mid LA was significantly correlated with indices of diastolic function (E/e', e', and LA size). CONCLUSIONS: The SR is a useful tool for detailed evaluation of LA function, especially early dysfunction of LA in groups with normal LA size.

• 고려인삼학회:학술대회논문집
• /
• 고려인삼학회 2002년도 학술대회지
• /
• pp.27-34
• /
• 2002

Clinical study on hemodynamics of healthy elders before and after tread mill. Using doubleblind, placebo-controlled study design. Seventy-five 50-70 years old volunteers without organic disease were divided into two groups, Ginseng group and control group. Each subject was received 3 g Korea Red Ginseng (KRG) capsules or placebo per day for 4 weeks. Before and after administration 4 weeks, the symptoms were asked and hemodynamics parameter such as pump function, systolic function, preload and afterload were recorded before and after tread mill 1,5, 10 minutes by the method of thoracic impedance cardiograph. The result showed that Ginseng could improve quality of life, had obvious effect of increasing PEP (pre-ejection period), PEP/LVET (pre-ejection period/left ventricular ejection period), PCWP (wedged pressure pulmonary capillary). The change rate of HR (heart rate), SV (stroke volume) in KRG group were much lowered, while EF (ejection fraction), LVET (left ventricular ejection period), LVEDP (left ventricular end diastolic pressure) was recovered much quickly. The circulation showed Ginseng could improve the quality of life though its promoting circulation function which are increasing both the systolic function and the preload.

• Journal of Chest Surgery
• /
• 제44권6호
• /
• pp.399-405
• /
• 2011

Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

• 대한의용생체공학회:의공학회지
• /
• 제13권2호
• /
• pp.115-124
• /
• 1992

An algorithm has been proposed for the automatic detection of optimal epiand endocardial left ventricular borders from 2-D short axis echocardiogram which is degraded by noise and echo drop out. For the implementation of the algorithm, we modified Ballard's Generalized Hough Transform which can be applicable only for deterministic object border, and newly proposed Fuzzy Hough Transform method. The algorithm presented here allows detection of object whose exact shapes are unknown. The algorithm only requires an approximate model of target object based on anatomical data. To detect the approximate epicardial contour of left ventricle, Fuzzy Hough Transform was applied to the echocardiogram. The optimal epicardial contour was founded by using graph searching method which contains cost function analysis process. Using this optimal epicardial contour and average thickness imformation of left ventricular wall, the approximate endocardial line was founded, and graph searching method was also used to detect optimal endocardial contour.

• 대한수의학회지
• /
• 제55권4호
• /
• pp.221-225
• /
• 2015

This study evaluated the effects of alfaxalone (3 mg/kg, intravenously) on echocardiographic examination in healthy dogs using echocardiography. Six adult Beagle dogs were used for this study. Left ventricular dimensions with systolic indexes, trans-blood flow at all cardiac valvular annulus and trans-mitral tissue Doppler values were measured from routine transthoracic echocardiography. Although the changes were not statistically significant, heart rate, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, peak velocities of tricuspid A-wave and transpulmonic flow were increased after alfaxalone induction, while systolic blood pressure, fractional shortening, left ventricular ejection fraction, peak velocities of mitral E-wave, mitral A wave, tricuspid E-wave, transaortic flow and medial e'-, a'- and s'-peaks decreased after alfaxalone induction. No dogs showed hypoxemia during sedation, regardless of intubation and oxygen supply. Although alfaxalone showed mild cardiovascular depression, this protocol could be a good alternative sedative protocol for echocardiographic examination in healthy dogs because the cardiovascular depression was statistically and clinically insignificant. However, further studies in dogs with heart diseases should be conducted to confirm these findings after alfaxalone induction.

• 대한의용생체공학회:의공학회지
• /
• 제26권2호
• /
• pp.87-93
• /
• 2005

A new method for real-time estimating left ventricular relaxation time constant (T) from the left ventricular (LV) pressure waveform, based on the isovolumic relaxation model, is proposed. The presented method uses a recursive least squares (RLS) algorithm to accomplish real-time estimation. A new criterion to detect the end-point of the isovolumic relaxation period (IRP) for the estimation of T is also introduced, which is based on the pattern analysis of mean square errors between the original and reconstructed pressure waveforms. We have verified the performance of the new method in over 4,600 beats obtained from 70 patients. The results demonstrate that the proposed method provides more stable and reliable estimation of τ than the conventional 'off-line' methods.