• Journal of Chest Surgery
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• 제20권4호
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• pp.780-785
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• 1987

Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

• Journal of Chest Surgery
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• 제27권10호
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• pp.815-823
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• 1994

This study was undertaken to hemodynamically determine the differences of myocardial protective effect between crystalloid and blood cardioplegic solution. Twenty nine children undergoing cardiac operations due to cyanotic congenital heart diseases were randomized into two groups receiving crystalloid or blood cardioplegia. Cardiac indices and other hemodynamic datum were examined postoperatively. Although there was no statistical differences between groups, postoperative stroke volume indices and left ventricular stroke work indices were slightly better with blood cardioplegia. We also found that postoperative left atrial pressures[p=0.0003], central venous pressures[p=0.004], and heart rates[p=0.014] were significantly lower with blood cardioplegia. The fact that relatively lower ventricular preloads [left atrial pressure and central venous pressure] were required to provide adequate cardiac output in blood cardioplegia group suggested superior myocardial protective effect of blood cardioplegic solution.

• Journal of Chest Surgery
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• 제4권1호
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• pp.43-50
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• 1971

Three patients who sustained penetrating stab wound of the heart have been treated successfully by emergency thoracotomy in the Department of Thoracic Surgery, Chonnam University Hospital. There were two knife and one glass wound. The location of the injury were all on the right ventricle, but in one patient, it was penetrated to ventricular septum. All patients were in shock with a systolic pressure under 60 mmHg when admitted to the emergency room. In one of the three patients, blood pressure was not detectable and subsequently cardiac arrest. Two patients required immediate thoracotomy because of intrathoracic hemorrhage and increased pericardial tamponade and the other one required prompt thoracotomy because of sudden onset of cardiac arrest. There were no death postoperatively. Two patients are living without any complication in 4 years and 4 weeks after operation. One who had penetrating wound to ventricular septum, turned to cardiac decompensation, but he is living now in 4$\frac{1}{2}$ years after operation. Exploratory thoracotomy should be performed immediately in all the patients in whom a penetrating wound of the heart or pericardial tamponade following a penetrating wound of the chest wall is suspected.

• International Journal of Control, Automation, and Systems
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• 제1권3호
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• pp.368-375
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• 2003

Data fusion approach is investigated to avoid suction in the left ventricular assist system (LVAS) using a nonpulsatile pump. LVAS requires careful control of pump speed to support the heart while preventing suction in the left ventricle and providing proper cardiac output at adequate perfusion pressure to the body. Since the implanted sensors are usually unreliable for long-term use, a sensorless approach is adopted to detect suction. The pump model is developed to provide the load coefficient as a necessary signal to the data fusion system without the implanted sensors. The load coefficient of the pump mimics the pulsatility property of the actual pump flow and provides more comparable information than the pump flow after suction occurs. Four signals are generated from the load coefficient as inputs to the data fusion system for suction detection and a neural fuzzy method is implemented to construct the data fusion system. The data fusion approach has a good ability to classify suction status and it can also be used to design a controller for LVAS.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1994년도 춘계학술대회
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• pp.131-135
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• 1994

In order to study the shape and dimensions of heart, the procedures to reconstruct a three dimensional left ventricular geometry from two dimensional echocardiographic images is studied including the coordinate transformation, curve fitting and interpolation utilizing three dimensional position registration arm. Nonlinear material property of the left ventricular myocardium was obtained by finite element method performed on the reconstructed geometry and optimization techniques which compare the computer predicted 3D deformation with the experimentally determined deformation. Afterwards using the obtained nonlinear material propertry the stress distribution related with oxyzen consumption rate was analyzed.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1174-1179
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• 1990

Forty-five patients with double-outlet right ventricle[DORV] underwent complete intracardiac repair between July, 1983 and June, 1989. Patients with complete atrioventricular canal, atrioventricular discordance and uni-ventricular heart were excluded. The 32 male and 13 female patients ranged in age from 3 months to 15 years[mean 4 years]. Thirty-two patients had pulmonary stenosis. The early mortality was 11.ltd[5 /45] None of 27 died after a completely intraventricular repair. The mortality was 20%[1/5] for repair using transannular patch, 20% [1/5] for REV operation, 33.3%[1/3] for repair including extracardiac valved conduit, and 50% [1/2] for Jatene operation, respectively. Two modified Fontan procedures were performed without mortality. One died after Senning operation. Causes of early deaths included high residual right ventricular pressure[one patient] small left atrial and left ventricular volume[one patient], persisting severe pulmonary hypertension [one patient] and low cardiac output of unknown cause [two patients]. Complete heart block developed in one patient. Two late deaths occurred among the 40 operative survivors [5.0Po] from persisting severe pulmonary hypertension and bleeding at reoperation. Our results indicate that significant defects can be repaired with low mortality and morbidity.

• Journal of Chest Surgery
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• 제26권2호
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• pp.75-79
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• 1993

Myocardial protection against ischemic and reperfusion injuries is still in troublesome eventhough couples of the way of myocardial protection have been applied since 1970's. One of the possibility in myocardial protection is adding Fructose-l,6-diphosphate(FDP) in cardioplegic solution. It is assumed that FDP can promote ATP production under anaerobic condition as well as inhibiting the supressing effect of lactate on phosphofructokinase. We compared the myocardial protecting effects of FDP in crystalloid cardioplegic solution (St. Thomas formula, 10$^{\circ}C$, pH = 7.4) and reperfusate using isolated rat hearts in modified Langendorf apparatus by the parameters of preischemic and post reperfusing heart rate, time to first beat, occurance of arrhythmia, time to stabilization, and the rate of left ventricular pressure developing. Group A (n = 10), containing no FDP in cardioplegic and reperfusing solutions was control. Group B (n = 5), containing FDP in cardioplegic solution, showed statistically significant superiority of postischemic left ventricular pressure development than the control group. Group C (n = 5), containing FDP in reperfusate, showed statistically significant myocardial depressing effect than the controls. Other parameters were unremarkable. The cause is uncertain, but it is assumed that the negative feedback inhibition of FDP in energy metabolism or unknown blocking effect of FDP on certain transmembrane ionic currents is present. In conclusion, 1) FDP in cardioplegic solution has beneficial effect on postischemic left ventricular preservation. 2) FDP is strong acid when is hydrolyzed, so precise acid titration is neccessary. 3) FDP in reperfusate has negative left ventricular preservation, otherwise the mechanism is still uncertain.

• 대한수의학회지
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• 제55권4호
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• pp.221-225
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• 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.

• Journal of Chest Surgery
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• 제6권1호
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• pp.63-68
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• 1973

Two patients operated upon for tricuspid atresia by Glenn operation are presented. They were five years old and four years old females who were cyanotic shortly after birth, and remained cyanotic. On physical examination, cyanosis on digits and lips, clubbing of fingers, thrill and grade III systolic murmur on 4th I.C.S. along left sternal border were noted. In the first case, chest roentgenograms showed normal pulmonary markings, and the electrocardiogram was interpreted as showing left ventricular hypertrophy with left axis deviation and peaked P-wave in lead IL Right heart catheterization showed high pressure in right atrium and the catheter tip was easily inserted into the left atrium through septal defect. In the second case, chest roentgenograms showed cardiomegaly with sparse pulmonary vascular markings and narrowed vascular pedicle, and the electrocardiogram showed left ventricular hypertrophy with some element of right atrial hypertrophy. Angiocardiogram showed changes characteristic of tricuspid atresia, including "right ventricular window" The findings of right heart catheterization were similar to those of first case. On the basis of these observations, they were diagnosed as tricuspid atresia, and Glenn operation was performed. Normal position of great vessels combined with ventricular septal defect and pulmonary stenosis were noted on the first case, and on second case, transposition of great vessels was additional finding. Postoperative course was uneventful and favorable outcome was obtained.

• Journal of Chest Surgery
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• 제21권2호
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• pp.223-230
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• 1988

Emax, end-systolic pressure-volume relationship, has been established as a new concept which can be representative of ventricular contractility itself since 1970s. Comparing to ejection fraction[EF], Emax is independent of preload and afterload. However Emax has not been proved precisely in non-thoracotomized condition because current methods have limitation in measuring ventricular chamber volume accurately in in viva state. The Dynamic Spatial Reconstructor[DSR], high speed computerized tomography, can measure ventricular chamber volume accurately throughout cardiac cycle in non-thoracotomized state. So Emax and EF of the left ventricle was tried to measure precisely in in vivo condition with DSR. Emax was compared to EF to estimate its ability to evaluate ventricular contractility. 5 mongrel dogs, weighing 15-16kg, were used for measuring Emax and EF of the left ventricle in 3 or 4 different loading conditions using DSR. Emax value in 5 dogs was from 2.62 to 10.49. Each dog has one Emax value regardless of loading conditions. However EF in 5 dogs varies depending on loading conditions. The conclusions are that Emax is useful in in viva state and EF varies depending on loading conditions. So Emax should be tried to use in clinical situation rather than EF because it is always representative of contractility itself regardless loading conditions in in viva state.