• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.216-218
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• 1995

A new atrial pressures balancing method for moving actuator total artificial heart(TAH) without an extra compliance chamber is developed. The structural characteristics of the pendulous moving actuator have made it possible to compensate the left and right pump output difference by utilizing the interventricular air space as an internal compliance chamber in a pump housing. Furthermore, the balancing performance is increased through the improvement of the flexibility of part of the polyurathane housing. However, the increase of the flexibility of the housing causes a little loss of the cardiac output due to the reduction of active filling performance. In this paper, a good condition between the balance and pump output performance is evaluated by adjusting the air volume in the interventricular space through a series of in vitro experiment.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.249-250
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• 1998

In this study, we modeled moving-actuator type Total Artificial Heart (TAH) with cardiovascular system as a form of electric circuit. The bronchial circulation, important for the imbalance between the left cardiac output and the right one, was considered and added to the model. In the model, the relations of hemodynamic variables, just as blood pressures, volumes, or flow rates of each part of body, can be expressed as simultaneous first order ordinary differential equations. To solve the equations by the numerical analysis, Runge-Kutta forth order approximation method was adopted. The simulation software (SimTAH), implemented in C++ as a window-based application program, was developed to display the hemodynamic variables and to receive control inputs from users. SimTAH was evaluated by comparison of the simulation results with the results of mock-circulation tests, in vitro.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.88-90
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• 1996

The right and left atrial pressures are important parameters in automatic control of a total artificial heart (TAH) within normal physiological ranges. Our TAH is composed of a moving actuator, right and left ventricles and the interventricular space enclosed by a semi-rigid housing. During operation of the TAH, the jnterventpicular space's volume is changed dynamically by the difference between the ejection volume of one ventricle and the inflow volume of the other. Therefore, the changes in pressure of the interventricular space is related to both atrial pressures. We measured the interventricular pressure (IVP) waveform using a pressure sensor and attempted to indirectly estimate the changes of atrial pressures. This method has an advantage that the sensor does not contact the blood directly. Furthermore, the IVP waveforms have its zero baseline in each pump cycle, thus the pressure measurements are free from the transducer drift problems by measuring the peak pressure from these baseline values. From the In vitro experiments, we found that the IVP waveform contained several useful parameters such as negative peak, dP/dT on the initial break, the area enclosed by the profile in each stroke, which are associated with atrial pressures and the filling conditions of the ventricles. The measured atrial pressures were linearly related to the negative peak of the interventricular pressure.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.273-276
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• 1996

In the Total Artificial Heart (TAH) and Ventricular Assist Device (VAD), the size implanting the internal controller into human body is very serious problem. Hence, we need the size reduction of that controller for safe implantation. Using PSD302 chip for microcontroller-based applications, we could decrease the number of components in the digital control board and miniaturize the digital control board. We could replace a ROM, RAM, and a latch with that single chip, so the size of the newly developed board could be half the previous board.

• Journal of Biomedical Engineering Research
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• v.43 no.1
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• pp.45-51
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• 2022

The purpose of this study is to improve the classification accuracy compared to the existing InceptionV3 model by proposing a new model modified with the fully connected hierarchical structure of InceptionV3, which showed excellent performance in medical image classification. The data used for model training were trained after data augmentation on a total of 1026 chest X-ray images of patients diagnosed with normal heart and Cardiomegaly at Kyungpook National University Hospital. As a result of the experiment, the learning classification accuracy and loss of the InceptionV3 model were 99.57% and 1.42, and the accuracy and loss of the proposed model were 99.81% and 0.92. As a result of the classification performance evaluation for precision, recall, and F1 score of Inception V3, the precision of the normal heart was 78%, the recall rate was 100%, and the F1 score was 88. The classification accuracy for Cardiomegaly was 100%, the recall rate was 78%, and the F1 score was 88. On the other hand, in the case of the proposed model, the accuracy for a normal heart was 100%, the recall rate was 92%, and the F1 score was 96. The classification accuracy for Cardiomegaly was 95%, the recall rate was 100%, and the F1 score was 97. If the chest X-ray image for normal heart and Cardiomegaly can be classified using the model proposed based on the study results, better classification will be possible and the reliability of classification performance will gradually increase.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.25-32
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• 2015

Background: We evaluated operative outcomes after third or more cardiac operations for valvular heart disease, and analyzed whether pericardial coverage with artificial membrane is helpful for subsequent reoperation. Methods: From 2000 to 2012, 149 patients (male : female=70 : 79; mean age at operation, $57.0{\pm}11.3$ years) underwent their third to fifth operations for valvular heart disease. Early results were compared between patients who underwent their third operation (n=114) and those who underwent fourth or fifth operation (n=35). Outcomes were also compared between 71 patients who had their pericardium open during the previous operation and 27 patients who had artificial membrane coverage. Results: Intraoperative adverse events occurred in 22 patients (14.8%). Right atrium (n=6) and innominate vein (n=5) were most frequently injured. In-hospital mortality rate was 9.4%. Total cardiopulmonary bypass time ($225{\pm}77$ minutes vs. $287{\pm}134$ minutes, p=0.012) and the time required to prepare aortic cross clamp ($209{\pm}57$ minutes vs. $259{\pm}68$ minutes, p<0.001) increased as reoperations were repeated. However, intraoperative event rate (13.2% vs. 20.0%), in-hospital mortality (9.6% vs. 8.6%) and postoperative complications were not statistically different according to the number of previous operations. Pericardial closure using artificial membrane at previous operation was not beneficial in reducing intraoperative events (25.9% vs. 18.3%) and shortening operation time preparing aortic cross clamp ($248{\pm}64$ minutes vs. $225{\pm}59$ minutes) as compared to no-closure. Conclusion: Clinical outcomes of the third or more operations for valvular heart disease were acceptable in terms of intraoperative adverse events and in-hospital mortality rates. There were no differences in the incidence of intraoperative adverse events, early mortality and postoperative complications between third cardiac operation and fourth or more.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.277-280
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• 1996

We have developed a ground-isolation circuit in order to reduce the noise of the internal controller system for the total artificial heart(TAH) and ventricular assist device(VAD). Using the ground-isolation technique, we could transmit the analog target signal to other pheriperal device including IBM PC via RS232C and polygraph, with no noise. Experimental results of VAD showed that there was less impulsive noise in current signal which caused in our previous conventional system. Therefore it could be proved that implementation of isolation technique is very effective to improve the signal to noise ratios of analog signal transmission for TAH or VAD.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.05
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• pp.199-202
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• 1996

Artificial hearts are intended for use in patients with severe forms of heart disease for which no surgical repair is possible. The moving-actuator pump was developed to decrease the overall volume size of the electromechanical total artificial heart (TAH) by eliminating the occupied space of the fixed-actuator in the conventional pusher-plate type pump. In our pump, the actuator moves back and forth for alternative ejections of left and right ventricles. The problem of fitting the TAH to atrial remnants and arterial vessels could also be improved by circular or penduluous mot ion of the actuator instead of linear mot ion of the pusher-plate in the conventional pumps. We have evaluated two types of moving- actuator pump; one is a rolling cylinder type, and the other a pendulum type pump. In the rolling cylinder pump, frictional energy loss exists between the pump housing's guide bars and the actuator's end caps, while the bottom rack under the cylindrical actuator increases the height of the pump, the pump is therefor not implantable inside the small chest of human-sized animals with a body weight of less than 70kg. The new human type pump has a penduluous mot ion actuator to correct the above problems while maintaining the advantage of the moving- actuator's small total volume. The totally implantable TAH is composed of a blood pump, a control system and pheriperal equipments. The blood pump, which is constructed by a moving actuator, a right and left blood sac, and four artificial valves, is implanted in the thoracic. In 1988, the first implantation of the rolling cylinder TAH was performed into a female calf weighing 100kg, and the cal f recovered to the degree of voluntary standing and eat ing and survived to 100 hrs. We then survived two female sheep weighing about 63kg with the new human type TAH for three days.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.587-589
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• 1997

The virtual surgical trial of TAH is very important in some points as follows. The chests of patients who is under heart-disease are various types of undefine form. It is hard to say that there exist the standard shape of TAH and the position to surgern. So, the virtual surgery system is very important in realizing TAH surgery of human. We have implemented virtual surgery system of TAH that supporting multi volume fitting trial. We have acquired CT images of patients with DICOM format. Each organ of patients was segmented in 2-dimensional CT images. 3-dimensional objects were made with marching cube algorithm and save as file in VRML format. Virtual fitting trial was performed on Cosmo-World; a VRML editor. The collision points of TAH with other organs were well observed. And the best position and angles were determined and saved or each case. We believed that this virtual surgery will be helpful in TAH surgery and TAH customizing.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.281-288
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• 1979

For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.