• Title/Summary/Keyword: 맥동률

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Use of Intermittent Antegrade Warm Blood Cardioplegia in CABG (관상동맥 우회로조성술에서 간헐적 전방 온혈 심정지액의 이용)

  • 김정택;백완기;김영삼;윤용한;김혜숙;이춘수;임현경;김현태;김광호
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.828-833
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    • 2003
  • Background: It has been reported that the recently developed intermittent antegrade warm blood cardioplegia (IAWBC) has better myocardial protective effects during coronary artery bypass surgery than cold blood cardioplegia or continuos retrograde cold blood cardioplegia. The aim of this study is to evaluate the safety and usefulness of IAWBC by comparing it retrospectively with intermittent retrograde cold blood cardioplegia (lRCBC). Material and Method: From April 2001 to Feb. 2003, fifty seven patients who underwent isolated coronary surgery were divided into two groups (IAWBC vs. IRCBC). The two group had similar demographic and angiographic characteristics. There were no statistical differences in age, sex, Canadian Cardiovascular Society Functional Classification for angina, ejection fraction, and number of grafts. Result: Aortic cross clamping time and total pump time in IAWBC (99$\pm$23 and vs. 126$\pm$32 min) were shorter than those of IRCBC (118$\pm$32 min. and 185$\pm$48 min.)(p<0.05). The reperfusion time (13$\pm$7 min) in IAWBC was shorter than that of IRCBC (62$\pm$109 min.)(p<0.05). CKMB at 12 hours and 24 hours (16$\pm$15 and 9$\pm$13) in IAWBC was lower than that of IRCBC (33$\pm$47 and 17$\pm$26)(p<0.05). The awakening time in IAWBC (2$\pm$1 hour) was shorter than that of IRCBC (4$\pm$3)(p<0.05). The number of spontaneous heart beat recovery in IAWBC (85%) was more than that of IRCBC (35%)(p<0.05). The cardiac index after discontinuing cardio-pulmonary bypass was significantly elevated in the IAWBC group. The prevalence of perioperative myocardial infarction in IAWBC (4%) was lower than that of IRCBC group (20%)(p<0.05). Conclusion: Intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique for myocardial protection. It can also provide simpler and economic way than the retrograde cold cardioplegia by shortening of cardiopulmonary bypass time and avoiding retrograde cannulation for coronary sinus.

Early Result of Coronary Artery Bypass Surgery (관상동맥 우회술의 조기성적)

  • Park, Jae-Hyeong;Lee, Won-Yong;Kim, Eung-Jung;Hong, Gi-U
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.158-163
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    • 1997
  • From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years (range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction hi tory. Five patients had preoperative left ventricular ejection fraction of 40% or less, The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases.21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery,)1, radial artery; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).

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The quality improvement study on the crack of heat exchanger lubricating oil port in military aircraft (군용항공기 열교환기 윤활유 유입포트 균열개선 연구)

  • Park, Sung-Jae;Choi, Jae-Ho;Choi, Gil-Gyu;Lee, Dong-Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.4
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    • pp.164-172
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    • 2020
  • The fuel oil/heat exchanger installed in military aircraft is a device that cools the lubricant oil supplied to other devices, such as an AMAD, and a hydraulic pump using the low temperature of the fuel is cracked at the AMAD lubricant inlet port. If a crack in the heat exchanger occurs, the lubricant oil supplied to other equipment is not cooled. Therefore, the flight can no longer be performed. In this study, non-destructive inspection and microscopic examination of the fracture surface of the oil port were performed to analyze the crack tendency. The oil pipe connected to the oil port is a titanium pipe, which is fastened with over torque and has been identified as the leading cause of heat exchanger oil port cracks. In addition, it was verified as the main reason for cracking by finite element analysis. The material and diameter of the pipe were changed to improve this defect, and the applied torque was adjusted. In addition, the bending value of the pipe was adjusted to minimize the fatigue accumulation due to pulsating pressure. As a result, no cracks occurred on the heat exchanger via the ground test after the installation of an improved pipe under the same conditions.