• Title/Summary/Keyword: 바이패스

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Clinical Application of M-number for Aortic Cannulas During Cardiopulmonary Bypass (심폐바이패스시 대동맥캐늘라에 대한 M-NUMBER의 임상 적용)

  • 김원곤;박성식
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.510-516
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    • 1996
  • Cardiopulmonary bypass cannulas are usually characterized by the French number. However this de- scription provides only the external diameter of the cannula, which gives no information about the press- ure-flow characteristics of the cannula itself. A standardized system to describe the pressure-flow characteristics of a given cannula has recently been proposed and has been termed the M-number It is reported that the pressure-flow characteristics of a particular cannula can be determined from a novo- gram or chart, if the experimentally derived M-number of the cannula is known. In this regard, we conducted an investigation to analyze correlation between experimentally and clinical y derived M-numbers using three different sizes of pediatric aortic cannulas in fifty cardiac patients on cardiopulmonary bypass. The clinical and experimental M-numbers showed a strong correlation. The clinical M-numbers were typically 0.)5 to 0.55 greater than the experimental M-numbers. The clinical M-numbers also showed an inverse relationship to the temperature change of the patient, most probably due to an increase in blood viscosity from hypothermia. This inverse clinical M-numbersltemperature re- lationship was more marked in higher M-number cannulas. The clinical data obtained in this study suggest that the experimentally derived M-numbers correlated strongly with the clinical performance of the cannula with the significant influence of the temperature.

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Preparation of KCl through Removal of Heavy Metals from Chlorine By-Pass Dust (염소 바이패스 더스트를 이용한 염화칼륨 제조 및 중금속 제거)

  • Yun, Youngmin;Yeom, Nari;Lee, Kabsoo;Eom, Seonhui;Lee, Yonghyun;Chu, Yongsik
    • Resources Recycling
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    • v.26 no.2
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    • pp.11-17
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    • 2017
  • Many problems are occurred by using industrial by-product and municipal solid waste in the cement manufacturing process. The main components of chlorine by-pass dust generated by the use of the wastes are $K^+$, $Cl^-$, and a slight amount of heavy metals is also contained. In terms of waste recycling, it is necessary to eliminate the heavy metals. Therefore, in this study, the experiments for the removal of heavy metals from KCl which was produced by chlorine by-pass dust were conducted. In order to find optimum conditions for the removal of heavy metals, we have controlled the amount of water and precipitator. The type and concentration of heavy metals in KCl were analyzed. The concentration of heavy metals decreased as amount of precipitator increased. The heavy metals such as Pb, Cd, and As were not detected in dust A and B, when the mixing ratios between dust A(B) and water were controlled to be 1:2 (1:2, 1:3.5) with the addition of 3% precipitator (NaOCl).

Intra-aortic Balloon Pump Therapy for Hemodynamic Instability during Off-pump Coronary Artery Bypass Surgery (심폐바이패스를 사용하지 않는 관상동맥우회술 중 발생한 혈역학적 불안정에 대한 대동맥내 풍선펌프 치료)

  • Jeong, Dong-Seop;Kim, Ki-Bong;Choi, Eun-Seok
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.704-709
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    • 2009
  • Background: We assessed the efficacy of intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery. Material and Method: We studied seven hundred ninety-six patients who underwent off-pump coronary artery bypass between January 2000 and December 2006. The patient were divided into group I (n=39), which received intraoperative intra-aortic balloon pump therapy, and group II (n=757), which did not receive intraoperative intra-aortic balloon pump therapy. Result: There were no differences in the operative mortalities (2.6%, 1/39 vs 0.8%, 6/757; p=0.195) and morbidities such as atrial fibrillation (p=0.691), stroke (p=0.908) and mediastinitis (p=0.781) between the 2 groups, although the ventilator support time, the length of the intensive care unit stay and the length of the hospital stay were longer in group I than in group II (p<0.05). Multivariate analysis failed to prove that group I was a high risk group for operative mortality (p=0.549). There were 3 intraoperative intra-aortic balloon pump-related complications in group I (7.9%). However, no longer complications occurred after 2003, when the surgeons began using a smaller sized 8 F catheter that was inserted using a sheathless technique. Conclusion: Intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery can be performed safely and it showed comparable clinical results to that of not using intraoperative intra-aortic balloon pump therapy.

Routine Off-pump Total Arterial Coronary Revascularization (심폐바이때스 없이 시행된 동맥 도관만를 이용한 관상동맥 완전 재관혈화)

  • Lee, Jae-Won;Park, Nam-Hee;Kang, Seong-Sik;Choo, Suk-Jung;Park, Seung-Jung;Park, Seung-Wook;Hong, Myeong-Ki;Song, Hyun;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.309-315
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    • 2003
  • Background: To avoid the adverse effects of cardiopulmonary bypass and to overcome late vein graft failure we routinely peformed off-pump total arterial coronary revascularization. Material and Method: From July 2000 to August 2001, 104 consecutive patients underwent first elective off-pump total arterial coronary revascularization. Both internal mammary, radial and gastroepiploic arteries were used. Sequential and composite grafts were used to achieve complete revascularization. Perioperative adverse events and postoperative angiograms were analyzed. Result: A total of 252 arterial conduits were used with an average of 2.47 grafts per patient. A total of 326 distal anastomosis were performed with a mean of 3.13 distal anastomosis per patient. Cross over to on-pump occurred in seven patients (6.7%). Of these 4 were due to unstable hemodynamics during lateral or posterior wall stabilization as a result of cardiomegaly and 3 were due to uncontrolled bleeding during dissection of diffusely dimunitive deeply placed intramyocardial coronary arteries. There were no opeartive deaths. Two cases of perioperative myocardial infarction and transient neurologic complications occurred, respectively. Of the 312 distal anastomoses, 308 (98.7%) were compatible with Fitz-Gibboll A or B patency grading. Conclusion: Off-pump total arterial coronary revascularization was technically feasible in most elective cases with satisfactory early results. However, on-pump coronary bypass surgery should be considered in difficult circumstances, such as cardiomegaly or unfavorable anatomy of the target coronary artery.