• Title/Summary/Keyword: Bypass valve

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Mitral Valve Replacement -Report of Five Cases- (승모판막 이식수술 -5예 보고-)

  • 송요준
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.189-200
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    • 1974
  • The mitral valve replacement with Beall prosthetic valve was performed on three patients, and double valve replacement. aortic and mitral valve, was performed in this department.1) The preoperative studies about the first case were compatible with mitral steno-insufficency.The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary hypass using hypothermic hemodilution technique. The total perfusion time was eighty minutes. Immediate postoperative course was smooth, but this patient was died of asphyxia due to tracheomalacia complicated after tracheostomy 3 months after operation. Autopsy on this patient revealed that no thrombus and no ball variance could be found, and endothelization on the valve cuff was satisfactory. 2) The preoperative studies on the second case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve under the cardiopulmonary bypass using hypothermic hemodilution technigue. The total perfusion time was 123 minutes. This patient was discharged in good condition and follow-up study after 16 months revealed the patient had enjoyed healthy life. 3) The preoperative studies about the third case were compatible with aortic insufficiency and mitral stenoinsufficiency. The diseased valves were replaced with type 2 sutureless Magovern aortic valve and the medium sized Beall mitral prosthesis under cardiopulmonary bypass using hypothermic hemodilution technIque and coronary artery perfusion. The total perfusion time was 155 minutes. This patient was discharged in good condition, but thromboembolism was developed 2 months after discharge. 4) The preoperative studies about the fourth case were compatible with mitral insufficiency. The diseased mitral valve was replaced with the medium sized Beall prosthetic valve. The total perfusion time was 132 minutes. The atrioventricular block developed just after operation but converted to normal sinus rhythmn on the third postperative day. The preoperative NYHA functional classification IV was converted to Class 1 or 11 at the time of discharge and this patient enjoyed healthy life. Attendum; The fifth case, nineteen years old male with mital insufficiency underwent Beall valve replacement and his course was uneventful 2 weeks after operation.

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Left-Side Surgical Approach to Mitral Valve in Dog Cadaver Study

  • Moon, Jeong-hyeon;Hwang, Byungmoon;Kim, Daesik;Jung, Sunjun;Ha, Yongsu;Lee, Kicahng;Kim, Namsoo;KIM, Min-su
    • Journal of Veterinary Clinics
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    • v.35 no.1
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    • pp.10-12
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    • 2018
  • Mitral regurgitation is the most frequent cause of cardiac disability and death in dogs. A wide range of medical and surgical treatments have been used for mitral regurgitation. Surgical treatments for complete correction of mitral regurgitation include valve repair and valve replacement, which have the advantages of eliminating or correcting the primary cause. Surgical treatments approach the mitral valve via right- or left-side thoracotomy. Aortic root exposure is needed for cardiopulmonary bypass. To compare right-side and left-side approaches, 10 dog cadavers were used in this study. Subsequently, the left-side surgical approach was used in vivo and in conjunction with cardiopulmonary bypass and cardioplegic arrest. Based on the results, and considering ease of access to the aortic root, valve incision site, and visualization of the surgical field, a left-side approach is recommended.

Aortic Valve Replacement for Aortic Stenosis and Concomitant Coronary Artery Bypass: Long-term Outcomes and Predictors of Mortality

  • Cho, Won-Chul;Yoo, Dong-Gon;Kim, Joon-Bum;Lee, Jae-Won;Choo, Suk-Jung;Jung, Sung-Ho;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.131-136
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    • 2011
  • Background: We evaluated the surgical results and predictors of long-term survival in patients who underwent coronary artery bypass grafting (CABG) at the time of an aortic valve replacement (AVR) due to aortic stenosis. Materials and Methods: Between January 1990 and December 2009, 183 consecutive patients underwent CABG and concomitant aortic valve replacement for aortic stenosis. The mean follow-up period was $59.8{\pm}3.3$ months and follow-up was possible in 98.3% of cases. Predictors of mortality were determined by Cox regression analysis. Results: There were 5 (2.7%) in-hospital deaths. Follow-up of the in-hospital survivors documented late survival rates of 91.5%, 74.8%, and 59.6% at 1, 5, and 10 postoperative years, respectively. Age (p<0.001), a glomerular filtration rate (GFR) less than 60 mL/min (p=0.006), and left ventricular (LV) mass (p<0.001) were significant predictors of mortality in the multivariate analysis. Conclusion: The surgical results and long-term survival of aortic valve replacement with concomitant CABG in patients with aortic stenosis and coronary artery disease were acceptable. Age, a GFR less than 60 mL/min, and LV mass were significant predictors of mortality.

Prolonged aortic cross clamping time of open heart surgery [200min.] (개심술시 장시간 대동맥 차단 [200 분]: 3례 보고)

  • Choe, Yeong-Ho;Jang, Jeong-Su;Lee, Jong-Guk
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.295-300
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    • 1983
  • Three cases of multiple cardiac valve replacement were done in March 1983 at the department of thoracic and cardiovascular surgery, Chosun University College of Medicine. The patients were moderately symptomatic in all cases, and belonged to the class II and III of the NYHA functional criteria. The diseased valved were replaced with Bjork--Shiley, Ionescu-shiley valve prosthesis under cardiopulmonary bypass using hemodilution technique. The kind of cardioplegic solution used in our institute were Young and GIKs solution with core surface cooling. The average cardiopulmonary bypass time was 251.6 minutes and the average aortic cross clamping time was 223 minutes for aortic and mitral valve replacement. There was no operative morality.

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Outcomes after Mechanical Aortic Valve Replacement in Children with Congenital Heart Disease

  • Joon Young Kim;Won Chul Cho;Dong-Hee Kim;Eun Seok Choi;Bo Sang Kwon;Tae-Jin Yun;Chun Soo Park
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.394-402
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    • 2023
  • Background: The optimal choice of valve substitute for aortic valve replacement (AVR) in pediatric patients remains a matter of debate. This study investigated the outcomes following AVR using mechanical prostheses in children. Methods: Forty-four patients younger than 15 years who underwent mechanical AVR from March 1990 through March 2023 were included. The outcomes of interest were death or transplantation, hemorrhagic or thromboembolic events, and reoperation after mechanical AVR. Adverse events included any death, transplant, aortic valve reoperation, and major thromboembolic or hemorrhagic event. Results: The median age and weight at AVR were 139 months and 32 kg, respectively. The median follow-up duration was 56 months. The most commonly used valve size was 21 mm (14 [31.8%]). There were 2 in-hospital deaths, 1 in-hospital transplant, and 1 late death. The overall survival rates at 1 and 10 years post-AVR were 92.9% and 90.0%, respectively. Aortic valve reoperation was required in 4 patients at a median of 70 months post-AVR. No major hemorrhagic or thromboembolic events occurred. The 5- and 10-year adverse event-free survival rates were 81.8% and 72.2%, respectively. In univariable analysis, younger age, longer cardiopulmonary bypass time, and smaller valve size were associated with adverse events. The cut-off values for age and prosthetic valve size to minimize the risk of adverse events were 71 months and 20 mm, respectively. Conclusion: Mechanical AVR could be performed safely in children. Younger age, longer cardiopulmonary bypass time and smaller valve size were associated with adverse events. Thromboembolic or hemorrhagic complications might rarely occur.

An Experimental Study on the Performance Characteristics of Hot-gas and Liquid Bypass Heat Pump Systems for Capacity Modulation (고온가스 및 액체 바이패스 적용 용량가변 히트펌프의 성능특성에 관한 실험적 연구)

  • Ahn, Jae Hwan;Joo, Youngju;Yoon, Won Jae;Kang, Hoon;Kim, Yongchan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.25 no.3
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    • pp.137-142
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    • 2013
  • A small air-conditioner or chiller for a constant temperature bath normally uses a constant speed compressor. The constant speed compressor is relatively inexpensive, but it uses on/off control for capacity modulation. The on/off control has several disadvantages, specifically energy loss and large temperature fluctuation. Continuous operation with a bypass system can be an alternative to on/off control, for capacity modulation. In this study, a heat pump system having a hot-gas bypass and a liquid bypass was adopted. The performance of the bypass-type heat pump was measured, by varying the bypass valve opening. The differences of the COP between the hot-gas bypass and the liquid bypass, in the cooling and heating operations, were within 2% and 1%, respectively. The liquid bypass showed a wider range of capacity control in the cooling operation but the hot-gas bypass showed a wider range of capacity control in the heating operation.

A study on the basic design of bypass valve using CAE technology (CAE 기반 바이패스 밸브 기본설계에 대한 연구)

  • Oh, Jae-Won;Min, Cheon-Hong;Cho, Su-Gil;Park, Sang-Hyun;Kang, Kwan-Gu;Kim, Seong-Soon;Hong, Sup;Kim, Hyung-Woo
    • Journal of Advanced Marine Engineering and Technology
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    • v.40 no.7
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    • pp.663-670
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    • 2016
  • This paper introduces the concept of the computer-aided engineering(CAE) design method for a bypass valve in a system that is used for the safe lifting of mineral resources in deep-seabed mining. Although the bypass valve has a simple mechanism, its design is very difficult because of various influencing factors. This equipment, which has a complex design process, should be developed by CAE-based design method. The method can perform the design, design verification, and virtual experiment at the same time. In this study, the CAE-based method for the design of the bypass valve has been developed using fluid dynamics, multi-body dynamics, and optimization method.

Pressure Measurement in Double Inlet Pulse Tube Refrigerator (이중 입구형 맥동관 냉동기에서의 압력 파형 측정)

  • 정제헌;남관우;정상권;정은수
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.16 no.4
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    • pp.390-396
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    • 2004
  • A double-inlet pulse tube refrigerator was fabricated as a U-shape with $\Phi$19.0 mm${\times}$125 mm regenerator packed by #200 stainless steel mesh and $\Phi$12.7 mm${\times}$125 mm pulse tube. A pressure sensor was installed at the inlet of the regenerator and a differential pressure sensor was installed across the bypass. Amplitude of the pulsating pressure was independent of the opening of the orifice and the bypass valves. Helium flow through the orifice and the bypass was calculated based on the measured pressure. Energy loss through the orifice and the bypass was evaluated with the measured pressure and the calculated helium flow rate. The energy loss, which is equivalent to the refrigeration capacity at the cold end of the ideal pulse tube refrigerator, was mainly generated through the orifice. It was proportional to the opening of the orifice valve, but the real refrigerator displayed the best performance at the optimized opening of the orifice valve. This optimized performance of the tested pulse tube refrigerator can be explained by additional refrigeration losses. As an example, the shuttle heat transfer loss of the pulse tube was calculated from the measured experimental data.

Aortic Valve Replacement and Concomitant Multi-Vessel Coronary Artery Bypass: The Impact of Using the Bilateral Internal Thoracic Arteries on Early and Late Clinical Outcomes

  • Muhyung Heo;Myoung Young Kim;Jun Ho Lee;Suryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.197-203
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    • 2023
  • Background: The survival benefit of coronary artery bypass grafting (CABG) using the bilateral internal thoracic arteries (BITA) is well known; however, the role of BITA in concomitant aortic valve replacement (AVR) and CABG has not been studied. Methods: We retrospectively reviewed patients who underwent concomitant AVR and CABG. Cases not using an internal thoracic artery and less than 2 bypass grafts were excluded. We enrolled 114 patients in this study. The mean follow-up duration was 61.5±43.5 months. Results: Forty patients (35.1%) underwent CABG with a single internal thoracic artery (SITA) and 74 patients (64.9%) underwent CABG with BITA. The preoperative clinical characteristics were not significantly different between the 2 groups, with the exception of a higher prevalence of atrial fibrillation in the SITA group. Postoperative mortality and morbidity were not significantly higher in the BITA group than in the SITA group. In the univariable analysis, the survival of the BITA group was similar to that of the SITA group (p=0.157). Multivariable analysis showed that only mean age was a predictor of death (p=0.042), but using BITA was not an independent predictor (p=0.094). In low-risk patients whose preoperative ejection fraction was >45%, the survival of the BITA group was significantly better than that of the SITA group (p=0.043). Conclusion: BITA use in concomitant AVR and CABG showed no difference in mortality compared to using SITA. Although its impact on long-term survival was inconclusive, BITA use can be considered for low-risk patients.