• 제목/요약/키워드: Cardiac Output

검색결과 424건 처리시간 0.053초

만성 교약성 심낭염의 임상적 고찰 (A study of Chronic Constrictive Pericarditis)

  • 하종곤
    • Journal of Chest Surgery
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    • 제23권4호
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    • pp.676-682
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    • 1990
  • From August, 1978, to August, 1989, 22 patients underwent pericardiectomy for chronic constrictive pericarditis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 14 male and 6 female patients ranging from 11 years to 70 years old[mean age, 44. 1 years]. All patients underwent radical pericardiectomy through a median sternotomy. There was 1 postoperative death[4.s%]. This patient died of low cardiac output 7 days after pericardiectomy. Postoperative complications were hemothorax[2 patients], low cardiac output[2 patients], generalized seizure[1 patient], wound infection[1 patient] and pneumonia[1 patient]. Clinical and pathological findings showed tuberculous origin in 12 patients[54.6%], unknown etiology in 8 patients[36.4%] pyogenic pericarditis in 2 patients[9.1%]. Three hemodynamic responses to pericardiectomy were observed: [1] rapid response, where central venous pressure[CUP] fell below 10 cmH2O by 24 hours in 6 patients; [2] delayed response. Where CVP fell below 10 cmH2O by 48 hours in 12 patients; and [3] no response of CVP in 4 patients. Follow-up ranged from 6 to 62 months with an average of 35.3 months. Postoperative Functional Class was obtained for 21 surviving patients and showed 18 patients[81.8%] to be New York Heart Association functional class I or II.

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인공심장용 폴리머 밸브의 역류 특성 분석 (A study on the performance of the polymer valve in Total Artificial Heart)

  • 이정주;최종훈;이정훈;이서우;엄경식;안재목;민병구
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1998년도 추계학술대회
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    • pp.241-242
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    • 1998
  • For the aritificial heart valve, two types of valves-polymer and mechanical valve- are generally used. The polymer valve is used as a new low-cost artificial valve. Among the several properties of the artificial valve, the low-regurgitation property is important because it can provide better cardiac output characteristic. So in this study we analyzed and compared the regurgitation property of the mechanical valve which is generally used nowdays and the polymer valve which was made in our group. As results, the polymer valve showed the better regurgitation property compared to the mechanical valve approximately by 3 times, and increased the cardiac output by 10%.

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동물실험을 통한 공압식 좌심실보조장치의 평가 (Evaluation of Pneumatic Left Ventricular Assist Device for Animal Experiment)

  • 이혁수;오혜정;이상훈;김삼현;서필원;박성식;이계한;안혁;황승옥
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1998년도 추계학술대회
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    • pp.235-236
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    • 1998
  • The purpose of this paper is to develop diaphragm type pneumatic Left Ventricular Assist Device(LVAD) for clinical application and to evaluate its performance through the mock circulation and animal experiment. The blood housing and diaphragm are made by polyurethane. The relations of cardiac output us. beat rate and cardiac output vs. systolic-to-diastolic rate was estimated through the mock test and hemodynamic waves are recorded for the evaluation of VAD. We performed animal experiment and 4 animals survived more than 24hrs. As a result, the hemodynamic data and waves showed this system can be applicable to the animal experiment.

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In vitro Estimation of Cardiac Output for the TAH using an Adaptive Fuzzy Identifier

  • Choi, W.W.;Jo, Y.H.;Ahn, J.M.;Park, S.K.;Choi, J.S.;Om, K.S.;Lee, J.J.;Choi, J.H.;Kim, H.C.;Min, B.G.
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 추계학술대회
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    • pp.263-267
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    • 1996
  • An estimation algorithm based on training of fuzzy logic system using back-propagation is proposed, in this paper, for determining cardiac output in the TAH. The proposed estimation utilizes only a motor current waveform generated from the moving actuator of the electromechanical TAH without using any extra transducers as an information source for estimation. In in vitro tests, the resultant estimation performance was acceptable to alppy the proposed algorithm to animal experiments and further clinical applications.

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개심수술후 심장부정맥에 대한 임상적 연구: 원인,빈도 및 치료 (Postoperative Arrhythmia after Open Heart Surgery - Cause, Incidence and It`s Management -)

  • 장병철
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.843-852
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    • 1991
  • We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

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유아기의 개심술14례 보고 (Open Heart Surgery During The First 12 Months Of Life)

  • 안혁;서경필
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.381-387
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    • 1981
  • Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

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Ebstein`s 심기형의 개심수술 8예 (Open Heart Correction Of Ebstein`S Anomaly: A Report Of 8 Cases)

  • 김삼현
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.388-398
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    • 1981
  • Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

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Evaluation of Cardiac Function Analysis System Using Magnetic Resonance Images

  • Tae, Ki-Sik;Suh, Tae-Suk;Choe, Bo-Young;Lee, Hyoung-Koo;Shinn, Kyung-Sub;Jung, Seung-Eun;Lee, Jae-Moon
    • 한국의학물리학회지:의학물리
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    • 제10권3호
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    • pp.159-168
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    • 1999
  • Cardiac disease is one of the leading causes of death in Korea. In quantitative analysis of cardiac function and morphological information by three-dimensional reconstruction of magnetic resonance images, left ventricle provides an important role functionally and physiologically. However, existing procedures mostly rely on the extensive human interaction and are seldom evaluated on clinical applications. In this study, we developed a system which could perform automatic extraction of enpicardial and endocardial contour and analysis of cardiac function to evaluate reliability and stability of each system comparing with the result of ARGUS system offered 1.5T Siemens MRI system and manual method performed by clinicians. For various aspects, we investigated reliability of each system by compared with left ventricular contour, end-diastolic volume (EDV), end-systolic volume (ESV), stock volume (SV), ejection fraction (EF), cardiac output (CO) and wall thickness (WT). When comparing with manual method, extracted results of developed process using minimum error threshold (MET) method that automatically extracts contour from cardiac MR images and ARGUS system were demonstrated as successful rate 90% of the contour extraction. When calculating cardiac function parameters using MET and comparing with using correlation coefficients analysis method, the process extracts endocardial and epicardial contour using MET, values from automatic and ARGUS method agreed with manual values within :t 3% average error. It was successfully demonstrated that automatic method using threshold technique could provide high potential for assessing of each parameters with relatively high reliability compared with manual method. In this study, the method developed in this study could reduce processing time compared with ARGUS and manual method due to a simple threshold technique. This method is useful for diagnosis of cardiac disease, simulating physiological function and amount of blood flow of left ventricle. In addition, this method could be valuable in developing automatic systems in order to apply to other deformable image models.

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Ginseng total saponin attenuates myocardial injury via anti-oxidative and anti-inflammatory properties

  • Aravinthan, Adithan;Kim, Jong Han;Antonisamy, Paulrayer;Kang, Chang-Won;Choi, Jonghee;Kim, Nam Soo;Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • 제39권3호
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    • pp.206-212
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    • 2015
  • Background: Ginseng total saponin (GTS) contains various ginsenosides. These ginsenosides are widely used for treating cardiovascular diseases in Asian communities. The aim of this study was to study the effects of GTS on cardiac injury after global ischemia and reperfusion (I/R) in isolated guinea pig hearts. Methods: Animals were subjected to normothermic ischemia for 60 minutes, followed by 120 minutes of reperfusion. GTS significantly increased aortic flow, coronary flow, and cardiac output. Moreover, GTS significantly increased left ventricular systolic pressure and the maximal rate of contraction ($+dP/dt_{max}$) and relaxation ($-dP/dt_{max}$). In addition, GTS has been shown to ameliorate electrocardiographic changes such as the QRS complex, QT interval, and RR interval. Results: GTS significantly suppressed the biochemical parameters (i.e., lactate dehydrogenase, creatine kinase-MB fraction, and cardiac troponin I levels) and normalized the oxidative stress markers (i.e., malondialdehyde, glutathione, and nitrite). In addition, GTS also markedly inhibits the expression of interleukin-$1{\beta}$ (IL-$1{\beta}$), IL-6, and nuclear factor-${\kappa}B$, and improves the expression of IL-10 in cardiac tissue. Conclusion: These data indicate that GTS mitigates myocardial damage by modulating the biochemical and oxidative stress related to cardiac I/R injury.

심장판막 질환 성형술에 대한 임상적 고찰 (Reconstructive Procedures Combined with or Without Prosthetic Valve Replacement for Cardiac Valvular Lesions)

  • 김윤;조범구;홍승록
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.207-214
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    • 1976
  • Operations for cardiac valvular disease has been progressed in various ways. Since 1949 when Lord Russel operated mitral stenosis by closed technique at Johns Hopkins Hospital then much progress has been achieved and that nowadays severely diseased cardiac valve has been replaced by prosthetic valve, which is almost ideal in hemodynamic aspect, but still it has many problems such as thromboembolism, destruction of red blood cell, pressure gradient, and disturbance of left ventricular function, so in case of delicate situations, valve replacement should be decided carefully. Besides prosthetic valve, there are some kinds of reconstructive procedures and these have been resulted in better prognosis than prosthetic valve replacement in selected cases. So, authors have reviewed 61 Cases of cardiac patients who have been operated reconstructive valvular surgery by cardiopulmonary bypass, at Yonsei University, from Jan. 1963 to Mar. 1976. Out of 61 cases, 9 patients were replaced by prosthetic valve and rest of the patients were operated upon in various reconstructive procedures such as commissurotomy, valvotomy, valvuloplasty, and annuloplasty. Twenty cases of congenital heart diseases with valvular lesion, which had been operated for valvular lesion were also included in this statistics. Out of 9 cases of prosthetic valvular replacement five cases of prosthetic valvular replacement was done combined with other reconstructive procedures after attempted valvuloplasty. Comparative prognosis of both procedures are somewhat variable by reporters, average 19% of mortality after reconstructive surgery and 38% of mortality after prosthetic valve replacement in long term results. Most common cause of death in postoperative period was low output syndrome in both cases. It seems that good preoperative evaluation and proper reconstructive surgery will afford good prognosis in selected cardiac valvular diseased patient.

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