• Title/Summary/Keyword: Cardiac Output

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Replacement of the Prosthetic Heart Valves -Clinical analysis of 12 cases- (인공심장판막의 재치환술)

  • 김덕실;전상훈
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.164-170
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    • 1996
  • From January 1986 to June 1993, 12 patients Aad required reoperation: 9 had undergone mitral and 3 aortic valve replacement. Five were male and 7 female, and ages ranged from 29 to 61 years. Replacement of the prosthetic heart valve was performed at a mean interval of 98 $\pm$ 1 months after the Hrst operation. In aortic valve replacement patients the mean interval was 115 $\pm$ 2 months and in mitral valve replacement patients 98 $\pm$ 4 months. Primary tissue failure was the most frequent reason of replacement (10 patients) followed by valve thrombosis (1 patient) and prophylactic replacement (1 patient) in order. The most pronounced pathology of the failed prosthetic heart valves seen in the primary tissue failure group was calcification, perforation, shrinkage and tearing of the cusps. There was one early operative death (8.3%) due to intractable low cardiac output and acute renal failure. Eleven early survivors had successful operative results and there was no late death.

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Design of a Mechanical Artificial Heart Valve Prosthesis Appliing Design Methodology (설계방법론을 이용한 기계식 인공심장판막의 설계)

  • 천길정;류형태
    • Journal of Biomedical Engineering Research
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    • v.19 no.3
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    • pp.291-296
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    • 1998
  • A new mechanical heart valve prosthesis has been designed appling systematic design methodology. The function of the heart valve was defined, and search for design variation has been carried out according to the functional structure, Optimal model among the various variations was determined in view of the design specificationn. Proto type valve was fabricated and test has been carried out using a mock circulation system. It has been observed that the pressure profile, cardiac output and behavior characteristics are generally satisfactory.

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A Study on the Algorithm and Design of Ambulatory Cardiac Output Monitoring System (휴대용 심박출량 모니터링 시스템의 설계와 알고리듬 연구)

  • Song, C.G.;Byun, Y.H.;Kim, K.S.;Kim, N.G.;Lee, M.H.
    • Proceedings of the KIEE Conference
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    • 2002.07d
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    • pp.2702-2703
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    • 2002
  • 본 연구에서는 종래의 심박출량 및 일회 심박동량 측정장치를 휴대용 시스템으로 구현하기 위한 회로 설계방법을 연구하였다. 휴대용 시스템의 설계를 위한 아날로그 부분은 인체 안전을 위한 아이솔레이션 증폭기, 변복조기, 0.1Hz 고역통과 필터 및 잡음제거 회로로 구성되며, 연속 심박출량 모니터링 및 연산을 위한 디지탈 부분은 TMS32030C를 이용한 회로로 구성이 된다. 또한 기존의 방법에서의 문제점을 개선하기 위해 연속 심박출량 연산을 위한 새로운 알고리듬을 제안하였다. 제안된 방법은 앙상블 평균시에 기존의 심전도 R피이크 점을 기준으로 하지 않고, 임피던스 신호의 dZ/dt 최대점을 이용하는 방법을 적용하였다. 제안한 심박출량 신호처리 알고리듬을 이용하여 측정된 임피던스 신호를 분석한 결과 최대 25.5 %까지 개선됨을 확인하였다.

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The effects of high $CO_2$ concentration on the cardiorespiratory function in the yellowtail and the flounder (방어 및 넙치의 심혈관 기능에 미치는 고이산화탄소의 영향)

  • Lee, Kyoung-Seon
    • Proceedings of KOSOMES biannual meeting
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    • 2007.05a
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    • pp.97-99
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    • 2007
  • 대기중 이산화탄소 농도상승을 억제하기 위하여 $CO_2$를 해양에 처리하는 방안이 제안되고 있으며 해양생태계 및 해양생물에 대한 생물학적 영향에 대한 검토가 신중하게 검토되어야 할 것으로 생각된다. 본 연구에서는 고농도의 이산화탄소 환경에서 천해어종인 방어 및 넙치의 심혈관계 반용을 비교 검토하였다. 5% $CO_2$ 환경에서 방어는 8시간 이내에, 넙치는 48 시간 이내에 100% 폐사하였으며, 넙치는 혈액 pH가 회복하였음에도 불구하고 폐사하는 경향이었다. 방어의 cardiac output (심박출량)은 stroke volume (박동량)의 변화에 의해서 영향을 받으며, 넙치는 heart rate (심박수)의 변화가 심박출량의 변화에 큰 영향을 끼치는 것으로 나타났다.

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A review of the total correction of tetralogy of Fallot (Fallot 4징증의 근치수술에 대한 임상적 고찰)

  • 채성수
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.337-341
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    • 1983
  • The experience with operative treatment for total correction of Tetralogy of Fallot at the department of Thoracic and Cardiovascular Surgery, Korea University Hospital from January, 1977, through April, 1983 was reviewed. Of the 29 patients reviewed, male to female occurrence ratio was 22:7 Type of V.S.D. was type II in 26 cases[90%] and total conus defect in 3 cases[10%]. Average size of V.S.D. was 19 mm. Type of Right ventricular outflow tract stenosis was highest frequency with pulmonary valvular and infundibular stenosis combined type in 21 cases[72%], and there were 8 deaths In this group. Type of R.V.O.T. reconstruction contains 2 cases of infundibulectomy only, 1 case of infundibulectomy with valvular commissurotomy, 2 cases of pericardial patch, 23 Cases of pericardial patch with Teflon or Dacron felt reinforced and 1 case of pulmonary valved conduit reconstruction. Operative mortality was higher in outflow patch through pulmonary valve ring. Overall mortality was 31%. Major causes of death and postoperative complications were low output syndrome, complete A-V block acute renal failure, ventricular fibrillation, bleeding brain abscess, and sudden cardiac arrest.

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Clinical Evaluation of Multiple Valve Replacement (심장다판치환술의 임상적 고찰)

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.160-166
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    • 2000
  • Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

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Antihypertensive Action of Clonidine Patch (Clonidine Patch제의 효능시험 : 혈압강하작용)

  • 정재훈;신찬영;류재련;박우일;고광호
    • Biomolecules & Therapeutics
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    • v.4 no.2
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    • pp.205-207
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    • 1996
  • Clonidine, an antihypertensive drug, stimulates postsynaptic alpha-2 adrenergic receptors in the central nervous system and lowers arterial pressure through the effects on both cardiac output and peripheral resistance. However, many patients experience that sedation and xerostomia occur upon oral administration of clonidine. These side effects are due to high plasma peak concentration and can be avoided when clonidine is given transdermally. In this study, we tested the antihypertensive effects of trandermal administration of clonidine patch on spontaneously hypertensive rat (SHR) which is a model animal for human essential hypertension. Forty eight SHR (male) were divided into six groups according to the dose levels, respectively. After transdermal administration of clonidine patch of each dose, systolic blood pressure and heart rate were measured. Clonidine patch produced maximal antihypertensive and bradycardiac effects 48 hrs after administration and antihypertensive effects showed dose-dependency. We suggest that antihypertensive effects of clonidine patch are similar to those of orally given clonidine and clonidine patch can be used instead of clonidine tablet.

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Skin Irritation Test of Clonidine Patch (Clonidine Patch에 피부자극성 시험)

  • 이영순;박우일;고광호
    • Biomolecules & Therapeutics
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    • v.4 no.2
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    • pp.202-204
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    • 1996
  • Clonidine, an antihypertensive drug, stimulates postsynaptic $\alpha_2$adrenergic receptors in the CNS and lowers arterial pressure by erects on both cardiac output and peripheral resistance. However, many patients experience that sedation and xerostomia occured upon oral administration of clonidine. These side effects are due to high plasma peak concentration and can be avoided when clonidine is given transdermally. In this study, we performed the skin irritation test for transdermal administration of clonidine patch on New Zealand white rabbits. Twelve New Zealand white rabbits were divided into two groups according to the dose levels, respectively. After transdermal administration of clonidine patch with two doses, clinical manifestations, body weight loss and postmortem findings were observed. We could not find any significant evidence of skin irritation by transdermal administration of clonidine patch.

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Emergency Pulmonary Artery-to-Systemic Artery Shunt to Break the Positive Feedback Loop of a Pulmonary Hypertensive Crisis after Neonatal Coarctation Repair

  • Shin, Yu Rim;Yang, Young Ho;Park, Young-Hwan;Park, Han Ki
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.232-235
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    • 2019
  • A 2.5-kg neonate with coarctation of the aorta and a small left ventricle experienced a severe pulmonary hypertensive crisis. An emergency pulmonary artery-to-systemic artery shunt was placed to break the positive feedback loop caused by pulmonary hypertension and functional mitral stenosis. This shunt provided immediate relief of suprasystemic pulmonary hypertension and the resultant low cardiac output.

Study on the Short-Term Hemodynamic Effects of Experimental Cardiomyoplasty in Heart Failure Model (심부전 모델에서 실험적 심근성형술의 단기 혈역학적 효과에 관한 연구)

  • Jeong, Yoon-Seop;Youm, Wook;Lee, Chang-Ha;Kim, Wook-Seong;Lee, Young-Tak;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.224-236
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    • 1999
  • Background: To evaluate the short-term effect of dynamic cardiomyoplasty on circulatory function and detect the related factors that can affect it, experimental cardiomyoplasties were performed under the state of normal cardiac function and heart failure. Material and Method: A total of 10 mongrel dogs weighing 20 to 30kg were divided arbitrarily into two groups. Five dogs of group A underwent cardiomyoplasty with latissimus dorsi(LD) muscle mobilization followed by a 2-week vascular delay and 6-week muscle training. Then, hemodynamic studies were conducted. In group B, doxorubicin was given to 5 dogs in an IV dose of 1 mg/kg once a week for 8 weeks to induce chronic heart failure, and simultaneous muscle training was given for preconditioning during this period. Then, cardiomyoplasties were performed and hemodynamic studies were conducted immediately after these cardiomyoplasties in group B. Result: In group A, under the state of normal cardiac function, only mean right atrial pressure significantly increased with the pacer-on(p<0.05) and the left ventricular hemodynamic parameters did not change significantly. However, with pacer-on in group B, cardiac output(CO), rate of left ventricular pressure development(dp/dt), stroke volume(SV), and left ventricular stroke work(SW) increased by 16.7${\pm}$7.2%, 9.3${\pm}$3.2%, 16.8${\pm}$8.6%, and 23.1${\pm}$9.7%, respectively, whereas left ventricular end-diastole pressure(LVEDP) and mean pulmonary capillary wedge pressure(mPCWP) decreased by 32.1${\pm}$4.6% and 17.7${\pm}$9.1%, respectively(p<0.05). In group A, imipramine was infused at the rate of 7.5mg/kg/hour for 34${\pm}$2.6 minutes to induce acute heart failure, which resulted in the reduction of cardiac output by 17.5${\pm}$2.7%, systolic left ventricular pressure by 15.8${\pm}$2.5% and the elevation of left ventricular end-diastole pressure by 54.3${\pm}$15.2%(p<0.05). With pacer-on under this state of acute heart failu e, CO, dp/dt, SV, and SW increased by 4.5${\pm}$1.8% and 3.1${\pm}$1.1%, 5.7${\pm}$3.6%, and 6.9${\pm}$4.4%, respectively, whereas LVEDP decreased by 11.7${\pm}$4.7%(p<0.05). Comparing CO, dp/dt, SV, SW and LVEDP that changed significantly with pacer-on, both under the state of acute and chronic heart failure, augmentation widths of these left ventricular hemodynamic parameters were significantly larger under the state of chronic heart failure(group B) than acute heart failure(group A)(p<0.05). On gross inspection, variable degrees of adhesion and inflammation were present in all 5 dogs of group A, including 2 dogs that showed no muscle contraction. No adhesion and inflammation were, however, present in all 5 dogs of group B, which showed vivid muscle contractions. Considering these differences in gross findings along with the following premise that the acute heart failure state was not statistically different from the chronic one in terms of left ventricular parameters(p>0.05), the larger augmentation effect seen in group B is presumed to be mainly attributed to the viability and contractility of the LD muscle. Conclusion: These results indicate that the positive circulatory augmentation effect of cardiomyoplasty is apparent only under the state of heart failure and the preservation of muscle contractility is important to maximize this effect.

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