• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.167-176
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• 2022

Purpose: Driveline infection (DLI) is one of the major adverse events of Left Ventricular Assist Device (LVAD). The purpose of this study was to explore the incidence of DLI according to the driveline dressing methods. Methods: This study was a retrospective cohort study that investigated the medical records of 75 patients who implanted LVAD from January 2015 to December 2020 at a hospital in Seoul, Korea. Traditionally, sandwich dressing method was applied until October 2019, after which newly winded dressing method was adopted for driveline dressing to LVAD patients. The outcome variables were compared between sandwich dressing method applied group (n=41) and winded dressing method applied group (n=34). The follow-up period for DLI was 1 year. Results: When compared participants' characteristics, there was no difference between the two groups, except the type of LVAD device. The incidence of DLI was 17.1% in sandwich dressing group, while no infection was found in winded dressing group (p=.011). Conclusion: Although there were difference in the LVAD devices, it is considered that winded dressing contributed to the reduction of DLI. Further research on standardized dressing methods was required for DLI prevention in Korea.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.123-130
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• 2003

Background: In order to develop the acute heart failure model for the animal experiment of the pneumatic ventricular assist device, we decided to use young pig whose coronary artery distribution is almost the same as humans and also very cheap in price. The purpose of this study is to develop stable, reproducible acute ischemic heart failure model in swine using coronary artery ligation method. Material and Method: Five young pigs whose weights are the same as adult humans are under experiment. Each pig was under endotracheal intubation and connected to a mechanical ventilator. Through left lateral thoracotomy, we exposed the heart and induced ischemic heart failure by coronary artery ligation. The ligation began at the distal part of the left anterior descending coronary artery. After 5 minutes of initial ligation we reperfused the artery and then re-ligated. Before and after each ligation-reperfusion procedure we assessed the left ventricular end-diastolic pressure, arterial pressure, and cardiac index. We also measured left ventricular end-diastolic dimension, end-systolic dimension, fractional shortening, ejection fraction using intraoperative epicardial echocardiography. After appropriate heart failure was established with sequential (from distal part of LAD to proximal location) ligation-reperfusion-ligation procedure, we inserted the ventricular assist device and operated. Result: We established stable acute ischemic heart failure in 3 of 5 young pigs with this sequential ligation-reperfusion-ligation procedure, and could maintained 50% less ejection fraction before the procedure according to intraoperative epicardial echocardiography. We also observed no ventricular arrhythmia usually associated with simple coronary artery ligation in large animals and no cardiac arrest associated with ventricular arrhythmia or myocardial stunning. In pathologic specimen, we observed scattered ischemic myocardium in all around the ischemic field induced by coronary artery ligation. Conclusion: Under the concept of ischemic preconditioning, we developed safe and reproducible acute ischemic heart failure model in swine using sequential coronary artery ligation-reperfusion-ligation method.

• Journal of Biomedical Engineering Research
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• v.22 no.5
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• pp.449-458
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• 2001

This is a test report of system efficiency for the moving-actuator type Bi-ventricular assist device (AnyHear $t^{MT}$ ) Seoul National University). $AnyHeart^{TM}$), as an energy converter. utilities a brushless DC motor(S/M 566-26A. Sierracin/ Magnedyne, Carlsbad, CA. U.S.A.) generating their pendulous motion in the epicyclic gear train. It is necessary to know about the overall efficiency of the system. The system is subdivided into three parts: motor part, actuator part and blood sac part (including valves, etc.) according to system mechanism. The motor was operated with a variable range of torque. angular speed and width of voltage Pulse In this report. $AnyHeart^{TM}$ is focused on the efficiency of the motor and actuator parts. 4 $\ell/min$ pump output. which is normal condition of $AnyHeart^{TM}$ system, the total system efficiency is 8%, which is composed of 50%, 85% and 17% efficiency (motor Part, actuator Part and blood sac Part) respectively. In the analyzed result. applied input voltage on normal condition of $AnyHeart^{TM}$ is determined. Also speed Profile with considering filling state of blood sac is Provided. In the test of the in vitro mock circulation. some experimental results are Provided to demonstrate the effectiveness of the Presented approach.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.273-276
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• 1996

In the Total Artificial Heart (TAH) and Ventricular Assist Device (VAD), the size implanting the internal controller into human body is very serious problem. Hence, we need the size reduction of that controller for safe implantation. Using PSD302 chip for microcontroller-based applications, we could decrease the number of components in the digital control board and miniaturize the digital control board. We could replace a ROM, RAM, and a latch with that single chip, so the size of the newly developed board could be half the previous board.

• Proceedings of the Acoustical Society of Korea Conference
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• autumn
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• pp.131-134
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• 1999

This paper considers the acoustical characteristics of the mechanical valve employed in the Korean type Artificial Heart. $Bj\"{o}rk-Shiley$ tilting disc valve was chosen for the study and acoustic measurements were performed for the artificial heart operated in a mock circulation system as well as implanted to an animal as a Bi Ventricular Assist Device (BVAD). In the mock system, three different conditions of the valve were examined which were normal, damaged (torn off), pseudothrombus attached. Microphone measurements for the BVAD were carried out at a regular time interval for 5 days after the implantation operation. Of the recorded acoustic emissions from the artificial heart, click sounds mainly originated from the valves were further analyzed using Multiple Signal Classification (MUSIC) for estimating their spectral properties. It was shown that the spectral peaks below 4 kHz and the optimal order number for MUSIC, equivalent to the number of the spectral component, might be the key parameters which were highly correlated to the physiological states of the valve like the mechanical damage of the valve or the formation of thrombus on the valves.

• Journal of Biomedical Engineering Research
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• v.18 no.2
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• pp.147-156
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• 1997

Various prosthetic heart valves have been developed and used clinically, but they have problems, such as thrombogenecity, hemoltsis, high cost and low durability. New types of trileaflet polymer heart valves have been developed in order to use them as inlet and outlet valves in a ventricular assist device. The aim of this study is to determine the hydrodynamic effectiveness of the newly designed trileaflet polymer valves and their feasibility for temporary use in the blood pumps. Trileaflet polymer valves are made of polyurethane, because of its good blood compatibility, high tonsil strength and good resistance to fatigue. An in vitro experimental investigation was perf'ormed in order to ev91ua1e hydrodynamic performance of the trileaflet polymer valves having different design and fabrication tech- niques. The St. Jude Medical valve (SJMV) and floating-type monoleaflet polymer valve (MLPV) were also tested The pressure drop across the valve, leakage volume, and the flow patterns mere investigated for valves. The result of comparative tests showed that the trileaflet polymer valves had a better hydrodynamic performance than the others. TPV which has two stable membrane shape showed the lowest back flow. The pressure hops of TPVs were lower than that of MLPV, but slightly higher than SJMV. The hydrodynamic performance of valves under the pulastile flow showed the similar results as steady flow. The velocity profiles and turbulent intensities were measured at the distal sites of valves using a hot-film anemometer. Central flow was maintained in trileaflet polymer valves, and the maximum turbulent intensities were lower in TPVs comparing to MLPV.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1041-1048
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• 2007

Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

• Journal of Biomedical Engineering Research
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• v.3 no.1
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• pp.43-48
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• 1982

Ventricular assist device(VAD) has been clinically applied as a temporary circulatory sup- porting system in the patients with severe heart failure, but small sized VAD for infant is not available. The purpose of this paper is to introduce small sized VAD and presents the result of in vitro test. Sejong VAD is diaphragmatic type of pneumatic pump and stroke volume is 11cc. Cardiac outputs of the Sejong VAD were measured by overflow tank under variable conditions of driving parameters. The cardiac output was 1.3 1/min at the heart rate of 120 per minute, left atrial pressure of 15cmH2O, percent systole of 43%, driving pressure of 240 mmHg, vacuum pressure of -40 mmHg, and mean aortic pressure of 70 mmHg. No mechanical problem was developed during the continuous in vitro test for 3 months.

• Journal of the Korean Institute of Intelligent Systems
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• v.22 no.4
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• pp.500-506
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• 2012

A method to model left ventricular assist device (LVAD) and detect suction occurrence for safe LVAD operation is presented. An axial flow blood pump as a LVAD has been used to assist patient with heart problems. While an axial flow blood pump, a kind of a non-pulsatile pump, has relative advantages of small size and efficiency compared to pulsatile devices, it has a difficulty in determining a safe pump operating condition. It can show different pump operating statuses such as a normal status and a suction status whether suction occurs in left ventricle or not. A fuzzy subtractive clustering method is used to determine a model of the axial flow blood pump with this pump operating characteristic and the developed pump model can provide blood flow estimates before and after suction occurrence in left ventricle. Also, a fuzzy subtractive clustering method is utilized to develop a suction detection model which can identify whether suction occurs in left ventricle or not.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.357-362
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• 1997

In vivo testings of the monoleaflet polymer valve were performed in seven dogs to prove its blood biocompatibility. The monoleaflet polymer valve used in this study was developed for short-term usage n the ventricular assist device. The frame and leaflet of the polymer valve were made of polyurethane. The inter-aortic valved conduit were implanted in four dogs and the ventriculo-atrial valved conduit was implanted in one dog. The ventricular assist devices with polymer valve were implanted in two dogs. The longest survival was 20 days. Main causes of death were bleeding and infection. To examine the blood compatibility, each blood sample was collected and RBC, WBC, hematocrit, hemoglobin, platelet and lactic acid dehydrogenase were analyzed. These studies thus far demonstrated that, with further development, a reliable and inexpensive polymer valve will be used in the ventricular assist device as short term usage.