• 대한의용생체공학회:의공학회지
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• 제22권4호
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• pp.349-358
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• 2001

A novel electro-mechanical implantable ventricular assist system is developed as a bridge to transplantation or recovery for patients with end-stage heart failure. The developed system is composed of an implanted blood pump, an external monitoring system which stores data, and a wearable system including a portable external driver and a portable power supply system. The blood pump is designed to be implanted into the left upper abdominal space and provides blood flow from the left ventricular apex to the aorta. The pulsatile blood flow is generated by a double cylindrical cam. There was mo excessive heat emission from the blood pump into the temperature-controlled chamber in the heat test and no stagnated flow within the blood sac by the observation in the flow visualization test. Animal experiments were performed using sheep and calves. The maximum assist flow rate reached 7.85L/min in the animal experiment. The evaluation results showed that the developed system was feasible for the implantable ventricular assist system. The long-term in vitro durability test and mid-term in vivo experiments are in progress and mow the modified next model is under development.

• Journal of Chest Surgery
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• 제54권6호
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• pp.543-546
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• 2021

A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

• Journal of Chest Surgery
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• 제57권2호
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• pp.184-194
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• 2024

Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013). Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion: The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

• Journal of Yeungnam Medical Science
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• 제38권2호
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• pp.95-106
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• 2021

Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 추계학술대회
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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.

• Journal of Chest Surgery
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• 제35권7호
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• pp.548-552
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• 2002

한국형 인공심장(AnyHeart)은 single moving actuator mechanism을 이용한 일체형 및 이식형 양심실 박동펌프이다. 저자 등은 양심 부전증에 의한 말기 심장병 환자에서 구난의료 차원으로 시도된 한국형 인공심장 (AnyHeart) 이식 1례를 경험하였기에 그 결과를 보고한다.

• 대한의용생체공학회:의공학회지
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• 제18권4호
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• pp.429-438
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• 1997

기계식 판막은 매몰식 인공장기에 널리 사용돼 왔으며, 판막의 이상은 환자의 죽음으르 의미한다. 판막의 이상에 영향을 미치는 것은 많은 요소들이 있는데 대표적으로 기계적인 고장과 혈전현상이 있다. 그래서 비침습적으로 이것들을 발견하는 것이 필요하게 된 것이다. 이 논문의 목적은 스펙트럼의 해석과 인공신경망을 이용하여 혈전현상을 발견하는데 있다. 신호의 측정은 공압식 좌심실 보조장치에 장착한 기계식 판막으로부터 마이크로폰과 증폭기를 이용하였다. 디스크 위의 모의 혈전현상과 봉합링의 주위에 혈전현상, 20%, 40% 60%로 자라나는 혈전현상은 펠레세인과 실리콘을 이용하여 제작하였다. 기초 성능 평가를 위해 1KHz 정현파를 인가하여 시스템을 평가하였으며, 정상적인 판막과 5 종류의 혈전현상의 스펙트럼은 혈전현상의 정보를 지닌 개폐시 peak의 신호 파형에서 구하였다. 데이터의 정량적인 해석을 위해 7,000개의 입력 노드와 20개의 은닉층과 1개의 출력층으로 이루어진 인공신경망을 사용하였다. 결론적으로 훈련된 인공신경망을 사용한 결과 정상 판막과 비정상 판막을 판단하는데 90%의 판단능력을 보였다. 이상의 실험을 통해 판막의 이상유무를 신호의 스펙트럼 해석과 인공신경망을 통해 평가할수 있음을 알 수 있었다. 본 논문의 결과는 앞으로 인공장기를 몸속에 지니고 있는 환자에게서 장기의 상태를 지속적으로 감시할 수 있는 기술적 토대를 제공할 것이다.

• Journal of Chest Surgery
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• 제54권2호
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• pp.99-105
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• 2021

Background: The number of heart transplantations (HTx) is increasing annually. Due to advances in medical and surgical support, the outcomes of HTx are also improving. Extracorporeal circulatory life support (ECLS) provides patients with decompensated heart failure a chance to undergo HTx. A medical approach involving collaboration among experienced experts in different fields should improve the outcomes and prognosis of ECLS-bridged HTx. Methods: From December 2003 to December 2018, 1,465 patients received ECLS at Samsung Medical Center. We excluded patients who had not undergone HTx or underwent repeated transplantations. Patients younger than 18 years were excluded. We also excluded patients who received an implantable durable left ventricular assist device before HTx. In total, 91 patients were included in this study. A multidisciplinary team approach began in March 2013 at our hospital. We divided the patients into 2 groups depending on whether they were treated before or after implementation of the team approach. Results: The 30-day mortality rate was significantly higher in the pre-ECLS team group than in the post-ECLS team group (n=5, 18.5% vs. n=2, 3.1%; p=0.023). The 1-year survival rate was better in the post-ECLS team group than in the pre-ECLS team group (n=57, 89.1% vs. n=19, 70.4%; p=0.023). Conclusion: We found that implementing a multidisciplinary team approach improved the outcomes of ECLS-bridged HTx. Team-based care should be adapted at HTx centers that perform high-risk HTx.