• Title/Summary/Keyword: Mock surgery

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Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

  • Wooil Kim;Minje Lim;You Joung Jang;Hyun Jung Koo;Joon-Won Kang;Sung-Ho Jung;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1054-1065
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    • 2021
  • Objective: We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods: From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results: During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and -9.4 mL, and 6.0 mL and -3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion: Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.

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

  • Lee, H.S.;Oh, H.J.;Lee, S.H.;Kim, S.H.;Seo, P.W.;Park, S.S.;Rhee, K.H.;Ahn, H.;Hwang, S.O.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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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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Time-Varying Hemodynamic Characteristics Simulation using Computerized Mock Circulatory Loop System with Servo Flow Regulator

  • Moon, Youngjin;Son, Kuk Hui;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.36 no.6
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    • pp.264-270
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    • 2015
  • A mock circulatory loop system has been developed to construct a simulator for trainees in cardiopulmonary bypass systems or to simulate a test environment for cardiac-assist devices. This paper proposes a computerized mock circulatory loop system whose node is modularized by using a servo control flow regulator to simulate dynamic change of the hemodynamic status. To observe the effect of time-varying resistance, one with hemodynamic properties, the proposed system replicates the planned cross-sectional areas of the outlet of a ventricular assist device in terms of voltage input of a servo valve. The experiment is performed (1) for steady-input commands of selected area sizes and (2) for dynamic commands such as monotonous increase and decrease, and oscillatory functions of the voltage input, and a computer program based on LabVIEW (National Instruments, Austin, USA) processes every measured data and control command to the servo valve. The results show that the pressure and flow at the target points with respect to time-varying resistance match intuitive estimation: the pressure at the outlet and the pressure drop between both sides of the valve increased and the flow at the outlet decreased for increased resistance.

Hemodynamic study of Pneumatic Artificial Heart Implanted in Calves (송아지에 이식한 공기구동형 인공심장의 혈역학적 연구)

  • 박표원
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.438-451
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    • 1990
  • Pneumatic total artificial heart[TAH] has been clinically applied for the purpose of permanent or temporary use followed by cardiac transplantation in the patients with end stage heart diseases. In spite of the good durability of the pneumatic TAH, thrombus formation, bleeding and infection resulted in death. The Tomasu heart, which is a type of pneumatic TAH, was used in this study. This model is a modified Jarvik heart and consists of atrial cuffs, outflow vascular grafts and thin-layer seamless diaphragm type of ventricles. Cardiac outputs of the left artificial heart were measured by Donovan`s mock circulation under variable conditions of driving parameters, and an experimental artificial heart implantation was performed in 4 calves to observe the changes of hemodynamic parameters in early postoperative period and hematologic and bio-chemical changes in a long-term survival case. In the mock circulation test, cardiac output of the heart was increased with the increase of the left atrial pressure and left driving pressure. Maximum cardiac output was obtained at the heart rate of 120 to 130/min and percent systole of 40 to 45Zo under the condition of a constant left driving pressure of 180mmHg and left atrial pressure of 10mmHg. During the first 24 hours of TAH pumping, driving pressure ranged from 178$\pm$5mmHg to 187$\pm$8mmHg for the left heart and from 58$\pm$6mmHg to 78$\pm$28mmHg for the right heart. The Mean arterial pressure significantly increased between 2 and 8 hours after the start of pumping. The survival time ranged from 27 hours to 46 days. The causes of death were respiratory failure in 2 cases, mechanical valve failure in one, and left ventricular outflow obstruction due to thrombus in a 46-day survival case. This study demonstrated that Tomasu artificial heart operated effectively during the first 24 hours of artificial heart pumping, but thrombus formation around the valve holding area was the main problem in long-term survival case.

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Development and Evaluation of Pneumatic Ventricular Assist Device (공압식 심실보조장치의 개발 및 평가)

  • Lee, S.H.;Park, I.T.;Kim, S.H.;Han, D.S.;Lee, H.J.
    • Proceedings of the KOSOMBE Conference
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    • v.1995 no.05
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    • pp.247-250
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    • 1995
  • The purpose of this paper is to develop diaphragm-type pneumatic ventricular assist device(VAD) for clinical application and to evaluate its performance through the mock circulation system. The blood housing and diaphragm are made by coating pellethane on the metallic mold and the back plate is made by machining process. The relations of cardiac output(CO) vs. beat rate and CO vs. systolic-to-diastolic rate was estimated through the mock test and hemodynamic waves are recorded for the evaluation of VAD. As a result, the volume of blood pump is 70 ml, maximum CO is 5 L/min and CO has a close relation to the input resistance of blood pump. The hemodynamic data and waves showed this system can be applicable to the animal experiment.

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A study on the air detector using relative dielectric constant (비유전율을 이용한 공기감지장치에 관한 연구)

  • Lee, Hyuk-Soo;Kim, Cheong-Worl
    • Journal of Sensor Science and Technology
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    • v.16 no.5
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    • pp.384-388
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    • 2007
  • Air embolism can be a lethal complication of surgical procedures during which venous pressure at the site of surgery is sub-atmospheric or air is forced under pressure into a body cavity. To solve the problem, we developed the air detector using relative dielectric constant change, which is expected to be used broadly in industrial circles. We designed a detection circuit of sensing scheme. In experiments with a mock system, the proposed system showed a signal difference depending on the amount of air in the tygon tube of the mock system.

Development of Computer Assisted 3-D Simulation and Prediction Surgery in Craniofacial Distraction Osteogenesis (악안면 골신장술의 치료계획을 위한 3차원 시뮬레이션 프로토콜의 개발)

  • Paeng Jun-Young;Lee Jee-Ho;Lee Jong-Ho;Baek Seung-Hak;Kim Myung-Jin
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.91-105
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    • 2003
  • There are significant limitations in the precision of mandibular distraction in setting a desired occlusal and facial esthetic outcome. The purpose of this study is to present the simulation method for the distraction osteogenesis treatment planning. 3-D surgery simulation software programs V-works and V-Surgery(Cybermed, Seoul, Korea) were used from the 3D CT data in addition to the conventional data facial photography, panorama and cephalogram, dental cast model. We have utilized already for the various surgical procedures to get information preoperatively for the maxillofacial surgery like cancer localization and reconstructive surgery, orthognathic surgery and implant surgery in the department of Oral and Maxillofacial surgery, Seoul National University Hospital. On the software, bone cutting can be done at any place and any direction. Separated bone segment can be mobilized in all 3 dimensional direction. After the 3D simulation on the software program, mock surgery on the RP model can be performed. This planning method was applied to two hemifacial microsomia patients. With this protocol, we could simulate the movement of bony segment after maxillofacial distraction osteogenesis

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Valved Conduit with Glutaraldehyde-Fixed Bovine Pericardium Treated by Anticalcification Protocol

  • Lim, Hong-Gook;Kim, Gi Beom;Jeong, Saeromi;Kim, Yong Jin
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.333-343
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    • 2014
  • Background: A preclinical study was conducted for evaluating a valved conduit manufactured with a glutaraldehyde (GA)-fixed bovine pericardium treated using an anticalcification protocol. Methods: Bovine pericardia were decellularized, fixed with GA in an organic solvent, and detoxified. We prepared a valved conduit using these bovine pericardia and a specially designed mold. The valved conduit was placed under in vitro circulation by using a mock circulation model, and the durability under mechanical stress was evaluated for 2 months. The valved conduit was implanted into the right ventricular outflow tract of a goat, and the hemodynamic, radiologic, histopathologic, and biochemical results were obtained for 6 months after the implantation. Results: The in vitro mock circulation demonstrated that valve motion was good and that the valved conduit had good gross and microscopic findings. The evaluation of echocardiography and cardiac catheterization demonstrated the good hemodynamic status and function of the pulmonary xenograft valve 6 months after the implantation. According to specimen radiography and a histopathologic examination, the durability of the xenografts was well preserved without calcification at 6 months after the implantation. The calcium and inorganic phosphorus concentrations of the explanted xenografts were low at 6 months after the implantation. Conclusion: This study demonstrated that our synergistic employment of multiple anticalcification therapies has promising safety and efficacy in the future clinical study.

Air detector using the change of dielectric constant for medical applications (의료분야 응용을 위한 유전상수 변화를 이용한 공기감지 장치)

  • Kim, Kyung-Hwa;Shim, Joon-Hwan
    • Journal of Advanced Marine Engineering and Technology
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    • v.34 no.6
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    • pp.864-870
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    • 2010
  • Air embolism can be a lethal complication of surgical procedures during which venous pressure at the site of surgery is sub-atmospheric or air is forced under pressure into a body cavity. To solve the problem, we developed the air detector using relative dielectric constant change, which is expected to be used broadly in industrial circles. We designed air detection system with air control equipment, detection circuit and LabVIEW system for air sensing. In experiments with a mock system, the proposed system showed a signal difference depending on the amount of air in the Tygon tube of the mock system.