• Title/Summary/Keyword: Off-pump

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Graft Strategy for Coronary Artery Bypass Grafting in Patients with Severe Left Ventricular Dysfunction

  • Hong, Tae Hee;Ha, You Jin;Jeong, Dong Seop;Kim, Wook Sung;Lee, Young Tak
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.16-24
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    • 2019
  • Background: Optimal graft selection for coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) dysfunction remains debatable. We report an analysis of our experiences of isolated CABG in patients with severe LV dysfunction and the impact of graft strategy on long-term outcomes. Methods: We analyzed 209 patients with severe LV dysfunction (ejection fraction [EF] <30%) who underwent primary isolated CABG. Of these, 169 were revascularized with a bilateral internal thoracic arterial (ITA) graft (BITA group) and 40 were revascularized with a single ITA graft (SITA group). The mean follow-up duration was $22{\pm}32$ months. Results: There were 18 early deaths (8.6%). Overall survival at 5 years was 66.7%. The rate of freedom from cardiac-related death at 5 years was 74.1%, and was significantly higher in patients who underwent off-pump CABG (p=0.005) and in the BITA group (p=0.023). Multivariate analysis demonstrated that old age (hazard ratio [HR], 2.548; 95% confidence interval [CI], 1.134-5.762; p=0.024), off-pump CABG (HR, 0.245; 95% CI, 0.090-0.661; p=0.006), and BITA grafts (HR, 0.333; 95% CI, 0.146-0.757; p=0.009) were correlated with cardiac mortality. Conclusion: CABG in patients with severe LV dysfunction (EF <30%) showed reasonable long-term outcomes. The rate of freedom from cardiac-related death was significantly higher in patients who underwent off-pump CABG and in the BITA group. Off-pump BITA grafting strategies can be accepted as a viable primary option in patients with severe LV dysfunction if performed by an experienced surgeon.

Analysis on Cascade Cycle Heat Pump Application as Night Storage Heater (심야전력을 이용한 Cascade Heat Pump Cycle의 운전결과 분석)

  • JUNG, H.;HWANG, S.W.;LEE, C.H.
    • Journal of the Korean Society of Mechanical Technology
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    • v.13 no.1
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    • pp.113-118
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    • 2011
  • To analyze and verify the effect of replacing thermal storage heater by a cascade cycle heat pump using midnight electricity was installed and tested at a customer's house in Wonju, Korea. The electric night storage heater is consist of 30kW electric heater and 2,700 liters of thermal storage water tank to supply hot water for warming house floor. The power for electric heater was cut off and hot water was only generated by cascade cycle heat pump. Current thermal storage water tank was not eliminated and electric heater wiring was modified. Some operation logic of the heat pump was also modified for proper operation. The required capacity of the heat pump and hot water temperature for given warming condition were estimated. The estimated capacity of heat pump was about 19kW and estimated hot water temperature for proper heating was at least $75^{\circ}C$.

Design of SR Drive Using Passive Converter for Hydraulic Pump System (패시브 컨버터를 적용한 유압유니트용 SRM 제어기 설계)

  • Seok, Seung-Hun;Liang, Jianing;Lee, Dong-Hee;Ahn, Jin-Woo
    • Proceedings of the KIEE Conference
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    • 2009.07a
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    • pp.863_864
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    • 2009
  • Design and drive characteristics of SR drive for hydraulic pump system using passive converter is presented in this paper. In oder to get the high performance, a simple passive circuit is added in the front-end of a conventional asymmetric converter, which consists of three diodes and one capacitor. This passive converter has the high demagnetization voltage, to reduce the demagnetization time. Futhermore optimal turn-off angle for the proposed passive converter is proposed. According to motor speed and current, an optimal turn-off angle can be achieved by look-up table to reduce torque ripple. The characteristic of proposed hydraulic pump system using passive converter is verified by simulation and experimental results.

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Adrenal Crisis after Off-pump Coronary Artery Bypass Surgery (체외순환 없이 시행한 관상동맥 우회로 조성술 후 부신성 위기)

  • 최용선;류상완;홍성범;정명호;김상형;안병희
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.601-605
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    • 2004
  • Addisonian crisis, also commonly referred to as adrenal crisis, occurs when the cortisol produced by the adrenal gland is insufficient to meet the body's needs. Pituitary apoplexy usually occurs as hemorrhagic and ischemic necrosis in the presence of a pre-existing pituitary adenoma, and is a rare sequela of cardiovascular surgery. Most pituitary apoplexy that happens in cardiovascular surgery has been known to be related to harmful effects of the cardiopulmonary bypass. The case presented herein illustrates occult pituitary apoplexy that occurred after off-pump coronary artery bypass grafting. In this patient, . the initial signs of addisonian crisis was similar to those of septic shock, and were overlooked. However, once recognized, they were reduced dramatically with standard stress-dose cortisone.

Spinal Cord Infarction following Off-pump Coronary Artery Bypass Surgery (체외순환 없이 시행한 관동맥우회술 후 발생한 척추신경경색)

  • Jung Tae-Eun;Kwon Jin-Tae;Ahn Sang-Ho;Lee Dong-Hyup
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.553-555
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    • 2006
  • A 62-year-old woman with ischemic heart disease, hypertension and hypercholesterolemia had developed spinal cord infarction after off-pump coronary artery bypass (OPCAB). The incidence of postoperative neurological complications is well known to be less in OPCAB than that of conventional coronary bypass surgery. Furthermore, spinal cord infarction is an uncommon clinical event after coronary bypass surgery Here we report a case of spinal cord infarction following OPCAB, discuss possible mechanism of spinal cord infarction with relate literatures.

Off-pump Reoperative Coronary Artery Bypass by Thoracotomy and Laparotomy -A case report - (개흉술과 복부 절개술을 통한 심폐바이패스를 이용하지 않은 관상동맥 재수술 - 1예 보고 -)

  • Kim Jeong-Won;Hahm Shee-Young;Je Hyoung-Gon;Cho Won-Chul;Song Meong-Gun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.710-713
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    • 2006
  • The incidence of reoperative coronary artery bypass grafting (CABG) has increased because of the rise in the number of patients who have undergone initial CABG. In addition, recent technological advances have resulted in widespread application of off pump coronary artery bypass (OPCAB). We report a case of redo OPCAB through thoracotomy and small laparotomy in 76-year-old man with recurrent unstable angina.

A development off displacement pump performance evaluation method by using dimensionless parameter (무차원계수를 이용한 왕복펌프의 성능평가 방법 개발)

  • 조희근;윤진하;전종길;김경원;이인복
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2002.05a
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    • pp.731-734
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    • 2002
  • There have been no obvious design criteria of high efficient displacement pump using a dimensionless parameter which can represent many physical aspect of displacement pump could be very useful to estimate displacement pump performance. Many dimensionless analysis methods have been developed in fluid dynamics, machine design and so on. In this study a new dimensionless parameter is developed for estimate displacement pump performance and efficiency, until now to evaluate the performance of displacement pumps which are widely used in industry field, primarily experimental methods have been used. The dimensionless parameter contains many physical information about pump design. For example, they are the relation between flow rate and power, displacement operation displacement and size, inlet and outlet valve size. And the developed dimensionless functions are induced from numerical method.

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Performance Evaluation of Air Source Multi Heat Pump Floor Heating System in Apartment (공동주택 공기열 멀티 히트펌프의 바닥난방 성능 평가)

  • LEE, C.H.;Nah, H.S.;JUNG, H.;Kim, K.S.
    • Journal of the Korean Society of Mechanical Technology
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    • v.13 no.3
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    • pp.93-98
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    • 2011
  • To analyze and evaluate the performance of developing air to water multi heat pump, the heat pump was installed and tested at low energy house in Daejeon, korea. Heating capacity of heat pump is 16.5KW and cooling capacity is 14.0KW. Space heating/cooling, floor heating and hot water is available. The results performance evaluation of heat pump in lab test showed that the coefficient of performance (cop) was 3.75, and heating capacity was 16.0KW in ambient temperature $7^{\circ}C$. Also at ambient temperature $-15^{\circ}C$, the COP was 1.69. At a low energy house, floor heating is controled by a floor heating water temperature and a room temperature. The COP of heat pump is decreased with frequent on/off operation for controlling of floor heating water temperature.

Property Analysis for On/off Surge of High-Voltage Motor (고압모터의 개폐써지 특성 분석)

  • Lee, Eun-Chun;Shin, Gang-Wook;Hong, Sung-Taek
    • Proceedings of the KIEE Conference
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    • 2000.07a
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    • pp.422-424
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    • 2000
  • Whenever the large-capacitor and high-voltage pump motor is opened and closed, the power factor improvement condenser and the low-voltage equipment are often damaged by the sparking and the on-off power serge. In order to find the reason and resolve the problem, we have installed a transition wave recorder for obtaining the transient on-off power serge wave and a power disturbance analyzer for long-time monitoring. In this way we measured and analysed the condition of the high-voltage pump motor whenever it is opened and closed.

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