• Title/Summary/Keyword: bypass flow

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Budd-Chiari Syndrome Resulting from a Membranous Obstruction of the Inferior Vena Cava -8 Case Report- (하공정맥 막성폐쇄에 의한 Budd-Chiari증후군의 치료)

  • Kim, Dong-Won;Kim, Jun-U;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.268-273
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    • 1995
  • Budd- chiari syndrome resulting from a membranous obstruction of the inferior vena cava[IVC is a rare congenital anomaly. From January 1989 to December 1993, 8 cases of IVC obstruction was treated in Kyung Hee Univ. Hospital. There were 2 male and 6 female patients between 34 and 66 years of age[mean 47.3$\pm$11.9 years of age . 4 patients were treated with angioplasty by balloon catheter and 4 patients were treated with operative correction using cardiopulmonary bypass, profound hypothermia and total circulatory arrest. These 4 patients were repaired the constricted IVC with autologous pericardial patch. In surgically treated patients, all of the specimens were confirmed to be membranous web histopathologically. Postoperative outcome in operative correcting patients was uneventful and postoperative angiography showed unobstructed flow through the IVC with filling of the hepatic veins.The above 8 patients were followed up from 10 months to 56 months [ mean 36.43 17.24 months and recurrent IVC obstruction or stenosis was not seen.

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Bidirectional Cavopulmonary Shunt Operations as Palliation or Pre-Fontan Stage Operation - Early Results - (고식적 목적 혹은 Fontan 수술 전단계로서 시행한 양방향성 상공정맥 폐동맥 단락술의 조기 임상 결과)

  • 한재진
    • Journal of Chest Surgery
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    • v.25 no.4
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    • pp.406-411
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    • 1992
  • Thirty-four patients were received bidirectional cavopulmonary shunt[BCPS] from Aug. 1989 to Apr. 1991 at Sejong General Hospital, Puchon, Korea. Their ages were from 43 days to 21 years old with 19 cases of infant, 10 from 1 to 5 years old and 5 cases above 6 years old. Their diagnoses were as follows: 13 cases with uni-ventricular heart, 9 tricuspid atresia, 6 double outlet of right ventricle, 4 pulmonary atresia with intact ventricular septum, and 2 transposition of great arteries with pulmonary stenosis. Among them, 10 patients had received other palliative operations before. The BCPS operations were performed under the cardiopulmonary bypass and 10 patients who had bilateral superior vena cava received bilateral BCPS. Other associated procedures were 9 cases of takedown of Blalock-Taussig shunt, 3 pulmonary artery angioplasty, 1 unifocalization, 1 repair of total anomalous pulmonary venous return, 1 Damus procedure, 1 relief of sub-aortic stenosis, 1 right ventricular outflow tract reconstruction and one case of tricuspid valve obliteration. There were 3 operative deaths[8.8%] and two late deaths. The remainders show good postoperative state and their oxygen saturation was increased significantly. Conclusively, the bidirectional cavopulmonary shunt is very effective and safe palliative or pre-Fontan stage operation for the many complex congenital anomalies with low pulmonary blood flow especially for the patients who have the risk of Fontan repair.

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A Clinical Study of Bidirectional Cavopulmonary Shunt (양방향성 상대정맥-폐동맥 단락술의 임상적 연구)

  • 지현근
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.759-765
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    • 1995
  • We reviewed our experiences on 33 patients who underwent a bidirectional cavopulmonary shunt[BCPS from February 1992 to July 1994. There were 19 male an 14 female patients, and their weight ranged from 4.4 to 13.3 Kg[mean weight 8.4 $\pm$2.9 Kg . The age ranged from 2 to 55 months [mean age 16.7 $\pm$15.5 months . Their diagnosis included single ventricle group in 16, unbalanced ventricles in 8 whose associated anomalies were double outlet right ventricle, transposition of great arteries and total anomalous pulmonary venous return, tricuspid atresia in 7, hypoplastic left heart syndrome in 1 who underwent a Norwood procedure and double outlet right ventricle with pulmonic stenosis and tricuspid stenosis in 1 who underwent biventricular repair. Among them 10 patients had received other palliative operation before [Norwood procedure 1, pulmonary artery banding 3, modified Blalock-Taussig shunt 6 . The BCPS operations were performed under the cardiopulmonary bypass. 16 patients underwent unilateral BCPS and 17 patients who had bilateral SVC underwent bilateral BCPS. Three patients whose associated anomalies were interruption of IVC underwent total cavopulmonary shunt. There were 5 operative deaths [mortality rate 15.1 % and 2 late deaths. The risk factor for the operation was high mean pulmonary artery pressure [p value<0.05 . The survivors showed good postoperative course and their postoperative oxygen saturation was increased significantly compared to that of preoperative status[p value<0.05 .Conclusively, BCPS operation is effective and safe palliative procedure for the many cyanotic complex congenital anomalies with decreased pulmonary blood flow especialy for the patients who have the high risk factors for Fontan operations.

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Use of Intraluminal Sutureless Graft in the Surgical Treatment of Dissecting Aneurysm(Debakey type III) of the Thoracic Aorta (무봉합 혈관내 인조혈관을 사용한 박리성 하행흉부대동맥류의 치료 -2례 보고-)

  • 홍순필
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.862-867
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    • 1994
  • We experienced two cases of dissecting aneurysm[DeBakey type III] of the thoracic aorta treated using intraluminal sutureless graft. Controversy still exists about the exact timing of surgical intervention for dissection of the descending thoracic aorta. The surgical indication of dissecting aneurysm[DeBakey type III] is continuous flow in the false lumen, continuous chest pain, compromise of arterial supply to a specific organ or limb, or extension of the dissection while the patient is receiving satisfactory medical treatment. Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with a intraluminal sutureless graft that requires no end-to-end anastomosis has been developed. In our cases, cardiopulmonary bypass and circulatory arrest was utilized in repairing dissecting aneurysm of descending aorta[DeBakey type III] in order to avoid the aortic cross clamping because of friable aortic intima. The basic technique consists of vertical incision of descending aorta in the area of intimal tear and inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. Postoperative course was uneventful.

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Myocardial Revascularization in Two Patients Associated with Antiphospholipid Syndrome: Different Pathogenic Patterns and Angiographic Results

  • Park, Samina;Hwang, Ho-Young;Kang, Hyun-Jae;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.44 no.6
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    • pp.423-426
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    • 2011
  • We report on two women who underwent myocardial revascularization associated with antiphospholipid syndrome (APS) with different pathogenic patterns. The first woman presented with acute myocardial infarction, and preoperative angiograms demonstrated rapidly progressing coronary lesions, presumptive unstable plaque, and dissection. Operative findings, however, showed fresh thrombi in the coronary arteries, and she was diagnosed postoperatively as having APS. Her one-year angiogram demonstrated improved coronary lesions and a competitive flow pattern in the grafts. The second woman presented with unstable angina and had been treated for systemic lupus erythematosus and secondary APS for more than 14 years. She underwent myocardial revascularization due to accelerated coronary atherosclerosis. Her one-year angiogram demonstrated patent grafts.

Deep Vein as a Graft Conduit (도관으로 사용된 심부정맥)

  • Yie, Kil-Soo;Cheon, Sung-Bin;Oh, Won-Sub;Ryu, Se-Min;Lee, Bong-Ki;Kim, Hyung-Rae;Kim, Keun-Woo
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.441-446
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    • 2010
  • The ideal graft requires acceptable size, less tissue toxicity, resistance to infection, and long-term durability. Great saphenous veins are gaining popularity as acceptable graft conduits, but they require time to grow in caliber. We report 2 cases of graft bypass and reconstruction using superficial femoral veins to acheive immediate high-flow patency.

Optimization of Middle Pressure and Bypass Mass Flow Rate in Cryogenic Refrigeration Cascade Cycle (초저온 케스케이드 냉동사이클의 중간압력 및 바이패스 유량 최적화)

  • Oh, S.T.;Choi, W.J.;Lee, H.S.;Yoon, J.I.;Yoo, S.I.;Choi, K.H.;Lee, S.G.
    • Journal of Power System Engineering
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    • v.14 no.2
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    • pp.28-33
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    • 2010
  • In this research, cascade liquefaction process was simulated using two-staged direct expansion with inter-cooler. Evaporated gaseous refrigerant which has low pressure and temperature from the inter-cooler is mixed with gaseous refrigerant from outlet of 1st compressor, and flows into 2nd compressor. Therefore this prevents superheating compression. Compressor work of process which includes inter-cooler to all cycles shows the lowest value of 338.68 MW and it is lower 16.34% than that of basic process. Refrigeration capacity shows decreasing tendency as applied inter-cooler and that of process which includes inter-cooler to all cycles shows the lowest value of 449 MW. COP was increased when the inter-cooler was applied, and process which includes inter-cooler to all cycles shows highest value of 1.33. It shows that COP was increased because decrement of compressor work by applying inter-cooler was higher than decrement of refrigeration capacity.

Coronary three vessel disease: hydrodynamic simulations including the time-dependence of the microvascular resistances

  • Harmouche, Majid;Anselmi, Amedeo;Maasrani, Mahmoud;Mariano, Chiara;Corbineau, Herve;Verhoye, Jean-Philippe;Drochon, Agnes
    • Advances in biomechanics and applications
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    • v.1 no.4
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    • pp.279-292
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    • 2014
  • This paper presents some simulations of fluxes and pressures in the coronary network, in the case of very severe coronary disease (several stenoses on the left branches and total occlusion of the right coronary artery). In that case, coronary artery bypass graft surgery is the commonly performed procedure. However, the success of the intervention depends on many factors. Modeling of the coronary circulation is thus important since it can help to understand the influence of all these factors on the coronary haemodynamics. We previously developed an analog electrical model that includes the eventual presence of collateral flows, and can describe the different revascularization strategies (two grafts, three grafts, ...). The aim of the present work is to introduce in our simulations the time-dependence of the coronary microvascular resistances, in order to better represent the effect of the systolic ventricular contraction (which induces an elevation of the resistances because the vessels are squeezed).

Axial Thrust Control of High-speed Centrifugal Pump with Cavity Vanes (캐비티 베인이 있는 고속 원심펌프의 축추력 제어)

  • Kim, Dae-Jin;Choi, Chang-Ho;Noh, Jun-Gu;Kim, Jinhan
    • The KSFM Journal of Fluid Machinery
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    • v.15 no.6
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    • pp.46-50
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    • 2012
  • A high-speed centrifugal pump requires more attention to the control of its axial thrust due to the high discharge pressure than a conventional industrial pump. Vanes employed toward the rear cavity of the impeller can be an effective device to control the axial thrust of the pump. The vanes disturb circumferential flow of the cavity and it can modify the axial force acting on the impeller. In this paper, three types of vanes are installed in the high-speed centrifugal pump for liquid rocket engines and the thrust of the pump is measured with an additional thrust measurement unit. According to the results, shapes of cavity vanes have effects on the axial thrust of the pump. As the height of vanes increases, the outlet pressure of the rear floating ring seal decreases which results in a decrease of the thrust. On the other hand, head of the pump is almost same regardless of cavity vanes. Also, the pressure drop of the bypass pipeline increases when vanes are removed.

A Clinical Study of Ventilator Weaning Following Open Heart Surgery (개심술후의 Ventilator Weaning 에 관한 임상적 고찰)

  • Kim, Kyou-Tae;Han, Sung-Sae;Lee, Chong-Tae
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.187-194
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    • 1981
  • Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.

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