• Journal of Chest Surgery
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• v.57 no.3
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• pp.315-318
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• 2024

The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.168-179
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• 2007

Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

• 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 Chest Surgery
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• v.32 no.5
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• pp.428-432
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• 1999

Background: It has been shown that low-grade electrical stimulus can transform fatigue resistant muscles which then can be used to protect the heart. The bulky and cumbersome power sources of the artificial heart or implantable ventricular assist devices are still in need of solution; however, on the other hand, the implantable ventricular assist devices using the resistant muscles as the power source have the advantages of using its own muscle contractions. The purpose of this study was to determine the possibility of a clinical application of the skeletal muscle ventricle. Material and Method: Latissimus dorsi muscles (LDM) of 8 canines were used for skeletal muscle ventricle. A latex chamber was wrapped one and a half times with LDM. The chamber was attached to a pressure transducer via Tygon tube. An electrode stimulator was placed around the thoracodorsal nerve and LDM was stimulated in cyclic bursts of 0.31 sec on time and 6.0 sec off time using 3.0 volt Itrel stimulator. The preload volume was added to the system in 25cc increments. Ejection volumes, pressures, and peak power outputs were measured. Result: Ejection volume was 76.3cc with 0cc of preload. Ejection volumes were less than 70ml with increments of preload over 75cc Pressures were more than 107 mmHg when the preloads were less than 75cc and less than 100 mmHg when the preloads were more than 100cc. Peak power output of 16.6 W/kg was observed at 50cc preload. Conclusion: Depending on the changes of preload, the volumes ejected from skeletal muscle ventricle and pressures from the skeletal muscle contraction surpassed those of the normal heart. These data suggest that there are clinical applications for skeletal muscle ventricular assist system.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.38 no.9
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• pp.739-745
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• 2014

Although medication is given to heart disease patients, conventional medication alone is not sufficient to treat heart disease. However, it has been reported that left ventricular assist device (LVAD) transplantation is an effective bridge to heart transplantation by assisting cardiac function. This study used long-term animal testing and emergency situations with a bovine model (Holstein) and canine model (Labrador-retriever) to evaluate the biocompatibility of LibraHeart-I (LH-1), which is a bent-tube type of LVAD that was developed in a previous study. In the long-term animal testing with the bovine model, the subjects survived for 49 days with no irregularities observed in their complete blood cell counts or the vital sign tests that were carried out during the test period. In short-term animal testing with the canine model, it was observed that blood did not remain inside the LH-I even without power support from an external drive source. In this study, the biocompatibility of the LH-I that was developed in a previous study was verified by the ejection performance during long-term animal testing and emergency situations.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.11
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• pp.1205-1211
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• 2011

In this paper, we developed a pacemaker that can increase the efficacy of a left ventricular assist device (LVAD) and increase the survival rate for patients suffering end-stage heart failure. Because LVAD patients can experience arrhythmia, the pacemaker incorporated into the LVAD has the important role of sustaining sufficient blood circulation during arrhythmia. The electrode of the pacemaker is located at the apex of the left ventricle, where the VAD's inlet cannula is connected. This is efficient placement, in that the electrode can transmit electrical stimulation directly to the Purkinje fibers of the myocardium. The pacemaker can change the stimulation rate from 0 bpm to 191.4 bpm when a button is pressed on the external control module, and the pacemaker normally stimulates the heart at 60 bpm with 0.25 J of energy. We performed animal experiments to evaluate the performance and reliability of the combination of the LVAD and pacemaker. At pacemaker stimulation rates of 86.4 bpm, 100.2 bpm, 126.6 bpm, we recorded the ECGs, aortic pressures, and flow rates to analyze the heart loads.

• Journal of Magnetics
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• v.22 no.2
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• pp.344-351
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• 2017

Wireless magnet pumps are used in medical applications and are particularly useful as artificial heart ventricular assist devices (VADs). To investigate wireless operation of magnetic pumps, we fabricated three types of magnetic impellers using bonded magnets by blending magnetic powders of SmFeN, NdFeB, and Sr-ferrite. We investigated the magnetic properties of the fabricated magnetic impellers, which are driven by the application of magnetic coupling with an external driving magnet or external coil system, without a driving motor, shaft, or mechanical bearings. The use of wireless magnetic pumps is therefore not complicated by critical issues of size, heat, and vibration, which are very important issues for blood pumps. The magnetic properties of the impellers, such as their rotational speed, driving torque and hydrodynamic performance, determine their wireless driving ranges. We conducted performance evaluations of the impeller's magnetic wireless manipulation, heat, and vibration. In addition, we carried out an animal test to confirm the suitability of the wireless magnetic pumps for use as biventricular assist devices (BiVADs).

• Proceedings of the Korean Society of Precision Engineering Conference
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• 1996.04a
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• pp.346-350
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• 1996

This paper presents a Neural Network Identification (NNI) method for modeling of highly complicated nonlinear and time varing human system with a pneumatically driven mock circulation system of Left Ventricular Assist Device(LVD). This system consists of electronic circuits and pneumatic driving circuits. The initation of systole and the pumping duration can be determined by the computer program. The line pressure from a pressure transducer inserted in the pneumatic line was recorded. System modeling is completed using the adaptively trained backpropagation learning algorithms with input variables, Heart Rate(HR), Systole-Diastole Rate(SDR), which can vary state of system, and preload, afterload, which indicate the systemic dynamic characteristics and output parameters are preload, afterload.

• 제어로봇시스템학회:학술대회논문집
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• 1986.10a
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• pp.643-647
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• 1986

A new type of motor-driven Total Artificial Heart (TAH) system with rolling-ball mechanism has been developed. To test its performance as a Left Ventricular Assist Device (LVAD), LVAD is controlled to bypass blood for impaired heart triggered by the R-wave in ECG. Results of the test with a Mock Circulation System (MCS) and an animal experiment with a dog are also included. More powerful system using a brushless DC motor has been developed and its control scheme is represented.

• Proceedings of the KTCVS Conference
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• 1998.10a
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• pp.4-4
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• 1998